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Intimate partner violence and maternal health services utilization: evidence from 36 National Household Surveys.
BMC Public Health. 2021 02 25; 21(1):405.BP

Abstract

BACKGROUND

High rates of maternal mortality and intimate partner violence (IPV) are both major worldwide health challenges. Evidence from single-country samples suggests that IPV may be an important risk factor for low utilization of maternal health services, but there is little large-scale evidence on this association. This paper evaluates whether IPV is a risk factor for low utilization of maternal health services in a large cross-country sample, and also compiles evidence on the relative effects of different forms of IPV.

METHODS

We analyze the association between intimate partner violence and utilization of maternal health care, using a dataset compiling all Demographic and Health Surveys that report data on intimate partner violence. Using data on 166,685 women observed in 36 countries between 2005 and 2016, we estimate logistic regression models to analyze the relationship between lifetime experience of IPV and utilization of antenatal care (ANC), facility delivery care, and postnatal care. We estimate both unadjusted models and models adjusted for geographic and sociodemographic characteristics that are generally correlated with utilization of maternal health care (including age, education, number of children, wealth status, marital status, and urbanity).

RESULTS

Lifetime experience of any IPV is associated with decreased use of maternal health services in a broad sample of births observed in lower and middle-income countries: in particular, the utilization of four or more ANC visits, the number of ANC visits, and the utilization of facility care at birth. This association remains statistically significant even after adjusting for country of residence, subnational region of residence, and additional individual-level covariates; however, there is no statistically significant association between experience of any IPV and postnatal care. The only form of IPV significantly associated with care utilization is physical IPV.

CONCLUSIONS

Women experiencing physical intimate partner violence show lower levels of utilization of maternal health services in a large sample of developing and middle-income countries. Given that reduced utilization of maternal health services is correlated with maternal and neonatal health outcomes, this pattern suggests that IPV prevention may be an important component of interventions targeting enhanced maternal and neonatal health.

Authors+Show Affiliations

(IFPRI) Poverty, Health and Nutrition Division, 1201 Eye St., Washington, D.C, 20005, USA. j.leight@cgiar.org.Department of Economics, Reed College, 3203 SE Woodstock Blvd, Portland, OR, 97202, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33632170

Citation

Leight, Jessica, and Nicholas Wilson. "Intimate Partner Violence and Maternal Health Services Utilization: Evidence From 36 National Household Surveys." BMC Public Health, vol. 21, no. 1, 2021, p. 405.
Leight J, Wilson N. Intimate partner violence and maternal health services utilization: evidence from 36 National Household Surveys. BMC Public Health. 2021;21(1):405.
Leight, J., & Wilson, N. (2021). Intimate partner violence and maternal health services utilization: evidence from 36 National Household Surveys. BMC Public Health, 21(1), 405. https://doi.org/10.1186/s12889-021-10447-y
Leight J, Wilson N. Intimate Partner Violence and Maternal Health Services Utilization: Evidence From 36 National Household Surveys. BMC Public Health. 2021 02 25;21(1):405. PubMed PMID: 33632170.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intimate partner violence and maternal health services utilization: evidence from 36 National Household Surveys. AU - Leight,Jessica, AU - Wilson,Nicholas, Y1 - 2021/02/25/ PY - 2020/06/04/received PY - 2021/02/15/accepted PY - 2021/2/26/entrez PY - 2021/2/27/pubmed PY - 2021/5/21/medline KW - Antenatal care KW - Intimate partner violence KW - Maternal health KW - Postnatal care KW - Skilled delivery care SP - 405 EP - 405 JF - BMC public health JO - BMC Public Health VL - 21 IS - 1 N2 - BACKGROUND: High rates of maternal mortality and intimate partner violence (IPV) are both major worldwide health challenges. Evidence from single-country samples suggests that IPV may be an important risk factor for low utilization of maternal health services, but there is little large-scale evidence on this association. This paper evaluates whether IPV is a risk factor for low utilization of maternal health services in a large cross-country sample, and also compiles evidence on the relative effects of different forms of IPV. METHODS: We analyze the association between intimate partner violence and utilization of maternal health care, using a dataset compiling all Demographic and Health Surveys that report data on intimate partner violence. Using data on 166,685 women observed in 36 countries between 2005 and 2016, we estimate logistic regression models to analyze the relationship between lifetime experience of IPV and utilization of antenatal care (ANC), facility delivery care, and postnatal care. We estimate both unadjusted models and models adjusted for geographic and sociodemographic characteristics that are generally correlated with utilization of maternal health care (including age, education, number of children, wealth status, marital status, and urbanity). RESULTS: Lifetime experience of any IPV is associated with decreased use of maternal health services in a broad sample of births observed in lower and middle-income countries: in particular, the utilization of four or more ANC visits, the number of ANC visits, and the utilization of facility care at birth. This association remains statistically significant even after adjusting for country of residence, subnational region of residence, and additional individual-level covariates; however, there is no statistically significant association between experience of any IPV and postnatal care. The only form of IPV significantly associated with care utilization is physical IPV. CONCLUSIONS: Women experiencing physical intimate partner violence show lower levels of utilization of maternal health services in a large sample of developing and middle-income countries. Given that reduced utilization of maternal health services is correlated with maternal and neonatal health outcomes, this pattern suggests that IPV prevention may be an important component of interventions targeting enhanced maternal and neonatal health. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/33632170/Intimate_partner_violence_and_maternal_health_services_utilization:_evidence_from_36_National_Household_Surveys_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10447-y DB - PRIME DP - Unbound Medicine ER -