prevalence and pattern of domestic violence among antenatal and postnatal women in selected health care facilities in ekiti state

Description

ABSTRACT

Introduction: Domestic violence affects nearly one in three families in Nigeria and has significant health consequences on sufferers. When it occurs among pregnant women, it can be associated with pregnancy-related complications or when occur after pregnancy it can still result to postpartum depression. There is dearth of data on the association between certain family and clinical factors of During Pregnancy, Postpartum Period, and domestic violence in Nigeria. This study was conducted to determine the prevalence and pattern of domestic violence and its association with certain clinical factors and family functioning of pregnant women attending the antenatal clinic at the Ekiti State University Teaching Hospital, Ekiti.

Methods: a total of 333 respondents were recruited for the cross-sectional study between June and August, 2017 using systematic sampling technique. Structured questionnaires were used to obtain information about domestic violence and family functioning among the study participants. Blood pressure, urinalysis and packed cell volume of respondents were obtained following standard procedures. Data were analyzed using SPSS-20 and Chi-square was used to identify significant risk factors for domestic violence among the study subjects.

Results: the results of this study showed that the prevalence of domestic violence among the study population was 34.5%. The most common form of violence in this study was psychological aggression (74.8%), followed by sexual coercion (47.8%), then physical assault (14.8%) and physical assault with injury (3.5%). There was a statistically significant association between domestic violence and; 1) family dysfunction p<0.001); 2) anaemia (p<0.001).

Conclusion: pregnant and postpartum women presenting with anaemia as well as those from dysfunctional families are particularly at high risk of domestic violence and as such, special attention should be drawn to these factors with a view to screen and identify victims of abuse during routine antenatal clinic visits

TABLE OF CONTENTS

COVER PAGE

TITLE PAGE

APPROVAL PAGE

DEDICATION

ACKNOWLEDGEMENT

ABSTRACT

CHAPTER ONE

INTRODUCTION

1.1      Background of the study

• Problem statement
• Aim and objective of the study
• Research Questions
• Research Hypotheses 
• Significance of the study
• Scope of the study
• Limitation of study
• Definitions of Terms

CHAPTER TWO

LITERATURE REVIEW

• Review of the study
• Concept of domestic violence (dv)
• Risk factors of domestic violence during pregnancy
• Education And Domestic Violence

CHAPTER THREE

METHODOLOGY

• Study Area
• Sample and Sampling Method
• Data collection tools
• Data analysis
• Ethical consideration

CHAPTER FOUR

4.1      Results and Discussion

CHAPTER FIVE

• Conclusion
• Recommendation
• Limits/strength of the study

References

 

CHAPTER ONE

1.0                                                   INTRODUCTION 

1.1                                           BACKGROUND OF THE STUDY

Domestic Violence (DV) is a pattern of abusive behaviours by one or both partners in an intimate relationship such as marriage, dating, cohabitation or within the family [1]. Domestic violence, known as the most common type of gender-related violence, affects nearly one in three women globally and has significant health consequences [2]. It is an important problem because it is global, violates fundamental human rights of women and is a major public health problem [3].

Violence against women is a significant and disturbing problem which affects women around the world, including those who are pregnant or postpartum. Although numerous studies from around the globe agree that violence is a common problem among pregnant women, estimates of the prevalence of this violence vary considerably. Fewer studies have estimated the prevalence of violence during the postpartum period, with most of these studies finding a lower prevalence of violence during the nine months of pregnancy than during the first 12 months postpartum.

