Intimate partner violence as a predictor of antenatal care services utilization in Rwanda

Bahati, Claire; Izabayo, Josias; Niyonsenga, Japhet; Sezibera, Vincent; Mutesa, Léon

doi:10.1186/s12884-021-04230-5

Cited by 14 publications

(12 citation statements)

References 39 publications

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“…These were pregnancy wantedness (planned, when pregnancy was wanted at the time of occurrence or unplanned when pregnancy was not wanted at all or not wanted at the time of occurrence) and spousal violence during pregnancy (experienced or not experienced). The two variables have been identified as having significant predictive power on antenatal care utilization [49][50][51][52]. Two external environmental factors, namely, place of residence and geo-political zone were included for statistical control.…”

Section: Explanatory Variablesmentioning

confidence: 99%

What predicts delayed first antenatal care contact among primiparous women? Findings from a cross-sectional study in Nigeria

Solanke

Oyediran

Opadere

et al. 2022

BMC Pregnancy Childbirth

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Background Delayed first antenatal care contact refers to first antenatal care contact occurring above twelfth weeks of gestation. Studies in Nigeria and in other countries have examined the prevalence and predictors of delayed first antenatal care contact. Nevertheless, existing studies have rarely examined the predictors among primiparous women. In addition, the evidence of higher health risks associated with primigravida emphasizes the need to focus on primiparous women. This study, therefore, examined the predictors of delayed first antenatal care contact among primiparous women in Nigeria. Methods The study was a descriptive cross-sectional design that analyzed data extracted from the 2018 Nigeria Demographic and Health Survey. The study analyzed a weighted sample of 3,523 primiparous women. The outcome variable was delayed first antenatal care contact. explanatory variables were grouped into predisposing, enabling, and need factors. The predisposing factors were maternal age, education, media exposure, religion, household size, The knowledge of the fertile period, and women’s autonomy. The enabling factors were household wealth, employment status, health insurance, partner’s education, financial inclusion, and barriers to accessing healthcare. The need factors were pregnancy wantedness and spousal violence during pregnancy. Data were analyzed using Stata 14. Two multivariable logistic regression models were fitted. Statistical significance was set at p < 0.05. Results Nearly two-thirds (65.0%) of primiparous women delayed first antenatal care contact. Maternal age, maternal education, media exposure, religion, household membership, and knowledge of the fertile period were predisposing factors that significantly influenced the likelihood of delayed first antenatal care contact. Also, household wealth, employment status, health insurance, partner’s education, perception of distance to the health facility, and financial inclusion were enabling factors that had significant effects on delayed first antenatal care contact. Pregnancy wantedness was the only need factor that significantly influenced the likelihood of delayed first antenatal care contact. Conclusion The majority of primiparous women in Nigeria delayed first antenatal care contact and the delay was predicted by varied predisposing, enabling, and need factors. Therefore, a public health education program that targets women of reproductive age especially primiparous women is needed to enhance early antenatal care contact in the country.

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Section: Explanatory Variablesmentioning

confidence: 99%

What predicts delayed first antenatal care contact among primiparous women? Findings from a cross-sectional study in Nigeria

Solanke

Oyediran

Opadere

et al. 2022

BMC Pregnancy Childbirth

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“…Intimate partner violence is considered as a public health and human rights issue. Prior research has shown that women who experienced physical or sexual intimate partner violence have a risk of developing physical problems [3][4][5], including difficulty accessing and using antenatal care services for pregnant women [6], as well as mental health issues such as depression, anxiety, posttraumatic stress disorder, suicide, and alcohol abuse [4].…”

Section: Introductionmentioning

confidence: 99%

Trends and correlates of intimate partner violence (IPV) victimization in Rwanda: results from the 2015 and 2020 Rwanda Demographic Health Survey (RDHS 2015 and 2020)

