Prevalence and risk factors for gender based violence during pregnancy in Kisumu county Kenya

Abstract

Background: Gender Based Violence (GBV) is a pervasive and systemic public health problem affecting pregnant women but there is paucity of data on the magnitude of GBV during pregnancy and the factors associated with it in Kenya, particularly in areas where the prevalence of GBV in the general population is unacceptably high.
Objectives: To determine the prevalence and factors associated with GBV during pregnancy in Kisumu County.
Design: A cross sectional survey conducted between May and October 2016. Multivariate Logistic Regression was performed and the Odds Ratio (OR) at 95% Confidence Interval (CI) calculated to identify the factors associated with GBV.
Setting: Two public primary health care facilities in each of the six sub counties in Kisumu County.
Subjects: 691 eligible pregnant women attending antenatal care in the selected facilities responded to a questionnaire and were screened for GBV.
Results: The mean and median age was 24.5 and 24 years respectively, and the age at sexual debut was 16.7 2.2 years. Thirty nine (39.2%) had experienced physical violence during the current pregnancy, perpetrated by an intimate partner (97%).
Increased risk of violence was associated with having secondary level of education or more in the women OR=2.088,95% CI[1.147-3.802],occasional alcohol consumption by the intimate partner(IP) OR=2.843, 95%CI[1.519-4.059], witnessing violence as a child OR=3.380, 95%CI[2.427-6.046] and prior experience of physical OR=13.116,95%CI[7.976-21.569] or sexual violence OR=4.208,95% CI[2.603-6.803]. Male partner dominance in decision making, OR=5.930, 95%CI [3.998-8.797] and infidelity by the woman OR=3.442, 95% CI [1.696-9.686] or her IP, OR=9.906, 95% CI [6.088-16.119] were associated with increased violence. The belief in the social superiority of a man OR=3.949, 95%CI [2.044-7.631], man’s right to assert over a woman OR=3.163, 95%CI [1.930-5.185] and the belief that women should tolerate violence to save a relationship/marriage OR=9.493, 95% CI [5.746-5.681] were predictors of increased violence.
Conclusion: A substantial proportion of pregnant women experience GBV in Kisumu County. The findings indicate the need for routine screening for GBV at ANC and the potential for initiation of interventions to mitigate the negative effects of violence for the affected women. Approaches targeting beliefs and strengthening of legal structures may be viable primary prevention options.