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Intimate partner violence against women in Ethiopia and its association with unintended pregnancy: a national cross-sectional survey

Abstract

Objectives

To investigate the association between intimate partner violence (IPV) and unintended pregnancy among women in Ethiopia.

Methods

A retrospective analysis of nationally representative data was conducted among 2969 married women of reproductive age (15–49 years). Logistic regression models were used to estimate the association of IPV with the outcome variable.

Results

Unintended pregnancy was reported by 26.5% of women. About 36% of participants reported having ever experienced IPV (a composite measure of physical, sexual, and emotional abuse) and 56% had experienced at least one act of partner controlling behaviour. After controlling for potential confounders, a significant association was observed between IPV and unintended pregnancy (AOR 1.39, 95% CI 1.05, 1.85) and between multiple acts of partner controlling behaviours and unintended pregnancy (AOR 1.57, 95% CI 1.16, 2.14).

Conclusions

In Ethiopia, which has a high fertility rate (4.6 children per woman) and low use of contraception (36%), IPV including partner controlling behaviour further contributes to the problem of unintended pregnancy. Reproductive health programs should be sensitive to the relational aspects of fertility control and incorporate IPV interventions into reproductive health services.

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Acknowledgements

We are grateful to the Central Statistical Agency of Ethiopia and Measure Demographic and Health Survey program, which allowed us to access and use the data freely. We are also thankful to the women who participated in the survey and shared their experiences. We thank the University of Newcastle, Australia, the Hunter Medical Research Institute, and the Priority Research Centre for Generational Health and Ageing for creating a quality research environment for us to accomplish this work.

Funding

This study is partially funded by the University of Newcastle, which has provided a scholarship for the student researcher (Tenaw Yimer Tiruye) and supported him in obtaining statistical support and training. Dr. Melissa Harris is funded by an Australian Research Council Discovery Early Career Research Award.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Tenaw Yimer Tiruye.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (National Research Ethics Review Committee (NRERC) of Ethiopia (Ref. No: 3.10/114/2016 and the University of Newcastle’s Human Research Ethics Committee (Ref. No: H-2018-0055)) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Prior to the original survey, informed consent was obtained from all individual participants included in the study. Prior to analysis, we have obtained permission from the Demographic and Health Survey program to access the de-identified secondary data.

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Publisher's Note

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Appendix

Appendix

The tool used to assess intimate partner violence in Ethiopian Demographic and Health Survey, 2016.

Women were asked whether or not they had experienced the following acts within their relationship, perpetrated by their husband/partner for currently married women and recent husband/partner for previously married women (CSA and ISF 2017):

  1. 1.

    Push you, shake you, or throw something at you?

  2. 2.

    Slap you?

  3. 3.

    Twist your arm or pull your hair?

  4. 4.

    Punch you with his/her fist or with something that could hurt you?

  5. 5.

    Kick you, drag you, or beat you up?

  6. 6.

    Try to choke you or burn you on purpose?

  7. 7.

    Threaten or attack you with a knife, gun, or any other weapon?

  8. 8.

    Physically force you to have sexual intercourse with him even when you did not want to?

  9. 9.

    Physically force you to perform any other sexual acts you did not want to?

  10. 10.

    Force you with threats or in any other way to perform sexual acts you did not want to?

  11. 11.

    Say or do something to humiliate you in front of others?

  12. 12.

    Threaten to hurt or harm you or someone close to you?

  13. 13.

    Insult you or make you feel bad about yourself?

Questions 1–7 measure physical spousal abuse, questions 8–10 measure sexual IPV, and questions 11–13 measure emotional IPV. Those women who were married more than once were also asked about spousal violence committed by any other husband/partner using the following two questions.

  1. (a)

    Did any previous (husband/partner) ever hit, slap, kick, or do anything else to hurt you physically?

  2. (b)

    Did any previous (husband/partner) physically force you to have intercourse or perform any other sexual acts against your will?

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Tiruye, T.Y., Harris, M.L., Chojenta, C. et al. Intimate partner violence against women in Ethiopia and its association with unintended pregnancy: a national cross-sectional survey. Int J Public Health 65, 1657–1667 (2020). https://doi.org/10.1007/s00038-020-01510-3

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  • DOI: https://doi.org/10.1007/s00038-020-01510-3

Keywords

  • Intimate partner violence
  • Partner controlling behaviour
  • Unintended pregnancy
  • Demographic and health survey
  • Ethiopia