Forms of domestic violence include but not limited to physical assault, sexual abuse and psychological violence [4]. Researchers have described domestic violence during pregnancy as a global public health problem due to its adverse health consequences and intervention potential [5,6]. The subject has also become popular among policy makers and some international human right movement groups who are interested in women´s health. It is known that pregnancy neither provides immunity from domestic violence nor reduces the risk of abusive relationship. Some researchers have even argued that pregnancy constitutes a period of heightened risk for domestic violence irrespective of the woman´s age, race, socioeconomic status or educational level [7,8]. Pregnant women are at a higher risk of experiencing gender-based violence because they are more likely to be in relationships compared to non-pregnant women. In addition, their age group (15-49 years old) has also been identified a higher risk group for domestic violence [9]. Also, wrong opinions about pregnancy, abnormal emotions of the partner regarding pregnancy, and reduction in sexual contact are some other factors that make pregnant women vulnerable [10]. Violence can affect pregnancy through direct and indirect mechanisms [11]. A blow to a pregnant woman´s abdomen can cause adverse outcome directly. The indirect mechanisms are related to a woman´s victimization experience from domestic violence and how it can induce intermediate risks (such as psychological stress) that could cause poor pregnancy outcomes like foetal injury, placental abruption among others.

James and colleagues, in a Meta-analytic review of studies from selected developed and developing countries, found a wide variation in the prevalence of domestic violence among pregnant women, with figures ranging from 4.8-63.4% [12]. A similar and more recent systematic review in Nigeria also found a range of between 2.3% and 44.6% [9]. This variation is probably attributable to differences across studies in the sampled population, as well as differences in definitions and methodologies. There are evidences that the overall prevalence of domestic violence during pregnancy in less developed countries is higher than that in developed countries [5,12]. Gyuse and Ushie, in a study among pregnant women in Jos, North-Central Nigeria, found that 63.2% had experienced domestic violence. Of these, 26.5% were physically abused, 38.0% had endured verbal insults, whereas sexual and emotional insults accounted for 10.7% and 1.4%, respectively [13]. Also, Onon and colleagues in South-East Nigeria found an overall prevalence of 44.6% in the index pregnancy with verbal abuse being the most common form (60.1%), whereas emotional and physical abuse constituted 21% of the reported forms of domestic violence [14]. In a similar study in Northern Nigeria, the overall prevalence was 7.4%, the majority reported being physically assaulted (58.6%) [15].

The family unit which is seen as a medium of socialization has been reported to be a place where much violence is directed at its female members [16]. One potential influencer of domestic violence that has received very little attention is family functioning. Family functioning is defined as the way in which family members interact, react to, and treat other family members; It includes variables within the family such as communication, styles, tradition, clear roles and boundaries, and the degree of fusion, flexibility, adaptation and resilience [17]. Dysfunction in a family occurs when there is a conflict, misbehaviour on the part of individual family members continually, leading other members to accommodate such actions [18]. Family dysfunction has an important influence and provides powerful source of information about the risk for future violence [19]. Studies have also reported that abusive families have poorer family functioning, more problems and more problematic relationships [20,21]. Also, families where there is domestic violence have poor family relationships and provide low levels of support and protection [22]. On the other hand, there is evidence that women who had adequate family support were less likely to be abused by their husbands [23].

Furthermore, the relationships between domestic violence and some obstetric complications, like anaemia and hypertensive disorders of pregnancy, have also been studied. Pregnant women who experience domestic violence have been found to have a higher risk obstetric complications, for example hypertension, and anaemia [6,24]. On the other hand however, there was no significant association between domestic violence and hypertensive disorders of pregnancy in a survey of pregnant women in Belgium [25]. Also, Hoang et al. found no significant association between domestic violence and anaemia among pregnant women in Vietnam [26]. While domestic violence may occur in as many as one of every three families [27], studies on family factors associated with development and maintenance of abuse remain scarce all over the world. Also, apart from some of the negative health outcomes of domestic violence in pregnancy, it has also been reported as a contributing factor to maternal mortality [24]. Therefore, there is need to quantify the problem, synthesize information on common risk factors among the parturient population. This study sought to provide evidence about undetected domestic violence, as well as its association with family functioning and certain clinical factors among pregnant women attending antenatal clinic at University Of Ilorin Teaching Hospital, Ilorin, Nigeria. Such information can help to advocate for health interventions that will contribute to safe motherhood and healthy babies.

