Impact of Intimate Partner Violence on Primary Health Care Use for Children: Evidences from Rio de Janeiro, Brazil.
Objectives To assess whether severe physical intimate partner violence (PIPV) after childbirth affects the number of pediatric visits in Primary Health Care (PHC) units during this period. Methods Cross-sectional study including 927 mothers of infants under 6 months, users of 27 PHC units in Rio de Janeiro, Brazil. PIPV from childbirth to the date of interview was measured using the Revised Conflict Tactics Scales (CTS2). The number of pediatric visits in the first 6 months of life was the outcome measure of interest. Poisson and multinomial regression models were used for data analysis to control for confounders. Results Children of mothers who experienced severe PIPV had a reduced number of pediatric visits than those not reporting it. This finding was identified only among children who had health problems: relative to five or more baseline pediatric visits, the chance of 3-4 and 1-2 visits increased three- and five-fold, respectively, when severe PIPV was present. Conclusions The maternal experience of severe PIPV reduces the number of pediatric visits in PHC services among the most vulnerable children. This is a hindrance to adequate health promotion, prevention and care, required for the healthy growth and development of children. Early violence detection by pediatricians and other health professionals could be a step in the right direction.
Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University (UERJ), Rua São Francisco Xavier 524 7º andar, Rio de Janeiro, RJ, 20559-900, Brazil.|Medical School, Estácio de Sá University (UNESA), Rio de Janeiro, Brazil.
Claudia Leite de
CL
Moraes
Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University (UERJ), Rua São Francisco Xavier 524 7º andar, Rio de Janeiro, RJ, 20559-900, Brazil. alinegaudard@yahoo.com.br.
Aline Gaudard E Silva de
AG
Oliveira
Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University (UERJ), Rua São Francisco Xavier 524 7º andar, Rio de Janeiro, RJ, 20559-900, Brazil.
Michael Eduardo
ME
Reichenheim
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D000066511:Intimate Partner Violence / Q000523:psychology* / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013179:Spouse Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
Child health services; Domestic violence; Primary health care; Spouse abuse