scholarly journals The mediation effect of contraceptive use and women’s autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tenaw Yimer Tiruye ◽  
Melissa L. Harris ◽  
Catherine Chojenta ◽  
Elizabeth Holliday ◽  
Deborah Loxton
Keyword(s):  
Unintended Pregnancy ◽  
Partner Violence ◽  
Emotional Abuse ◽  
Contraceptive Use ◽  
Mediation Effect ◽  
Composite Measure ◽  
Multiple Partner ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Controlling Behaviour

Abstract Background Intimate partner violence (IPV) affects one in every three women globally. Previous studies have revealed that women’s experiences of different forms of IPV are significantly associated with a higher rate of unintended pregnancy, reduced uptake of contraception, and reduced ability to make decisions regarding their fertility. The aim of this study was to investigate whether previously observed relationships between IPV and unintended pregnancy in Ethiopia are mediated by contraceptive use and women’s autonomy. Methods This study was performed using nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS). A subsample of married women of reproductive age reporting a pregnancy within the 5 years preceding 2016 and who participated in the domestic violence sub-study of the survey were included in analyses. Logistic regression models, together with the product of coefficients method, were used to estimate direct and mediated effects. Results Twenty six percent of participants reported an unintended pregnancy in the 5 years preceding the survey. Sixty-four percent reported having ever experienced IPV (a composite measure of physical, sexual, emotional abuse, and partner controlling behaviour). After adjusting for potential confounding factors, unintended pregnancy was significantly positively associated with reporting sexual IPV, emotional IPV, IPV (a composite measure of physical, sexual, or emotional abuse), and multiple partner controlling behaviour. However, IPV (as a composite of all four forms), physical IPV, and partner control (single act) were not significantly associated with unintended pregnancy. Women’s autonomy, but not contraception use, had a significant partial mediation effect in the relationships between some forms of IPV and unintended pregnancy. Women’s autonomy mediated about 35, 35, and 43% of the total effect of emotional IPV, IPV (physical, sexual, and/or emotional), and multiple partner control on unintended pregnancy respectively. Conclusion Women’s autonomy appears to play a significant role in mediating the effect of IPV on unintended pregnancy in Ethiopia. Maternal health service interventions in Ethiopia could incorporate measures to improve women’s decision-making power to reduce the negative reproductive health effects of IPV.

scholarly journals Does gender inequality matter for access to and utilization of maternal healthcare services in Bangladesh?

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257388
Author(s):  
Firoz Ahmed ◽  
Fahmida Akter Oni ◽  
Sk. Sharafat Hossen
Keyword(s):  
Gender Inequality ◽  
Gender Gap ◽  
Partner Violence ◽  
Bargaining Power ◽  
Healthcare Services ◽  
Household Wealth ◽  
Maternal Healthcare ◽  
Intrahousehold Bargaining ◽  
Women’S Autonomy ◽  
Women's Autonomy

There is a high prevalence of gender gap in Bangladesh which might affect women’s likelihood to receive maternal healthcare services. In this backdrop, we aim to investigate how gender inequality measured by intrahousehold bargaining power (or autonomy) of women and their attitudes towards intimate partner violence (IPV) affects accessing and utilizing maternal health care services. We used Bangladesh Demographic and Health Survey (BDHS) data of 2014 covering 5460 women who gave birth at least one child in the last three years preceding the survey. We performed logistic regression to estimate the effect of women’s autonomy and their attitude towards IPV on access to and utilization of maternal healthcare services. Besides, we employed different channels to understand the heterogeneous effect of gender inequality on access to maternal healthcare services. We observed that women having autonomy positively influenced attaining five required antenatal care (ANC) services (AOR: 1.17; 95% CI: 0.98–1.41) and women’s negative attitudes towards IPV were positively associated with five ANC services (AOR: 1.42; 95% CI: 1.02–1.97), sufficient ANC visits (COR: 1.55; CI: 1.19–2.01), skilled birth attendant (SBA) (AOR: 1.43; 95% CI: 1.05–1.94) and postnatal care (PNC) services (AOR: 1.44; 95% CI: 1.12–1.84). Besides, rural residency, religion, household wealth, education of both women and husband were found to have some of the important channels which were making stronger effect of gender inequality on access to maternal healthcare services. The findings of our study indicate a significant association between access to maternal healthcare services and women’s autonomy as well as attitude towards IPV in Bangladesh. We, therefore, recommend to protect women from violence at home and mprove their intrahousehold bargaining power to increase their access to and utilization of required maternal healthcare services.

