Factors influencing disclosure among women experiencing intimate partner violence during pregnancy in Moshi Municipality, Tanzania

Abstract

BackgroundIntimate Partner Violence (IPV) has serious negative health effects to millions of women around the globe. While disclosing IPV could open doors for support and eventually prevent partner abuse, the factors associated with IPV disclosure during pregnancy are not well known. The aim of this study was to examine factors influencing IPV disclosure to any person of interest or organization supporting women during pregnancy in Moshi Municipality, Tanzania.MethodsData were from a prospective cohort study of 1123 pregnant women followed-up by the project aiming to assess the impact of violence in the reproductive health conducted in Moshi Municipality, Tanzania from March 2014 to May 2015. Inclusion criteria to the current analysis were all 339 pregnant women who reported to have experienced physical, sexual and/or emotional violence during the index pregnancy. Data analysis used SPSS Version 20. Odds ratio with 95 % Confidence Interval (CI) for factors associated with IPV disclosure was estimated using multivariate logistic regression models while controlling for age, education and parity. A p-value of less than 0.05 was considered for a statistically significant difference.ResultsIPV disclosure was found to be 23.3 % (n = 79). Disclosure of IPV was less likely among unemployed (OR = 0.5, 95 % CI 0.30–0.90) and women whose index pregnancy was unplanned (OR = 0.53, 95 % CI 0.29–0.98). Women who regularly participated in women’s or community groups, religious groups or political associations at least once a month had 2 times higher odds of IPV disclosure compared to those who did not attend regularly (OR = 2.12, 95 % CI 1.13–3.95). Most of the abused women during pregnancy who disclosed their experience of IPV (69 %) disclosed to a member of the family of birth followed by friends (14 %) and a member of family of the partner (11 %).ConclusionsMost of the women who experienced IPV during pregnancy kept suffering in silence while less than a quarter of all the abused (23.3 %) disclosed their experience to someone. Identification of the women experiencing IPV during pregnancy should be done as a starting point for supporting victim of IPV. Women empowerment in economical and reproductive health will reduce their vulnerability and facilitate disclosure of IPV for support. Key individuals who informally support victims of IPV should be targeted in interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3345-x) contains supplementary material, which is available to authorized users.

“Staying for the children”: The role of natal relatives in supporting women experiencing intimate partner violence during pregnancy in northern Tanzania – A qualitative study

“…This finding is supported by a study conducted in Tanzania, which showed that women who are considered inferior by other community members were more likely to feel ashamed to seek help and, as a result, they hide and continue suffering in silence [ 36 ]. Socially isolated women are also less likely to join supportive groups hence decreasing their chances to be supported by other informal and formal support networks [ 22 ].…”

“…Experiencing physical violence during pregnancy was associated with unwanted birth outcomes of preterm birth and low birth weight [ 13 ]. Victims of physical violence during pregnancy were also more likely to disclose their experience to natal relatives than those with other forms of partner violence [ 22 ]. This sample was therefore selected to understand their experiences with partner violence, their decision-making process for disclosure to natal relatives and support received.…”

“…Research has shown that the majority of victims of IPV seek support from informal support network members (e.g. family, friends, neighbors, classmates, work-mates) [ 21 ] and support from the natal family is the most utilized [ 22 ]. A review of studies on social support has shown that natal family support to victims of IPV range from emotional support, advice and information to practical/tangible support.…”

The prevalence and predictors of intimate partner violence among pregnant women attending a midwife and obstetrics unit in the Western Cape

“…While literature from low- and middle-income countries (LMIC) focuses on violence against women in the general population (Hamberger & Larsen, 2015 ; Katiti et al , 2016 ), pregnancy has been identified as a period of increased risk for exposure to intimate partner violence (IPV) (WHO, 2011 ; Bernstein, et al , 2016 ). IPV is a well-documented phenomenon of behaviour in the context of human relationships (WHO, 2005 ; Sarkar, 2008 ; Silva et al , 2011 ).…”

Protocol for a Matched-Pair Cluster Control Trial of ARCHES (Addressing Reproductive Coercion in Health Settings) among Women and Girls Seeking Contraceptive Services from Community-Based Clinics in Nairobi, Kenya

“…ARCHES providersare trained to respond in a supportive and validating manner, and to never coerce or pressure a patient in any way to disclose either IPV or RC. This approach acknowledges that many women and girls do not disclose abuse to providers, or feel that is safe or appropriate to seek help from providers for GBV (32)(33)(34).Women who do disclose IPV are offered to be connected by the provider via phone to a trained counselor from a local GBVsurvivor support agency at the close of their clinic visit (i.e. a "warm referral"); this approach has been shown to reduce barriers to referral uptake (trust of service providers, perception that services are not appropriate for their situation) (35,36).…”