The associations between intimate partner violence and maternal health care service utilization: a systematic review and meta-analysis

Abstract

Background Intimate partner violence exposes women to a wide range of health problems that can either directly or indirectly lead to maternal death. Although in a number of studies intimate partner violence has been associated with inadequate utilization of antenatal care and skilled delivery care, in other studies no association has been found. Therefore, we aimed to comprehensively review the evidence, and quantify the strength and direction of the association between intimate partner violence and utilizing adequate antenatal and skilled delivery care services. Method We systematically searched studies from MEDLINE, Embase, Psych INFO, CINAHL, and Maternity and Infant Care. Two independent reviewers screened the articles for eligibility. Quality and risk of bias in the articles were evaluated by using the Newcastle-Ottawa scale for observational studies. Pooled odds ratios and 95% confidence intervals were computed to estimate the association of intimate partner violence and antenatal care, and skilled delivery care. Random-effects models were used to allow for the significant heterogeneity that might possibly be found between studies. The degree of heterogeneity was expressed by using the I 2 statistic. Results The meta-analyses have shown that women who experienced intimate partner violence had 25% decreased odds (AOR = 0.75, 95%CI = 0.61, 0.92) of using adequate antenatal care than those who did not experience IPV. Similarly, women who experienced IPV had 20% decreased odds (AOR = 0.8, 95%CI = 0.69, 0.92) of using skilled delivery care compared to those who did not experience IPV. Conclusion The meta-analyses indicated that experiencing intimate partner violence is associated with a lower likelihood of receiving adequate antenatal care and skilled delivery care. Both community-based and facility-based interventions that target the reduction of partner violence, and strictly implementing proven health facility-based counselling interventions, could aid in improving utilization of maternal health care services. Electronic supplementary material The online version of this article (10.1186/s12905-019-0735-0) contains supplementary material, which is available to authorized users.

Intimate Partner Violence During Pregnancy and Neonatal Mortality in Eastern Ethiopia: A Population Based Matched Case-Control Study

“…A similar association has been found in a previous study where partner controlling behavior was related to a number of poor neonatal outcomes, including neonatal death [59]. It is evident that controlling partner's restriction of women's movement might make women disadvantaged in terms of utilizing maternal and child health (MCH) services such as ante or postnatal cares and immunizations [24], which have short or long term sequel on newborn survival [15,25,56]. The ndings from present study showing signi cant proportion of women receiving no or limited support from signi cant others might also be indicative of partners controlling of the women's movement and contact.…”

“…The other possible pathway is that women in abusive or controlled relationships might have limited household decision autonomy and use of MCH services [24] which could indirectly contribute to poor newborn health and survival [25,26]. Chronic physical trauma, maternal sexual transmitted infections and pregnancy complications are also in a casual pathway between violence experienced during pregnancy and elevated risk of newborn deaths [17,25].…”

Does intimate partner violence influence the utilization of maternal health services?

“…A systematic review and meta-analysis [SRMA] showed that IPV reduces utilization of maternal health services by 25 and 20 percent in ANC visits and delivery services by skilled health workers respectively (33). Similarly, another SRMA from Ethiopia showed that women's and partners' educational status, as well as partners' alcohol use were significant predictors for IPV (34).…”

Does intimate partner violence influence the utilization of maternal health services?

“…A systematic review and meta-analysis [SRMA] shows that IPV reduces utilization of maternal health services by 25 and 20 percent in ANC visits and delivery services by skilled health worker respectively (32). Similarly, another SRMA from Ethiopia shows that women's and partners' educational status, partners' alcohol use were significant predictor for IPV (33).…”