Relative risk of intimate partner violence according to access to instrumental social support among pregnant women in Eswatini whose partners do and do not drink alcohol

Abstract

Background Intimate partner violence (IPV) affects 1 in 3 women around the world and is the 10th leading cause of death for women in the Africa region ages 15-29. Partner alcohol use, access to social support, and poverty all affect women’s likelihood of experiencing violence. We sought to understand how partner alcohol use differentially affected instrumental social support’s protective role against IPV for a clinic-based sample of women in the Kingdom of Eswatini (Swaziland).Methods We recruited 406 pregnant women from one rural and one urban antenatal clinic in Eswatini. Women used audio computer assisted self-interview software to answer a 45 minute behavioral survey with items on IPV, partner alcohol use, and likelihood that they could access small cash loans, large cash loans, or food loans from their social network. We then calculated the relative risk of experiencing IPV based on access to different forms of loans for the full sample and stratified by partner alcohol use.Results Confidence that she could access a fairly large loan (~$40) was associated with significantly decreased relative risk of IPV for all women. Confidence that she could access a fairly small loan (~$4) was associated with decreased relative risk of IPV for women whose partners did not drink but was insignificant for women whose partners did drink. Confidence that a friend or neighbor would lend her food was associated with decreased relative risk of IPV for women whose partners did drink.Conclusion Access to instrumental support (loans of food or money) is protective against IPV, but there are differential effects according to the type of loan and whether or not a woman’s partner drinks alcohol. Economic empowerment interventions to reduce IPV must be carefully tailored to ensure they are appropriate for a woman’s specific individual, relationship, and community context.