Spatial distribution and determinants of intimate partner violence among reproductive-age women in Ethiopia: Spatial and Multilevel analysis

Abstract

Background Intimate partner violence is a serious global public health problem particularly in low-and middle-income countries such as Ethiopia where women's empowerment is limited. Despite the high prevalence of intimate partner violence in Ethiopia, there is limited evidence on the spatial distribution and determinants of intimate partner violence among reproductive-age women. Exploring the spatial distribution of intimate partner violence is crucial to identify hotspot areas of intimate partner violence to design targeted health care interventions. Therefore, this study aimed to investigate the spatial distribution and determinants of intimate partner violence among reproductive-age women in Ethiopia. Methods A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 6090 reproductive-age women were included in the study. The spatial scan statistical analysis was done to identify the significant hotspot areas of intimate partner violence. A multilevel binary logistic regression analysis was fitted to identify significant determinants of intimate partner violence. Deviance, Intra-cluster Correlation Coefficient (ICC), Median Odds Ratio, and Proportional Change in Variance (PCV) were used for model comparison as well as for checking model fitness. Variables with a p-value less than 0.2 were considered in the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare statistical significance and strength of association between intimate partner violence and independent variables. Results The spatial analysis revealed that the spatial distribution of intimate partner violence was significantly varied across the country (Moran’s I = 0.1007, p-value < 0.0001). The SaTScan analysis identified a total of 192 significant clusters, of these 181 were primary clusters located in the Benishangul-Gumuz, Gambella, northwest Amhara, and west Oromia regions. In the multivariable multilevel analysis; women aged 45–49 years (AOR = 2.79, 95% CI 1.52–5.10), women attained secondary education (AOR = 0.61, 95% CI 0.38–0.98), women in the richest household (AOR = 0.58, 95% CI 0.35–0.97), > 10 family size (AOR = 3.85, 95% CI 1.41–10.54), and high community women empowerment (AOR = 0.66, 95% CI 0.49–0.8)) were significantly associated with intimate partner violence. Conclusions Intimate partner violence among reproductive-age women had significant spatial variation across the country. Women's age, education status, family size, community women empowerment, and wealth status were found significant determinants of intimate partner violence. Therefore, public health programs should design targeted interventions in identified hot spot areas to reduce the incidence of intimate partner violence. Besides, health programmers should scale up public health programs designed to enhance women's autonomy to reduce the incidence of intimate partner violence and its consequences.

Intimate partner violence and associated factors among reproductive age women in Liberia: a cross-sectional study using a recent Liberian demographic and health survey

“…Women with education were more likely to face IPV as compared with those with no education. This finding is inconsistent with the studies conducted in Ethiopia and Sub-Saharan Africa [ 14 , 35 ]. The possible reason might be, even though education is important to change an attitude and behavior we cannot conclude that knowing is enough to get the actual intended behavior.…”

“…Women residing in south central were less likely to experience IPV as compared with those live in north western region of Liberia. This might be due to the fact that IPV has spatial variation within the country and across countries [ 35 ]. Regions within the country might have different socio-demographic makeup that might affect the prevalence of IPV.…”

Intimate partner violence and associated factors among reproductive age women in Liberia: Further analysis of recent Liberian demographic and health survey

“…Women with education were more likely to face IPV as compared with those with no education. This nding is inconsistent with the studies conducted in Ethiopia and Sub-Saharan Africa (13,31). The possible reason might be, even though education is important to change an attitude and behavior we cannot conclude that knowing is enough to get the actual intended behavior.…”

“…Women residing in south central were less likely to experience IPV as compared with those live in north western region of Liberia. This might be due to the fact that IPV has spatial variation with in the country and across countries (31). Regions within the country might have different socio-demographic makeup that might affect the prevalence of IPV.…”

Spatial distribution and determinant factors of intimate partner violence among reproductive age group women in Ethiopia: Using generalized structural equation modeling

“…Different studies were conducted in different parts of Ethiopia using a univariate analysis to determine factors associated with IPV, and low educational level and poor women’s empowerment occurred to be primary determinants of IPV [ 19 – 25 ]. In those studies, only one dependent variable was allowed, and the effect of multiple latent variables could not be estimated.…”