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Learning Objective 1: learn the factors resposible for sexual intimate partner violence
Learning Objective 2: identify the magnitude of sexual abuse among women of a developing country
METHODOLOGY: 500 mothers who delivered a live singleton baby were interviewed from September - December 2005 presenting to tertiary care hospitals of Karachi. Sexual abuse was determined by WHO Domestic Violence Module. Data were analyzed using appropriate descriptive analysis and the relationship between sexual abuse and the risk factors was determined using multiple logistic regression methods.
RESULTS: Twenty one percent of women reported experiencing sexual abuse in their married life. None of the women was enquired about the abuse in the health care setting before. A little over half of the women (59%) believe that antenatal care clinics were a good time to enquire about domestic violence; Doctors were preferred in 69% of the case and nurses in 56% of the cases. Factors such as physical and emotional violence (OR 7.84; CI 2.41, 25.56), contraceptive failure (OR 5.42; 1.71, 17.16), women's age (OR 8.73; CI 2.72, 28.06) and lack of dowry at the time of marriage (OR 6.78; CI 1.12, 21.33) were independently associated with spousal abuse during pregnancy. Women who had social support were less likely to be abused by their spouse (OR 0.54; CI 0.31, 0.94).
POLICY RELEVANCE: The magnitude of sexual violence among women represents a serious reproductive health concern of Pakistan. This has been recognized as a risk factor to women's sexual and reproductive health. Antenatal clinics provides a good venue to enquire about these issues. Strong social support is protective of abuse. It is recommended that counseling against abuse be provided to the couples against the identified risk factors and social groups should be formed to protect women against abuse.
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