Background: Intimate partner violence exposes women to a wide range of health problems that can either directly or indirectly lead to maternal death. Although a number of studies have reported an association of intimate partner violence with inadequate utilization of antenatal care and skilled delivery care, other studies have not found this association. Therefore, we aimed to comprehensively review the evidence, and quantify the strength and direction of an association between intimate partner violence and utilizing adequate antenatal and skilled delivery care services.

Method: We systematically searched articles from MEDLINE, Embase, PsychINFO, CINAHL, and Maternity and Infant Care databases. Two independent reviewers screened the articles for eligibility. Quality and risk of biases of the articles were evaluated by using the Newcastle-Ottawa scale for observational studies. Pooled odds ratios and 95% confidence intervals were computed to estimate the association between intimate partner violence and antenatal care, and skilled delivery care. Random-effects models were used to allow for the significant heterogeneity that might possibly be found between studies. The degree of heterogeneity was expressed by using the I² statistic.

Results: The meta-analyses have shown that women who experience intimate partner violence are at an increased risk of not having adequate antenatal care and not utilizing skilled delivery care services. Women who experienced intimate partner violence were 31% (AOR= 0.69, 95%CI= 0.58, 0.82) less likely to have adequate antenatal care than those who did not experience intimate partner violence. Similarly, women who experienced intimate partner violence were 17% (AOR= 0.83, 95%CI= 0.72, 0.95) less likely to receive skilled delivery care compared with women who do not experience intimate partner violence.

Conclusion

The meta-analyses indicated that experiencing intimate partner violence is associated with receiving inadequate antenatal care and not receiving skilled delivery services. Both community based and facility-based interventions that target reduction of IPV, and strictly implementing proven health facility-based counselling interventions could aid in improving utilization of maternal health care services.

Key words: Systematic review, Meta-analysis, Intimate partner violence, Maternal health care service use