title: The independent contribution of individual-, neighbourhood-, and country-level socioeconomic position on attitudes towards intimate partner violence against women in sub-Saharan Africa: a multilevel model of direct and moderating effects.
abstract: We examined associations between country, neighbourhood, and individual socioeconomic position (SEP) and attitudes towards intimate partner violence against women (IPVAW). We applied multivariable multilevel logistic regression analysis on Demographic and Health Survey data for 165,983 women and 68,501 men nested within 7465 communities from 17 countries in sub-Saharan Africa collected between 2003 and 2007. Contrary to expectation women were 34% more likely to justify IPVAW than men. We found that sex moderates associations of individual-, neighbourhood-, and country-level SEP with attitudes towards IPVAW. There was a significant positive interaction effect between sex and education attainment; women with no education were more likely to justify IPVAW than men with no education. Negative sex interaction with household wealth status indicates that differences in attitude are less pronounced among women. Unemployed men were more likely to justify IPVAW. Interaction effects indicate that the association of neighbourhood socioeconomic disadvantage with attitudes was more pronounced among women than among men. The association of country-level SEP with attitudes towards IPVWA was inconclusive. There was some evidence that neighbourhood modified the association between individual SEP and attitudes towards IPV. Also, there was cross-level interaction between country and neighbourhood SEP. Neighbourhood and individual SEP were independently associated with attitudes towards IPVAW. The relationship with country-level SEP was inconclusive. The findings underscore the need to implement public health prevention/intervention strategies not only at the level of individual SEP but also at the neighbourhood level.
authors.affiliation: Department of Public Health Sciences, Division of Social Medicine, Epidemiology, Karolinska Institutet, Stockholm, Sweden. olalekan.uthman@ki.se
authors.forename: Olalekan Abdulrahman
authors.initials: OA
authors.lastname: Uthman
authors.forename: Tahereh
authors.initials: T
authors.lastname: Moradi
authors.forename: Stephen
authors.initials: S
authors.lastname: Lawoko
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D001290:Attitude; D003431:Cross-Cultural Comparison; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012111:Residence Characteristics; D012737:Sex Factors; D012923:Social Class; D013179:Spouse Abuse / Q000191:economics* / Q000523:psychology* / Q000706:statistics & numerical data; D014933:Women's Rights / Q000191:economics*; D055815:Young Adult