scholarly journals Assessing the role of women’s autonomy and acceptability of intimate-partner violence in maternal health-care utilization in 63 low- and middle-income countries

2019 ◽  
Vol 48 (5) ◽  
pp. 1580-1592 ◽  
Author(s):  
Pooja Sripad ◽  
Charlotte E Warren ◽  
Michelle J Hindin ◽  
Mahesh Karra
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Partner Violence ◽  
Maternal Health Care ◽  
Care Utilization ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Maternal Health Care Utilization ◽  
Care Services

Abstract Background Our study investigates the associations between women’s autonomy and attitudes toward the acceptability of intimate-partner violence against women (IPVAW) and maternal health-care utilization outcomes. Methods We combine data from 113 Demographic and Health Surveys conducted between 2003 and 2016, which give us a pooled sample of 765 169 mothers and 777 352 births from 63 countries. We generate composite scores of women’s autonomy (six-point scale with reference: no contribution) and acceptability of IPVAW (five-point scale with reference: no acceptance) and assess the associations between these measures and women’s use of antenatal care services and facility delivery in pooled and unique country samples. Results A change in a woman’s autonomy score from ‘no contribution to any decision-making domain’ (a composite autonomy score of 0) to ‘contribution to all decision-making domains’ (a score of 6) is associated with a 31.2% increase in her odds of delivering in a facility and a 42.4% increase in her odds of receiving at least eight antenatal care visits over the course of her pregnancy. In contrast, a change in a woman’s attitude towards acceptability of IPVAW from ‘IPVAW is not acceptable under any scenario’ (a score of 0) to ‘IPVAW is acceptable in all scenarios’ (a score of 5) is associated with an 8.9% decrease in her odds of delivering in a facility and a 20.3% decrease in her odds of receiving eight antenatal care visits. Conclusions Our findings suggest that strong and significant associations exist between autonomy, acceptability of IPVAW and utilization of maternal health-care services.

Do women with autonomy in the household experience less intimate partner violence in Malawi? Evidence from the 2015–16 Demographic and Health Survey

2021 ◽  
pp. 1-20
Author(s):  
James Forty
Keyword(s):  
Intimate Partner Violence ◽  
Civic Education ◽  
Health Survey ◽  
Partner Violence ◽  
Secondary Data ◽  
Intimate Partner ◽  
Wife Beating ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Household Decision

Abstract In Malawi, the prevalence of intimate partner violence (IPV), or closely related violence, is estimated at 42% according to the 2015–16 Malawi Demography and Health Survey (MDHS). This study investigated the association between women’s autonomy in household decision-making participation as well as sexual autonomy and IPV among married and cohabiting women aged 15–49 years in Malawi. Secondary data were taken from the 2015–16 MDHS. Multivariate analysis was performed using a stepwise forward logistic (binary) regression model to assess the association of dimensions of women’s autonomy in the household and selected control variables with IPV. No association was found between dimensions of women’s autonomy in the household and IPV. However, other variables did have an association with some form of IPV, namely women justifying wife beating, having a jealous partner, being accused of unfaithfulness by their partner, having a partner who drinks alcohol and having a partner with another woman or more. In addition, religion, ethnicity, women education level and women’s occupation were found to be associated with the risk of experiencing IPV. The study recommends policy interventions aimed at supporting youth, especially girls, to complete secondary education before they marry or cohabit; the development of accessible and affordable psycho-social counselling specialists and platforms for married and cohabiting couples; nationwide rigorous advocacy and civic education on IPV; and enforcement of Malawi’s 2006 domestic violence law.

