title: Intimate partner violence and use of reproductive health services among married women: evidence from a national Bangladeshi sample.
abstract: BACKGROUND
  Data from a statewide survey in India and clinic-based studies in developed settings have previously suggested an association between maternal physical intimate partner violence (IPV) experiences and the low use of antenatal care (ANC). This study aimed to explore the association between maternal experiences of physical and sexual IPV and the use of reproductive health care services, using a large nationally representative data set from Bangladesh.
  
  
  METHODS
  This paper used data from the 2007 Bangladesh Demographic Health Survey. The analyses were based on the responses of 2001currently married women living with at least one child younger than 5 years. Exposure was determined from maternal reports of physical and sexual IPV. The utilization of ANC according to amount and type of provider and utilization of delivery assistance according to provider type were used as proxy outcome variables for reproductive health care utilization. Descriptive statistics and multivariate logistic regression analysis used in the study.
  
  
  RESULTS
  Approximately two out of four (48.2%) respondents had experienced physical IPV. Maternal experience of physical IPV was associated with low use of receiving sufficient ANC (adjusted odds ratio [AOR] 0.69; 95% confidence interval [CI] 0.49-0.96), lower likelihood of receiving ANC (AOR 0.69; 95% CI 0.53-0.89), and assisted deliveries from skilled provider (AOR 0.54; 95% CI 0.37-0.78). Women who had been sexually abused were significantly less likely to have visited a skilled ANC and delivery care provider. Furthermore, severity of physical IPV appeared to have more profound consequences on the outcome measured.
  
  
  CONCLUSIONS
  The association between exposure to IPV and use of reproductive health care services suggests that partner violence plays a significant role in lower utilization of reproductive health services among women in Bangladesh. Our findings suggest that, in addition to a wide range of socio-demographic factors, preventing maternal physical and sexual IPV need to be considered as an important psychosocial determinates for the higher utilization of reproductive health care services in Bangladesh.
authors.affiliation: International Health Section, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8519, Japan.
authors.forename: Mosiur
authors.initials: M
authors.lastname: Rahman
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kaoruko
authors.initials: K
authors.lastname: Seino
authors.forename: Masashi
authors.initials: M
authors.lastname: Kizuki
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult