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

Miscarriage, Preterm Delivery, and Stillbirth: Large Variations in Rates within a Cohort of Australian Women

Objectives We aimed to use simple clinical questions to group women and provide their specific rates of miscarriage, preterm delivery, and stillbirth for reference. Further, our purpose was to describe who has experienced particularly low or high rates of each event. Methods Data were collected as part of the Australian Longitudinal Study on Women's Health, a national prospective cohort. Reproductive histories were obtained from 5806 women aged 31–36 years in 2009, who had self-reported an outcome for one or more pregnancy. Age at first birth, number of live births, smoking status, fertility problems, use of in vitro fertilisation (IVF), education and physical activity were the variables that best separated women into groups for calculating the rates of miscarriage, preterm delivery, and stillbirth. Results Women reported 10,247 live births, 2544 miscarriages, 1113 preterm deliveries, and 113 stillbirths. Miscarriage was correlated with stillbirth (r = 0.09, P<0.001). The calculable rate of miscarriage ranged from 11.3 to 86.5 miscarriages per 100 live births. Women who had high rates of miscarriage typically had fewer live births, were more likely to smoke and were more likely to have tried unsuccessfully to conceive for ≥12 months. The highest proportion of live preterm delivery (32.2%) occurred in women who had one live birth, had tried unsuccessfully to conceive for ≥12 months, had used IVF, and had 12 years education or equivalent. Women aged 14–19.99 years at their first birth and reported low physical activity had 38.9 stillbirths per 1000 live births, compared to the lowest rate at 5.5 per 1000 live births. Conclusion Different groups of women experience vastly different rates of each adverse pregnancy event. We have used simple questions and established reference data that will stratify women into low- and high-rate groups, which may be useful in counselling those who have experienced miscarriage, preterm delivery, or stillbirth, plus women with fertility intent

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&ndash;58.82%). The prevalence of emotional abuse against an intimate or non-partner was 45.86% (95% CI: 42.87&ndash;48.86%), physical abuse was 45.77% (95% CI: 42.77&ndash;48.77%), and sexual abuse was 31.11% (95% CI: 28.32&ndash;33.90%). The perpetration of multiple types of gender-based violence (emotional, physical, and sexual) was 47.15% (95% CI: 43.15&ndash;51.25%), with 17.72% (95% CI: 14.75&ndash;21.03%) reporting emotionally and physically violent acts, 14.21% (95% CI: 11.51&ndash;17.27%) reporting emotionally violent acts only, and 12.88% (95% CI: 10.29&ndash;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 &ldquo;ever&rdquo; timeframe and the past 12 months (p &lt; 0.001). Effective prevention and intervention strategies should be developed at the school level to reduce gender-based violence perpetration

Mortality and disability outcomes of self-reported elder abuse: a 12-year prospective investigation

Objectives: To determine whether elder abuse can predict mortality and disability over the ensuing 12 years. Design: Population-based prospective cohort study of women aged 70 to 75 in 1996; survival analysis. Setting: Australia. Participants: Twelve thousand sixty-six women with complete data on elder abuse. Measurements: Elder abuse was assessed using the 12-item Vulnerability to Abuse Screening Scale (VASS) subscales: vulnerability, coercion, dependence, and dejection. Outcomes were death and disability (defined as an affirmative response to “Do you regularly need help with daily tasks because of long-term illness, disability or frailty?”). Results: In 1996, 8% reported vulnerability, 6% coercion, 18% dependence, and 22% dejection. By October 2008, 3,488 (29%) had died. Mortality was associated with coercion (hazard ratio (HR) = 1.21, 95% confidence interval (CI) = 1.06–1.40) and dejection (HR = 1.12, 95% CI = 1.03–1.23), after controlling for demographic characteristics, social support, and health behavior but not after adding chronic conditions to the coercion model. Over the 12 years, 2,158 of 11,027 women who had reported no disability in 1996 reported disability. Women who reported vulnerability (HR = 1.25, 95% CI = 1.06–1.49) or dejection (HR = 1.55, 95% CI = 1.38–1.73) were at greater risk of disability, after controlling for demographic characteristics, social support, and health behavior. The relationship remained significant for dejection when chronic conditions and mental health were included in the model (HR = 1.40, 95% CI = 1.24–1.58). Conclusion: Specific components of vulnerability to elder abuse were differently associated with rates of disability and mortality over the ensuing 12 years

Costs of medicines and health care: a concern for Australian women across the ages

