Social ecological factors and intimate partner violence in pregnancy

BackgroundIntimate partner violence (IPV) during pregnancy increases adverse pregnancy outcomes. Knowledge of societal, community, family and individual related factors associated with IPV in pregnancy is limited in Ethiopia. Our study examined these factors in an Ethiopian context.Materials and methodsA cross sectional study was conducted among pregnant women attending antenatal care at governmental health institutions, using a consecutive probability sampling strategy. A total of 720 pregnant women were interviewed by five trained nurses or midwives, using a standardized and /pretested survey questionnaire. Bivariate and multivariate logistic regression analyses were applied to assess factors contributing to IPV. We used Akaike’s information criteria, to identify the model that best describes the factors influencing IPV in pregnancy.ResultsAmong the women interviewed, physical IPV was reported by 35.6%, and lifetime emotional or physical abuse by 81.0%. Perceiving violence as a means to settle interpersonal conflicts, presence of supportive attitudes of wife beating in the society, regarding violence as an expression of masculinity, and presence of strict gender role differences in the society, were all positively associated to IPV in pregnancy. The presence of groups legitimizing men’s violence in the community, feeling isolated, having no social support for victims, and presence of high unemployment, were the perceived community related factors positively associated with IPV in pregnancy.ConclusionIPV in pregnancy is very prevalent in Ethiopia and is associated with multiple social ecologic factors. Reduction of IPV in pregnancy calls for cross sectorial efforts from stakeholders at different levels.背景：妊娠期亲密伴侣暴力（Intimate Partner Violence，IPV）会增加不良妊娠结局的发生风险。目前，埃塞俄比亚针对妊娠期亲密伴侣暴力相关的社会、社区、家庭及个体层面影响因素的认知仍较为有限。本研究于埃塞俄比亚情境下对上述影响因素展开了探究。 材料与方法：本研究采用横断面研究设计，选取在公立医疗卫生机构接受产前保健的孕妇作为研究对象，运用连续概率抽样法开展抽样。共计720名孕妇接受了调查，由5名经过培训的护士或助产士使用标准化且经过预试验的调查问卷完成访谈。采用双变量及多变量logistic回归分析方法，评估妊娠期亲密伴侣暴力的相关影响因素。本研究以赤池信息准则（Akaike’s Information Criterion）筛选出最能阐释妊娠期亲密伴侣暴力影响因素的最优模型。 结果：受访孕妇中，35.6%报告曾遭受躯体型亲密伴侣暴力，81.0%报告曾在一生中遭受情感或躯体虐待。将暴力视为解决人际冲突的手段、社会上存在支持殴打妻子的态度、将暴力视作男子气概的体现，以及社会中存在严格的性别角色差异，均与妊娠期亲密伴侣暴力呈正相关。社区层面的相关影响因素包括：存在将男性暴力合法化的群体、孕妇感到孤立无援、受害者缺乏社会支持，以及高失业率水平，上述因素同样与妊娠期亲密伴侣暴力呈正相关。 结论：妊娠期亲密伴侣暴力在埃塞俄比亚流行程度极高，且与多重社会生态层面的因素相关。降低妊娠期亲密伴侣暴力的发生风险，需要不同层级利益相关方开展跨部门协作。