Prevalence, Correlates, and Trends of Intimate Partner Violence Against Women in Cambodia: Findings From 2014 and 2021-22 Cross-Sectional Demographic and Health Surveys.

Intimate partner violence (IPV) is globally endemic and a gross violation of human rights, in addition to abuse of intimacy by some men against their female intimate partners. Based on literature review, attitudinal, socio-demographic, and experiential attributes of 15 to 49 year old ever partnered women in the heterosexual relationships were identified. This study used the anonymized 2020-21Cambodia Demographic and Health Survey (CDHS) data to compute the IPV prevalence and its correlates, in addition to computing the changes in IPV prevalence at the urban, rural, and at the national levels using data from the 2014 CDHS. Identified attitudinal, socio-demographic, and experiential attributes were used in the bivariate and multivariable analysis. Simple and multiple logistic regression models were used for computing the bivariate and multivariate associations with IPV; additionally, trend analysis was done to compute changes in IPV prevalence between the 2 surveys. Lifetime prevalence of IPV was 20.70%, while the most common subtype was emotional IPV at 18.70%. Ten out of 12 correlates studied were found to be statistically significantly associated with IPV in the bivariate analysis. These were added in the multivariable model and 7 were found to be statistically significantly associated with IPV. Which included educational attainment of women and their intimate partners, number of living children, women's IPV acceptance, male partner's alcohol use, knowledge of physical beating of mother by one's father, and controlling behavior exercised by partner. During the intervening period between the 2 CDHSs, IPV and its subtypes were decreased in both urban and rural areas, as well as nationally. IPV decrease between the 2 DHSs and lower IPV rates in 2021-22 augur well for the health and human rights of Cambodian women. However, the ultimate target of eliminating IPV against women, will require measures that ensure economic and gender empowerment, and gender equality.

Prevalence, correlates, and trends of intimate partner violence against women in Pakistan: Results from Pakistan Demographic and Health surveys 2012-13 and 2017-18.

BACKGROUND: Intimate partner violence (IPV) is a global public health problem. The objectives of this study were to analyze the prevalence and correlates of IPV perpetrated by men against women from the recent nationally representative Pakistan Demographic and Health Survey (PDHS) 2017-18, and to analyze levels and trends of IPV perpetrated by current/former husbands from PDHS conducted in 2012-13, in the four provinces and the capital city. METHODS: Association of having ever experienced IPV, defined as either emotional, physical and/or sexual violence, by ever married women aged 15-49, with 12 explanatory socio-demographic, attitudinal, and experiences were analyzed using simple and multiple logistic regression models. RESULTS: The prevalence of having ever experienced IPV was 33.48% (95% CI: 30.76-36.32). In the final multivariable model, number of living children, having knowledge of parental physical IPV, husband's use of alcohol, and marital control were statistically significantly associated with IPV. Proportions and trend analysis of emotional and physical IPV between the PDHS 2017-18 and PDHS 2012-13, showed that in general, rural areas of provinces reported higher prevalence of emotional and physical IPV, compared with urban areas, and in general, emotional, and physical IPV prevalence declined from PDHS2012-13 to PDHS2017-18. CONCLUSIONS: The prevalence of having experienced physical and/or sexual intimate partner violence in Pakistan was lower than the prevalence for the WHO Eastern Mediterranean region. However, IPV burden at the provincial urban-rural residency status underscore the need for location specific strategies to effectively address IPV in Pakistan.

Prevalence, correlates, and trends of intimate partner violence against women in Sierra Leone: findings from 2013 and 2019 demographic and health surveys.

Background: Intimate partner violence (IPV) is a globally pervasive public health and medical problem in addition to being a serious violation of women's rights. The two-fold objectives of this study were to compute the lifetime prevalence and correlates of IPV perpetrated by current/former husbands/partners of ever-married women aged 15-49 years using the nationally representative Sierra Leone Demographic and Health Survey (DHS) conducted in 2019; ethnicity-based levels and trends of IPV were also computed using the data from the DHS conducted in 2013 along with the 2019 DHS. Methods: Twelve IPV correlates pertaining to socio-demographic, attitudinal, and experiential attributes were analyzed using logistic regression models for bivariate and multivariable analysis. IPV was computed as a composite variable comprising of physical, emotional, and/or sexual IPV. Results: Lifetime prevalence of experiencing any kind of IPV was a staggering 60.81%, whereas emotional, physical, and sexual IPV prevalence were reported by 45.90%, 49.81%, and 8.14% of the respondents, respectively. No ethnicity reported a statistically significant decrease in any type of IPV during the intervening period between the two surveys. Five out of nine ethnicities reported a statistically significant increase in emotional IPV, while few ethnicities reported a statistically significant increase in one or more types of IPV. Conclusion: The high lifetime prevalence of IPV is alarming and points to the need for targeted health promotion campaigns to reverse the tide of IPV in Sierra Leone, including focusing on changes in cultural and ethnicity-based norms and mores to ensure women's human rights are respected and upheld.

