Measuring the impacts of maternal child marriage and maternal intimate partner violence and the moderating effects of proximity to conflict on stunting among children under 5 in post-conflict Sri Lanka

SSM: Population Health

Anita Raj¹  Lotus McDougal²  Ruvani W. Fonseka³  Elizabeth Reed³  Rebecka Lundgren³  Jay G. Silverman³  Lianne Urada⁴ 

[1] Corresponding author. San José State University School of Social Work, 1 Washington Square, San Jose, CA 95112, USA.;San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health, 9500 Gilman Dr, La Jolla, CA, 92093, USA;Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA;San Diego State University School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182, USA;

关键词: Sri Lanka;    Girl child marriage;    Intimate partner violence (IPV);    Post-conflict;    Stunting;   

DOI  :  

来源: DOAJ

【 摘 要 】

This study aimed to understand whether maternal child marriage and past year intimate partner violence (IPV) impact stunting among Sri Lankan children under 5 years old, and, secondarily, whether proximity to conflict is associated with stunting. Additionally, we assessed whether proximity to conflict moderates the relationships between maternal child marriage and past year IPV (sexual, physical, and emotional). We tested these questions using logistic regression analyses of the 2016 Sri Lankan Demographic and Health Survey (n = 4941 mother-child dyads). In country-wide adjusted analyses, we did not find associations between maternal child marriage or IPV and stunting (p > 0.05). Children in districts proximal and central to conflict were significantly less likely to be stunted compared to children in districts distal to conflict (proximal adjusted odds ratio/aOR: 0.43, 95% confidence interval/CI: 0.22–0.82; central aOR: 0.53, CI: 0.29–0.98). We found significant interaction effects on stunting between proximity to conflict and both sexual and emotional IPV, which we further explored in stratified analyses. In districts distal to conflict, maternal sexual IPV was significantly associated with increased odds of stunting (aOR: 2.71, CI: 1.16–6.35), and in districts central to conflict, maternal emotional IPV was significantly associated with increased odds of stunting (aOR: 1.80, CI: 1.13–2.89). Maternal emotional IPV was significantly associated with decreased odds of stunting in districts proximal to conflict (aOR: 0.42, CI: 0.18–0.96). Maternal child marriage and physical IPV were not associated with stunting in Sri Lanka. Variations in associations between maternal IPV and stunting across Sri Lanka may reflect the lasting and differential impact of conflict, as well as differential humanitarian responses which may have improved child nutrition practices and resources in districts central and proximal to conflict. Policies and programs addressing stunting in Sri Lanka should consider the role of maternal IPV as well as community-level variations based on proximity to conflict.

【 授权许可】

Unknown