BACKGROUND: Quantification of the disease burden caused by different risks informs prevention by ... more BACKGROUND: Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS: We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS: In 2010, the three leading risk factors for global disease burden were high blood pressure (7.0% [95% uncertainty interval 6.2-7.7] of global DALYs), tobacco smoking including second-hand smoke (6.3% [5.5-7.0]), and alcohol use (5.5% [5.0-5.9]). In 1990, the leading risks were childhood underweight (7.9% [6.8-9.4]), household air pollution from solid fuels (HAP; 7.0% [5.6-8.3]), and tobacco smoking including second-hand smoke (6.1% [5.4-6.8]). Dietary risk factors and physical inactivity collectively accounted for 10.0% (95% UI 9.2-10.8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0.9% (0.4-1.6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION: Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children. FUNDING: Bill & Melinda Gates Foundation.
International Journal of Gynecology & Obstetrics, 2015
To establish the prevalence of symptoms of anxiety, depression, and post-traumatic stress disorde... more To establish the prevalence of symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) among women attending prenatal care in Tanzania, and identify associated factors. A cross-sectional study was conducted of one in five physically well women attending a prenatal-care clinic in Muhimbili National Hospital, Dar es Salaam, between December 2011 and April 2012. Trained research assistants carried out face-to-face interviews using a structured questionnaire. The Hopkins Symptoms Checklist and the PTSD Diagnostic Scale were used to establish levels of depression and anxiety symptoms. Among the 1180 women interviewed, 905 (76.7%) had symptoms of anxiety, 923 (78.2%) had symptoms of depression, and 58 (4.9%) had moderate/severe PTSD symptoms. After adjustment for women's sociodemographic characteristics, age of the woman and their partner, educational level of the woman and their partner, relationship duration, employment, and marital status were associated with symptoms of at least one of the three mental disorders (P<0.05 for all). Many pregnant women had symptoms of mental health disorders. Screening of mental health disorders during prenatal care and training of healthcare providers are needed.
BJOG An International Journal of Obstetrics & Gynaecology
OBJECTIVE: Violence against pregnant women is a prevalent issue with severe health implications, ... more OBJECTIVE: Violence against pregnant women is a prevalent issue with severe health implications, especially during pregnancy. This study seeks to determine the prevalence of intimate partner violence against women during pregnancy and its associated mental health symptoms. DESIGN: Cross-sectional survey conducted from December 2011 to April 2012. SETTING: Muhimbili National Hospital antenatal clinic in Dar es Salaam, Tanzania. SAMPLE: 1180 pregnant antenatal care patients. METHODS: Trained interviewers conducted face-to-face standardised interviews with the women in a private room prior to their antenatal care appointment. (PTSD), anxiety and depressive symptoms were assessed through the Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. MAIN OUTCOME MEASURES: The Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. RESULTS: Of the 1180 women who were interviewed, 27% reported exp...
Homicide–suicides are the term for homicides followed by the suicide of the offender. This study ... more Homicide–suicides are the term for homicides followed by the suicide of the offender. This study utilized police statistics, information from the penal files and an online search of news reports to establish the prevalence of homicide–suicides in Romania. We compare characteristics of homicide–suicides among current or former Romanian emigrants and Romanians who never emigrated. The estimated homicide–suicide rate was 0.005–0.146 per 100,000 inhabitants in Romania between 2002 and 2013. Intimate partners committed significantly more homicide–suicides among emigrants than non-emigrants. Emigrant homicide–suicides also had significantly more reports of prior abuse than non-emigrant homicide–suicides. The findings of this study call for improvements in intimate partner violence prevention in Romania and among Romanian migrant communities abroad.
