The Role of Women’s Autonomy and Experience of Intimate Partner Violence as a Predictor of Maternal Healthcare Service Utilization in Nepal

Gautam, Sujan; Jeong, Hyoung Sun

doi:10.3390/ijerph16050895

Cited by 26 publications

(41 citation statements)

References 43 publications

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“…This consistency could be supported by a male-dominated marital power structure has been documented to be highly related with marital con ict and husband-to-wife violence (48). Women's decision-making autonomy is not only reduced the risk IPV but also increased the utilization of maternal service (31,49).…”

Section: Discussionmentioning

confidence: 96%

Spatial Distribution and Determinant Factors of Intimate Partner Violence Among Reproductive age Group Women in Ethiopia; Generalized Structural Equation Modeling

Tusa

Kebede

Weldesenbet

2020

Preprint

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Background: Intimate Partner Violence (IPV) is the most serious and pervasive yet under recognized human rights violation in the world as well as in Ethiopia. The objective of this study was to find the spatial distribution of IPV and its determinant factors in Ethiopia. Methods: Secondary data analysis was conducted among 2,687 reproductive age group women (15–49 years). The distribution of IPV across the country was observed by ArcGIS software. In SaTScan software, the Bernoulli model was fitted by Kulldorff methods to identify the purely spatial clusters of IPV. Generalized Structural Equation Model (GSEM) was used to determine factors associated with each domain of IPV (physical, emotional & sexual violence).Result: The spatial distribution of IPV was found to be clustered in Ethiopia with Global Moran’s I 0.09 (p < 0.001) and the highest IPV cluster was observed in Oromia (p < 0.001), Somali (p < 0.001) and Southern Nation and Nationality and Peoples (SNNP) (p < 0.001) regions . Watching television and not having attitudes toward wife beating were negatively associated with physical violence. Being richest and nonsmoker were inversely associated with emotional violence. The odds of experiencing sexual violence were increased among pregnant and wife of uneducated husband/partner. Women’s decision-making autonomy and husband/partner drinking alcohol have positive and negative association with all domains of IPV respectively. Conclusions: There was a significant clustering of IPV in Ethiopia and the highest IPV cluster was observed in Oromia, Somali and SNNP regions. Being richest, watching television, not having attitudes toward wife beating, women’s decision autonomy and husband’s/partner’s high education and non-alcohol drinker status were negatively associated with IPV. The likelihood of experiencing IPV was also increased among smoker and pregnant women. We recommend that improving the economic status of the household and power of women's decision autonomy, increasing community awareness about the consequences of IPV with particular emphasis in Oromia, Somali and SNNP regions.

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Section: Discussionmentioning

confidence: 96%

Spatial Distribution and Determinant Factors of Intimate Partner Violence Among Reproductive age Group Women in Ethiopia; Generalized Structural Equation Modeling

Tusa

Kebede

Weldesenbet

2020

Preprint

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“…However, there is evidence that partner controlling behaviour is a reflection of power dynamics in an intimate relationship and indicates imminent risk of other forms of abuse [27,39]. Studies have also revealed that partners' control influences women's decision-making power [27], health service access and utilization [27,40], and fertility control [15,41,42]. Therefore, we have adopted the World Health Organization (WHO) definition of IPV (1 p89) and included partner control as a form of IPV in our analysis.…”

Section: Introductionmentioning

confidence: 99%

The mediation effect of contraceptive use and women’s autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia

