Intimate partner violence influence on deliveries assisted by skilled health personnel

Abstract

Objective:Millennium Development Goal 5 calls for increasing proportions of deliveries assisted by skilled health personnel to reduce maternal mortality. This study aims to identifying the implication of exposure to intimate partner violence on these proportions.Methodology:This study used domestic violence modules data of Demographic and Health Surveys of six countries from 2005 to 2007. Proportions of assisted deliveries were examined by sociodemographic characteristics and exposure to intimate partner violence in the studied countries. Influence on the proportion was examined against exposure to intimate partner violence through odds ratio and 95% of logistic regression analysis after controlling for women age, residence (urban/rural), household wealth level, economic level of country, educational level and working status of women and their husbands/partners.Results:Data sets of 18,507 participants over 20 years of age showed that almost three-quarters (73%) of women had deliveries assisted by skilled health personnel. One-third of the women were ever exposed to intimate partner violence (37%) and 9% of them to the severe level. Exposure to intimate partner violence statistically significantly lowered this proportion to 69% (odds ratio: 0.73; 95% confidence interval: 0.67–0.78) meanwhile severe violence lowered it to 65% (odds ratio 0.64; 95% confidence interval: 0.58–0.72). When running multiple regression analysis, exposure to intimate partner violence retained its statistically significant decreasing influence on proportions and was not biased by the other stronger socioeconomic characteristics.Conclusion and recommendations:Intimate partner violence has an independent influence on reducing assisted deliveries by skilled health personnel. Programs working for increasing proportions of assisted deliveries by skilled health personnel are recommended to integrate protection women from violence.

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

“…Overall, seven studies with a total of 40,257 participants were included for skilled delivery care utilization assessment. Among the included studies, four were from Africa [13, 15, 24, 30], and two from Asia [27, 28] while the remainder were multi-country studies from low and middle-income countries [29]; all were community-based studies. Regarding the types of IPV reported, five studies reported on physical violence [13, 24, 28–30], four studies on sexual violence [13, 24, 28, 30], and three studies on emotional violence [13, 24, 30] while combined IPV was reported in three studies [15, 27, 28].…”

“…Regarding the types of IPV reported, five studies reported on physical violence [13, 24, 28–30], four studies on sexual violence [13, 24, 28, 30], and three studies on emotional violence [13, 24, 30] while combined IPV was reported in three studies [15, 27, 28]. Regarding IPV assessment tools, three studies used the DHS tool [13, 27, 29], another three studies used the conflict tactics scale [15, 28, 30] while the remaining study used the WHO tool [24].…”

“…Concerning the period of IPV ascertainment, three studies reported on IPV ever experienced by women in a current relationship [13, 24, 27], two studies reported on IPV experienced during lifetime [28, 29], one study reported on IPV experienced in the year prior to the survey being conducted [15] while one study reported on IPV experienced in any relationship since 15 years of age [30] (Table 4).…”

“…In two studies which investigated this association, it was shown that women aged 15–24 were less likely to receive skilled delivery compared to those above 24 years of age [28, 30]. Women who were married were more likely to utilize skilled delivery care compared to unmarried women [29]. Similarly, women who had received primary and above education [29, 30] and whose partner had received primary and above education [15, 28–30] were more likely to use skilled delivery care.…”

“…Women who were married were more likely to utilize skilled delivery care compared to unmarried women [29]. Similarly, women who had received primary and above education [29, 30] and whose partner had received primary and above education [15, 28–30] were more likely to use skilled delivery care. Women with a DHS wealth index categorized as rich were more likely to utilize skilled delivery care [29, 30].…”