Violence against women and the risk of under-five mortality: analysis of community-based data from rural Bangladesh.
OBJECTIVE
To assess whether violence against women was associated with increased mortality risks for their daughters and sons before the age of 5.


METHODS
Secondary analysis of longitudinal data from rural Bangladesh of 2691 live-born children in relation to their mother's experience of physical, sexual and emotional partner violence and level of controlling behaviour in marriage. Analyses were adjusted for potential confounders and stratified by gender.


RESULTS
Under five-mortality was 88 per 1000 in this cohort. Overall, there was no association between different forms of violence against women and under-five mortality. However, more educated women had an increased risk of under-five deaths of their female offspring if ever exposed to severe physical violence (adjusted hazard ratio 2.2, 95% CI 1.06-4.50) or to a high level of controlling behaviour in marriage (adjusted hazard ratio 2.5, 95% CI 1.30-4.90). Controlling behaviour in marriage increased the hazard ratios in a dose-response manner. Increased mortality risks were neither shown for offspring of women with low or no education nor for boys in any educational group.


CONCLUSIONS
Severe physical violence and controlling behaviour in marriage were associated with higher under-five mortality among daughters of educated mothers in rural Bangladesh, indicating gender-biased consequences of partner violence for child mortality.
Asling-Monemi
Kajsa
K
International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Sweden. kajsa.asling@kbh.uu.se
Tabassum Naved
Ruchira
R
Persson
Lars Ake
LA
D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D046688:Child Mortality; D002675:Child, Preschool; D017579:Domestic Violence / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012737:Sex Factors; D013179:Spouse Abuse / Q000706:statistics & numerical data*