Intimate Partner Violence in Pregnancy Among Antenatal Attendees at Health Facilities in West Pokot County, Kenya

Abstract

Violence against women perpetuated by intimate partners is worldwide and an important public health concern as well as human rights issue. Intimate partner violence in pregnancy has drawn attention due to its prevalence, detrimental health consequences and intervention potential. In Kenya, the 2014 Kenya Demographic and Health Survey report estimates that 38 % of ever-married women age 15-49 have ever experienced Intimate Partner Violence. There is scanty information on the prevalence and associated risk factors of intimate partner violence in pregnancy in West Pokot County. The objective of this study was to investigate factors contributing to intimate partner violence in pregnancy among antenatal attendees at the health facilities in West Pokot Sub-County. The study was done in 11 health facilities in West Pokot Sub-County. Using cross sectional study design, a total of 238 antenatal attendees who were proportionately and systematically selected from a sample frame of 622 were interviewed for experience of various forms of intimate partner violence in their current pregnancy. This was followed by qualitative research comprising of 4 Focused Group Discussions with 48 community health workers and key informant interviews with 20 health workers. The qualitative study explored community level risk factors on intimate partner violence in pregnancy and the quality of care offered to antenatal attendee experiencing intimate partner violence in pregnancy. Quantitative data was managed using the statistical package for social scientist (SPSS) while Qualitative data was consolidated into various themes. Bivariate and logistic regression analysis was done to determine factors associated with experience of IPV in the index of pregnancy with P :s 0.05 being considered significant. Informed consent was sought from the participants. Confidentiality and privacy was maintained throughout the study. Ethical clearance was obtained from Kenyatta University Ethics Review Committee, and a research permit from National Council for Science, Technology and Innovation. The study found prevalence of overall, physical, psychological and sexual IPV in pregnancy to be 66.9%, 29.9%, 55.8% and 39.2% respectively. After adjusting for confounders, Overall IPV in pregnancy was significantly associated with Alcohol intake by partner (OR 2.116, 95% Cl 1.950-2.260, P 0.000) and partner's level of education (OR 1.265, 95% Cl 1.079-1.487, P 0.031), while psychological and sexual IPV was significantly associated with age of partner (OR 2.292, 95% Cl 2.123-2.722, P 0.007) and age of pregnant women (OR 1.174,95% Cl 1.001- 1.397 P 0.049) respectively. The care offered to antenatal attendees experiencing IPV is not in line with WHO guidelines and standard on handling gender based violence cases. The study findings indicates that IPV in pregnancy among antenatal attendees in West Pokot is very high. This unearths the weaknesses and gaps on gender based violence interventions both in health facilities and community level. Based on this study there is need for the national government, County government of West Pokot to integrate screening of fPV with maternal and child health services.