title: Intimate partner violence and utilization of maternal health care services in Addis Ababa, Ethiopia.
abstract: Despite its prominence, intimate partner violence (IPV) against women has received little attention in Ethiopia. And as many of sub-Saharan African countries, maternal health care services utilization remains poor. Full access and utilization of maternal health care services is a key to significant reduction in maternal and child mortality, and eliminate new HIV infection in infants. Identifying the factors that contribute to the poor access and utilization should aid the design of appropriate policy and intervention strategies. Thus the objective of this study was to examine the association between IPV and use of maternal health care services in Addis Ababa, Ethiopia.
  
  
  
  A cross sectional study on couples (N = 210; male/female pairs) with an infant less than 6 months of age was conducted. The dependent variable was use of maternal health care services and the main independent variable was IPV. Data was collected using face-to-face self-reported questionnaires and analyzed using SPSS version 20.0. Bivariate and multivariate logistic regression models were used to examine the relationship between the dependent and independent variables.
  
  
  
  The mean age of the women was 28.7 years (SD = 5.4), on average women were 7.4 years (SD = 7.4) younger than their partners. Although most of the women (95.2%) had at least one antenatal care (ANC), only 35 (2%) had ≥4 ANC visits and about half (49.0%) had their first ANC visit within the first trimester. Women who experienced emotional IPV in their relationship were less likely to have their 1stANC within three months of pregnancy (AOR = 0.69; 95%CI = 0.49-0.96). Women who reported physical IPV in their relationship were less likely to use ≥4 ANC (AOR = 0.48; 95%CI = 0.21-0.71), be tested for HIV (AOR = 0.26; 95%CI = 0.09-0.79), have skilled delivery attendant (AOR = 0.31; 95%CI = 0.12-0.98), and deliver in a health facility (AOR = 0.35; 95%CI = 0.14-0.88). Likewise, women experienced sexual IPV or partner control in their relationship were less likely to use ANC ≥4 times (AORsexual-IPV= 0.91; 95%CI = 0.84-0.98 and AORpartner-control= 0.38; 95%CI = 0.17-0.85 respectively).
  
  
  
  IPV is prevalent among couples in Addis Ababa, Ethiopia where three out of four women reported having experienced one or more type of IPV in their current relationship. And all types of IPV showed significant association with poor utilization of one or more maternal health care services. Thus efforts to sustain the recent success in maternal health and further improvement should give due consideration to IPV.
authors.affiliation: School of Public Health, The University of Hong Kong, G09, G/F, Patrick Manson Building, 7 Sassoon Road, Pokfulam, Hong Kong. bedredin4444@yahoo.com.
authors.forename: Bedru Hussen
authors.identifier: 0000-0002-1236-6187
authors.initials: BH
authors.lastname: Mohammed
authors.affiliation: School of Public Health, The University of Hong Kong, G09, G/F, Patrick Manson Building, 7 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Janice Mary
authors.initials: JM
authors.lastname: Johnston
authors.affiliation: Clinton Health Access Initiative, Boston, USA.
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Harwell
authors.affiliation: JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Huso
authors.initials: H
authors.lastname: Yi
authors.affiliation: JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Katrina Wai-Kay
authors.initials: KW
authors.lastname: Tsang
authors.affiliation: School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Jemal Ali
authors.initials: JA
authors.lastname: Haidar
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006268:Health Facilities; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D000066511:Intimate Partner Violence / Q000706:statistics & numerical data*; D016015:Logistic Models; D000068097:Maternal Health; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D011295:Prenatal Care / Q000706:statistics & numerical data; D012747:Sexual Partners; D013179:Spouse Abuse / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Addis Ababa; Antenatal care; Intimate partner violence; Maternal health care; Prevention of mother-to-child transmission