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      Prevalence and correlates of intimate partner violence against women in conflict affected northern Uganda: a cross-sectional study

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          Abstract

          Background

          Intimate partner violence (IPV) is an important public health issue as it impacts negatively on health, economic and development outcomes. In conflict affected northern Uganda, IPV prevalence is high and additional context-specific risk factors exist. People residing in this region have been displaced, exposed to war and violence, and had livelihoods destroyed. There are few studies examining IPV in this setting. In this study we aim to further understand the prevalence of IPV towards women and its associations in conflict affected northern Uganda.

          Methods

          This was a cross-sectional, behavioural survey designed to capture quantitative information related to experiences of IPV among women living near two health clinics in rural northern Uganda. There were 409 women who participated in the survey. Data were analysed using logistic regression.

          Results

          High rates of emotional, physical and sexual IPV were found; 78.5% of women had experienced at least one type of IPV, and slightly more than half of the participants had experienced IPV in the 12 months prior to the survey. Many women felt that IPV was justified in certain situations. Significant determinants of IPV included alcohol abuse by the male partner (OR 2.22, 95% CI 1.34–3.73); partner having been in a physical fight with another man (OR 1.90, 95% CI 1.12–3.23); controlling behaviours by the male partner (OR 1.21, CI 1.08–1.36). and younger age of the woman (OR 0.95, 95% CI 0.92–0.98). Educational level was not independently associated with IPV.

          Conclusions

          Our findings show that IPV is a significant issue in conflict affected northern Uganda, and attitudes that normalise and justify IPV are common. Alcohol abuse among young men in northern Uganda is highly prevalent and strongly associated with IPV towards women, as are controlling behaviours exhibited by the male partner. Interventions to reduce alcohol consumption among men in this region are likely to have important benefits in reducing the prevalence of IPV, and attitudes and behaviours that support IPV need to be further understood and addressed. Many women in conflict affected northern Uganda likely have additional risk factors for IPV related to previous exposure to war violence, however this was not directly measured in the present study. Further research into IPV in northern Uganda, and its relationship to exposure to conflict, is greatly needed.

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          Most cited references 19

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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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            Domestic violence in rural Uganda: evidence from a community-based study.

            Although domestic violence is an increasing public health concern in developing countries, evidence from representative, community-based studies is limited. In a survey of 5109 women of reproductive age in the Rakai District of Uganda, 30% of women had experienced physical threats or physical abuse from their current partner--20% during the year before the survey. Three of five women who reported recent physical threats or abuse reported three or more specific acts of violence during the preceding year, and just under a half reported injuries as a result. Analysis of risk factors highlights the pivotal roles of the male partner's alcohol consumption and his perceived human immunodeficiency virus (HIV) risk in increasing the risk of male against female domestic violence. Most respondents--70% of men and 90% of women--viewed beating of the wife or female partner as justifiable in some circumstances, posing a central challenge to preventing violence in such settings.
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              Factors associated with attitudes towards intimate partner violence against women: a comparative analysis of 17 sub-Saharan countries

              Background Violence against women, especially by intimate partners, is a serious public health problem that is associated with physical, reproductive and mental health consequences. Even though most societies proscribe violence against women, the reality is that violations against women's rights are often sanctioned under the garb of cultural practices and norms, or through misinterpretation of religious tenets. Methods We utilised data from 17 Demographic and Health Surveys (DHS) conducted between 2003 and 2007 in sub-Saharan Africa to assess the net effects of socio-demographic factors on men's and women's attitudes toward intimate partner violence against women (IPVAW) using multiple logistic regression models estimated by likelihood ratio test. Results IPVAW was widely accepted under certain circumstances by men and women in all the countries studied. Women were more likely to justify IPVAW than men. "Neglecting the children" was the most common reason agreed to by both women and men for justifying IPVAW followed by "going out without informing husband" and "arguing back with the husband". Increasing wealth status, education attainment, urbanization, access to media, and joint decision making were associated with decreased odds of justifying IPVAW in most countries. Conclusion In most Sub-Saharan African countries studied where IPVAW is widely accepted as a response to women's transgressing gender norms, men find less justification for the practice than do women. The present study suggests that proactive efforts are needed to change these norms, such as promotion of higher education and socio-demographic development. The magnitude and direction of factors associated with attitudes towards IPVAW varies widely across the countries, thus suggesting the significance of capitalizing on need-adapted interventions tailored to fit conditions in each country.
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                Author and article information

                Contributors
                +61413037188 , ellie.black@gmail.com
                Journal
                Confl Health
                Confl Health
                Conflict and Health
                BioMed Central (London )
                1752-1505
                30 July 2019
                30 July 2019
                2019
                : 13
                Affiliations
                [1 ]ISNI 0000 0004 4902 0432, GRID grid.1005.4, University of New South Wales – Faculty of Medicine, School of Public Health and Community Medicine, ; Kensington, Australia
                [2 ]GRID grid.442626.0, Gulu University – Faculty of Medicine, School of Public Health, ; Gulu, Uganda
                Article
                219
                10.1186/s13031-019-0219-8
                6668065
                © The Author(s). 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Health & Social care

                intimate partner violence, conflict affected, northern uganda, alcohol

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