Intimate partner violence and utilization of maternal health care services in Addis Ababa, Ethiopia

Abstract

BackgroundDespite its prominence, intimate partner violence (IPV) against women has received little attention in Ethiopia. And as many of sub-Saharan African countries, maternal health care services utilization remains poor. Full access and utilization of maternal health care services is a key to significant reduction in maternal and child mortality, and eliminate new HIV infection in infants. Identifying the factors that contribute to the poor access and utilization should aid the design of appropriate policy and intervention strategies. Thus the objective of this study was to examine the association between IPV and use of maternal health care services in Addis Ababa, Ethiopia.MethodsA cross sectional study on couples (N = 210; male/female pairs) with an infant less than 6 months of age was conducted. The dependent variable was use of maternal health care services and the main independent variable was IPV. Data was collected using face-to-face self-reported questionnaires and analyzed using SPSS version 20.0. Bivariate and multivariate logistic regression models were used to examine the relationship between the dependent and independent variables.ResultsThe mean age of the women was 28.7 years (SD = 5.4), on average women were 7.4 years (SD = 7.4) younger than their partners. Although most of the women (95.2%) had at least one antenatal care (ANC), only 35 (2%) had ≥4 ANC visits and about half (49.0%) had their first ANC visit within the first trimester. Women who experienced emotional IPV in their relationship were less likely to have their 1st ANC within three months of pregnancy (AOR = 0.69; 95%CI = 0.49–0.96). Women who reported physical IPV in their relationship were less likely to use ≥4 ANC (AOR = 0.48; 95%CI = 0.21–0.71), be tested for HIV (AOR = 0.26; 95%CI = 0.09–0.79), have skilled delivery attendant (AOR = 0.31; 95%CI = 0.12–0.98), and deliver in a health facility (AOR = 0.35; 95%CI = 0.14–0.88). Likewise, women experienced sexual IPV or partner control in their relationship were less likely to use ANC ≥4 times (AORsexual-IPV = 0.91; 95%CI = 0.84–0.98 and AORpartner-control = 0.38; 95%CI = 0.17–0.85 respectively).ConclusionsIPV is prevalent among couples in Addis Ababa, Ethiopia where three out of four women reported having experienced one or more type of IPV in their current relationship. And all types of IPV showed significant association with poor utilization of one or more maternal health care services. Thus efforts to sustain the recent success in maternal health and further improvement should give due consideration to IPV.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2121-7) contains supplementary material, which is available to authorized users.

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

“…Without such care, IPV can cause mothers to be unsuccessful in carrying a pregnancy to full term or in providing adequate care for their children. Adequate care can be provided by ensuring that mothers have access to maternal health care services and are trained to negotiate for contraceptive use and safer sex in order to enhance sexual autonomy [25,26]. WHO has provided guidance on the role of the health system in managing and combatting IPV.…”

Determinants of intimate partner violence against women in Ethiopia: A multi-level analysis

“…Although the consequences are underexamined in this country, some existing evidence shows its potential for producing severe physical, emotional, and reproductive health problems [7][8][9][10]. Severe consequences of IPV include reduced maternal health care utilization and adverse child health outcomes [10][11][12][13]. As there are no IPV interventions in the country, comprehensive IPV intervention strategies are needed.…”

Intimate partner violence against women and its association with pregnancy loss in Ethiopia: evidence from a national survey

“…The existing evidence regarding the effects of IPV on women’s health in Ethiopia is also limited. Existing studies have found associations between IPV and depression [ 28 – 31 ], psychiatric disorders [ 32 ], risk of acquiring sexually transmitted infections [ 27 ] and Human Immunodeficiency Virus (HIV) [ 33 , 34 ], unmet need for family planning [ 35 ], unintended pregnancy [ 27 ], and low maternal health service utilization [ 36 , 37 ]. Most of the studies have been conducted in small geographic locations that lack national level representativeness.…”