Academic journal article Journal of Health Population and Nutrition

Association between Intimate Partner Violence and Child Morbidity in South Asia

Academic journal article Journal of Health Population and Nutrition

Association between Intimate Partner Violence and Child Morbidity in South Asia

Article excerpt

Background

During the last decade several studies investigated the impact of intimate partner violence (IPV) on children's health. A recent study by World Health Organization (WHO) shows that the global prevalence of physical and/or sexual intimate partner violence among all ever-partnered women was 30.0 % [39]. The estimates of physical and sexual violence are substantially higher in the developing countries in general [12, 14, 25]. South Asia reports some of the highest rates of violence [17, 20, 30].

Evidence is available on negative consequences of IPV for women's health and well-being [6]. Several studies reported the link between IPV and women's mental health and depression [8, 28]. Some of the studies also highlighted an association between such violence and reproductive health outcomes like non-use of contraception, gynecological problems, unintended pregnancy and sexually transmitted infections including HIV/AIDS. These results suggest there may be direct or indirect impact of IPV on children as well.

Significant attention has also been dedicated to the potential negative role of IPV on the health and survival of infants. Some population based studies have reported considerable adverse effects of IPV upon gestational and birth outcomes [3]. This also contributes in part to the association between IPV and prematurity or low birth weight [31, 38].

Studies on the association between IPV and childhood mortality are much more limited. Most of such studies come from developed countries. Scanty literature on this topic in the developing world includes some studies from India and one study from Bangladesh. Several studies from north India suggested significant association between lifetime IPV and infant mortality risks [1, 2, 19, 23]. A population-based study from rural Bangladesh convincingly showed association between IPV and child mortality [5].

Studies in Bangladesh convincingly showed that children of women exposed to IPV have greater exposure to potentially dangerous conditions like diarrhea and Acute Respiratory Infection (ARI) [4, 36]. Impact of IPV on child nutrition has also been demonstrated by a few studies [3, 40].

The current study builds upon the existing literature and explores association between IPV and childhood morbidity expanding the study beyond a single country to include three neighboring countries in South Asia, i.e., Bangladesh, India and Nepal.

Methods

Study population and sampling procedure

The study uses three datasets [16]- Bangladesh Demographic and Health Survey (DHS) 2007, India National Family and Health Survey (NFHS) - 2005-06 and Nepal DHS 2011. Both DHS and NFHS are nationally-representative household surveys on population, health, and nutrition. These surveys employed a two stage sampling procedure with the first stage involving the selection of primary sampling units (PSUs); these were probability proportional to the size and represent the number of households within the PSU. The second stage used a systematic technique to sample households from each of the selected PSUs. The details of the methods and procedures used in data collection in DHS and NFHS surveys are provided in the respective DHS and NFHS reports [18, 27, 29]. Informed consent was obtained from the study participants. All these three surveys have similar modules on violence. These questions were administered to a sub-sample.

This secondary analysis includes a total of 40,394 women from India, Bangladesh and Nepal. The women selected for the violence module had at least one child under the age of 5 years during the survey. We included all the children under the age of 5 years in this sample. Therefore a total number of 58,725 children of these women were included in the study.

Ethical clearance and considerations

The original survey was administrated in accordance with the WHO ethical and safety guidelines for research on IPV. The institution review board of ICF Macro (formerly Macro International Inc. …

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