ASSOCIATION BETWEEN INTIMATE PARTNER VIOLENCE AND UTILIZATION OF MATERNAL HEALTH CARE SERVICES AMONG WOMEN AGED BETWEEN 15 AND 49 YEARS IN RWANDA

Abstract

Abstract

Background: The prevalence of intimate partner violence (IPV) among women is a significant global health concern, including in Rwanda. Existing literature suggests that IPV may significantly hinder the utilization of maternal health services. However, the available evidence indicates a limited understanding of the association between IPV and maternal health care service utilization specifically in Rwanda. Therefore, this study aims to examine the association between IPV and maternal health care service utilization among women of reproductive age in Rwanda.

Methods: The data for this study was extracted from two consecutive Rwanda Demographic and Health Surveys (RDHS) conducted in 2014-2015 and 2019-20. A total of 1,903 women of reproductive age from RDHS 2014-15 and 1,947 women from RDHS 2019-20 were included in this study. Data was analyzed using SPSS version 25. Both univariate and multivariate logistic regression analyses were then employed to estimate the association between intimate partner violence and maternal health care service utilization.

Results: The results show that the prevalence of women who experienced any type of IPV increased from 40.1% in 2015 to 46% in 2020. The most prevalent forms of IPV were physical IPV (2015: 31.3%, 2020: 36.5%) and emotional IPV (2014-2015: 26.9%, 2019-2020: 34.3%). The prevalence of women experiencing sexual IPV also increased from 11.6% in 2015 to 15.3% in 2020. Regarding the utilization of maternal health care services, the percentage of women who received at least four ANC visits increased from 45.8% in 2015 to 46.6% in 2020, while the percentage of those who received all recommended components of PNC decreased from 58.3% to 37%. We found that there was a significant association between IPV and both ANC and PNC service utilization. According to RDHS 2014-15 data, women who had experienced physical IPV were less likely to receive at least four ANC visits (AOR: 0.70, 95% CI: 0.51-0.96), while no significant association was found between emotional or sexual IPV and ANC visits after controlling for covariates. In the same year, no association was found between any form of IPV and PNC. However, RDHS 2019-20 data indicated that experiencing emotional IPV was associated with receiving inadequate ANC visits (AOR: 0.52, 95% CI: 0.27-0.90), and inadequate PNC components (AOR:0.71, 95%CI:0.52-0.97). No association was found between physical IPV and PNC in the same year.

Conclusion: In this study, the prevalence of IPV remains high, and there is evidence that it significantly impacts both ANC and PNC. Consequently, the results support ongoing efforts to reduce intimate partner violence by enhancing IPV screening during the provision of maternal health care services.