Abstract
Intimate partner violence (IPV) continues to be a major public health problem globally. Although Ethiopia has a high prevalence of IPV, previous studies in this country have only investigated individual-level determinants of IPV within small geographic areas. The current study aimed to identify the individual-, relationship-, community-, and societal-level determinants of IPV directed against women in Ethiopia since women are predominantly affected. A retrospective analysis of nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS) was conducted. A sample of 3,897 married women of reproductive age (15-49 years) who participated in the domestic violence module of the survey were included in the analysis. Three-level mixed-effects multilevel logistic regression models were used to estimate the individual-, relationship-, community-, and societal-level determinants of IPV. Variability at the community- and societal-level were also assessed. About 1,328 (34.1%) of 3,897 participants reported experiencing IPV (a composite measure of physical, sexual and emotional abuse). In adjusted models, the odds of lifetime IPV experience were higher among women who were older, were married before the age of 18 years, witnessed inter-parental violence during their childhood, had a partner who drank alcohol, and lived in a community with high IPV accepting norms. Alternatively, the odds of IPV were lower among women who had decision-making autonomy in the household, had the same or lower educational attainment as their partner, and lived in a community with low proportions of educated women. These findings reveal that although individual-level factors were significant determinants of IPV, higher level factors, including female education and IPV acceptance in the community, were also important influences on this major public health issue in Ethiopia. These findings suggest combined interventions at different levels may reduce IPV in this country.
Highlights
Intimate partner violence (IPV) is a ‘health hazard’ [1] that continues to be a global public health problem with higher prevalences in low-income countries [1, 2]
Regarding community- and region-level characteristics, the majority of respondents were living in a community with rural residence (83.8%), high early marriage (52.1%), low female literacy (53.5%), low women’s autonomy (54.9%), and high IPV accepting norms (52.0%) and in societies with high Multi-dimensional Poverty Index (MPI) (66.3%) and low Gender Empowerment Index (GEI) (86.6%) (Table 3)
The results showed that higher age, early age at first marriage, witnessing inter-parental violence during childhood, an IPV accepting attitude, higher educational attainment, and having a partner who drank alcohol were positively associated with IPV, while having decision-making autonomy was negatively associated with IPV
Summary
Intimate partner violence (IPV) is a ‘health hazard’ [1] that continues to be a global public health problem with higher prevalences in low-income countries [1, 2]. Ethiopia is one African country with a high prevalence of IPV, where the lifetime prevalence has been estimated at 20% to 78% in different areas [6]. The consequences are underexamined in this country, some existing evidence shows its potential for producing severe physical, emotional, and reproductive health problems [7,8,9,10]. As there are no IPV interventions in the country, comprehensive IPV intervention strategies are needed This requires an understanding of the factors that are associated with IPV
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