Domestic violence is an important source of premature mortality for women worldwide, with an esti... more Domestic violence is an important source of premature mortality for women worldwide, with an estimated one in three female homicides committed by an intimate partner. Among women in high income countries it can be even higher, with up to 1 in 2 female homicides being perpetrated by an intimate partner. The aim of the paper is to discuss the role of the National Members States and the EU in advocating, promoting and monitoring policies against gender violence; the paper will also present existing quantitative data on violence against women in ten high income European countries (Finland, France, Germany, Italy, Netherlands, Portugal, Slovenia, Spain, Sweden and UK). In the first part, we will analyze similarities and diversities in policies to combat violence against women, and the extent to which the different Member States, as well as the European Commission and Parliament have been players in policy-making. Items such as the National Welfare pattern, government funding, nongovernme...
BJOG An International Journal of Obstetrics & Gynaecology
OBJECTIVE: Violence against pregnant women is a prevalent issue with severe health implications, ... more OBJECTIVE: Violence against pregnant women is a prevalent issue with severe health implications, especially during pregnancy. This study seeks to determine the prevalence of intimate partner violence against women during pregnancy and its associated mental health symptoms. DESIGN: Cross-sectional survey conducted from December 2011 to April 2012. SETTING: Muhimbili National Hospital antenatal clinic in Dar es Salaam, Tanzania. SAMPLE: 1180 pregnant antenatal care patients. METHODS: Trained interviewers conducted face-to-face standardised interviews with the women in a private room prior to their antenatal care appointment. (PTSD), anxiety and depressive symptoms were assessed through the Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. MAIN OUTCOME MEASURES: The Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. RESULTS: Of the 1180 women who were interviewed, 27% reported exp...
International Journal of Gynecology & Obstetrics, 2015
To establish the prevalence of symptoms of anxiety, depression, and post-traumatic stress disorde... more To establish the prevalence of symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) among women attending prenatal care in Tanzania, and identify associated factors. A cross-sectional study was conducted of one in five physically well women attending a prenatal-care clinic in Muhimbili National Hospital, Dar es Salaam, between December 2011 and April 2012. Trained research assistants carried out face-to-face interviews using a structured questionnaire. The Hopkins Symptoms Checklist and the PTSD Diagnostic Scale were used to establish levels of depression and anxiety symptoms. Among the 1180 women interviewed, 905 (76.7%) had symptoms of anxiety, 923 (78.2%) had symptoms of depression, and 58 (4.9%) had moderate/severe PTSD symptoms. After adjustment for women's sociodemographic characteristics, age of the woman and their partner, educational level of the woman and their partner, relationship duration, employment, and marital status were associated with symptoms of at least one of the three mental disorders (P<0.05 for all). Many pregnant women had symptoms of mental health disorders. Screening of mental health disorders during prenatal care and training of healthcare providers are needed.
Partner violence is a serious human rights violation and public health issue. Although its pervas... more Partner violence is a serious human rights violation and public health issue. Although its pervasiveness is well documented, more research is needed on risk and protective factors to inform interventions. This study is based on a secondary analysis of the first national survey on violence against women in Germany. Women who reported partner violence by their current partner were compared to women who never reported partner violence. The prevalence of physical or sexual violence, or both, by current partners was 17 per cent. Women who experienced violence during their childhood had higher odds of experiencing partner violence. Partner violence was associated with women's drug use in the last 5 years, physical disability or debilitating illness, having more than three children, experiencing violence by a non-partner and feeling socially excluded. The odds of violence also increased if both partners were unemployed or lacked vocational training or if only the woman had vocational skills. Relationships shorter than 5 years or where the man or both partners drank heavily were likewise associated with higher odds of violence. Partner violence interventions should focus on reducing children's exposure to violence and preparing women and men for the job market as well as including interventions that tackle social isolation and substance use.
Background Homicide is an important cause of premature mortality globally, but evidence for the m... more Background Homicide is an important cause of premature mortality globally, but evidence for the magnitude of homicides by intimate partners is scarce and hampered by the large amount of missing information about the victim-off ender relationship. The objective of the study was to estimate global and regional prevalence of intimate partner homicide.