scholarly journals Women’s Autonomy Decision Making Power on Postpartum Modern Contraceptive Use and Associated Factors in North West Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Samrawit Yonas Tadesse ◽  
Amanu Aragaw Emiru ◽  
Tadese Ejigu Tafere ◽  
Melash Belachew Asresie
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Immunization Service ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Autonomous Decision ◽  
Postpartum Family Planning ◽  
Modern Contraceptive Use

Background. Most postpartum women (95%) do not want pregnancy within 24 months after birth, however, 70% of them do not use modern contraceptives. In Ethiopia postpartum modern contraceptive use is low. Evidences show that women’s autonomy within the household is the most important thing in modern contraceptive use. Yet, there is dearth of information in Ethiopian context. Therefore, this study was aimed to assess women’s autonomy on modern contraceptive use and its associated factors among women who attended their children immunization service. Methods. Facility-based cross-sectional study was carried out from May 5 to Jone15, 2017 in sekota town and its surroundings among 415 women who attended immunization service for their children. Participants were selected by using a systematic sampling technique. The data were collected through face-to-face interviews using pre-tested structured questionnaires. The data were entered into epi.info version7 and analyzed using SPSS version 23. Both descriptive and logistic regression analyses were performed. A P-value less than or equal to 0.05 at 95% confidence interval was set to test statistical significance. Result. The proportion of women’s decision making power on postpartum modern contraceptive use was 77.3%. Being counseled on postpartum family planning (2.29, 95% CI: 1.27, 5.71), discussed on postpartum family planning with their husbands (AOR = 14.62, 95% CI: 6.52, 32.75), and had the index child within one year after previous birth (AOR = 7.98, 95% CI: 2.52, 30.65) were found positively associated with women’s autonomous decision making power on postpartum modern contraceptive use. In addition, those women who knew that pregnancy could happen during the postpartum period (AOR = 6.53, 95% CI: 3.2, 14.12) were more autonomous in decision to use postpartum contraception. Conclusion. The proportion of women’s autonomous decision making power on postpartum modern contraceptive use was low. Those women who were counseled on postpartum family planning, discussed with partners, and those who knew that pregnancy could happen during the postpartum period had higher odds of autonomous decision making power. Therefore, strengthening counseling, educating on postpartum family planning, and encouraging women to discuss postpartum family planning with their husbands may improve women’s power.

Moderating Effect of Husband’s Controlling Attitudes on the Relation Between Women’s Household Decision-Making Autonomy and Intimate Partner Violence Experience in Nigeria

2019 ◽  
pp. 088626051988853
Author(s):  
Adegbenga M. Sunmola ◽  
Mohammed N. Sambo ◽  
Olusegun A. Mayungbo ◽  
Luqman A. Morakinyo
Keyword(s):  
Decision Making ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Intimate Partner ◽  
Cross Sectional ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Household Decision ◽  
Household Decision Making ◽  
Nationally Representative

Existing studies show a consensus on the importance of women’s household decision-making autonomy. However, the studies also show mixed findings of the association between the variable and intimate partner violence (IPV). In this study, moderating effects of husband’s controlling and domineering attitudes on the association between women’s household decision-making autonomy and husband-perpetrated physical, sexual, and emotional violence were investigated. Data used in the study were drawn from an existing database of a 2013 cross-sectional Demographic and Health Survey (DHS) of nationally representative sample ( N = 19,360) of Nigerian married women. Participants were interviewed on measures of women’s autonomy, husband’s attitudes, and husband-perpetrated violence. Results revealed that women who exercised high household decision-making autonomy significantly experienced more physical ( b = .31, t = 11.78, p < .001), sexual ( b = .05, t = 3.59, p < .01), and emotional ( b = .17, t = 9.76, p < .001) violence if they reported relationship with husbands who endorsed high controlling and domineering attitudes. The results represent an extension over existing research and have implications on how husband’s attitudes could improve women’s autonomy and reduce their IPV experience in various intervention settings.

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