Prevalence and Health Outcomes of Domestic Violence Amongst Clinical Populations in Arab Countries: A Systematic Review and Meta-Analysis

Abstract

Background An estimated 30% of women worldwide experience intimate partner violence (IPV) during their lifetime. Exposure to IPV is associated with poor health outcomes. We conducted a systematic review and meta-analysis of prevalence and health outcomes of domestic violence (IPV or violence from an adult family member) in clinical populations in Arab countries. Methods Using terms related to domestic violence, Arab countries, and date limit ≥ year 2000, we searched seven databases: Medline, EMBASE, PsycINFO, CINAHL, Web of Science:core collection, IBSS, Westlaw, IMEMR. We included observational studies reporting estimates of prevalence or health outcomes of domestic violence amongst women aged ≥15 years, recruited while accessing healthcare in Arab countries. Data were summarised and meta-analysis performed where appropriate. PROSPERO - CRD42017071415 Findings 6341 papers were screened and 41 papers (29 studies) were included. Total of 19,101 participants. Pooled prevalence estimates of lifetime exposure to any IPV of 73·3%(95% CI 64·1-81·6), physical IPV 35·6%(95% CI 24·4-47·5), sexual IPV 22%(95% CI 13·3-32) and emotional/psychological IPV 49·8%(95% CI 37·3-62·3). Domestic violence exposure was associated with increased odds of adverse health outcomes: depression OR 3·3(95% CI 1·7-6·4), sleep problems OR 3·2(95% CI 1·5-6·8), abortion OR 3·5(95% CI 1·2-10·2), pain OR 2·6(95% CI 1·6-4·1) and hypertension OR 1·6(95% CI 1·2-2·0). Interpretation Domestic violence is common amongst women seeking healthcare in Arab countries and is associated with several poor health outcomes. Funding: CH: NIHR badged GPACF, Severn Deanery. AS and GF: HERA project, MRC grant MR/P025102/1 RH: Wellcome Trust, Institutional Strategic Support Fund and Elizabeth Blackwell Institute. Declaration of Interest: JU was lead author of one and co-author of another paper included in the review. Inclusion decisions for these papers were made by CH, HE and GF. For these two papers, quality assessment was performed by CH and GF with no input from JU. Ethical Approval: Ethics committee approval was not required for this work.