Résumé
Women are at risk of violence at all stages of their life, including during pregnancy. Using a intervieweradministered questionnaire, 306 pregnant women were interviewed in two public secondary health facilities in Ibadan to compare prevalence and risk factors of VAW before and during pregnancy. Prevalence of VAW a year before current pregnancy was 41.5% compared to 17.7% during pregnancy. Perpetrators before pregnancy were mostly relatives (22%), while during pregnancy, partners (64%). Major reasons for violence were “not obeying instructions” (33.3%) and “misbehaving” (26%). Education (OR 0.49; 95%CI 0.29-0.83) and polygamous union (OR 9.56; 95%CI 3.71-24.63) and consumption of alcohol (OR 7.19; 95%CI 0.04- 0.53) were statistically significant a year before pregnancy. Mothers occupation (OR 0.19; 95%CI 1.05-4.49); type of union (OR14.13; 95%CI 6.13-32.59), alcohol consumption by partner (OR 6.06; 95%CI 0.05-0.54); and not wanting pregnancy (OR 3.53; 95%CI 1.20- 9.30) were statistically significant in the index pregnancy. Hemorrhage (7.4% vs. 4.8%), abortion (1.9% vs. 1.2%), intrauterine death (3.7% vs. 1.2%) and premature labour (9.3% vs. 3.2%) were more often found in women who experienced VAW than those who did not, the latter was statistically significant (P<0.05). Violence avoidance strategies included ‘playing along’ (51.3%) and ‘praying’ (21%). Pregnancy was protective against VAW. Empowerment of women through education and employment is crucial. Counselling on planning of families is also necessary. Screening for violence in pregnancy and close monitoring of the abused to ensure good obstetric outcome is recommended.
Keywords: Intimate partner violence, domestic violence, pregnancy, VAW, Africa.
Résumé
Les femmes sont exposées à des risque de violence a tous les étapes de leur vie, y compris pendant la grossesse. Utilisant un questionnaire d’interview, «- femmes enceintes étaient interviewées dans deux centres de santé public à Ibadan pour comparer la prévalence et les facteurs à risque de VAW avant et pendant la grossesse. La prévalence de VAW un an avant la grossesse était de 41.5 % comparée à 17.7% pendant la grossesse. Les femmes a risque de violence a tous les stages de leur vie, inclut pendant la grossesse. Trois cent six (306) femmes enceintes étaient interviewé dans deux centres se santé publique secondaires a Ibadan a comparer la prévalence et les facteurs a risque du VAW avant et après la grossesse. La prévalence du VAW l’année avant la grossesse courante était de 41.5% compare a 17.7% pendant la grossesse. Les coupables avant la grossesse étaient principalement des frères (22%), cependant durant la grossesse, les partenaires (64%). Les raisons majeurs de la violence étaient “non obéissance des instructions” (33.3%) et “mauvais comportements” (26%). Education (OR 0.49; 95% CI 0.29-0.83) et union polygame (OR 9.56; 95% CI 3.71-24.63) et consommation d’alcool (OR 7.19; 95%CI 0.04-0.53) étaient statistiquement significatif l’année avant la grossesse. L’occupation maternelle (OR 0.19; 95%CI 1.05-4.49); le type d’union (OR14.13; 95%CI 6.13- 32.59), La consommation alcoolique du partenaire (OR 6.06; 95%CI 0.05-0.54); et évitant la grossesse (OR 3.53; 95%CI 1.20- 9.30) étaient statistiquement significative dans l’indexe de la grossesse. L’hémorragie (7.4% vs. 4.8%), l’abortion (1.9% vs. 1.2%), le décès intra-utérine (3.7% vs. 1.2%) et le travail prématuré (9.3% vs. 3.2%) étaient plus retrouves chez les femmes qui expérimentées le VAW que ceux qui ne faisaient pas mais était statistiquement significatif (P<0.05). Les stratégies d’éviter la violence incluaient ‘jouant avec’ (51.3%) et ‘priant’ (21%). La grossesse était protective contre VAW. La promotion de la femme par l’éducation et l’emploi est cruciale. Le conseil sur le planning familial est aussi nécessaire, également, le dépistage de la violence en grossesse et un suivi proche des cas d’abus pour assurer un bon résultat obstétrique
Correspondence: Dr. Olufunmilayo I. Fawole, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: fawoleo@ymail.com
Références
World Health Organisation. “Violence against women: A priority health issue”. WHO, 1997 Geneva.
UNIFEM. “A world free of violence against women”. United Nations Inter Agency Global Video Conference. 1999 UNIFEM, New York.
World Health Organisation . World report on violence and health. WHO Geneva 2002.
UNICEF/FMOH: Children’s women’s rights in Nigeria. A wake-up call. UNICEF, 2001.
Womens reproductive Right in Nigeria: A shadow Report. The Centre for Reproductive Law and Policy 1998. New York.
Odujirin, O. Domestic violence among married women in Lagos. Intl J of Gynae and Obs.1993; 34, 1: 361 – 366.
