Neonatal, infant, and child mortality among women exposed to intimate partner violence in East Africa: a multi-country analysis

Abstract

Background: Most neonatal, infant, and child deaths occur in low-and middle-income countries (LMICs), where incidence of intimate partner violence (IPV) is highest in the world. Despite these facts, research regarding whether the two are associated is limited. The main objective was to examine associations between IPV amongst East African women and risk of death among their neonates, infants, and children, as well as related variables. Methods: Analysis was conducted on data drawn from the Demographic and Health Surveys (DHS) conducted by ICF Macro/MEASURE DHS in five East African countries: Burundi, Kenya, Rwanda, Tanzania, and Uganda. The analytical sample included 11,512 women of reproductive age (15-49 years). The outcome variables, described by proportions and frequencies, were the presence or absence of neonatal, infant, and under-five mortality. Our variable of interest, intimate partner violence, was a composite variable of physical, sexual, and emotional abuse; chi-square tests were used to analyze its relationship with categorical variables. Adjusted odds ratios (aOR) were also used in linking sexual autonomy to independent variables. Results: Children born to women who experienced IPV were significantly more likely to die as newborns (aOR = 1.3, 95% confidence interval [CI]: 1.4-2.2) and infants (aOR = 1.9, 95% CI: 1.6-2.2), and they were more likely to die by the age of five (aOR = 1.5, 95% CI: 1.01-1.55). Socioeconomic indicators including area of residence, wealth index, age of mother/husband, religion, level of education, employment status, and mass media usage were also significantly associated with IPV. After regression modelling, mothers who were currently using contraceptives were determined less likely to have their children die as newborns (aOR = 0.5, 95% CI: 0.3-0-7), as infants (aOR = 0.5, 95% CI: 0.3-06), and by age five (aOR = 0.4, 95% CI: 02-0.6). Conclusion: Understanding IPV as a risk indicator for neonatal, infant, and child deaths can help in determining appropriate interventions. IPV against women should be considered an urgent priority within programs and policies aimed at maximizing survival of infants and children in East Africa and the wellbeing and safety of their mothers.

Impact of High-Risk Fertility Behaviour on Under-five Mortality in Asia and Africa: Evidence from Demographic and Health Surveys

“…Under-five mortality in this study is a binary variable and is considered to be present if the index child died before reaching the fifth birthday within five years before the mother's interview (coded as 1), and absent if the index child was alive at the time of mother's interview (coded as 0). Many studies have similarly constructed the outcome child mortality variable using Demographic and Health Surveys data [19][20][21][22]. The age distribution of the underfive children in our sample is given in Figure 1.…”

Impact of High-Risk Fertility Behaviour on Under-five Mortality in Asia and Africa: Evidence from Demographic and Health Surveys

“…If the index child died before reaching the fifth birthday within five years before the mother's interview (coded as 1), and absent if the index child was alive at the time of mother's interview (coded as 0). Many studies have similarly constructed the outcome child mortality variable using Demographic and Health Surveys data [19][20][21][22]…”

Determinants of Infant Mortality in Bhutan: Evidence from the 2012 National Health Survey Data

“…A range of proximal (e.g., health-related factors), intermediate (e.g., water and sanitation), and distal (e.g., education and income) determinants are thought to predict infant and child mortality (Mosley & Chen, 2003). These determinants include breastfeeding (Iram & Butt, 2008;Lamichhane et al, 2017;Reno & Hyder, 2018), baby's birth size and weight (Lamichhane et al, 2017;Memiah et al, 2020;Vidal e Silva et al, 2018), and place and type of delivery (Iram & Butt, 2008;Lamichhane et al, 2017;Memiah et al, 2020). Poor health of newborn (Vidal e Silva et al, 2018), prenatal and postnatal care (Iram & Butt, 2008;Reno & Hyder, 2018), multiple births (Dwomoh et al, 2019;Vidal e Silva et al, 2018), and birth interval (Dwomoh et al, 2019;Lamichhane et al, 2017;Reno & Hyder, 2018) are also found to be associated with infant mortality.…”