Intimate partner violence against women in rural Vietnam - different socio-demographic factors are associated with different forms of violence: Need for new intervention guidelines?

Background: This population-based study investigated the different forms, magnitude and risk factors of men's violence against women in intimate relationships in a rural part of northern Vietnam and whether a difference in risk factors were at hand for the different forms of violence. Vietnam has undergone a rapid transition in the last 20 years, moving towards a more equal situation for men and women however, Confucian doctrine is still strong and little is known about men's violence against women within the Vietnamese family. Methods: This is a cross-sectional population-based study that used a questionnaire developed by the World Health Organisation for investigating women's health and violence against women in different settings. Face-to face structured interviewing was performed and 883 married women, aged 17 to 60 participated. Bi- and multivariate analyses was used for risk factor assessment. Results: The lifetime prevalence of physical violence was 30.9 percent and past year prevalence was 8.3 per cent, while the corresponding figures for physical and sexual violence combined was 32.7 and 9.2 percent. The lifetime prevalence was highest for psychological abuse ( 27.9 percent) as a single entity. In most cases the violence was of a severe nature and exercised as repeated acts over time. Woman's low educational level, husband's low education, low household income and the husband having more than one wife/partner were risk factors for lifetime and past year physical/sexual violence. The pattern of factors associated with psychological abuse alone was however different. Husband's low professional status and women's intermediate level of education appeared as risk factors. Conclusion: Men's violence against women in intimate relationships is commonly occurring in rural Vietnam. There is an obvious need of preventive and treatment activities. Our findings point at that pure psychological abuse is different from physical/sexual violence in terms of differing characteristics of the perpetrators and it might be that also different strategies are needed to reduce and prevent this violence

The burden, distribution and risk factors for cervical oncogenic human papilloma virus infection in HIV positive Nigerian women

Background: The expected reduction in cervical cancer incidence as a result of increased access to antiretroviral therapy is yet to be seen. In this study we investigated the effect of HIV infection and treatment on high-risk (hr) human papilloma virus (HPV) prevalence and distribution. Methods: Cervical cells from 515 (220 HIV positive and 295 HIV negative) women, recruited during community cervical cancer screening programme in states of Ogun and Lagos and at the cervical cancer screen clinic, Nigerian Institute of Medical Research Lagos were evaluated for the presence of 13 hr HPV genotypes by polymerase chain reaction based assay. Results: The prevalence of high-risk HPV was 19.6% in the studied population. HPV 16 (3.9%), 35 (3.5%), 58 (3.3%) and 31 (3.3%) were the most common hr HPV infections detected. We observed that the prevalence of hr HPV was higher in HIV positives (24.5%) than 15.9% in HIV negative women (OR = 1.7; 95% CI: 1.1-2.7). A multivariate logistic regression analysis showed a lower hr HPV prevalence in HIV positive women on antiretroviral drugs (OR = 0.4; 95% CI: 0.3-0.5) and with CD4 count of 500 and above (OR = 0.7; 95% CI: 0.5-0.8). A higher prevalence of hr HPV was also noted in HIV positive women with CD4 count <200 cells/mm3 (OR = 2.4; 95% CI: 1.7-5.9). Conclusion: HPV 16, 35, 58 and 31 genotypes were the most common hr HPV infection in our study group, which could be regarded as high risk general population sample; with higher prevalence of HPV 16 and 35 in HIV positive women than in HIV negative women. The use of antiretroviral drugs was found to be associated with a lower prevalence of hr HPV infection, compared to those not on treatment. This study raises important issues that should be further investigated to enable the development of robust cervical cancer prevention and control strategies for women in our setting

Spousal violence against women and its association with sociodemographic factors and husbands’ controlling behaviour : the findings of Myanmar Demographic and Health Survey (2015–2016)

Background: Spousal violence is the most common domestic violence against women and a growing public health problem globally. As a behaviour, marital control is commonly accepted as a precursor to spousal violence. Objective: This study examines the prevalence of different types of spousal violence among women in Myanmar and their association with sociodemographic factors and husbands’ controlling behaviour. Methods: This study used data from the Myanmar Demographic and Health Survey (MDHS) 2015–2016. Based on the responses of 3,425 ever-married women, cross-tabulations (Chi-squared test) and multivariate logistic regressions were applied to examine the association between controlling behaviour by husbands and lifetime physical, sexual and emotional spousal violence against Myanmar women. Synergy factor and population attributable fraction were estimated to recommend preventive strategies. Results: The prevalence of lifetime physical violence was 16.8%, of sexual violence 3.8%, of emotional violence 15.9%, and of husband’s controlling behaviour 30.2%. Women who were exposed to controlling behaviour by their husbands reported higher likelihoods of lifetime physical spousal violence (OR = 3.7; 95% CI: 3.0–4.7), lifetime sexual spousal violence (OR = 5.3; 95% CI: 3.3–8.6), and lifetime emotional spousal violence (OR = 5.6; 95% CI: 4.4–7.2). Controlling behaviour by husbands was attributed to 22.0% of lifetime physical spousal violence; and to 24.5% of lifetime sexual spousal violence and to 24.8% of lifetime emotional spousal violence in this sample of Myanmar women. Additional associated factors of spousal violence were poor wealth status, women’s wife-beating justification, exposure to parental violence, and alcohol abuse among husbands. Conclusion: Controlling behaviour by husbands was significantly associated with higher likelihoods of lifetime spousal violence among ever-married Myanmar women in this study. These findings reflect an obvious need for policy development and preventive strategies against marital controlling behaviour in Myanmar

Validity test of the IPD-Work consortium approach for creating comparable job strain groups between Job Content Questionnaire and Demand-Control Questionnaire.

