Sewhareg Belay^1*, Ayalew Astatkie¹, Maria Emmelin², Sven Gudmund Hinderaker³.

¹School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; ²Department of Social Medicine and Global Health, Lund University, Lund, Sweden; ³Centre for International Health, University of Bergen, Bergen, Norway

Abstract

Background: Intimate partner violence (IPV) is regarded as an important public health and human rights issue, and is characterized by physical, sexual or emotional abuse. Globally more than one in three women report having experienced physical or sexual violence by their intimate partner. We found no studies from Ethiopia using standard tools in assessing both IPV and depression among pregnant women.

Objectives: To measure the prevalence of physical, sexual, and emotional violence during pregnancy, measure the prevalence of antenatal depression and assess the association between IPV and depression and other determinants.

Methods: This is a community based cross-sectional study conducted as part of a prospective cohort study which enrolled 589 pregnant women with a gestational age of 25-34 weeks or 6-8 equivalent months reported by the mother based in two urban and three rural kebeles of Wondo-Genet district. Exposure to IPV was assessed using a standard structured questionnaire of the WHO multi-country study of violence against women and maternal depression, was measured by the Edinburgh Postnatal Depression Scale (EPDS)at the time of enrollment. Data was collected by five female nurses. Data was double entered and validated using Epi-data and analyzed using SPSS. Descriptive statistics was computed and multivariable logistic regression was carried out to estimate the risk and adjust for confounders, keeping in the model variables with associations p<0.25.

Results: A total of 589 women out of 606 were interviewed and enrolled, making a response rate of 97%. The mean age of the participants was 25 years, ranging from 16 to 45 years. The overall prevalence of IPV was 21% (95%CI, 18.1-24.7). The prevalence of emotional, physical and sexual violence was 14.6%, 9.2% and 9.5% respectively. After adjusting for potential confounders, risk of IPV remained among rural participants (AOR=2.09; 95%CI=1.06-4.09), parental exposure to IPV (AOR=14.00; 95%CI=6.43-30.48), pregnancy not desired (AOR=9.64; 95%CI=3.44-27.03), alcohol use by husband (AOR=17.08; 95%CI=3.83-76.19), depressed (AOR=4.71; 95%CI=1.37-16.18) and low social support (AOR=13.93; 95%CI=6.98-27.77). The prevalence of antenatal depressive symptom (with EPDS score above 13) was 6.8% (95% CI 6.2-11.3). Exposure to IPV (AOR=17.60; 95%CI=6.18-50.10) and alcohol use by husband (AOR=3.31; 95%CI=1.33-8.24) were predictors of depression.

Conclusion: In our study one in five pregnant women experienced domestic violence, confirming that pregnancy does not protect from IPV; and it was strongly associated with depression. Screening for both IPV and depression at antenatal visits with referral of identified survivors to relevant care and service is recommended. Future studies should focus on testing interventions to prevent and reduce IPV.

*Correspondence:

Sewhreg Belay (PhD fellow)

School of Public Health, College of Medicine and Health Sciences, Hawassa University

Hawassa, Ethiopia

e-mail: betigsew@gmail.com

Tel: +251 916 87 41 05