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Physical Intimate Partner Violence Among Pregnant Women in Ofla District, Tigray, Ethiopia

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Physical Intimate Partner Violence Among Pregnant Women in Ofla District, Tigray, Ethiopia American Journal of Health Research 2020; 8(4): 69-77 http://www.sciencepublishinggroup.com/j/ajhr doi: 10.11648/j.ajhr.20200804.13 ISSN: 2330-8788 (Print); ISSN: 2330-8796 (Online) Physical Intimate Partner Violence Among Pregnant Women in Ofla District, Tigray, Ethiopia Girmay Adhena 1, *, Lemessa Oljira 2, Tesfay Temesgen 3 1Department of Reproductive Health, Tigray Regional Health Bureau, Tigray, Ethiopia 2School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia 3Department of Midwifery, College of Health Science, Dilla University, Dilla, Ethiopia Email address: *Corresponding author To cite this article: Girmay Adhena, Lemessa Oljira, Tesfay Temesgen. Physical Intimate Partner Violence Among Pregnant Women in Ofla District, Tigray, Ethiopia. American Journal of Health Research. Vol. 8, No. 4, 2020, pp. 69-77. doi: 10.11648/j.ajhr.20200804.13 Received : June 1, 2020; Accepted : June 18, 2020; Published : August 4, 2020 Abstract: Background: Physical violence by an intimate partner during pregnancy is the most common, hidden, and serious public health problem worldwide particularly in Africa. However, this issue has received little attention in Ethiopia. This study assessed the magnitude of intimate partner physical violence and associated factors among pregnant women in Ofla District, Tigray, Ethiopia. Methods: Institutional based cross-sectional study was conducted among pregnant women who attended antenatal care in public health facilities. Participants were selected using a systematic random sampling technique. Pretested, structured, and face to face data collection process was done using a standardized World Health Organization multi-country questionnaire. Bivariable and multivariable logistic regression analyses were carried out. Odds ratio with 95% to show the strength and finally variables with p-value <0.05 was considered as statistically significant. Results: The overall proportion of physical violence by an intimate partner during the current pregnancy was 13.4%. Violence was associated with being unmarried [(AOR=3.23, 95% CI: (1.19, 8.82)], being rural dweller [(AOR=3.99, 95% CI: (1.44, 11.1)], undesired pregnancy by intimate partner [(AOR=4.18, 95% CI: (1.7, 10.29)], having alcoholic partner [(AOR=3.3, 95% CI: (1.51, 7.19)], spouse’s multiple sexual partners status [(AOR=3.77, 95% CI: (1.6, 8.87)]. Conclusions: Considerable proportion of pregnant women experienced physical violence by their intimate partner during a recent pregnancy. Addressing male involvement in sexual and reproductive health issues and empowering women in the community through awareness and intervention measures are very important to minimize the problem. Keywords: Physical Violence, Intimate Partner, Pregnant Women, Ethiopia More than one-third of women have experienced physical 1. Background and/or sexual violence worldwide and out of this number, Intimate partner physical violence is any non-accidental most of these women have experienced by their intimate act or behavior threatened or actual against a woman or man partner in their lifetime [5]. Women experienced lifetime within a relationship causing in or has a high likelihood of physical intimate partner violence ranges from 6% to 48% resulting in injury, trauma, physical suffering, and death [1]. globally [6, 7]. In low- and middle-income countries ranges It is the most common form of violence against women and between 13% and 68% of women have experienced at least major public health issues globally [2]. It is also a complex one incident of physical violence by their intimate partner [8]. and silent pandemic that has detrimental effects on female It is also highest in sub-Saharan Africa, 38 to 83% of women victims’ mental health and causes a significantly higher use were abused by their intimate partners [2]. and cost of health care services [3]. Physical violence during The prevalence of physical intimate partner violence in pregnancy is the most devastating problem for both mother pregnancy ranges between 1% in Japan to 28% in Peru and fetus because of its morbidity and mortality [2, 4]. Province, with the majority of sites ranging between 4% and 12% [8]. Demographic and Health Surveys and the 70 Girmay Adhena et al. : Physical Intimate Partner Violence Among Pregnant Women in Ofla District, Tigray, Ethiopia International Violence against Women Survey found that Ethiopia. prevalence rates for intimate partner physical violence during pregnancy between 2% in Australia, Denmark, Cambodia, 2. Methods and Philippines to 13.5% in Uganda, with the majority ranging between 4% and 9% [9]. Other studies also showed 2.1. Study Area and Period that the highest prevalence in Egypt with 32%, followed by India (28%), Saudi Arabia (21%), and Mexico (11%) [6]. A The study was conducted in Ofla District which is one of review of clinical studies from Africa reports the prevalence the Districts in Tigray Regional State, Ethiopia. It is located rates of 23–40% physical intimate