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Intimate partner violence in pregnancy: a cross-sectional study from post-conflict northern Uganda
  1. Susan Clarke1,
  2. Robyn Richmond1,
  3. Eleanor Black1,
  4. Helen Fry1,
  5. James Henry Obol1,2,
  6. Heather Worth1
  1. 1 School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia
  2. 2 Faculty of Medicine, Gulu University, Gulu, Uganda
  1. Correspondence to Dr Susan Clarke; susan.clarke{at}unswalumni.com

Abstract

Objectives To determine the prevalence of intimate partner violence (IPV) in pregnancy and to understand associations and determinants.

Design Cross-sectional survey.

Setting Two rural health clinics in post-conflict northern Uganda.

Participants Women attending two rural health clinics for a new service providing cervical cancer screening, who had experienced pregnancy.

Primary and secondary outcome measures Data were collected by a questionnaire using validated questions from the demographic health survey women’s questionnaire and the domestic violence module. Data were entered into tablets using Questionnaire Development System software. Bivariate and multivariate logistic regression was performed, using experience of IPV in pregnancy as the dependent variable. SPSS V.25 was used for all analysis.

Results Of 409 participant women, 26.7% (95% CI 18.6% to 35.9%) reported having been slapped, hit or beaten by a partner while pregnant. For 32.3% (95% CI 20.2% to 37.9%) of the women the violence became worse during pregnancy. Women who had ever experienced IPV in pregnancy were more likely to have experienced violence in the previous 12 months (OR 4.45, 95% CI 2.80 to 7.09). In multivariate logistic regression, the strongest independent associations with IPV in pregnancy were partner’s daily drinking of alcohol (OR 2.02, 95% CI 1.19 to 3.43) and controlling behaviours (OR 1.17, 95% CI 1.03 to 1.33).

Conclusions The women in this study had more exposure to IPV in pregnancy than previously reported for this region. Women’s previous experience of intimate partner violence, partner’s daily use of alcohol and his controlling behaviours were strong associations with IPV in pregnancy. This study highlights the uneven distribution of risk and the importance of research among the most vulnerable population in rural and disadvantaged settings. More research is needed in local rural and urban settings to illuminate this result and inform intervention and policy.

  • intimate partner violence
  • pregnancy
  • war exposure
  • alcohol drinking

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Footnotes

  • Twitter @susanclarke_1

  • Contributors We declare that all authors have made substantial contributions. RR, HW and JO conceived the study, developed the protocol and supervised the study. All authors collected data. HF, EB and SC performed the preliminary data analysis. SC and JO performed the final data analysis. All authors contributed to interpretation of results. SC and EB drafted the manuscript and all authors contributed to critical revisions of the manuscript. All authors read and approved the final manuscript.

  • Funding The authors received funding from the Institute for Global Development (University of New South Wales) and this was used for travel expenses for UNSW staff. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. All authors had full access to all of the data in the study and can take responsibility for the integrity and accuracy of the data.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval was obtained from the University of New South Wales Human Research Ethics Committee (HREC HC17795) and the Gulu University Research Ethics Committee (GU REC).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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