Abstract
Background: Adverse reproductive health outcome (unwanted pregnancy, abortion and/or still birth) are a major sexual and reproductive health problem worldwide. This study was done to assess the magnitude of adverse reproductive health outcomes and its correlates with gender-based violence.
Methods: A community-based cross-sectional study was conducted from January to June 2015 using the World Health Organization multi-country and Ethiopian Demography Health Survey (EDHS) questionnaire to measure adverse reproductive health outcome and violence against women. A multistage random sampling technique was used to select households from community. Trained data collectors interviewed 832 married women who were selected by systematic sampling technique in Debre Tabor, Northwest Ethiopia. Epi info version 6.0 for data entry and SPSS version 20 for analysis were used. Data were principally analyzed using binary logistic regression.
Results: Three hundred and eleven (37.4%) of women had experienced at least one type of adverse reproductive health outcomes in their life time, such as unwanted pregnancy (22.2%), abortion (16.8%) and still birth (5.8%). Gender-based violence (AOR=1.28; 95%CI:1.08-1.98), such as psychological violence (AOR=1.38:95% CI;1.05-2.29), physical violence (AOR=2.48; 95%CI:1.60-3.85) and sexual violence (AOR=1.31:95% CI:1.01-1.99) were factors associated with an increased risk of adverse reproductive health outcomes. Psychological violence (AOR= 1.94; 95%CI; 1.07-3.50), physical violence (AOR=1.88; 95%CI; 1.13-3.12) and sexual violence (AOR=1.84; 95%CI; 1.17-2.28) were factors associated with an increased risk of unwanted pregnancy. Physical violence (AOR=1.19; 95%CI; 1.12-2.83) and sexual violence (AOR=1.80; 95%CI; 1.11-2.93) were factors associated with an increased risk of abortion.while physical violence (AOR= 2.10; 95%CI; 1.86-5.11) was factor associated with an increased risk of still birth.
Conclusions: Adverse reproductive health outcome was a serious problem and gender-based violence led to significantly increased risk of adverse reproductive health outcomes among married women. Multifaceted interventions such as male counseling, increasing awareness on the consequences of Gender-Based Violence (GBV) will help to reduce adverse reproductive health outcomes.
Keywords: Adverse reproductive health outcome, unwanted pregnancy, abortion, still birth, Gender-Based Violence.
Résumé
Contexte: Les résultats adverses de santé reproductive (grossesse non désirée, avortement et / ou mortinatalité) sont l’un des principaux problèmes de santé sexuelle et reproductive dans le monde entier. Cette étude a été réalisée pour évaluer l’ampleur des effetsindésirablesde la santé reproductive et ses corrélats avec la violence basée sur le genre de sexe.
Méthodes: Une étude transversale communautaire a été menée de Janvier à Juin 2015 à l’aide duquestionnairemulti-pays de l’Organisation Mondiale de la Santé et l’EnquêteDémographiquede Santé Ethiopienne (EDSE) et pour mesurer les résultats défavorables de santé reproductrice et la violence contre les femmes. Une technique d’échantillonnage aléatoire à plusieurs-hiérarchies a été utilisée pour sélectionner les ménages de la communauté. Les collecteurs de données formés ont interrogés 832 femmes mariées qui ont été sélectionnés par la technique d’échantillonnage systématique à Debre Tabor, Nord-Ouest de l’Ethiopie. Le logiciel Epi-info version 6.0pour la saisie des données et le logiciel SPSS version 20 pour l’analyse, ont été utilisés. Les données ont été principalement analysées en utilisant la régression logistique binaire.
Résultats: Trois cent onze (37,4%) des femmes avaient une expérience d’au moins un type de résultats défavorables en matière de santé reproductrice dans leur durée de vie, telle que la grossesse non désirée (22,2%), l’avortement (16,8%) et la mortinatalité (5,8%). Les femmes qui ont connu la violence basée sur le genre de sexe(AOR = 1,28; IC à 95%: 1,08 - 1,98), la violence psychologique (AOR = 1,38: IC à 95%, de 1,05 - 2,29), la violence physique (AOR = 2,48; IC à 95%: 1.60- 3.85), la violence sexuelle (AOR = 1,31: IC à 95%: 1,01 - 1,99) étaient des facteurs associés à un risque accru d’effets indésirables sur la santé de la reproduction. La violence psychologique (AOR = 1,94; IC 95%; 1,07 - 3,50), la violence physique (AOR = 1,88; IC à 95%, de 1,13 à 3,12) et la violence sexuelle (AOR = 1,84; IC 95%; 1,17 - 2,28) étaient des facteurs associés avec un risque accru de grossesse non désirée. La violence physique (AOR = 1,19; IC 95%; 1,12 - 2,83), la violence sexuelle (AOR = 1,80; IC 95%; 1,11 - 2,93) étaient des facteurs associés à un risque accru d’avortement. La violence physique (AOR = 2,10; IC 95%; 1,86 - 5,11) était un facteur associé au risque accru de mortinatalité.
Conclusions: Le résultatadverse sur la santé reproductive était un problème sérieuxet la violence basée sur le genre de sexea conduit à une augmentation significative du risque des effets indésirables sur la santé de la reproduction chez les femmes mariées. Les interventions multidimensionnelles telles que les conseils de sexe masculin, la sensibilisation sur les conséquences de la violence basée sur le genre (VBG) contribueront à réduire les effets néfastes sur la santé de la reproduction.
Mots-clés: Résultatadverse sur la santé reproductive, grossesses non désirées, avortement, mortinatalité, Violence Basée sur le Genre.
Correspondence: Achenef Asmamaw Muche, Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia. E-mail: ashua2014@gmail.com
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