Intimate partner violence during pregnancy is receiving increased attention because of its high p... more Intimate partner violence during pregnancy is receiving increased attention because of its high prevalence and health effects. Still, little is known about women's perceptions on how their pregnancy influences the context in which intimate partner violence occurs. We conducted 19 in-depth interviews with women who had experienced intimate partner violence around the time of pregnancy. Women clearly perceived pregnancy as a turning point, because it created new expectations and a feeling of being overwhelmed. This led to violence by reducing women's acceptance of their partner's unemployment, alcohol abuse and lack of relationship commitment, or by increasing women's vulnerability because they felt too young to raise a child alone. Pregnancy also led to violence by bringing back childhood memories or by taking attention away from their partners. Understanding how pregnancy influences the context in which intimate partner violence occurs is important to provide abused, pregnant women with the services they need.
Abstract: Testai's articleVictim Protection Policy in Italy: Between Emancipation and Red... more Abstract: Testai's articleVictim Protection Policy in Italy: Between Emancipation and Redemption'adeptly captures the international debates on human trafficking, as well as their influence on the implementation of Italian anti-trafficking policy and the provision of ...
Background: Violence by an intimate partner is increasingly recognized as an important public and... more Background: Violence by an intimate partner is increasingly recognized as an important public and reproductive health issue. The aim of this study is to investigate the extent to which physical and/or sexual intimate partner violence is associated with induced abortion and pregnancy loss from other causes and to compare this with other, more commonly recognized explanatory factors. Methods: This study analyzes the data of the Tanzania section of the WHO Multi-Country Study on Women's Health and Domestic Violence, a large population-based cross-sectional survey of women of reproductive age in Dar es Salaam and Mbeya, Tanzania, conducted from 2001 to 2002. All women who answered positively to at least one of the questions about specific acts of physical or sexual violence committed by a partner towards her at any point in her life were considered to have experienced intimate partner violence. Associations between self reported induced abortion and pregnancy loss with intimate partner violence were analysed using multiple regression models. Results: Lifetime physical and/or sexual intimate partner violence was reported by 41% and 56% of ever partnered, ever pregnant women in Dar es Salaam and Mbeya respectively. Among the ever pregnant, ever partnered women, 23% experienced involuntary pregnancy loss, while 7% reported induced abortion. Even after adjusting for other explanatory factors, women who experienced intimate partner violence were 1.6 (95%CI: 1.06,1.60) times more likely to report an pregnancy loss and 1.9 (95%CI: 1.30,2.89) times more likely to report an induced abortion. Intimate partner violence had a stronger influence on induced abortion and pregnancy loss than women's age, socio-economic status, and number of live born children. Conclusions: Intimate partner violence is likely to be an important influence on levels of induced abortion and pregnancy loss in Tanzania. Preventing intimate partner violence may therefore be beneficial for maternal health and pregnancy outcomes.
Background: The prevalence and detrimental health effects of intimate partner violence have resul... more Background: The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or casebased inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women.
Introduction: Prevention of mother-to-child transmission (PMTCT) has the potential to eliminate n... more Introduction: Prevention of mother-to-child transmission (PMTCT) has the potential to eliminate new HIV infections among infants. Yet in many parts of sub-Saharan Africa, PMTCT coverage remains low, leading to unacceptably high rates of morbidity among mothers and new infections among infants. Intimate partner violence (IPV) may be a structural driver of poor PMTCT uptake, but has received little attention in the literature to date. Methods: We conducted qualitative research in three Johannesburg antenatal clinics to understand the links between IPV and HIV-related health of pregnant women. We held focus group discussions with pregnant women (n=13) alongside qualitative interviews with health care providers (n=10), district health managers (n=10) and pregnant abused women (n=5). Data were analysed in Nvivo10 using a team-based approach to thematic coding. Findings: We found qualitative evidence of strong bidirectional links between IPV and HIV among pregnant women. HIV diagnosis dur...
St€ ockl H, Kalra N, Jacobi J, Watts C. Is early sexual debut a risk factor for hiv infection amo... more St€ ockl H, Kalra N, Jacobi J, Watts C. Is early sexual debut a risk factor for hiv infection among women in sub-Saharan Africa? A systematic review.
