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      Intimate partner violence among pregnant women in Rwanda

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          Abstract

          Background

          Intimate partner violence (IPV), defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence (IPV) against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with IPV among Rwandan pregnant women.

          Methods

          A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, IPV, and alcohol use by the male partner. Mean age and proportions of IPV in different groups were assessed. Odds of IPV were estimated using logistic regression analysis.

          Results

          Of the 600 respondents, 35.1% reported IPV in the last 12 months. HIV+ pregnant women had higher rates of all forms of IVP violence than HIV- pregnant women: pulling hair (44.3% vs. 20.3%), slapping (32.0% vs. 15.3%), kicking with fists (36.3% vs. 19.7%), throwing to the ground and kicking with feet (23.3% vs. 12.7%), and burning with hot liquid (4.1% vs. 3.5%). HIV positive participants were more than twice likely to report physical IPV than those who were HIV negative (OR = 2.38; 95% CI [1.59, 3.57]). Other factors positively associated with physical IPV included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29]), having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers), and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime IPV.

          Conclusion

          We have reported on prevalence of IPV violence among pregnant women attending antenatal care in Rwanda, Central Africa. We advocate that screening for IPV be an integral part of HIV and AIDS care, as well as routine antenatal care. Services for battered women should also be made available.

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          Most cited references42

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          Health consequences of intimate partner violence.

          Intimate partner violence, which describes physical or sexual assault, or both, of a spouse or sexual intimate, is a common health-care issue. In this article, I have reviewed research on the mental and physical health sequelae of such violence. Increased health problems such as injury, chronic pain, gastrointestinal, and gynaecological signs including sexually-transmitted diseases, depression, and post-traumatic stress disorder are well documented by controlled research in abused women in various settings. Intimate partner violence has been noted in 3-13% of pregnancies in many studies from around the world, and is associated with detrimental outcomes to mothers and infants. I recommend increased assessment and interventions for intimate partner violence in health-care settings.
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            The impact of intimate partner violence on women's reproductive health and pregnancy outcome.

            N N Sarkar (2008)
            The aim of this study was to evaluate and elucidate the impact of intimate partner violence (IPV) on women's reproductive health and pregnancy outcomes taking into account data from various countries. The search of the literature was made in MEDLINE database service for the years 2002-2008. Original articles, reviews, surveys, clinical trials and investigations pertinent to the theme were considered for this review. The lifetime physical or sexual IPV or both varied from 15% to 71% in many countries. Adolescent violence, negative emotionality and quality of the relationship with the intimate partner were associated with genesis of IPV, besides demographic, social and structural difference in attitudes. IPV affected woman's physical and mental health, reduced sexual autonomy, increased risk for unintended pregnancy and multiple abortions. Risk for sexual assault decreased by 59% or 70% for women contacting the police or applying for a protection order, respectively. Quality of life of IPV victims was found significantly impaired. Women battered by IPV reported high levels of anxiety and depression that often led to alcohol and drug abuse. Violence on pregnant women significantly increased risk for low birth weight infants, pre-term delivery and neonatal death and also affected breast-feeding postpartum. Women preferred an active role to be played by healthcare providers in response to IPV disclosure. Gynaecologists reported interventions for the patient disclosing IPV and provided treatment for their physical and emotional complaints. Educating and empowering women and upgrading their socioeconomic status may abate the incidence of IPV. Women should also seek protection against IPV.
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              Intimate partner violence and physical health consequences: policy and practice implications.

              S Plichta (2004)
              Extensive research indicates that intimate partner violence (IPV) poses a significant risk to the physical health of women. IPV is associated with increased mortality, injury and disability, worse general health, chronic pain, substance abuse, reproductive disorders, and poorer pregnancy outcomes. IPV is also associated with an overuse of health services and unmet need for services, as well as strained relationships with providers. The body of IPV research has several critical gaps. There are almost no longitudinal studies of IPV and health. Most studies are clustered into a few specialties, with almost no research in the areas of allied health, dentistry, or management. A common definition of IPV is still not used. Finally, with some notable exceptions, there has been little success in moving the health care system to routinely screen women for IPV.
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                Author and article information

                Journal
                BMC Womens Health
                BMC Women's Health
                BioMed Central
                1472-6874
                2008
                10 October 2008
                : 8
                : 17
                Affiliations
                [1 ]Department of Epidemiology, School of Public Health, National University of Rwanda, Kigali, Rwanda
                [2 ]Department of Public Health, Division of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi
                [3 ]Department of Community Medicine, University of Zambia, Lusaka, Zambia
                [4 ]Division of Epidemiology and Biostatistics, San Diego State University, San Diego, California, USA
                Article
                1472-6874-8-17
                10.1186/1472-6874-8-17
                2570659
                18847476
                0af00d09-2c06-4bf1-9632-5b7abb2d2739
                Copyright © 2008 Ntaganira et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 January 2008
                : 10 October 2008
                Categories
                Research Article

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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