title: The influence of family violence and child marriage on unmet need for family planning in Jordan.
abstract: BACKGROUND
  Risk for unmet need for contraception is associated with men's perpetration of intimate partner violence (IPV) against women and may be influenced by violence perpetrated by other family members (family violence, FV). Women who married as minors may be most vulnerable to the potential compounding effect of IPV and FV on unmet need.
  
  
  OBJECTIVE
  Using nationally representative data from the 2012 Jordan Population and Family Health Survey we examined unmet need by exposure to IPV and FV by women's age at marriage (<18, 18+ years).
  
  
  METHODS
  Logistic regression was used to test whether IPV and FV were independently associated with unmet need, by age at marriage. Interaction terms (IPV×FV) were tested in both models. Stratification by FV was employed to clarify the interpretation of significant interactions.
  
  
  RESULTS
  IPV increased the odds of unmet need by 87% [adjusted odds ratio (AOR) 1.87; 95% confidence interval (95% CI) 1.13-3.10] and 76% (AOR 1.76; 95% CI 1.30-2.38) among women who married prior to and after the age of 18 years, respectively. Women married as minors who experienced IPV and FV had a four-fold higher likelihood of having an unmet need (AOR 6.75; 95% CI 1.95-23.29) compared to those experiencing only IPV (AOR 1.49; 95% CI 0.84-2.38). No interaction between IPV and FV was detected for women married at or above majority.
  
  
  CONCLUSIONS
  Laws that prohibit child marriage should be strengthened and health sector screening for violence experience could help identify women at risk of unmet need and improve women's reproductive agency.
authors.affiliation: Assistant Professor, Medical School; Adjunct Assistant Professor, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Cari Jo
authors.initials: CJ
authors.lastname: Clark
authors.affiliation: Independent Researcher, Atlanta, GA, USA.
authors.forename: Rachael A
authors.initials: RA
authors.lastname: Spencer
authors.affiliation: Professor of Maternal Child Health Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan.
authors.forename: Inaam A
authors.initials: IA
authors.lastname: Khalaf
authors.affiliation: Associate Professor, Co-Director, Social Intervention Group (SIG); Co-Director, Global Health Research Center of Central Asia (GHRCCA) Columbia University School of Social Work, New York, NY, USA.
authors.forename: Louisa
authors.initials: L
authors.lastname: Gilbert
authors.affiliation: Professor, Columbia University School of Social Work; The Willma and Albert Musher Professor of Social Work, Director of the Global Health Research Center of Central Asia; Director of the Social Intervention Group (SIG), New York, NY, USA.
authors.forename: Nabila
authors.initials: N
authors.lastname: El-Bassel
authors.affiliation: Director of Research, Center on Gender Equity and Health; Professor of Medicine and Global Public Health, University of California at San Diego, La Jolla, CA, USA.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Silverman
authors.affiliation: Professor, Center on Gender Equity and Health; Division of Global Public Health, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Raj
keywords: Jordan; epidemiology; family planning service provision; intimate partner violence; unmet need