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      Prevalence and risk factors of intimate partner violence among women in four districts of the central region of Ghana: Baseline findings from a cluster randomised controlled trial

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          Abstract

          Intimate partner violence (IPV) is a significant global public health problem. Understanding risk factors is crucial for developing prevention programmes. Yet, little evidence exists on population-based prevalence and risk factors for IPV in West Africa. Our objective was to measure both lifetime and past year prevalence of IPV and to determine factors associated with past year physical or sexual IPV experience. This population-based survey involved 2000 randomly selected women aged 18 to 49 years living in 40 localities within four districts of the Central Region of Ghana. Questionnaires were interviewer-administered from February to May 2016. Respondents were currently or ever-partnered, and resident in study area ≥12months preceding the survey. Data collected included: socio-demographics; sexual behavior; mental health and substance use; employment status; 12-month and lifetime experience of violence; household food insecurity; gender norms/attitudes; partner characteristics and childhood trauma. Logistic regression modelling was used to determine factors associated with sexual or physical IPV, adjusting for age and survey design. About 34% of respondents had experienced IPV in the past year, with 21.4% reporting sexual and or physical forms. Past year experience of emotional and economic IPV were 24.6% and 7.4% respectively. Senior high school education or higher was protective of IPV (AOR = 0.51[0.30–0.86]). Depression (AOR = 1.06[1.04–1.08], disability (AOR = 2.30[1.57–3.35]), witnessing abuse of mother (AOR = 2.1.98[1.44–2.72]), experience of childhood sexual abuse (AOR = 1.46[1.07–1.99]), having had multiple sexual partners in past year (AOR = 2.60[1.49–4.53]), control by male partner (AOR = 1.03[1.00–1.06]), male partner alcohol use in past year (AOR = 2.65[2.12–3.31]) and male partner infidelity (AOR = 2.31[1.72–3.09]) were significantly associated with increased odds of past year physical or sexual IPV experience. Male perpetrated IPV remains a significant public health issue in Ghana. Evidence-based interventions targeting women’s mental health, disabilities, exposure to violence in childhood, risky sexual behavior and unequal power in relationships will be critical in reducing IPV in this setting.

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          What factors are associated with recent intimate partner violence? findings from the WHO multi-country study on women's health and domestic violence

          Background Intimate partner violence (IPV) against women is a global public health and human rights concern. Despite a growing body of research into risk factors for IPV, methodological differences limit the extent to which comparisons can be made between studies. We used data from ten countries included in the WHO Multi-country Study on Women's Health and Domestic Violence to identify factors that are consistently associated with abuse across sites, in order to inform the design of IPV prevention programs. Methods Standardised population-based household surveys were done between 2000 and 2003. One woman aged 15-49 years was randomly selected from each sampled household. Those who had ever had a male partner were asked about their experiences of physically and sexually violent acts. We performed multivariate logistic regression to identify predictors of physical and/or sexual partner violence within the past 12 months. Results Despite wide variations in the prevalence of IPV, many factors affected IPV risk similarly across sites. Secondary education, high SES, and formal marriage offered protection, while alcohol abuse, cohabitation, young age, attitudes supportive of wife beating, having outside sexual partners, experiencing childhood abuse, growing up with domestic violence, and experiencing or perpetrating other forms of violence in adulthood, increased the risk of IPV. The strength of the association was greatest when both the woman and her partner had the risk factor. Conclusions IPV prevention programs should increase focus on transforming gender norms and attitudes, addressing childhood abuse, and reducing harmful drinking. Development initiatives to improve access to education for girls and boys may also have an important role in violence prevention.
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            Intimate Partner Violence and Incident Depressive Symptoms and Suicide Attempts: A Systematic Review of Longitudinal Studies

            Karen Devries and colleagues conduct a systematic review of longitudinal studies to evaluate the direction of association between symptoms of depression and intimate partner violence. Please see later in the article for the Editors' Summary
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              Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review

              Background Intimate partner violence (IPV) has been known to adversely affect the mental health of victims. Research has tended to focus on the mental health impact of physical violence rather than considering other forms of violence. Objective To systematically review the literature in order to identify the impact of all types of IPV victimisation on various mental health outcomes. Method A systematic review of 11 electronic databases (2004–2014) was conducted. Fifty eight papers were identified and later described and reviewed in relation to the main objective. Results Main findings suggest that IPV can have increasing adverse effects on the mental health of victims in comparison with those who have never experienced IPV or those experiencing other traumatic events. The most significant outcomes were associations between IPV experiences with depression, posttraumatic stress disorder, and anxiety. Findings confirm previous observations that the severity and extent of IPV exposure can increase mental health symptoms. The effect of psychological violence on mental health is more prominent than originally thought. Individual differences such as gender and childhood experience of violence also increase IPV risk and affect mental health outcomes in diverse ways. Conclusions Psychological violence should be considered as a more serious form of IPV which can affect the mental health of victims. Experiencing more than one form of IPV can increase severity of outcomes. Researchers should look at IPV as a multi-dimensional experience. A uniformed definition and measure of IPV could help advance knowledge and understanding of this disparaging global issue.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: ResourcesRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                19 July 2018
                2018
                : 13
                : 7
                : e0200874
                Affiliations
                [1 ] Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
                [2 ] Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
                [3 ] Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
                [4 ] Gender Studies and Human Rights Documentation Centre, Accra, Ghana
                Erasmus Medical Center, NETHERLANDS
                Author notes

                Competing Interests: The authors have declared that no competing interests exist

                Author information
                http://orcid.org/0000-0001-8852-7189
                Article
                PONE-D-18-06909
                10.1371/journal.pone.0200874
                6053193
                30024948
                07ab258f-4e5c-48be-b1de-25b852c11537
                © 2018 Ogum Alangea et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 5 March 2018
                : 5 July 2018
                Page count
                Figures: 1, Tables: 5, Pages: 19
                Funding
                This document is a product from a C-RCT funded through the What Works to Prevent Violence: A Global Programme on violence Against Women and Girls VAWG ( www.whatworks.co.za), funded by the UK Aid from the UK's Department for International Development (DFID). The funding was managed by the South African Medical Research Council. However, the views expressed, and information contain in it do not necessarily reflect the UK government's official policies. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.
                Categories
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                Medicine and Health Sciences
                Public and Occupational Health
                Traumatic Injury Risk Factors
                Violent Crime
                Intimate Partner Violence
                Social Sciences
                Sociology
                Criminology
                Crime
                Violent Crime
                Intimate Partner Violence
                Medicine and Health Sciences
                Public and Occupational Health
                Traumatic Injury Risk Factors
                Child Abuse
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                Medicine and Health Sciences
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                Behavior
                Human Sexual Behavior
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                People and Places
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                Africa
                Ghana
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Child Psychiatry
                Medicine and Health Sciences
                Public and Occupational Health
                Traumatic Injury Risk Factors
                Violent Crime
                Domestic Violence
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