1. Preparé et Presenté par : Sidikiba SIDIBE
Thème: Intimate Partner Violence Against Women: Prevalence and/or Determinants, attitudes, consequences. A systematic Review study of Sub-Saharan Africa countries
Memoire Master 2 Presenté en November 2011 à Bordeaux
Preparé et Presenté par :
Sidikiba SIDIBE

2. Plan Introduction Purpose/Objective Methods Result
Prevalence
Determinants
Relationship with HIV
Attitudes and Consequences
Discussion and Conclusion

3. Intimate partner violence, serious public problem
Introduction
Intimate partner violence, serious public problem
Women reproductive age more vulnerable
Lifetime prevalence ranged 15% in Japan to 71% in Ethiopia (WHO 2005)
Associated to health negatives outcomes (WHO 2005)
Women negatives attitudes contribute to sustain intimate partner violence

4. Objective
Conduct a systematic review on the prevalence of Intimate Partner Violence (domestic violence) against women and/or determinants, atitudes and consequences. The study assessed also the reviewed studies limitations.

5. Method (1) Search strategy Criteria
Medline database supplemented by Google Scholar and hand searching
Criteria
Studies on domestic violence (Married, Cohabiting women)
English Published studies from 2000 to 2011
Prevalence on Intimate partner violence (Sexual, Physical and Emotional)
Articles/Abstracts based on quantitative research
Women as principle source of information

6. Method (2) Assessed for Eligibility (n=168)
Stage 1: selected
(n=116)
Excluded for not meeting selection criteria
(n=52 )
Stage 2: References Selected
(n=56)
References Excluded
(n=40 )
Eligible but not yielded in the review
N=3
Eligible and included in the review
N=53

7. Method (3) Data Collection Items (Variables) Excel Country
Article Design (time of follow up)
Sample
Type of violence (physical, sexual and psychological)
Tools Used
Prevalence and incidence
Determinants, Attitudes and consequences
Limitations of studies 7

8. Method (4) Data analysis No formal meta-analyze was done
Descriptive using Excel and Word offices 2003
Prevalence
Determinants
Attitudes and Consequences
Studies limitations
Odds Ratios or Risk Ratio (95%) 8

9. Results

10. Result (1) Design methodological tool 45 Cross sectional
5 Prospective (cohort)
1 Case control
1 Trial Randomized
1 systematically review
methodological tool
49 administered questionnaires
4 conflict tactics scale
3 WHO administered questionnaire
3 Self-Interviewing 10

11. Result (2)
Prevalence
47 reported lifetime or 12 past months prevalence
Lifetime prevalence ranged from 14.2% to 99% and reported by 37 studies
12 past months prevalence ranged from 4.5% to 46%
Prevalence by types of violence
Physical lifetime ranged: 5.3% to 50.4% (n=24) v.s 17.4% to 52.2% in 12 past months
Sexual lifetime ranged : 0.6% to 65% (n=18) v.s 3.4% to 13.4%
Emotional/psychological lifetime: 9.2% to 67.5% (n=10) vs 10.8% to 51% 11

12. During Pregnancy (n=8 studies)
Result (2) con’t
During Pregnancy (n=8 studies)
Overall Ranged from 2.3% to 48.6%
Physical violence: 16.5% from 1 study
Sexual violence : 26.5% one study reporting 12

13. Result (3) Determinants (n=32 studies)
Low education reported by 17 studies
Polygamous unions reported by 13 studies
Low socio-economic status (n=11 studies)
Alcohol consumption (n=11 studies)
Young age (n=6 studies)
History of violence (n=5 studies)
Household size (n=5 studies)
Pregnancy and use of contraceptives 13

14. Result (4) Relationship with HIV OR IC 95% p-value n=10 studies
HIV positive women
2.38
Perception of HIV status
3.72
<.0001
Age younger women (<30years)
9.99
Having a HIV negative spouse
3.1
Experience of violence before diagnosed HIV+
44.4
Having HIV positive child
9,2 14

15. Result (5) Attitudes (n=17 studies) Reasons (11 studies)
- Woman disobeyed husband/elders - Woman’s refusal of sex - Arguments over money - Suspected infidelity woman/husband - Women’s insistence on use of condom - Woman used contraception without permission - Woman suspected to be HIV positive
- Husband drunk
- Neglects children - Going out without informing husband 15

16. Result (6) Consequences (n=24 studies)
women’s health or illnesses (n=8 studies)
Obstetrical complications
Depressive symptoms
Health risk behaviors : alcohol, smoking (n=3)
Infant illnesses or death (n=6 studies)
Diarrhea
Sexual risks (n=9)
HIV, STIs. HSV2 (n=7)
Inconstant condom use
Non-use female contraceptive 16

17. Result (7) Limitations (n=46 studies) Cross sectional design
Information and selection biases
Underreporting of violence
Generalization to whole population (n=9 studies)
Small size of sample (n=6 studies) 17

18. Discussion Our Study Past 12 months During pregnancy (n=8)
Overall prevalence 4.5% to 46%
Physical: 17.4% to 52.2%
During pregnancy (n=8)
Overall: 2.3% to 48.6%
Physical: 16.5% (n=1)
Sexual : 26.5% (n=1)
Recent systematic review Shamu et al, 2011
Past 12 months
Overall prevalence 14.2% to 43.4%
Physical: 14% to 41%
During Pregnancy (n=13)
Overall: 2.7 to 26.5%
Physical: 22% to 40% (n=4)
Sexual: 2.7% to 35% (n=6)) 18

19. Conclusion
Strong association between intimate partner violence and several determinants as risks factors
Demonstrated the strong association between wife beating and health/illnesses outcomes issues (obstetrical complications, negative health behavior issues (Smoking, alcohol drinking) and women’s depression or mental problems.
Main reasons justifying wife beating demonstrated
Violence against women is sustained by women’s positive attitudes, religious and socio-cultural acceptability
Further future research to elucidate the temporal relationship should be undertaken.

20. Acknowledgements
ISPED
SIDACTION
Tutors 20

21. Thank you for your attention