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Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study.
BMC Womens Health. 2018 07 04; 18(1):119.BW

Abstract

BACKGROUND

Rates of violence against women are reported to be highest in Africa compared to other continents. We aimed to determine associations between mental illness, demographic, psychosocial and economic factors with experience of intimate partner violence (IPV) among pregnant women in a low resource setting in Cape Town and to explore the contextual elements pertaining to domestic violence.

METHODS

We recruited adult women attending antenatal services at a primary-level maternity facility. Demographic, socioeconomic and psychosocial data were collected by questionnaire. The Expanded Mini- International Neuropsychiatric Interview (MINI) Version 5.0.0 was used to assess mental health status and the Revised Conflict Tactic Scale (CTS2) used to assess IPV in the six months prior to the study. Non-parametric tests, Wilcoxon sum of rank test, Fisher Exact and two sample T test and multicollinearity tests were performed. Descriptive, bivariate and logistic regression analyses were conducted to identify associations between the outcome of interest and key predictors. A probability value of p ≤ 0.05 was selected. From counselling case notes, a thematic content analysis was conducted to describe contextual factors pertaining to forms of domestic violence (DV).

RESULTS

The prevalence of IPV was 15% of a sample of 376 women. Women who were food insecure, unemployed, in stable but unmarried relationships, had experienced any form of past abuse and were not pleased about the current pregnancy were more likely to experience IPV. MINI-defined mental health problems and a history of mental illness were significantly associated with IPV. Qualitative analysis of 95 counselling case notes revealed that DV within the household was not limited to intimate partners and, DV in this context was often perceived as 'normal' behaviour by the participants.

CONCLUSIONS

This study contributes towards a greater understanding of the risk profile for IPV amongst pregnant women in low-income settings. Adversity, including food insecurity and mental ill-health are closely associated with IPV during the antenatal period. Advocates against violence against pregnant women are advised to consider that violence in the home may be perpetrated by non-intimate partners and may by enabled by a pervasive belief in the acceptability of the violence.

Authors+Show Affiliations

Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa. sally.field@uct.ac.za.Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa. School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa.Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29973182

Citation

Field, Sally, et al. "Domestic and Intimate Partner Violence Among Pregnant Women in a Low Resource Setting in South Africa: a Facility-based, Mixed Methods Study." BMC Women's Health, vol. 18, no. 1, 2018, p. 119.
Field S, Onah M, van Heyningen T, et al. Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study. BMC Womens Health. 2018;18(1):119.
Field, S., Onah, M., van Heyningen, T., & Honikman, S. (2018). Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study. BMC Women's Health, 18(1), 119. https://doi.org/10.1186/s12905-018-0612-2
Field S, et al. Domestic and Intimate Partner Violence Among Pregnant Women in a Low Resource Setting in South Africa: a Facility-based, Mixed Methods Study. BMC Womens Health. 2018 07 4;18(1):119. PubMed PMID: 29973182.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study. AU - Field,Sally, AU - Onah,Michael, AU - van Heyningen,Thandi, AU - Honikman,Simone, Y1 - 2018/07/04/ PY - 2016/11/21/received PY - 2018/06/22/accepted PY - 2018/7/6/entrez PY - 2018/7/6/pubmed PY - 2019/3/5/medline KW - Abuse KW - Antenatal KW - Domestic violence KW - Food insecurity KW - Intimate partner violence KW - Low-income setting KW - Mental disorders KW - Mixed methods KW - Pregnancy KW - South Africa SP - 119 EP - 119 JF - BMC women's health JO - BMC Womens Health VL - 18 IS - 1 N2 - BACKGROUND: Rates of violence against women are reported to be highest in Africa compared to other continents. We aimed to determine associations between mental illness, demographic, psychosocial and economic factors with experience of intimate partner violence (IPV) among pregnant women in a low resource setting in Cape Town and to explore the contextual elements pertaining to domestic violence. METHODS: We recruited adult women attending antenatal services at a primary-level maternity facility. Demographic, socioeconomic and psychosocial data were collected by questionnaire. The Expanded Mini- International Neuropsychiatric Interview (MINI) Version 5.0.0 was used to assess mental health status and the Revised Conflict Tactic Scale (CTS2) used to assess IPV in the six months prior to the study. Non-parametric tests, Wilcoxon sum of rank test, Fisher Exact and two sample T test and multicollinearity tests were performed. Descriptive, bivariate and logistic regression analyses were conducted to identify associations between the outcome of interest and key predictors. A probability value of p ≤ 0.05 was selected. From counselling case notes, a thematic content analysis was conducted to describe contextual factors pertaining to forms of domestic violence (DV). RESULTS: The prevalence of IPV was 15% of a sample of 376 women. Women who were food insecure, unemployed, in stable but unmarried relationships, had experienced any form of past abuse and were not pleased about the current pregnancy were more likely to experience IPV. MINI-defined mental health problems and a history of mental illness were significantly associated with IPV. Qualitative analysis of 95 counselling case notes revealed that DV within the household was not limited to intimate partners and, DV in this context was often perceived as 'normal' behaviour by the participants. CONCLUSIONS: This study contributes towards a greater understanding of the risk profile for IPV amongst pregnant women in low-income settings. Adversity, including food insecurity and mental ill-health are closely associated with IPV during the antenatal period. Advocates against violence against pregnant women are advised to consider that violence in the home may be perpetrated by non-intimate partners and may by enabled by a pervasive belief in the acceptability of the violence. SN - 1472-6874 UR - https://www.unboundmedicine.com/medline/citation/29973182/Domestic_and_intimate_partner_violence_among_pregnant_women_in_a_low_resource_setting_in_South_Africa:_a_facility_based_mixed_methods_study_ L2 - https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-018-0612-2 DB - PRIME DP - Unbound Medicine ER -