1.2      Problem Statement

In spite of the impressive effort the government and non-governmental organization are making, to eradicate or minimize domestic violence, significant percentage of pregnant and postpartum women in Nigeria and Ekiti state are still suffering in silence. In Nigeria, Police will not intervene in domestic quarrels, and do not consider wife beating as a crime, because, existing legal instruments do not treat wife abuse as a criminal offence. For instance, Penal Code Law Cap 89 laws of Northern Nigeria (1969) as cited by Odimegwu & Okengbo (2001) states that domestic quarrels is not an offence if committed by a husband for the purpose of correcting his wife. This law sees husband-wife relationship as being similar to parent-child relationship (Odimegwu & Okemgbo, 2001). Information obtained from the increasing number of prevalence of domestic voilence and health consequences on pregnant and postpartum women has not been scientifically analyzed in Ekiti state. It was observed that 75% of pregnant women who have experienced domestic violence have never been asked about sexual abuse in a medical exam. Based on this there is need for more empirical studies in this direction. Therefore, this study is specifically designed to examine the prevalence and pattern of domestic violence among pregnant and postpartum women and negative health outcome, in Ekiti state Nigeria.

1.3   Aim and Objectives of the Study

The main aim of this study is to determine the prevalence and pattern of domestic violence among antenatal and postnatal women in selected health care facilities in ekiti state. However, the specific objectives are:

1. i)             To study the extent of the awareness on domestic violence in Nigeria
2. ii)           To determine extent of Violence against women who are who are pregnant or postpartum.

iii)         To identify different types of domestic violence during and after pregnancy.

iv).      To explore prevalence and incidence of domestic violence during and after pregnancy.

1.4   Research Questions

The following are some of the questions which this study intends to answer:

1. i)             What are the various ways Nigerian Government has help in raising awareness on domestic violence in Nigeria?
2. ii)           In what ways has the Government of Nigeria helped in reducing the rate of domestic violence?

iii)         What are steps of reducing the rate of domestic violence?

1.5   Research Hypotheses 

The following shall be the research hypotheses to be tested:

1. i)           There is a significant relationship between domestic violence and family functioning.
2. ii)           There is no significant relationship between domestic violence and family functioning.

1.6   Significance of the Study

This study will investigate the detailed knowledge on the association between specific types of exposure to partner violence and postpartum depression. This study will therefore investigate the association between exposure to emotional violence, physical violence, and sexual violence during pregnancy and postpartum depression among women in Ekiti State of Nigeria. In addition, the study will provide adequate information to the government by revealing different cases of domestic violence in the country and as well provide necessary solutions to the government on the various ways by which the victims of domestic violence can be helped, more especially, by establishing rehabilitation homes that will help their social and psychological lives. This study will be beneficial to students, teachers and researchers of mass communication as it is a material for academic exercise; it will as well serve as a foundation upon which further research can be conducted.

This study will also help campaign coordinators harness the power of the teaching hospital to develop effective campaigns aimed at empowering participants to take action to prevent violence against women.

1.7   Scope of the Study

The study covers determining the extent of Violence against women who are who are pregnant or postpartum. It identifies different types of domestic violence during and after pregnancy The study showed strong and statistically significant associations between partner violence and postpartum depression. These findings clearly demonstrate a crucial need for relevant health professionals to identify women who are exposed to partner violence and screen for postpartum depression in order to mitigate the negative mental health outcomes among

1.8      DEFINITION OF TERMS

Postnatal: This is the period of time immediately after childbirth, and is defined for the baby.

Postpartum Period: The postpartum period begins soon after the delivery of the baby and usually lasts six to eight weeks and ends when the mother’s body has nearly returned to its pre-pregnant state.

Antenatal: This is a period of medical care of women when they are expecting a baby.

Antenatal care: is a type of preventive healthcare which is provided in the form of medical checkups, consisting of recommendations on managing a healthy lifestyle and the provision of medical information such as maternal physiological changes in pregnancy, biological changes, and prenatal nutrition including prenatal vitamins, which prevents potential health problems throughout the course of the pregnancy and promotes the mother and child’s health alike.

Domestic violence: is any behavior the purpose of which is to gain power and control over a spouse, partner, girl/boyfriend or intimate family member.