Intimate Partner Violence (IPV) in Zambia: Sociodemographic Determinants and Association with Use of Maternal Health Care

In Zambia, evidence shows that 43% of women age 15-49 have experienced physical violence, and 37% experienced physical violence in the 12 months preceding the 2013-2014 Zambia Demographic and Health Survey (ZDHS). The documented factors of IPV operate on different levels, ranging from individual sociodemographic characteristics to culturally related factors. Sociodemographic factors associated with IPV include the woman's age, childhood experience of domestic violence, having a low level of education, being unemployed, financial dependence on the partner, using drugs or drinking alcohol, and having more surviving children. Women's experience of IPV has been associated with poor sexual and reproductive health outcomes, such as sexually transmitted infections (STIs), including HIV, pregnancy complications and abortion, urinary tract infections, and sexual dysfunction. The experience of IPV also has an indirect effect on maternal health by making it difficult for women to access a variety of maternal health care services. The study used the 2013-2014 Zambia Demographic and Health Survey (ZDHS) dataset to examine the sociodemographic characteristics associated with IPV and the relationship between IPV and use of maternal health care. The study found that women's characteristics, including marital status, household wealth, witnessing parental violence, and attitudes justifying wife beating, were significantly associated with reporting experience of IPV, after adjusting for educational attainment, occupation, alcohol consumption, area of residence, and other socio-economic factors. Partner characteristics significantly associated with IPV were alcohol consumption and controlling behavior. The study also found that IPV is only significantly associated with maternal delivery in a health facility at the bivariate level of analysis. However, it is not significantly associated with use of maternal health care after adjusting for area of residence, mother's age for the most recent birth, birth order, educational attainment, and wealth. The study indicates that gender inequality and problematic cultural norms that privilege men with power over women still exist in Zambia, and thus IPV preventive strategies should incorporate a way to adjust such cultural norms, not only to increase the use of maternal health services but also to enhance the welfare of women. The study's findings have implications for the development of effective IPV prevention and intervention strategies in Zambia. The study suggests that addressing the root causes of IPV, including gender inequality and cultural norms that perpetuate violence against women, is essential for reducing the prevalence of IPV and improving maternal health outcomes. The study also highlights the need for targeted interventions to support women who have experienced IPV, including access to maternal health care services and other forms of support.