Consequences of gender-based violence on female high school students in eastern Ethiopia

Gender-based violence (GBV) is a significant global public health problem and adversely impacts the physical and mental health of women. This study aimed to determine the consequences of GBV (including sexual, physical, emotional, and overall GBV) on female high school students in eastern Ethiopia. An institutional-based cross-sectional survey was conducted among 1,199 female high school students in eastern Ethiopia using a self-administered questionnaire. Descriptive statistics were calculated. Chi-square tests were used to analyse the data. This study revealed that more than half (55%) of the study participants had experienced any type of GBV during their lifetime. There were statistically significant differences between the educational status and childhood residence of participants who experienced and participants who did not experience sexual violence, physical violence, emotional violence, and any type of GBV in their lifetime (p<0.001). Students who had experienced sexual violence during their lifetime reported consequences of physical health, including swelling around genitalia (33.7%), unusual vaginal discharge (30.7%), and injury around the genitalia (23.9%). Mental health consequences included self-blame (35.7%), and anxiety (23.3%). Educational consequences included poor school performance (36.1%), absenteeism (34.6%), and dropout (28.9%). Students who had experienced any type of GBV during their lifetime reported consequences of physical violence, including poor school performance (18.7%), and withdrawal from school (9.0%). The main perpetrators of any type of GBV were reported to be family members, students, or boyfriends/husbands. GBV is a severe public health problem among female high school students. Primary and secondary prevention is vital to curb the consequences of GBV.   La violence basée sur le genre (VBG) est un problème de santé publique mondial important et a un impact négatif sur la santé physique et mentale des femmes. Cette étude visait à déterminer les conséquences de la VBG (y compris sexuelle, physique, émotionnelle et globale) sur les lycéennes de l'est de l'Éthiopie. Une enquête transversale en milieu institutionnel a été menée auprès de 1 199 lycéennes dans l'est de l'Éthiopie à l'aide d'un questionnaire auto-administré. Des statistiques descriptives ont été calculées. Des tests du chi carré ont été utilisés pour analyser les données. Cette étude a révélé que plus de la moitié (55 %) des participants à l'étude avaient subi tout type de VBG au cours de leur vie. Il y avait des différences statistiquement significatives entre le statut scolaire et la résidence d'enfance des participants qui ont subi et des participants qui n'ont pas subi de violence sexuelle, de violence physique, de violence émotionnelle et de tout type de VBG au cours de leur vie (p<0,001). Les élèves qui ont subi des violences sexuelles au cours de leur vie ont signalé des conséquences sur leur santé physique, notamment un gonflement autour des organes génitaux (33,7 %), des pertes vaginales inhabituelles (30,7%) et des blessures autour des organes génitaux (23,9 %). Les conséquences sur la santé mentale comprenaient l'auto-accusation (35,7%) et l'anxiété (23,3 %). Les conséquences sur l'éducation comprenaient de mauvais résultats scolaires (36, %), l'absentéisme (34,6 %) et le décrochage (28,9 %). Les élèves qui ont subi tout type de VBG au cours de leur vie ont signalé les conséquences de la violence physique, notamment de mauvais résultats scolaires (18,7 %) et le retrait de l'école (9,0 %). Les principaux auteurs de tout type de VBG seraient des membres de la famille, des étudiants ou des petits amis/maris. La VBG est un grave problème de santé publique chez les lycéennes. La prévention primaire et secondaire est vitale pour freiner les conséquences de la VBG

Prevalence, antecedents and perceptions of efficacy of treatments of postnatal depression in Australia

