2 research outputs found
A meta-analysis of the association between intimate partner violence and age disparity in sub-Saharan Africa
Thesis (MSc)--Stellenbosch University, 2017ENGLISH ABSTRACT : Intimate partner violence (IPV) is the most common form of violence against women
and a worldwide human rights and public health problem. IPV against women can be
emotional, physical, and sexual in nature. The current body of research has identified
multiple risk factors for IPV including age disparity between women and their partners.
Studies that have looked at age disparity as a risk factor of IPV show conflicting
results. We conducted a meta-analysis to examine the association between IPV against
women experienced within 12 months before the survey and age disparity using survey
data from Demographic and Health Surveys (DHS) collected in 21 sub-Saharan African
countries. Two-stage sample weights were proportionally used to represent the different
countries. The age disparity was divided into two groups: relationships where the age
difference (age of the male partner minus age of the woman) was less than five years
and those where the age difference was five or more years. Three generalized linear
models were used to estimate relative risk (RR) of the association between IPV and age
disparity. These models were: modified Poisson regression, logistic regression model
where RR was estimated from odds ratio, and log-binomial model. Modified Poisson
regression proved to be a better model after comparing the three models using DHS
data. The RR from modified Poisson regression model were pooled in a meta-analysis.
A random-effects model was used in the meta-analyses. We found that weighted relative
risk averages (WRRAs) from the meta-analysis were less than 1, and significant at alpha = 0.05 level for less severe and severe physical violence, which suggest that
having an older partner has a protective effect against physical IPV. This study also indicates
high country heterogeneity. For instance, results from Burkina Faso, and Sierra
Leone indicated that having an older partner is protective against emotional and less severe
IPV, while the results show that having an older partner puts a woman at a higher
risk of experiencing emotional and less severe IPV in Kenya. We also calculated the
prevalence of IPV against women and found that there is high prevalence of IPV against
women in sub-Saharan Africa. In conclusion, this study shows an association between
IPV and age disparity but the association is country dependent. We speculate that heterogeneities
in underlying socio-cultural and economic histories and current realities
explain dependence. Therefore, IPV prevention programmes should be country dependent
when considering age disparity as a risk factor for IPV.AFRIKAANSE OPSOMMING : Intieme lewensmaat geweld (IPV in Engels) is een van die mees algemene vorme van
geweld teenoor vroue en is wêreldwyd ‘n menseregte- en openbare gesondheidsprobleem.
IPV teenoor vroue kan emosioneel, fisies en seksueel van aard wees. Die huidige
navorsingsliggaam het risikofaktore vir IPV geïdentifiseer, insluitende ouderdomsongelykheid
tussen paartjies. Studies wat ouderdomsongelykheid as risikofaktor ondersoek
het, toon teenstrydige resultate. In hierdie studie is ‘n meta-analise gedoen om die verband
tussen IPV teenoor vroue in die 12 maande voor die opname en die ouderdomsverskille
tussen paartjies te bepaal, met behulp van die Demografiese en Gesondheidsopname
(DHS in Engels) in 21 sub-Sahara lande. Twee-stadium steekproefgewigte was
proporsioneel gebruik om die verskillende lande te verteenwoordig. Ouderdomsongelykheid
is in twee groepe verdeel: verhoudings met ouderdomverskille (ouderdom van
manlike metgesel minus ouderdom van die vrou) minder as vyf jaar en ouderdomsverskille
van vyf en meer jare. Drie veralgemeende lineêre modelle is gebruik om relatiewe
risiko (RR) van die verband tussen IPV en ouderdomsverskil te beraam. Hierdie modelle
was: gewysigde Poisson regressie, logistieke regressie model waar RR benader is
deur die odds verhouding, en log-binomiaal model. Gewysigde Poisson-regressie was ‘n beter model nadat die drie modelle met behulp van DHS data vergelyk is. Die RR van
gewysigde Poisson regressiemodel is in ‘n meta-analise saamgevoeg. ‘n Ewekansigeeffekmodel
is in die meta-analises gebruik. Ons het gevind dat die geweegde relatiewe
risiko gemiddeldes (WRRAs in Engels) van die meta-analise minder as 1 was, en betekenisvol
by ‘n alfa = 0,05 vlak vir minder ernstige en ernstige fisiese geweld, wat aandui
dat ouer metgeselle ‘n beskermende effek teen fisiese IPV het. Hierdie studie dui ook op
hoë heterogeniteit tussen verskillende lande. Byvoorbeeld, resultate van Burkina Faso
en Sierra Leone het aangedui dat ‘n ouer lewensmaat beskermend is teen emosionele
en minder ernstige IPV, terwyl die resultate toon dat ‘n ouer lewensmaat dui op ‘n hoër
risiko vir emosionele en minder ernstige IPV in Kenia. Ons het ook die voorkoms van
IPV teen vroue beraam en het gevind dat daar ‘n hoë voorkoms van IPV teen vroue
in sub-Sahara Afrika is. Ten slotte toon hierdie studie ‘n verband tussen IPV en ouderdomsverskil,
maar die sterkte van die verband is afhanklik van die land. Daar word dus
gespekuleer dat die heterogeniteit onderliggend aan die sosio-kulturele en ekonomiese
geskiedenisse, asook huidige realiteite, hierdie afhanklikheid verduidelik. Gevolglik
word voorgestel dat IVP voorkomings programme landsgebonde moet wees wanneer
ouderdomsongelykhede binne verhoudings as risikofaktor vir IPV beskou word
Determinants of COVID-19 Vaccine Acceptability among Healthcare Workers in Kenya—A Mixed Methods Analysis
Healthcare workers (HCWs) were a priority group for COVID-19 vaccination. Adopting the World Health Organization’s 3C and the expanded 5C vaccine hesitancy models, we assessed the factors associated with COVID-19 vaccine acceptability among HCWs in Kenya. In a mixed methods study, respondents were from eight selected counties across the country. An online survey (n = 746), key informant interviews (n = 18) and focus group discussions (n = 3) were conducted. The data were analyzed concurrently. Quantitative data showed that all the 3C antecedents were strong predictors of vaccine acceptability. The association of vaccine acceptability was strongest with convenience (aOR 20.13, 95% CI 9.01–44.96), then complacency (aOR 10.15, 95% CI 4.63–22.21) and confidence (aOR 6.37, 95% CI 2.90–14.02). Marital status was a significant independent factor associated with vaccine acceptability (aOR 2.70, 95% CI 1.20–6.08). Qualitatively, convenience presented as the no-cost availability of vaccines at the health facilities, whereas non-complacency manifested from the first-hand observed experience of COVID cases, and the need to protect oneself and family members. Confidence was mainly attributed to increased knowledge, resulting from multiple training sessions and trust in regulatory authorities. Other social factors including workplace pressure, religion and misinformation had a role in influencing HCW vaccination decisions. In the background of a pandemic, the 3C model is a strong predictor of vaccine acceptability, and making the vaccines easily available and convenient to HCWs significantly impacts their uptake