Background: Evidence from Australia and other countries suggests that some individuals struggle to meet the costs of their health care, including medicines, despite the presence of Government subsidies for low-income earners. The aim of our study was to elucidate women’s experiences with the day to day expenses that relate to medicines and their health care. Methods: The Australian Longitudinal Study on Women’s Health (ALSWH) conducts regular surveys of women in three age cohorts (born 1973–78, 1946–51, and 1921–26). Our data were obtained from free text comments included in surveys 1 to 5 for each cohort. All comments were scanned for mentions of attitudes, beliefs and behaviours around the costs of medicines and health care. Relevant comments were coded by category and themes identified. Results: Over 150,000 responses were received to the surveys, and 42,305 (27%) of these responses included free-text comments; 379 were relevant to medicines and health care costs (from 319 individuals). Three broad themes were identified: costs of medicines (33% of relevant comments), doctor visits (49%), and complementary medicines (13%). Age-specific issues with medicine costs included contraceptive medicines (1973–78 cohort), hormone replacement therapy (1946–51 cohort) and osteoporosis medications (1921–26 cohort). Concerns about doctor visits mostly related to reduced (or no) access to bulk-billed medical services, where there are no out-of pocket costs to the patient, and costs of specialist services. Some women in the 1973–78 and 1946–51 cohorts reported ‘too much income’ to qualify for government health benefits, but not enough to pay for visits to the doctor. In some cases, care and medicines were avoided because of the costs. Personal feelings of embarrassment over financial positions and judgments about bulk-billing practices (‘good ones don’t bulk-bill’) were barriers to service use, as were travel expenses for rural women. Conclusions: For some individuals, difficulty in accessing bulk-billing services and increasing out-of-pocket costs in Australia limit affordability of health services, including medications. At greatest risk may be those falling below thresholds for subsidised care such as self-funded retirees and those on low-middle incomes, in addition to those on very low incomes, who may find even small co-payments difficult to manage

Understanding women who self-harm : predictors and long-term outcomes in a longitudinal community sample

Objective: There is growing awareness of the range of psychosocial, lifestyle, and sociodemographic factors related to self-harm, however this research is often limited by using cross-sectional or convenience samples. And while we generally assume that young adults who self-harm experience poorer long-term outcomes, longitudinal research is needed. This paper builds on prior research using a large, representative, longitudinal sample. Methods: 5765 Australian women completed 5 surveys (age 18–23 to 31–36). Six-month self-harm was measured by self-report. We had two aims: firstly to predict future self-harm, separately for women with and without prior self-harm. Secondly, to identify outcomes 3 and 6 years following self-harm. Results: Six-month self-harm prevalence was 2.5%. Predictors among women without recent self-harm included depression, dieting behaviours, number of male sexual partners, and abuse. Among women with recent or current self-harm, predictors were number of dieting behaviours, tiredness of life, and stress. Women who self-harmed reported poorer outcomes, namely greater difficulties in relationships at 3- and 6-year follow-up. Conclusions: Longitudinal risk factors for self-harm differed depending on prior self-harm status, and included depression, dieting behaviours, tiredness of life and stress. These factors may serve as warning signs for new or continued self-harm. This study offers new insight into long-term outcomes up to six years after self-harm, particularly with relationships.10 page(s

How rates of perinatal mental health screening in Australia have changed over time and which women are missing out

Objectives: To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally and postnatally more recently (2013–2017). Methods: A longitudinal community-based study of self-reported perinatal mental health screening with a national sample of 7,566 mothers from the Australian Longitudinal Study on Women\u27s Health reporting on 9,384 children. The main outcome measure was whether mothers were asked about their emotional wellbeing by a health professional, including completing a questionnaire. Results: From 2000 to 2017, the percentage of women not screened decreased from 40.6% to 1.7%. The percentage of women screened both antenatally and postnatally increased from 21.3% to 79.3%. From 2013 to 2017, women who were older (aOR, 0.65; 95%CI, 0.52–0.81) or had reported emotional distress (aOR, 0.77; 95%CI, 0.60–0.99) were less likely to have been screened both antenatally and postnatally. Conclusions: Despite improvements, perinatal mental health screening is not yet universal. One-in-five women are not screened both antenatally and postnatally, including women in high-risk populations such as those who have reported emotional distress. Implications for public health: Women are in regular contact with health professionals in the perinatal period. This opportunity to detect women at risk of perinatal mental health issues is too important to be missed