Intimate partner violence against women in Nepal: an analysis through individual, empowerment, family and societal level factors

The current study estimated the national prevalence rate of intimate partner violence against women [IPVAW] in Nepal. Besides, the individual level, empowerment level, family and societal level factors were assessed to relate with the victims of IPAVW in Nepal. Nationally representative sample of 4210 women of reproductive age [15-49 yr] were included in the study. Household surveys using two stage sampling procedures, face to face interview with pre-tested questionnaires were performed. Emotional, physical and sexual violence were target variables. A violence variable was constructed from these three types of violence. Individual level factors were measured by age, residency, education, religion and husband's education. Empowerment factors included employment status and various decision making elements. Family and societal factors included economic status, neighborhood socioeconomic disadvantage index, history of family violence, husband's controlling behavior and other issues. Cross tabulation with chi-square tests and multivariate logistic regression were employed. Prevalence of emotional IPVAW was 17.5%, physical IPAVW 23.4% and sexual IPAVW 14.7%. Overall the prevalence of IPVAW in Nepal was 32.4%. Joint decision making for contraception, husband's non-controlling behavior to wives and friendly feelings were emerged as less likely to be IPVAW perpetration. The findings have immense policy importance as a nationally representative study and indicating necessity of more gender equality

Economics of global burden of road traffic injuries and their relationship with health system variables

To estimate the economic loss due to road traffic injuries [RTIs] of the World Health Organization [WHO] member countries and to explore the relationship between the economic loss and relevant health system factors. Data from the World Bank and the WHO were applied to set up the databases. Disability-adjusted life year [DALY] and gross domestic product per capita were used to estimate the economic loss relating to RTIs. Regression analysis was used. Data were analyzed by IBM SPSS Statistics, Versions 20.0. In 2005, the total economic loss of RTIs was estimated to be 167,752.4 million United States Dollars. High income countries [HIC] showed the greatest economic losses. The majority [96%] of the top 25 countries with the greatest DALY losses are low and middle income countries while 48% of the top 25 countries with the highest economic losses are HIC. The linear regression model indicates an inverse relationship between nurse density in the health system and economic loss due to RTI. RTIs cause enormous death and DALYs loss in low-middle income countries and enormous economic loss in HIC. More road traffic prevention programs should be promoted in these areas to reduce both incidence and economic burden of RTIs

Tuberculosis in Asia and the pacific: the role of socioeconomic status and health system development

To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Incidence, prevalence and mortality rates of tuberculosis and 20 variables of socioeconomic, health system and biological-behavioral issues were included in the study involving all 46 countries of the Asian Development Bank region [2007 data]. Both univariate and multivariate linear regressions were used. The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product [GDP] per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of lowering the corruption and improving the sanitation

influence of individual and contextual socioeconomic status on obstetric care utilization in the Democratic Republic of Congo: a population-based study

Maternal health care utilization continues to focus on the agenda of health care planners around the world, with high attention being paid to the developing countries. The devastating effect of maternal death at birth on the affected families is untold. This study examines the utilization of obstetric care in the Democratic Republic of Congo. We have used the nationally representative data from the 2007. Democratic Republic of Congo Demographic and Health Survey. Multilevel regression analysis has been applied to a nationally representative sample of 6,695 women, clustered around 299 communities in the country. The results show that there are variations in the use of antenatal care and delivery care. Individual-level characteristics, such as women's occupation and household wealth status are shown to be associated with the use of antenatal care. Uptake of facility-based delivery has been seen to be dependent on the household wealth status, women's education, and partner's education. The effect of the neighborhoods' socioeconomic disadvantage on the use of antenatal care and facility-based delivery are the same. Women from highly socioeconomically disadvantaged communities, compared to their counterparts from less socioeconomically disadvantaged neighborhoods, are less likely to utilize both the antenatal services and healthcare facility for child delivery. The result of this study has shown that both individual and contextual socioeconomic status play an important role in obstetric care uptake. Thus, intervention aimed at improving the utilization of obstetrics care should target both the individual economic abilities of the women and that of their environment when considering the demand side

Economic cost of childhood unintentional injuries

This study aims to review the economic cost of childhood [0-18 years] unintentional injuries [UI] and focuses upon comparing the cost burden between developing and developed countries. Articles were selected from PUBMED using the search words "Economic Cost", "Unintentional injuries" and "Children". Nine articles were selected. Studies in China focused upon cost to hospitals, in Bangladesh they focused on personal payment in rural areas, and in Vietnam they focused upon community-based cost analysis. There was one study from Norway on UI at home. There were 5 articles from the USA focusing on submersion injury, UI insurance, unintentional traumatic brain injury, UI due to firearms and UI medical costs. The cost of childhood UI is enormous, ranging from US $516,938 to US $9,550,704 per year. This represents a large economic burden on society. Additionally, there is a large gap between lower-middle income countries [LMIC] and high income countries [HIC] in the burden of injury, injury health care and insurance systems. Different bases and contexts of studies make it difficult to draw a solid conclusion about the amount of costs of UI among children. Therefore, more studies of children's unintentional injuries should be carried out in low and middle income countries

Does economic empowerment protect women from intimate partner violence?

The current study compared working and non-working groups of women in relation to intimate partner violence. The paper aims to explore the relationship between womens economic empowerment, their exposures to IPV and their help seeking behavior using a nationally representative sample in India. This was a cross sectional study of 124,385 ever married women of reproductive age from all 29 member states in India. Chi-square tests were used to examine differences in proportions of dependent variables [exposure to IPV] and independent variables. Multivariate logistic regressions were used to assess the independent contribution of the variables of economic empowerment in predicting exposure to IPV. Out of 124,385 women, 69432 [56%] were eligible for this study. Among those that were eligible 35% were working. In general, prevalence of IPV [ever] among women in India were: emotional violence 14%, less severe physical violence 31%, severe physical violence 10% and sexual violence 8%. For working women, the IPV prevalence was: emotional violence 18%, less severe physical violence 37%, severe physical violence 14% and sexual violence 10%; whilst for non-working women the rate was 12, 27, 8 and 8 percents, respectively. Working women seek more help from different sources. Economic empowerment is not the sole protective factor. Economic empowerment, together with higher education and modified cultural norms against women, may protect women from IPV

relationship between intimate partner violence and maternal practices to correct child behavior: a study on women in Egypt

This paper scrutinizers the association between maternal practices to correct child behavior and the mothers' exposure to and attitudes towards intimate partner violence [IPV]. Nationally representative data comprising 14 016 married women were retrieved from the Egyptian Demographic and Health Survey, 2005. Data on practices used to correct child behavior, exposure to IPV, attitudes towards IPV were our primary interest. Data were analyzed using Chi-square test and logistic regression. The majority of the mothers reported use of violent methods, like shouting [90.6%], striking [69.1%] and slapping [39.3%] to correct child behavior. Seven percent of the mothers used only the explanation option. Exposure to physical IPV and tolerant attitudes towards IPV were associated with an augmented risk of using violent methods [shouting, striking or slapping] to correct child behavior. On the other hand non-tolerant attitudes towards IPV were associated with increased likelihood of sole use of the explanation method. We thus recommend the implementation of local parental education programs focusing on communicative skills to reduce IPV and related child abuse