et al. 2020

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Background Intimate partner violence (IPV) affects one in every three women globally. Previous studies have revealed that women’s experiences of different forms of IPV are significantly associated with a higher rate of unintended pregnancy, reduced uptake of contraception, and reduced ability to make decisions regarding their fertility. The aim of this study was to investigate whether previously observed relationships between IPV and unintended pregnancy in Ethiopia are mediated by contraceptive use and women’s autonomy. Methods This study was performed using nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS). A subsample of married women of reproductive age reporting a pregnancy within the 5 years preceding 2016 and who participated in the domestic violence sub-study of the survey were included in analyses. Logistic regression models, together with the product of coefficients method, were used to estimate direct and mediated effects. Results Twenty six percent of participants reported an unintended pregnancy in the 5 years preceding the survey. Sixty-four percent reported having ever experienced IPV (a composite measure of physical, sexual, emotional abuse, and partner controlling behaviour). After adjusting for potential confounding factors, unintended pregnancy was significantly positively associated with reporting sexual IPV, emotional IPV, IPV (a composite measure of physical, sexual, or emotional abuse), and multiple partner controlling behaviour. However, IPV (as a composite of all four forms), physical IPV, and partner control (single act) were not significantly associated with unintended pregnancy. Women’s autonomy, but not contraception use, had a significant partial mediation effect in the relationships between some forms of IPV and unintended pregnancy. Women’s autonomy mediated about 35, 35, and 43% of the total effect of emotional IPV, IPV (physical, sexual, and/or emotional), and multiple partner control on unintended pregnancy respectively. Conclusion Women’s autonomy appears to play a significant role in mediating the effect of IPV on unintended pregnancy in Ethiopia. Maternal health service interventions in Ethiopia could incorporate measures to improve women’s decision-making power to reduce the negative reproductive health effects of IPV.

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“…In relation to women's working status, those who are working are more likely to be educated, involve in household decision making and get access to reproductive health services than those who are not. The ANC visits help young women have better understanding of risk in regard to the complication of pregnancy and childbirth and enable them to make a decision regarding the use of SBAs [41].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing the use of reproductive health services among young women in Nepal: analysis of the 2016 Nepal demographic and health survey

Thapa

2020

Reprod Health

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Background: Utilization of reproductive health services is a key component for preventing young women from different sexual and reproductive health problems. Thus, the objective of this study is to determine the factors influencing the use of reproductive health services among young women in Nepal. Methods: Data have been extracted from the 2016 Nepal Demographic and Health Survey (NDHS) datasets wherein the weighted sample population size was restricted for modern contraceptive use to 1593 whereas for the antenatal care and skilled birth attendants to1606. This study has selected three reproductive health indicators as outcome variables of reproductive health service utilization for the analysis viz, modern contraceptive use, at least four antenatal care visits, and use of skilled birth attendants. Likewise, all calculations are based on standard sample weight of NDHS. Results: The study has found that 21% of young women used modern contraception, 71% attended at least four ANC visits, and 67% utilized a skilled birth attendant at delivery. Young Janajati women, women having 1-2, and 3 or more living children, women participating household decision-making, and the ones having exposure to media were more likely to use modern contraceptives, whereas the women who want more children were less likely to use them. Higher education attainments, higher wealth quintile, and lower birth order were associated with higher level of receiving at least four ANC visits and SBAs. However, the young women willing to have more children and having access to media have higher odds of receiving at least four ANC visits; and the women attending four and more ANC visits have higher odds of using SBAs. Conclusions: In order to improve the use of reproductive health services among young women, efforts should be made to enrich the young women of lower educational level, lower economic status, higher birth order, and lower exposure to media. Further research is required to detect the causes that affect the use of reproductive health services.

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The Role of Women’s Autonomy and Experience of Intimate Partner Violence as a Predictor of Maternal Healthcare Service Utilization in Nepal

Cited by 26 publications

References 43 publications

Spatial Distribution and Determinant Factors of Intimate Partner Violence Among Reproductive age Group Women in Ethiopia; Generalized Structural Equation Modeling

Spatial Distribution and Determinant Factors of Intimate Partner Violence Among Reproductive age Group Women in Ethiopia; Generalized Structural Equation Modeling

The mediation effect of contraceptive use and women’s autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia

Factors influencing the use of reproductive health services among young women in Nepal: analysis of the 2016 Nepal demographic and health survey

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