BACKGROUND: Quantification of the disease burden caused by different risks informs prevention by ... more BACKGROUND: Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS: We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS: In 2010, the three leading risk factors for global disease burden were high blood pressure (7.0% [95% uncertainty interval 6.2-7.7] of global DALYs), tobacco smoking including second-hand smoke (6.3% [5.5-7.0]), and alcohol use (5.5% [5.0-5.9]). In 1990, the leading risks were childhood underweight (7.9% [6.8-9.4]), household air pollution from solid fuels (HAP; 7.0% [5.6-8.3]), and tobacco smoking including second-hand smoke (6.1% [5.4-6.8]). Dietary risk factors and physical inactivity collectively accounted for 10.0% (95% UI 9.2-10.8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0.9% (0.4-1.6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION: Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children. FUNDING: Bill & Melinda Gates Foundation.
International Journal of Gynecology & Obstetrics, 2015
To establish the prevalence of symptoms of anxiety, depression, and post-traumatic stress disorde... more To establish the prevalence of symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) among women attending prenatal care in Tanzania, and identify associated factors. A cross-sectional study was conducted of one in five physically well women attending a prenatal-care clinic in Muhimbili National Hospital, Dar es Salaam, between December 2011 and April 2012. Trained research assistants carried out face-to-face interviews using a structured questionnaire. The Hopkins Symptoms Checklist and the PTSD Diagnostic Scale were used to establish levels of depression and anxiety symptoms. Among the 1180 women interviewed, 905 (76.7%) had symptoms of anxiety, 923 (78.2%) had symptoms of depression, and 58 (4.9%) had moderate/severe PTSD symptoms. After adjustment for women's sociodemographic characteristics, age of the woman and their partner, educational level of the woman and their partner, relationship duration, employment, and marital status were associated with symptoms of at least one of the three mental disorders (P<0.05 for all). Many pregnant women had symptoms of mental health disorders. Screening of mental health disorders during prenatal care and training of healthcare providers are needed.
BJOG An International Journal of Obstetrics & Gynaecology
OBJECTIVE: Violence against pregnant women is a prevalent issue with severe health implications, ... more OBJECTIVE: Violence against pregnant women is a prevalent issue with severe health implications, especially during pregnancy. This study seeks to determine the prevalence of intimate partner violence against women during pregnancy and its associated mental health symptoms. DESIGN: Cross-sectional survey conducted from December 2011 to April 2012. SETTING: Muhimbili National Hospital antenatal clinic in Dar es Salaam, Tanzania. SAMPLE: 1180 pregnant antenatal care patients. METHODS: Trained interviewers conducted face-to-face standardised interviews with the women in a private room prior to their antenatal care appointment. (PTSD), anxiety and depressive symptoms were assessed through the Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. MAIN OUTCOME MEASURES: The Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. RESULTS: Of the 1180 women who were interviewed, 27% reported exp...
Homicide–suicides are the term for homicides followed by the suicide of the offender. This study ... more Homicide–suicides are the term for homicides followed by the suicide of the offender. This study utilized police statistics, information from the penal files and an online search of news reports to establish the prevalence of homicide–suicides in Romania. We compare characteristics of homicide–suicides among current or former Romanian emigrants and Romanians who never emigrated. The estimated homicide–suicide rate was 0.005–0.146 per 100,000 inhabitants in Romania between 2002 and 2013. Intimate partners committed significantly more homicide–suicides among emigrants than non-emigrants. Emigrant homicide–suicides also had significantly more reports of prior abuse than non-emigrant homicide–suicides. The findings of this study call for improvements in intimate partner violence prevention in Romania and among Romanian migrant communities abroad.