Research Doctorate - Doctor of Philosophy (PhD)While new motherhood is socially perceived to be a time of great elation and joy, this life stage is also a time of great risk for mental health problems and emotional difficulties. For women, these problems can have long-term impacts including putting them at risk for ongoing mental health problems and dissatisfaction with motherhood. This in turn may reduce infant-mother bonding which can have impacts on the infant’s mental health and intelligence even into childhood. The most common form of mental health morbidity in the perinatal period is postnatal depression, affecting between 10-20% of mothers in Australia (National Health and Medical Research Council 2000). This thesis fills a gap in the current literature by examining both the proximal and distal factors related to postnatal depression in Australia by using longitudinal data collected on a national, broadly representative, sample of women. A longitudinal, multi-methods design was employed to examine the complex associations between risk factors and to also explore the lived experience of new mothers who have experienced postnatal depression. Prior history of mental health conditions were particularly evident as having a significant impact on risk of postnatal depression, as was long-term experience of stressful life events and lack of social support. In addition health and stressful life events in pregnancy and postpartum such as breastfeeding, emotional distress during labour and sleep deprivation had an impact on the occurrence of postnatal depression. The results indicated that understanding a woman’s mental health history is very important in the detection of those who are most vulnerable to postnatal depression. These findings also indicate that treatment and management of depression and anxiety earlier in life may have a positive impact on the incidence of postnatal depression. The findings of this project can direct future mental health clinical guidelines regarding postnatal depression and support the premise of early intervention for mental health problems. By preventing first incidences of mental health problems, recurrences such as those in the perinatal period should be reduced, which in turn will have a positive impact on mother-infant bonding, and on maternal health outcomes and infant outcomes

High rate of partner violence during pregnancy in eastern Ethiopia: Findings from a facility-based study.

INTRODUCTION:Intimate partner violence during pregnancy can contribute to maternal mortality and morbidity by limiting women's ability to receive maternal health services including antenatal care and skilled delivery care. In Ethiopia, evidence regarding intimate partner violence during pregnancy is limited, and no previous studies have been conducted in the Harari region. Therefore, this study aimed to investigate the prevalence and associated factors of intimate partner violence during pregnancy among women who had given birth in public hospitals in Harari regional state, eastern Ethiopia. METHODS:A hospital-based cross-sectional study was conducted from November 2018 to April 2019 among women who had given birth in public hospitals in Harari regional state, East Ethiopia. A systematic random sampling method was employed to select 648 participants. Data were collected using an interviewer-administered standardized questionnaire based on the World Health Organization Multi-Country Study on Women's Health and Domestic Violence against Women survey. Crude and adjusted odds ratios with respective confidence intervals were computed. Variables with a p-value of ≤0.05 were considered to have a significant association with intimate partner violence during pregnancy. RESULTS:The prevalence of intimate partner violence during the most recent pregnancy was found to be 39.81%. Furthermore, the prevalence of physical, emotional and sexual violence were found to be 25.93%, 25.62% and 3.7%, respectively. Longer duration of marriage (adjusted odds ratio = 1.68, 95% confidence interval = 1.01-2.79), most recent pregnancy being unplanned (adjusted odds ratio = 1.55, 95% confidence interval = 1.03-2.34), experiencing controlling behaviour by a partner, (adjusted odds ratio = 2.23, 95% confidence interval = 1.46-3.40) and having an attitude that justifies intimate partner violence (adjusted odds ratio = 1.60, 95% confidence interval = 1.09-2.36) were associated with experiencing intimate partner violence. CONCLUSION:The prevalence of intimate partner violence during pregnancy was found to be high. Pregnancy monitoring programs, which can detect and intervene with regard to partner's controlling behaviors and women's perception regarding justification of intimate partner violence, especially in those women with an unplanned pregnancy, could help to reduce intimate partner violence during pregnancy. Further, changing social norms that condone violence through advocacy and awareness creation might help in preventing partner violence

How do previous mental health, social support and stressful life events contribute to postnatal depression in a representative sample of Australian women?

Introduction: The purpose of this study was to examine the risk factors for postnatal depression (PND) using longitudinal data in a representative sample of Australian women

Quality, rigour and usefulness of free-text comments collected by a large population based longitudinal study - ALSWH

