Abstract
BackgroundDomestic violence (DV) during pregnancy is recognized as a global health problem associated with serious health consequences for both the mother and her baby. Several interventions aimed at addressing DV around the time of pregnancy have been developed in the last decade, but they are primarily from developed countries. Low- and middle-income countries (LMICs) are facing both a mounting burden of DV as well as severe resource constraints that keep them from emulating some of the effective interventions implemented in developed settings. A systematic review was conducted to examine the approaches and effects of interventions designed for reducing or controlling DV among pregnant women in LMICs.MethodsElectronic databases were systematically searched, and the search was augmented by bibliographic reviews and expert consultations. Two reviewers assessed eligibility and quality of the studies and extracted data independently. The third reviewer was involved to resolve any discrepancies between the reviewers. Due to the limited number of studies and varied outcomes, a meta-analysis was not possible. Primary outcomes of this review included frequency and/or severity of DV and secondary outcomes included mental health, safety behaviours, and use of community resources. In addition, findings from the critical appraisal of studies were utilised to inform the initial draft of Theory of Change (ToC).ResultsOnly five studies (two randomized trials and three non-randomized trials) met the eligibility criteria. The interventions consisting of supportive counselling demonstrated a reduction in DV and an improvement in use of safety behaviours. One study has embedded the DV intervention into an existing program on human immunodeficiency virus (HIV). Limited evidence could be drawn for outcomes such as quality of life and the use of community resources.DiscussionThis review attempted to address the knowledge gap by collating evidence on interventions aimed at addressing DV among pregnant women in LMICs. The development of a ToC was critical in understanding how certain activities led to the desired outcomes. This ToC can guide the design of future research and development of practice guidelines. The participatory involvement of the stakeholders is recommended to refine the current ToC to support its further development for practice.Systematic review registrationPROSPERO, CRD42017073938
Highlights
Domestic violence (DV) during pregnancy is recognized as a global health problem associated with serious health consequences for both the mother and her baby
The use of the term domestic violence is based on the understanding that many women from these countries live within an extended family setting and in some instances, it is the family members who are the perpetrators of DV [4, 6]
This review indicated that the interventions addressing DV are just beginning to emerge in developing countries
Summary
Domestic violence (DV) during pregnancy is recognized as a global health problem associated with serious health consequences for both the mother and her baby. Low- and middle-income countries (LMICs) are facing both a mounting burden of DV as well as severe resource constraints that keep them from emulating some of the effective interventions implemented in developed settings. A number of studies from low- and middle-income countries (LMICs) most commonly use the term DV as opposed to the term IPV [3,4,5]. The use of the term domestic violence is based on the understanding that many women from these countries live within an extended family setting and in some instances, it is the family members who are the perpetrators of DV [4, 6]. The term domestic violence (DV) has been used in this particular review to denote any forms of violence and abuse perpetrated against woman by someone in her family [5, 7]
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