Intimate Partner Violence in Pregnancy in Ethiopia

Abstract

Intimate partner violence (IPV) during pregnancy imposes a substantial effect on the health of the woman and her fetus. However, studies on the extent of the problem, contributing factors, and how the communities’ different institutions perceive and respond to IPV in pregnancy, are limited in Ethiopia. This thesis is aimed to investigate the prevalence and factors contributing to IPV during pregnancy, its influence on the initiation of antenatal care, the perceptions and responses of community institutions and health care workers (HCWs) on IPV, using quantitative and qualitative methods. The quantitative data were collected from 720 pregnant women at antenatal care (ANC) clinics. The interviews data were obtained from HCWs and individuals representing different community institutions. The results show that IPV in pregnancy is prevalent (35.6 %) in Ethiopia and multi-factorial. Late entry into ANC is also very common (52%), especially among multiparous women reporting IPV. We also identified socio-cultural, structural and economic factors, acting as barriers for victims to receive adequate assistance. The HCWs as well as the community informants expressed limited awareness of the adverse impacts IPV has on pregnant women and fetal health, disclosed the absence of support to IPV victims or any networks aimed at IPV mitigation among relevant institutions. Additionally, despite regular contact with pregnant IPV victims, HCWs mainly focusing on treating apparent obstetric complications and/or visible trauma. This thesis adds knowledge to the Ethiopian society of the complex social ecologic risk factors of IPV in pregnancy and how IPV directly impacts the use of ANC during pregnancy. It also highlights the perceptions and attitude of HCWs and different community stakeholders towards IPV in pregnancy. Together these four papers provide invaluable information when planning a cross-sectoral community intervention mitigating IPV and its impact on women and children.