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Violence against women in relation to literacy and area of residence
School of Public Health, Addis Ababa University, Ethiopia .
Addis Continental Institute of Public Health, Ethiopia .
International Center for Research on Women, Washington DC, United States .
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
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2010 (English)In: Global health action, ISSN 1654-9880, Vol. 3, no 2070Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: This study explores violence against women in a low-income setting in relation to residency and literacy. SETTING: The study was conducted within the Butajira Rural Health Programme (a Health and Demographic Surveillance Site), which includes rural and semi-urban settings in south-central Ethiopia. DESIGN: This is a community-based cross-sectional study and is part of the WHO Women's Health and Life Events multi-country study. It included 1,994 randomly selected married women. METHODS: A standardised WHO questionnaire was used to measure physical violence, residency, literacy of the woman and her spouse, and attitudes of women about gender roles and violence. Analyses present prevalence with 95% confidence intervals and odds ratios derived from bivariate and multivariate logistic regression models. RESULTS: In urban and rural areas of the study area, the women were of varying ages, had varying levels of literacy and had spouses with varying levels of literacy. Women in the overall study area had beliefs and norms favouring violence against women, and women living in rural communities and illiterate women were more likely to accept such attitudes. In general, violence against women was more prevalent in rural communities. In particular, violence against rural literate women and rural women who married a literate spouse was more prevalent. Literate rural women who were married to an illiterate spouse had the highest odds (Adj. OR = 3.4; 95% CI: 1.7-6.9) of experiencing physical violence by an intimate partner. CONCLUSION: Semi-urban lifestyle and literacy promote changes in attitudes and norms against intimate partner violence; however, within the rural lifestyle, literate women married to illiterate husbands were exposed to the highest risks of violence.

Place, publisher, year, edition, pages
2010. Vol. 3, no 2070
Keyword [en]
intimate partner violence, health system and gender, Africa
National Category
Research subject
URN: urn:nbn:se:umu:diva-32851DOI: 10.3402/gha.v3i0.2070ISI: 000208160600009PubMedID: 20200660OAI: diva2:306424
Available from: 2010-03-29 Created: 2010-03-29 Last updated: 2012-02-22Bibliographically approved
In thesis
1. Intimate partner violence and depression among women in rural Ethiopia
Open this publication in new window or tab >>Intimate partner violence and depression among women in rural Ethiopia
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Several studies have reported socioeconomic, socio-demographic factors, including violence against women to be associated with depression among women, but knowledge in the area among women living under extreme poverty in developing countries remains scarce. Relationship between intimate partner violence and women’s literacy in societies where violence is normative is complex, there are only limited data describing this difference in the distribution of violence exposure by residency and literacy. Few studies have addressed consequences of maternal depression and experiencing violence among women on children’s survival.

Objective: The aim of this thesis is to determine prevalence of depressive episode and examine its association with violence by intimate partner and socioeconomic status It also assesses contribution of residency and literacy of women on vulnerability to physical violence by intimate partner, and independent effect of intimate partner violence and maternal depression on the risk of child death in rural Ethiopia.

Methods: A community-based cross-sectional study was undertaken among 3016 randomly selected women in the age group between 15-49 years conducted from January to December 2002. A cohort study was done through following up women who gave birth to a live child within a year of the survey, in rural Ethiopia. Analysis was made using all the 3016 women, 1994 of the married women and 561 of women who gave birth within a year of the data collection time. Cases of depression were identified using the Amharic version of the Composite International Diagnostic Interview, experience of physical, sexual and emotional violence by intimate partner was made using the WHO multi-country study on women’s life events, and child death was measured by continuous demographic surveillance data from the Butajira Rural Health Program.

Result: The twelve-month prevalence of depression was estimated to be 4.4%. In the analyses being currently married, divorced and widowed women, living in rural villages, having frequent khat chewing habit, having seasonal job and living in extreme poverty were factors independently associated with depression. Similarly, among the married women, experiencing physical violence, childhood sexual abuse, emotional violence and spousal control were factors independently associated with depressive episode. Women in the overall study area had beliefs and norms permissive towards violence against women. Violence against women was more prevalent in rural communities, in particular, among rural literate women and rural women who married a literate spouse. In this study, maternal depression was associated with under five child death. Although no association was seen between experiencing violence and child death, the risk of child death increases when maternal depression is combined with physical and emotional violence.

Conclusion: Prevalence of depression among women was still in the lower range as compared to studies from high-income countries. Though depression is associated with socio-demographic factors and extreme poverty, the association is complex. The high prevalence of violence against women could be a contributing factor for preponderance of depression among women than in men. Urbanization and literacy are thought to promote changes in attitudes and norms against intimate partner violence. However, literacy within rural community might expose women to the higher risk of violence. Improving awareness of clinicians and public health workers on the devastating consequences of violence against women and depression is essential in order to identify and take measure when violence and maternal depression co-occurred.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2010. 60 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1335
depression, extreme poverty, intimate partner violence, spousal-control, child death, rural Ethiopia
National Category
Research subject
urn:nbn:se:umu:diva-32856 (URN)978-91-7264-959-0 (ISBN)
Public defence
2010-09-13, Tandläkarhögskolan, 9 trp., Sal A, Norrlands universitetssjukhus, Umeå, 13:00 (English)
Available from: 2010-04-01 Created: 2010-03-29 Last updated: 2011-04-08Bibliographically approved

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