Domestic violence is an important source of premature mortality for women worldwide, with an esti... more Domestic violence is an important source of premature mortality for women worldwide, with an estimated one in three female homicides committed by an intimate partner. Among women in high income countries it can be even higher, with up to 1 in 2 female homicides being perpetrated by an intimate partner. The aim of the paper is to discuss the role of the National Members States and the EU in advocating, promoting and monitoring policies against gender violence; the paper will also present existing quantitative data on violence against women in ten high income European countries (Finland, France, Germany, Italy, Netherlands, Portugal, Slovenia, Spain, Sweden and UK). In the first part, we will analyze similarities and diversities in policies to combat violence against women, and the extent to which the different Member States, as well as the European Commission and Parliament have been players in policy-making. Items such as the National Welfare pattern, government funding, nongovernme...
BJOG An International Journal of Obstetrics & Gynaecology
OBJECTIVE: Violence against pregnant women is a prevalent issue with severe health implications, ... more OBJECTIVE: Violence against pregnant women is a prevalent issue with severe health implications, especially during pregnancy. This study seeks to determine the prevalence of intimate partner violence against women during pregnancy and its associated mental health symptoms. DESIGN: Cross-sectional survey conducted from December 2011 to April 2012. SETTING: Muhimbili National Hospital antenatal clinic in Dar es Salaam, Tanzania. SAMPLE: 1180 pregnant antenatal care patients. METHODS: Trained interviewers conducted face-to-face standardised interviews with the women in a private room prior to their antenatal care appointment. (PTSD), anxiety and depressive symptoms were assessed through the Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. MAIN OUTCOME MEASURES: The Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. RESULTS: Of the 1180 women who were interviewed, 27% reported exp...
International Journal of Gynecology & Obstetrics, 2015
To establish the prevalence of symptoms of anxiety, depression, and post-traumatic stress disorde... more To establish the prevalence of symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) among women attending prenatal care in Tanzania, and identify associated factors. A cross-sectional study was conducted of one in five physically well women attending a prenatal-care clinic in Muhimbili National Hospital, Dar es Salaam, between December 2011 and April 2012. Trained research assistants carried out face-to-face interviews using a structured questionnaire. The Hopkins Symptoms Checklist and the PTSD Diagnostic Scale were used to establish levels of depression and anxiety symptoms. Among the 1180 women interviewed, 905 (76.7%) had symptoms of anxiety, 923 (78.2%) had symptoms of depression, and 58 (4.9%) had moderate/severe PTSD symptoms. After adjustment for women's sociodemographic characteristics, age of the woman and their partner, educational level of the woman and their partner, relationship duration, employment, and marital status were associated with symptoms of at least one of the three mental disorders (P<0.05 for all). Many pregnant women had symptoms of mental health disorders. Screening of mental health disorders during prenatal care and training of healthcare providers are needed.
Partner violence is a serious human rights violation and public health issue. Although its pervas... more Partner violence is a serious human rights violation and public health issue. Although its pervasiveness is well documented, more research is needed on risk and protective factors to inform interventions. This study is based on a secondary analysis of the first national survey on violence against women in Germany. Women who reported partner violence by their current partner were compared to women who never reported partner violence. The prevalence of physical or sexual violence, or both, by current partners was 17 per cent. Women who experienced violence during their childhood had higher odds of experiencing partner violence. Partner violence was associated with women's drug use in the last 5 years, physical disability or debilitating illness, having more than three children, experiencing violence by a non-partner and feeling socially excluded. The odds of violence also increased if both partners were unemployed or lacked vocational training or if only the woman had vocational skills. Relationships shorter than 5 years or where the man or both partners drank heavily were likewise associated with higher odds of violence. Partner violence interventions should focus on reducing children's exposure to violence and preparing women and men for the job market as well as including interventions that tackle social isolation and substance use.
Background Homicide is an important cause of premature mortality globally, but evidence for the m... more Background Homicide is an important cause of premature mortality globally, but evidence for the magnitude of homicides by intimate partners is scarce and hampered by the large amount of missing information about the victim-off ender relationship. The objective of the study was to estimate global and regional prevalence of intimate partner homicide.