Okemgbo, CN, Omideyi, AK and Odimegwu, CO. Prevalence, patterns and correlates of domestic violence in selected Igbo communities of Imo State, Nigeria. Afr. J. Rep. Hlth. 2002; 6: 101-114.
Ilika, AL, Okonkwo PI and Adogu P. Intimate Partner violence among women of child bearing age in Primary Health Centre in Nigeria. Afr. J. Rep. Hlth. 2002; 6, 3: 53 – 58.
Fawole OI, Ajuwon AJ, Osungbade KO, et al: Prevalence and nature of violence among young female hawkers in motor-parks in south-western Nigeria. Hlth Educ. 2002; 5: 102 -107.
Heise, L, More K and Toubia, N. Sexual coercion and women’s reproductive health. A focus on research. Population council, New York 1995:59.
Aimakhu CO, Olayemi O, Iwe CA, et al. Current causes and management of violence against women in Nigeria: J Obs. and Gynae. 2004; 24,1: 58-63.
Coker AL, Sanderson M and Donj B. Partner violence during pregnancy and risk of adverse pregnancy outcomes. Paed Perinat Epidemiol 2004; 18, 4: 260-269.
Amaro H, Fried LE, Cabral H et al. Violence during pregnancy and substance use. Am J Pub Hlth 1990; 80, 5: 575 – 579.
Curry MA, Perrin N and Wall E. Effects of abuse on maternal complications and birth weight in adult and adolescent women. Obs Gynae 1998; 92,41: 530 – 534.
Ganatra B, Coyaji KJ and Rao VN. Community cum hospital based case-control study on maternal mortality. Kem Hospital Research Centre, Pune, India. 1996; 62.
Fawole, OI, Ajuwon, AJ, Osungbade, KO et al. Interventions for violence prevention to young female hawkers in motor parks in south western Nigeria: A review of effectiveness. Afr J Rep Hlth 2002, 7, 1: 71-82.
Fawole OI, Ajuwon AJ, Osungbade KO. Evaluation of interventions to prevent violence against female apprentices in Nigeria. Hth Educ 2005; 105, 3, 186-203.
Heise L, Ellsberg M and Goheemoeller, M. Ending violence against women. Popn Rep Ser, 1999; 1:11.
Koening MA, Lutato T, Zhao F et al. Domestic Violence in rural Uganda: Evidence from a community-based study: Bulletin WHO 2003, 81:1.
Mclanky K, Kern DE, Kolodner K et al. The battering Syndrome: Prevalence and clinical characteristics of domestic violence in primary health care internal medicine practices. Ann Int Med 1995, 123, 10: 737 – 746
World Health Organisation. Putting women first: Ethical and safety recommendations for research on domestic violence against women. Department of Gender and Womens Health, Family and Community Health, WHO 2001.
Odimegwu CO. – Couple formation and domestic violence among the Tiv of Benue State Nigeria. Intl colloquium Gender, popn and dev in Africa, Abidjan 2001.
Hyginus EU and Arthur C. Domestic violence against Pregnant Nigerian women. Tropical J Obstet and Gynaecol, 2003, 20: 116-118.
Gelles R.J. Violence and pregnancy: a note on resident of the problems and need service Fam Cood 1997, 24: 81 – 86
Gazmararian, J.A. Adam. M and Saltzman E. The relationship between pregnancy intendedness and physical violence in mothers of newborns. Obst. Gynaecol. 1995 (85): 1031 – 1038.
Pak, I.I., Reece F.A., and Chan, I. Is adverse pregnancy outcome predictable after blunt? abdominal trauma? Am J Obs Gynae 1998, 179, 5: 1140 – 1144.
Schuler SR, Hashemi SM, Riley AP and Akhter S. Credit programs, patriarchy and men’s violence against women in rural Bangladesh. Soc Sci Med 1996; 43:1729–1742.
Rao V. Wife–beating in rural South India: a qualitative and econometric analysis. Soc. Sci. Med 1997; 44: 1169–1180.
Jewkes R, Levin J and Penn–Kekana L. Risk factors for domestic violence: findings from a South African cross–sectional study. Soc. Sci Med 2002; 55: 603–170.
Jejeebhoy SJ. Wife–beating in rural India: a husband’s right? Evidence from survey data. Econ Pol Wkly 1998; 33:855–862.
Temple JR, Weston R, Stuart GL and Marshall LL. The longitudinal association between alcohol use and intimate partner violence among ethnically diverse community women. PLos Medicine 2008 ;33,9:1244-1248.
Fossos N, Neighbors C, Kaysen D and Hove MC. Intimate partner violence perpetration and problem drinking among college students: The roles of expectancies and subjective evaluations of alcohol aggression. J Stud Alc Drugs 2007; 68, 5:706-713.
Stickley A, Timofeeva I and Sparén P. Risk factors for intimate partner violence against women in St. Petersburg, Russia. VAW 2008; 14, 4:483-495.
Intimate partner violence by men abusing and non-abusing alcohol in Poland. Int J Environ Res Public Health. 2007, 4,1:76-80
Campbell JC. Health consequences of intimate partner violence. The lancet 2002; 359, 9314: 1331-1336.