title: The role of individual, community and societal gender inequality in forming women's attitudes toward intimate-partner violence against women: a multilevel analysis.
abstract: BACKGROUND
  Establishing risk factors for intimate partner violence against women (IPVAW) is crucial for addressing women's health and development. Acceptance of IPVAW has been suggested as one of the strongest predictors of IPVAWs. The aim of this study was to examine the independent contributions of individual, community, and societal measures of gender inequality in forming women's attitudes toward IPVAW.
  
  
  METHODS
  We applied multivariable multilevel logistic regression analysis to Demographic and Health Survey data for 120,467 women nested within 7463 communities from 17 countries in sub-Saharan Africa.
  
  
  RESULTS
  We found that women whose husband had higher education (odds ratio [OR] =1.06; 95% confidence interval [CI] 1.02 to 1.10) and women whose husband had more than one wife (OR=1.14; 95% CI 1.09 to 1.19) were more likely to accept IPVAW than other women. Unemployed women with an unemployed partner were more likely to justify IPVAW than employed women with working partners (OR=1.32; 95% CI 1.08 to 1.61). Both community and societal measures of gender inequality were associated with women's attitudes toward IPVAW, even after controlling for gender inequality at the individual level. There was evidence of clustering of women's attitudes within communities and within countries.
  
  
  CONCLUSIONS
  We provide evidence that community and societal forms of gender inequality influence women's attitudes toward IPVAW beyond individual factors. Choices women make are important, but community and society also impose restraints on women's attitudes toward IPVAW. Thus, policies and programs aimed at reducing or eliminating IPVAW must address people, the communities and societies in which they live in order to be successful.
authors.affiliation: Department of Public Health Sciences, Division of Social Medicine, Epidemiology, Karolinska Institutet, Stockholm, Sweden. olalekan.uthman@ki.se
authors.forename: Olalekan A
authors.initials: OA
authors.lastname: Uthman
authors.forename: Stephen
authors.initials: S
authors.lastname: Lawoko
authors.forename: Tahereh
authors.initials: T
authors.lastname: Moradi
mesh_terms: D017954:Africa South of the Sahara; D001290:Attitude; D018585:Battered Women; D005260:Female; D005783:Gender Identity; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D012737:Sex Factors; D012747:Sexual Partners; D012927:Social Control, Informal; D014754:Violence; D014930:Women / Q000523:psychology*