A psychosocial intervention to reduce gender-based violence and antepartum depressive symptoms in pregnant women in Kisumu County, Kenya: a quasi-experimental study

Redempta Kalekye Mutisya,Kenneth Ngure,Christina Mwachari

doi:10.11604/pamj.2018.29.11.13596

Redempta Kalekye Mutisya, Kenneth Ngure + Show 1 more

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https://doi.org/10.11604/pamj.2018.29.11.13596

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Abstract

IntroductionGender-based violence during pregnancy and its associated adverse health effects are disproportionately higher in developing countries like Kenya where screening for and management of gender-based violence is currently not part of routine antenatal care. This study assessed the effect of a psychosocial intervention on gender-based violence and antepartum depressive symptoms in pregnant women.MethodsThis quasi-experimental study compared gender-based violence and antepartum depression scores of 288 pregnant women in the two arms; one exposed to a psychosocial intervention and another receiving usual antenatal care. We used analysis of covariance to estimate the intervention effect and Chi-square to test the equality of proportions.ResultsThe difference between the psychosocial intervention and the usual antenatal care group in the total intimate partner violence and physical violence scores was a significant, with small effect sizes of partial eta = 0.196 and 0.305 respectively. The two arms did not differ in terms of the proportion of women reporting other acts of gender-based violence by intimate and non-intimate partners post-intervention. The intervention group had significantly lower mean depression scores compared to the usual care group, post-intervention, with a medium effect size of 0.500.ConclusionThis intervention aimed at reduction of gender-based violence and improvement of mental health of pregnant women is promising. Primary health care facilities in resource-constrained settings can take advantage of local capacity to deliver focused non-specialized psychosocial support to pregnant women experiencing violence.

Highlights

Gender-based violence during pregnancy and its associated adverse health effects are disproportionately higher in developing countries like Kenya where screening for and management of gender-based violence is currently not part of routine antenatal care
Three (3) women requested for referral and two (2) others were lost to follow-up after completing the baseline
We found no significant difference in the proportion of women reporting physical violence by a non-intimate partner in both groups post-intervention despite finding the intervention effective in lowering physical violence from an intimate partner

Summary

Introduction

Gender-based violence during pregnancy and its associated adverse health effects are disproportionately higher in developing countries like Kenya where screening for and management of gender-based violence is currently not part of routine antenatal care. Gender-based violence (GBV) in this study referred to a selfreported experience of one or more acts of physical, sexual, psychological and economic violence by intimate partners, family members or any other persons (non-partner violence) in the 12 months preceding the pregnancy and during the current pregnancy. Such violence is pervasive and a systemic public health problem affecting women of all socio-economic and cultural groups throughout the world at a high cost to the individual and society [1]. Depression during pregnancy has been associated with gestational hypertension and subsequent preeclampsia [12, 13], spontaneous abortion [14] and bleeding during gestation [15]

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