et al. 2022

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Background Intimate partner violence (IPV) is reported to be a public health issue given its magnitude and long-lasting consequences. Men are generally thought to be perpetrators of IPV, but they can also be victims. In Rwanda, the experience of men as victims has not yet been described and characterized. The aim of this study is to examine the trends and correlates of IPV victimization for men and women in Rwanda. Methods The data for this study were extracted from the Rwanda Demographic and Health Survey (RDHS) in 2014/15 (female: n = 8292, male: n = 3470) and 2019/2020 (female = 8574, male: n = 3590). The survey had used a structured measure of IPV (i.e. physical, sexual, or emotional) and its related demographic characteristics to collect data in a nationally representative sample of ever-married women aged 15–49 years and men aged 15–59 years. Multiple logistic regression was applied to examine the association between demographic characteristics and IPV in both women and men. Result The prevalence of IPV among women increased from 40% in 2015 to 46% in 2020, while it decreased from 21 to 18% in men during the same time period. The associated factors for women IPV victimization in 2015 were: uneducated husband (Adjusted Odds Ratios (AOR) = 5.570, 95% CI 1.29–24.02), woman from the poorest household (AOR = 2.834, 95% CI 1.9–93.12), husband aged from 30 to 39 years (AOR = 2.797, 95% CI 1.517–5.158), husband consuming alcohol (AOR = 3.021, 95% CI 1.517–5.158); women involved in decisions about their own earnings (AOR = 0.576, 95% CI 0.37–0.88); and purchases (AOR = 0.472, 95% CI 0.27–0.82). However, the factors such as uneducated husbands (AOR = 3.032, 95% CI 1.117–8.24); husbands consuming alcohol (AOR = 1.712, 95% CI 2.408–4.486); a woman's involvement in decisions on her personal health (AOR = 0.443, 95% CI 0.30–0.63) and visits from her family or relatives (AOR = 0.405, 95% = 0.41–0.22) were factors of IPV in 2020. On the other hand, the associated factors for men IPV victimization in 2015 were being from richer wealth index (AOR = 0.21, 95% CI 0.04–1.04), frequency of being hit in last 12 months by other than partner (AOR = 5.49, 95% CI 1.65–18.25), woman often consuming alcohol (AOR = 13.30, 95% CI 1.9–93.12); whereas its associated factor in 2020 were women consuming alcohol (3.91, 95% CI 0.55–9.87). Conclusion The present study revealed a significant increase in IPV against women, and slight decrease of IPV against men in Rwanda from 2015 to 2020, as well as its associated risks and protective factors over time. This increase needs further exploration given that government and partners have invested in policies and strategies to mitigate the IPV with limited impact. Since there is a relationship between IPV prevalence and education, the existing laws on domestic violence need to be known by the citizens. Findings from this study evidenced also visits from extended families to be a protective factor and therefore suggesting the necessity of a family and community-based approach in managing IPV in Rwanda. Future studies to assess the effectiveness of community-based approach in preventing IPV.

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“…Women who experience intimate partner violence are less likely to have control over their reproductive health (i.e., access to contraception and/or protection, forced pregnancy or forced termination, etc. ), less likely to have access to ANC, especially early initiation of ANC, and are at higher risk for STIs, mental health disorders, and adverse birth outcomes ( 86 , 102 – 106 ). At the most extreme end of intimate partner violence, homicide is a leading cause of death amongst pregnant women and women of reproductive age in the US ( 106 , 107 ).…”

Section: Promoting Reproductive Health To Improve Population Healthmentioning

confidence: 99%

Developmental origins of disease highlight the immediate need for expanded access to comprehensive prenatal care

McDonald

Weckman²,

Wright³

et al. 2022

Front. Public Health

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The prenatal environment plays a critical role in shaping fetal development and ultimately the long-term health of the child. Here, we present data linking prenatal health, via maternal nutrition, comorbidities in pregnancy (e.g., diabetes, hypertension), and infectious and inflammatory exposures, to lifelong health through the developmental origins of disease framework. It is well-established that poor maternal health puts a child at risk for adverse outcomes in the first 1,000 days of life, yet the full health impact of the in utero environment is not confined to this narrow window. The developmental origins of disease framework identifies cognitive, neuropsychiatric, metabolic and cardiovascular disorders, and chronic diseases in childhood and adulthood that have their genesis in prenatal life. This perspective highlights the enormous public health implications for millions of pregnancies where maternal care, and therefore maternal health and fetal health, is lacking. Despite near universal agreement that access to antenatal care is a priority to protect the health of women and children in the first 1,000 days of life, insufficient progress has been achieved. Instead, in some regions there has been a political shift toward deprioritizing maternal health, which will further negatively impact the health and safety of pregnant people and their children across the lifespan. In this article we argue that the lifelong health impact attributed to the perinatal environment justifies policies aimed at improving access to comprehensive antenatal care globally.

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Intimate partner violence as a predictor of antenatal care services utilization in Rwanda

Cited by 14 publications

References 39 publications

What predicts delayed first antenatal care contact among primiparous women? Findings from a cross-sectional study in Nigeria

What predicts delayed first antenatal care contact among primiparous women? Findings from a cross-sectional study in Nigeria

Trends and correlates of intimate partner violence (IPV) victimization in Rwanda: results from the 2015 and 2020 Rwanda Demographic Health Survey (RDHS 2015 and 2020)

Developmental origins of disease highlight the immediate need for expanded access to comprehensive prenatal care

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