ObjectivesThis study aims to test the validity of the IPD-Work Consortium approach for creating comparable job strain groups between the Job Content Questionnaire (JCQ) and the Demand-Control Questionnaire (DCQ).Material and methodsA random population sample (N = 682) of all middle-aged Malmö males and females was given a questionnaire with the 14-item JCQ and 11-item DCQ for the job control and job demands. The JCQ job control and job demands scores were calculated in 3 different ways: using the 14-item JCQ standard scale formulas (method 1); dropping 3 job control items and using the 11-item JCQ standard scale formulas with additional scale weights (method 2); and the approach of the IPD Group (method 3), dropping 3 job control items, but using the simple 11-item summation-based scale formulas. The high job strain was defined as a combination of high demands and low control.ResultsBetween the 2 questionnaires, false negatives for the high job strain were much greater than false positives (37-49% vs. 7-13%). When the method 3 was applied, the sensitivity of the JCQ for the high job strain against the DCQ was lowest (0.51 vs. 0.60-0.63 when the methods 1 and 2 were applied), although the specificity was highest (0.93 vs. 0.87-0.89 when the methods 1 and 2 were applied). The prevalence of the high job strain with the JCQ (the method 3 was applied) was considerably lower (4-7%) than with the JCQ (the methods 1 and 2 were applied) and the DCQ. The number of congruent cases for the high job strain between the 2 questionnaires was smallest when the method 3 was applied.ConclusionsThe IPD-Work Consortium approach showed 2 major weaknesses to be used for epidemiological studies on the high job strain and health outcomes as compared to the standard JCQ methods: the greater misclassification of the high job strain and lower prevalence of the high job strain

Is ‘legal empowerment of the poor’ relevant to people with disabilities in developing countries? : An empirical and normative review

Background: Legal empowerment of the poor is highly relevant to public health as it aims to relieve income poverty, a main determinant of health. The Commission on Legal Empowerment of the Poor (CLEP) has proposed legal empowerment measures in the following four domains: access to justice and the rule of law, property, labor, and business rights. Despite being overrepresented among the poor, CLEP has not explicitly considered the situation of people with disabilities. Objectives: To examine the empirical evidence for the relevance of the CLEP legal empowerment measures to people with disabilities in low-and lower middle-income countries, and to evaluate the extent to which the Convention on the Rights of Persons with Disabilities (CRPD) addresses those measures. Methods: Critical literature review of empirical studies and a checklist assessment of the CRPD. Results: Fourteen included articles confirm that people with disabilities experience problems in the domains of access to justice and the rule of law, labor rights, and business rights. No texts on property rights were found. Evidence for the effectiveness of the proposed measures is insufficient. Overall, the CRPD fully or partially supports two-thirds of the proposed measures (seven out of nine measures for access to justice and the rule of law, none of the five measures for property rights, all seven measures for labor rights, and six out of nine measures for business rights). Conclusions: Although most of the domains of the CLEP legal empowerment measures are relevant to people with disabilities from both empirical and normative perspectives, it is uncertain whether the devised measures are of immediate relevance to them. Further research is warranted in this regard

Do Assistive Products Enhance or Equalize Opportunities? : A Comparison of Capability across Persons with Impairments Using and Not Using Assistive Products and Persons without Impairments in Bangladesh

Aiming to compare capability across persons with impairments using and not using assistive products and persons without impairments in Bangladesh for 16 different functionings, we contrast two sets of self-reported cross-sectional data from eight districts of Bangladesh: (i) data from persons with hearing impairment not using hearing aids, persons with hearing impairment using hearing aids and persons without impairments (N = 572); and (ii) data from persons with ambulatory impairment not using manual wheelchairs, persons with ambulatory impairment using manual wheelchairs and persons without impairments (N = 598). Kruskal-Wallis tests were used to compare levels of capability across the three groups in each data set. Results showed that, for all functionings in both data sets, the levels of capability were statistically significantly highest for persons without impairments. Compared to persons with hearing impairment not using hearing aids, persons with hearing impairment using hearing aids scored higher in all functionings, with statistical significance at the .05 level for 12 of them. Persons with ambulatory impairment using manual wheelchairs scored higher than persons with ambulatory impairment not using manual wheelchairs for 11 of the functionings, but none of the comparisons between the two groups were significant at the .05 level. Assistive products-hearing aids more than manual wheelchairs-enhance capabilities but do not fully equalize opportunities between people with and without impairments