While it is common practice for health surveys to include an open-ended question asking for additional comments, the responses to these questions are often not analysed or used by researchers as data. The current project employed an automated semantic program to assess the useability and thematic content of the responses to an open-ended free response item included in the Australian Longitudinal Study on Women’s Health (ALSWH) surveys. The study examined the comments of three cohorts of women, born between 1973–78, 1946–51, and 1921–26, from Survey 1 (in 1996) and Survey 5 (in 2007–2009). Findings revealed important differences in the health status of responders compared to non-responders. Across all three cohorts, and at both time points, women who commented tended to have poorer physical health (except for women aged 82–87) and social functioning, experienced more life events, were less likely to be partnered, and (except for women aged 18–23 years) more likely to have higher levels of education, than women who did not comment. Results for mental health were mixed. The analysis revealed differences between cohorts as well as changes over time. The most common themes to emerge for the 1973–78 cohort were health, time, pregnant and work, for the 1946–51 cohort, the most common themes were health, life, time and work, while for the 1921–26 cohort, the most common themes were husband, health and family. The concepts and frequency of concepts changed from the first to the fifth survey. For women in the 1973–78 cohort, pregnant emerged as a prevalent theme, while eating disappeared. Among women in the 1946–51 cohort, cancer, operation and medication emerged as prevalent themes, while for women in the 1921–26 cohort, the concept children disappeared, while family emerged. This analysis suggests that free-text comments are a valuable data source, suitable for content, thematic and narrative analysis, particularly when collected over time

Gender-Based Violence Perpetration by Male High School Students in Eastern Ethiopia

Gender-based violence (GBV) perpetration is a global public health problem due to its detrimental effect on health and education. This study aims to determine the prevalence of gender-based violence perpetration by male students in eastern Ethiopia. A cross-sectional study was conducted in eastern Ethiopia in December 2018. A total of 1064 male students were involved in the study. Data were collected using an adaptation of the WHO Multi-Country Study self-administered questionnaire on the Women Health and Life Event. Descriptive statistics were calculated using STATA version 14. The prevalence of gender-based violence committed by a male in the last 12 months was 55.83% (95% CI: 52.84–58.82%). The prevalence of emotional abuse against an intimate or non-partner was 45.86% (95% CI: 42.87–48.86%), physical abuse was 45.77% (95% CI: 42.77–48.77%), and sexual abuse was 31.11% (95% CI: 28.32–33.90%). The perpetration of multiple types of gender-based violence (emotional, physical, and sexual) was 47.15% (95% CI: 43.15–51.25%), with 17.72% (95% CI: 14.75–21.03%) reporting emotionally and physically violent acts, 14.21% (95% CI: 11.51–17.27%) reporting emotionally violent acts only, and 12.88% (95% CI: 10.29–15.82%) reporting physically violent acts only. There were statistically significant differences between the age of participants who committed acts of all forms of GBV in the “ever” timeframe and the past 12 months (p < 0.001). Effective prevention and intervention strategies should be developed at the school level to reduce gender-based violence perpetration

Generating qualitative data by design: the Australian Longitudinal Study on Women's Health qualitative data collection.

Objectives and importance of study: The purpose of this study was to illustrate how qualitative free-text comments, collected within the context of a health survey, represent a rich data source for understanding specific phenomena. Study type: Work conducted with data from the Australian Longitudinal Study on Women’s Health (ALSWH) was used to demonstrate the breadth and depth of qualitative information that can be collected. The ALSWH has been collecting data on women’s health since 1996, and represents a unique opportunity for understanding lived experiences across the lifecourse. Methods: A multiple case study design was used to demonstrate the techniques that researchers have used to manage free-text qualitative comments collected by the ALSWH. Results and conclusions: Eleven projects conducted using free-text comments are discussed according to the method of analysis. These methods include coding (both inductively and deductively), longitudinal analyses and software-based analyses. This work shows that free-text comments are a data resource in their own right, and have the potential to provide rich and valuable information about a wide variety of topics

An actuarial investigation into maternal out-of-hospital cost risk factors for public patients

This paper adopts an actuarial approach to identify the risk factors of government-funded maternal out-of-hospital costs in Australia, with a focus on women who experience adverse birth outcomes. We use a two-phase modelling methodology incorporating both classification and regression trees and generalised linear models on a data set that links administrative and longitudinal survey data from a large sample of women, to address maternal out-of-hospital costs. We find that adverse births are a statistically significant risk factor of out-of-hospital costs in both the delivery and postnatal periods. Furthermore, other significant cost risk factors are in-vitro fertilisation, specialist use, general practitioner use, area of residence and mental health factors (including anxiety, intense anxiety, postnatal depression and stress about own health) and the results vary by perinatal sub-period and the patient’s private health insurance status. We highlight these differences and use the results as an evidence base to inform public policy. Mental health policy is identified as a priority area for further investigation due to the dominance of these factors in many of the fitted models.The authors are grateful to the Australian Government Department of Health for funding and to the women who provided the survey data