Prevalence and correlates of reproductive coercion across ten sites: commonalities and divergence

Reproductive Health

Research

Funmilola M. OlaOlorun¹  Haley L. Thomas²  Shannon N. Wood³  Michele R. Decker⁴  Rosine Mosso⁵  Raimi Fassassi⁵  Simon Peter Sebina Kibira⁶  Anoop Khanna⁶  Sani Oumarou⁷  Georges Guiella⁸  Fiacre Bazié⁸  Mary Thiongo⁹  Peter Gichangi^1,10  Pierre Z. Akilimali^1,11  Fredrick Makumbi^1,12  Elizabeth Omoluabi^1,13 

[1] College of Medicine, University of Ibadan, Ibadan, Nigeria;Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4009, 21205, Baltimore, MD, USA;Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4009, 21205, Baltimore, MD, USA;Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA;Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4009, 21205, Baltimore, MD, USA;Department of Population, Family and Reproductive Health, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA;Johns Hopkins School of Nursing, Baltimore, USA;Ecole Nationale Superieure de Statistique et Appliquee d’Abidjan (ENSEA), Abidjan, Côte d’Ivoire;Indian Institute of Health Management Research, Sanganer, Jaipur, India;Institut National de la Statistique du Niger, Niamey, Niger;Institut Supérieur des Sciences de la Population (ISSP/University of Ouagadougou), Ouagadougou, Burkina Faso;International Centre for Reproductive Health-Kenya, Nairobi, Kenya;International Centre for Reproductive Health-Kenya, Nairobi, Kenya;Technical University of Mombasa, Mombasa, Kenya;Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium;Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo;Makerere University School of Public Health, Kampala, Uganda;University of the Western Cape, Cape Town, South Africa;

关键词: Reproductive coercion;    Violence;    Contraception;    National data;   

DOI  :  10.1186/s12978-023-01568-1

 received in 2022-10-14, accepted in 2023-01-13,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundReproductive coercion (RC) is a type of abuse where a partner asserts control over a woman’s reproductive health trajectories. Recent research emphasizes that RC experiences may differ within and across low- and middle-income countries (LMICs), as compared to higher income contexts, given social pressures surrounding childbearing. To date, nationally representative surveys have lacked comprehensive measures for RC, leading to gaps in understanding its prevalence and risk factors. Across eight LMICs (10 sites), we aimed to (1) validate the RC Scale; (2) calculate prevalence of RC and specific behaviors; and (3) assess correlates of RC.MethodsThis analysis leverages cross-sectional Performance Monitoring for Action (PMA) data collected from November 2020 to May 2022. Analyses were limited to women in need of contraception (Burkina Faso n = 2767; Côte d'Ivoire n = 1561; Kongo Central, Democratic Republic of Congo (DRC) n = 830; Kinshasa, DRC n = 846; Kenya n = 4588; Kano, Nigeria n = 535; Lagos, Nigeria n = 612; Niger n = 1525; Rajasthan, India n = 3017; Uganda n = 2020). Past-year RC was assessed via five items adapted from the original RC Scale and previously tested in LMICs. Confirmatory factor analysis examined fit statistics by site. Per-item and overall prevalence were calculated. Site-specific bivariate and multivariable logistic regression examined RC correlates across the socioecological framework.ResultsConfirmatory factor analysis confirmed goodness of fit across all sites, with moderate internal consistency (alpha range: 0.66 Cote d’Ivoire–0.89 Kinshasa, DRC/Lagos, Nigeria). Past-year reported prevalence of RC was highest in Kongo Central, DRC (20.3%) and lowest in Niger (3.1%). Prevalence of individual items varied substantially by geography. Polygyny was the most common RC risk factor across six sites (adjusted odds ratio (aOR) range: 1.59–10.76). Increased partner education levels were protective in Kenya and Kano, Nigeria (aOR range: 0.23–0.67). Other assessed correlates differed by site.ConclusionsUnderstanding RC prevalence and behaviors is central to providing woman-centered reproductive care. RC was most strongly correlated with factors at the partner dyad level; future research is needed to unpack the relative contributions of relationship power dynamics versus cultural norms surrounding childbearing. Family planning services must recognize and respond to women’s immediate needs to ensure RC does not alter reproductive trajectories, including vulnerability to unintended pregnancy.

【 授权许可】

CC BY   
© The Author(s) 2023