Intimate partner violence during pregnancy is receiving increased attention because of its high p... more Intimate partner violence during pregnancy is receiving increased attention because of its high prevalence and health effects. Still, little is known about women's perceptions on how their pregnancy influences the context in which intimate partner violence occurs. We conducted 19 in-depth interviews with women who had experienced intimate partner violence around the time of pregnancy. Women clearly perceived pregnancy as a turning point, because it created new expectations and a feeling of being overwhelmed. This led to violence by reducing women's acceptance of their partner's unemployment, alcohol abuse and lack of relationship commitment, or by increasing women's vulnerability because they felt too young to raise a child alone. Pregnancy also led to violence by bringing back childhood memories or by taking attention away from their partners. Understanding how pregnancy influences the context in which intimate partner violence occurs is important to provide abused, pregnant women with the services they need.
Abstract: Testai's articleVictim Protection Policy in Italy: Between Emancipation and Red... more Abstract: Testai's articleVictim Protection Policy in Italy: Between Emancipation and Redemption'adeptly captures the international debates on human trafficking, as well as their influence on the implementation of Italian anti-trafficking policy and the provision of ...
Background: Violence by an intimate partner is increasingly recognized as an important public and... more Background: Violence by an intimate partner is increasingly recognized as an important public and reproductive health issue. The aim of this study is to investigate the extent to which physical and/or sexual intimate partner violence is associated with induced abortion and pregnancy loss from other causes and to compare this with other, more commonly recognized explanatory factors. Methods: This study analyzes the data of the Tanzania section of the WHO Multi-Country Study on Women's Health and Domestic Violence, a large population-based cross-sectional survey of women of reproductive age in Dar es Salaam and Mbeya, Tanzania, conducted from 2001 to 2002. All women who answered positively to at least one of the questions about specific acts of physical or sexual violence committed by a partner towards her at any point in her life were considered to have experienced intimate partner violence. Associations between self reported induced abortion and pregnancy loss with intimate partner violence were analysed using multiple regression models. Results: Lifetime physical and/or sexual intimate partner violence was reported by 41% and 56% of ever partnered, ever pregnant women in Dar es Salaam and Mbeya respectively. Among the ever pregnant, ever partnered women, 23% experienced involuntary pregnancy loss, while 7% reported induced abortion. Even after adjusting for other explanatory factors, women who experienced intimate partner violence were 1.6 (95%CI: 1.06,1.60) times more likely to report an pregnancy loss and 1.9 (95%CI: 1.30,2.89) times more likely to report an induced abortion. Intimate partner violence had a stronger influence on induced abortion and pregnancy loss than women's age, socio-economic status, and number of live born children. Conclusions: Intimate partner violence is likely to be an important influence on levels of induced abortion and pregnancy loss in Tanzania. Preventing intimate partner violence may therefore be beneficial for maternal health and pregnancy outcomes.
Background: The prevalence and detrimental health effects of intimate partner violence have resul... more Background: The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or casebased inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women.
Introduction: Prevention of mother-to-child transmission (PMTCT) has the potential to eliminate n... more Introduction: Prevention of mother-to-child transmission (PMTCT) has the potential to eliminate new HIV infections among infants. Yet in many parts of sub-Saharan Africa, PMTCT coverage remains low, leading to unacceptably high rates of morbidity among mothers and new infections among infants. Intimate partner violence (IPV) may be a structural driver of poor PMTCT uptake, but has received little attention in the literature to date. Methods: We conducted qualitative research in three Johannesburg antenatal clinics to understand the links between IPV and HIV-related health of pregnant women. We held focus group discussions with pregnant women (n=13) alongside qualitative interviews with health care providers (n=10), district health managers (n=10) and pregnant abused women (n=5). Data were analysed in Nvivo10 using a team-based approach to thematic coding. Findings: We found qualitative evidence of strong bidirectional links between IPV and HIV among pregnant women. HIV diagnosis dur...
St€ ockl H, Kalra N, Jacobi J, Watts C. Is early sexual debut a risk factor for hiv infection amo... more St€ ockl H, Kalra N, Jacobi J, Watts C. Is early sexual debut a risk factor for hiv infection among women in sub-Saharan Africa? A systematic review.
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