Mental and Physical Health and Intimate Partner Violence against Women: A Review of the Literature

Associations between intimate partner violence (IPV) and poor physical and mental health of women have been demonstrated in the international and national literature across numerous studies. This paper presents a review of the literature on this topic. The 75 papers included in this review cover both original research studies and those which undertook secondary analyses of primary data sources. The reviewed research papers published from 2006 to 2012 include quantitative and qualitative studies from Western and developing countries. The results show that while there is variation in prevalence of IPV across various cultural settings, IPV was associated with a range of mental health issues including depression, PTSD, anxiety, self-harm, and sleep disorders. In most studies, these effects were observed using validated measurement tools. IPV was also found to be associated with poor physical health including poor functional health, somatic disorders, chronic disorders and chronic pain, gynaecological problems, and increased risk of STIs. An increased risk of HIV was reported to be associated with a history of sexual abuse and violence. The implications of the study findings in relation to methodological issues, clinical significance, and future research direction are discussed

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

A population-level data linkage study to explore the association between health facility level factors and unintended pregnancy in Bangladesh

The objective of this study was to investigate the effects of health facility-level factors, including the availability of long-acting modern contraceptives (LAMC) at the nearest health facility and its distance from women’s homes, on the occurrence of unintended pregnancy that resulted in a live birth. We analysed the 2017/18 Bangladesh Demographic and Health Survey data linked with the 2017 Bangladesh Health Facility Survey. The weighted sample comprised 5051 women of reproductive age, who had at least one live birth within 3 years of the survey. The outcome variable was women’s intention to conceive at their most recent pregnancy that ended with a live birth. The major explanatory variables were the health facility level factors. A multi-level multinomial logistic regression model was used to assess the association of the outcome variable with explanatory variables adjusting for individual, household, and community-level factors. Nearly 21% of the total respondents reported that their most recent live birth was unintended at conception. Better health facility management systems and health facility infrastructure were found to be 14–30% protective of unintended pregnancy that resulted in a live birth. LAMC availability at the nearest health facility was associated with a 31% reduction (95% CI 0.50–0.92) in the likelihood of an unwanted pregnancy that resulted in a live birth. Health facility readiness to provide LAMC was also associated with a 14–16% reduction in unintended pregnancies that ended with a birth. The likelihood of unintended pregnancy that resulted in a live birth increased around 20–22% with the increased distance of the nearest health facility providing LAMC from the women’s homes.The availability of health facilities near women’s homes and access to LAMC can significantly reduce unintended pregnancy. Policies and programs to ensure access and affordability of LAMC across current health facilities and to increase the number of health facilities are recommended

Rurality and Self-Reported Health in Women with a History of Intimate Partner Violence

Objective To investigate differences in self-reported health among Australian women with a history of intimate partner violence (IPV) in relation to rurality of residence. Methods Data were drawn from six survey waves of the Australian Longitudinal Study on Women's Health 1973–78 birth cohort. Self-reported general and mental health scores derived from the SF-36 scale were compared for women with a history of IPV living in metropolitan, regional and rural areas. Multivariable generalised estimating equations were constructed adjusting for income hardship, number of children, education, social support, age and marital status. Results Women with a history of IPV living in regional and rural areas had no significant differences in self-reported general health scores compared to their metropolitan counterparts. Rural women affected by IPV had slightly better self-reported mental health than equivalent women living in metropolitan or regional areas. The socio-demographic factors with the strongest association with self-reported health were income, education, social support, and number of children. Conclusions Women in regional and rural areas were no more disadvantaged, in terms of self-reported general health or mental health, than IPV affected women living in major cities in Australia

Mental and Physical Health and Intimate Partner Violence against Women: A Review of the Literature

Associations between intimate partner violence (IPV) and poor physical and mental health of women have been demonstrated in the international and national literature across numerous studies. This paper presents a review of the literature on this topic. The 75 papers included in this review cover both original research studies and those which undertook secondary analyses of primary data sources. The reviewed research papers published from 2006 to 2012 include quantitative and qualitative studies from Western and developing countries. The results show that while there is variation in prevalence of IPV across various cultural settings, IPV was associated with a range of mental health issues including depression, PTSD, anxiety, self-harm, and sleep disorders. In most studies, these effects were observed using validated measurement tools. IPV was also found to be associated with poor physical health including poor functional health, somatic disorders, chronic disorders and chronic pain, gynaecological problems, and increased risk of STIs. An increased risk of HIV was reported to be associated with a history of sexual abuse and violence. The implications of the study findings in relation to methodological issues, clinical significance, and future research direction are discussed

Policy briefs from the Australian Longitudinal Study on Women’s Health: report prepared for the Australian Government Department of Health and Ageing

This major report, a key deliverable of the Australian Longitudinal Study on Women's Health (ALSWH) to the Australian Government Department of Health, contains 10 policy briefs which overview evidence on mental health, violence and abuse, sexual health, reproductive health, pregnancy and maternal health, weight and weight gain, nutrition, physical activity and sedentary behaviour, chronic conditions and housing and care for older women

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

Use, access to, and impact of Medicare services for Australian women: findings from the Australian Longitudinal Study on Women’s Health

This major report from the Australian Longitudinal Study on Women’s Health (also known as Women’s Health Australia) adopts a life course approach to investigate changes in women’s health and health service use change across life stages. Women’s survey data were linked to Medicare Benefits Scheme (MBS) data, enabling analysis of women’s health, health behaviours and social circumstances over time, and how these relate to health care use at different life stages. Using these data, the report provides detailed information on how and when women use health services, and their costs, throughout the women’s life course