partner violence during 619 km away from Adis Ababa, the capital city of Ethiopia. pregnancy [10]. Ofla District is bordered to Machew by the North, Raya Although Ethiopia has ratified many international and Azebo by the East, Amhara Regional State by the West, and continental agreements that promote and protect women’s Alamata by the south. The District is the second rank in the rights and has established specific legal measures and actions size of the population in the Region. The total population of to address violence against women, this issue continues to be a the District was 175,659. Of this, 87,221 (49.65%) were major challenge and a threat to women’s empowerment. About males and 88,438 (50.35%) were females. Regarding the twenty-three percent of reproductive age women have health infrastructure, there was one general hospital, seven experienced physical violence since age 15years old, and 15% health centers, and 25 health posts that serve the population have experienced physical violence within a year. Out of this, in the District [17]. The study was conducted from March 1- 68% report their current partners as perpetrators of physical 30/2019. violence [11]. Intimate partner violence (IPV) is common in 2.2. Study Design and Population Ethiopia both in urban and rural families. About 68–81% of women agree on wife-beating if a husband has justified in at An institutional-based cross-sectional study was conducted. least one of the specified situations in Ethiopia [12]. All pregnants who were following ANC in the public health Physical violence by an intimate partner during pregnancy facilities of Ofla District were the source population. is associated with fatal and non-fatal adverse health outcomes Pregnant women who were attending ANC in the public for the pregnant woman and her baby due to the direct health facilities during the data collection period constituted trauma of abuse to a pregnant woman’s body, as well as the the study population. However, pregnant women with severe physiological effects of stress from current or past abuse on major danger signs of pregnancy during the data collection fetal growth and development [13]. There is also a particular period were excluded. concern if the abdomen is targeted during pregnancy due to the risk of injury to the fetus [12]. Women who have been 2.3. Sample Size Calculations and Sampling Procedures physically abused by their partners report higher rates of The sample size was calculated for the first objective health problems [1]. Apart from the violations of human (magnitude) and the second objective (factors). For the first rights, domestic violence is associated with various poor objective using single population formula (n=Z2 p (1−p)/d2), health outcomes for the newborn such as low birth weight, where z is the normal standard deviation set at 1.96, with a premature birth, fetal death, placental damage, fetal trauma, confidence level specified at 95% and a tolerable margin of preterm labor and among the women and girls include error (d) at 5%, considering 10% nonresponse rate and suicide, homicide, mental illness, physical injuries, disability. prevalence of IPPV (p) 20.6% from a previous similar study Moreover, violence also associated with various poor conducted in Shire EndaSelassie, Tigray, Ethiopia [16]. The reproductive health conditions such as induced abortion, calculated sample size for this was 251 and by adding the abdominal pain, bleeding, human immune virus (HIV), and non-response rate finally it gives 276 (251 + 251*10%). The other sexually transmitted infections [1, 8, 13-15]. sample size was also calculated for the second objective by Although the prevalence of intimate partner physical using the Epi-info version-7 with the assumption of a 95% violence (IPPV) varies across countries, the factors confidence interval, 80% power, 5% degree of precision, and associated with an increased risk of IPPV are similar. These 10% non-response rate. Since the sample size of the second may include the desire of pregnancy, attitudes towards IPV, objective (543) was higher than the first objective (276), the educational status, plan of pregnancy, discussion making total sample size finally used in this study was 543. power, socio-economic status, alcohol consumption by the For the sampling procedure, all public health facilities partner, and behavioral factors [14-16]. (seven health centers and one general hospital) in Ofla Even though the consequences of physical violence during District were considered. Pregnant women who attended pregnancy are worst, studies conducted so far were mostly ANC clinics for an average of six months before the study focused on IPV of non-pregnant women. The magnitude of period were used to estimate recruitment from each health IPPV during pregnancy and its associated factors were not facility. The average client flow per month and day in the well addressed in sub-Saharan countries including Ethiopia, public health facilities of Ofla District were considered and particularly in the study area. Therefore, this study was the population proportion sample size allocation was done to designed to assess the prevalence of IPPV and associated each health facility.
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