Spatial Distribution And Clustering Of The Proportion Of Disabled Individuals By Districts In Punjab.

Disabilities are globally endemic and will increase with population ageing and ubiquitous prevalence of non- communicable diseases. The Pakistan Social and Living Standards Measurement survey conducted in 2019-20 is the only district-level representative survey that provides proportion of disabled individuals. The survey used a standardized and validated six-questions from the 'Washington Group Questions' that identify functional disabilities pertaining to difficulty in the domains of sight, hearing, walking/climbing steps, remembering/ concentrating, self-care (washing/dressing), and communicating/being understood. Disabilities were more common in men in both urban and rural areas of districts. Clustering of highest percentage of disabled persons were found in the north-western districts, while lower percentages were seen on the north-eastern districts. Test for the spatial autocorrelation of cumulative disability in the entire study area of Punjab province was found to be statistically significant. Findings underscore the need for better targetted health and social services for the disabled individuals in the Punjab province.

Prevalence, Correlates, and Trends of Intimate Partner Violence Against Women in Gambia: Results From 2 National Cross-Sectional Health Surveys.

No country is immune from intimate partner violence (IPV). The objectives of this study were to analyze the prevalence, correlates and trends of this global public health menace perpetrated by men against women using the most recent nationally representative Gambia Demographic and Health Survey (GDHS) 2019-20; with analysis of levels and trends of IPV perpetrated by current/former husbands/partners from ever-married women, from GDHS conducted in 2013, at the 8 subnational regions. IPV association with 12 covariates entailing socio-demographic, experiential and attitudinal characteristics was analyzed in bivariate and multivariable models, using simple and multiple logistic regression. Physical, emotional, and sexual IPV was reported by 29.09%, 24.03%, and 5.52% respectively. While prevalence of having experienced any type of IPV was39.23%. Statistically significant association of IPV with various covariates computed in univariate analysis were used in the multivariable logistic regression model. Women's and husband's educational attainment, wealth status, having witnessed father physically beat mother, and marital control exhibited by the husband were statistically significantly associated with IPV, in the final model. Physical, emotional, and sexual IPV increased from 2023 to 2019-20 in all 8 regions, with the exception of sexual IPV in Kanifing region. However, not all these changes were not statistically significant. Physical and sexual IPV prevalence in Gambia was slightly lower compared with the African region. The disturbing finding of increase in all 3 types of violence in all regions-with one exception-paints a dire scenario that augurs the imperative of women empowerment and revisiting of cultural norms for protecting women.

Bivariate mapping of intimate partner violence prevalence and its correlates in Liberia by county: Results from the 2019-2020 Demographic and Health Survey.

Intimate partner violence (IPV) is a global public health concern and requires nuanced health policy response for effective addressal at the subnational level. Using the nationally and county level representative data from the 2019-20 Demographic and Health Survey of Liberia, the prevalence of IPV was computed for each of the sixteen Liberian counties in 15 - 49-year-old women. Additionally, prevalence of IPV acceptance and having parental IPV were also computed. Prevalence of each of the three metrics were mapped by county, in addition to bivariate mapping of the three attributes. Results demonstrate wide chasms in prevalence at the county level. Several countries with high prevalence of one metric were correlated with the high prevalence of the other two metrics, and vice versa. Albeit nuanced differences in associations at the county level were also observed. Findings auger for nuanced health policy measures to address IPV more effectively in Liberia.

Prevalence and correlates of physical fighting among adolescents in Paraguay: Findings from the 2017 national school-based health survey.

BACKGROUND: Interpersonal violence among adolescents is a serious public health issue across the globe and has been one of the leading causes of death among Paraguayan adolescents. This study aims to investigate the prevalence of physical fighting among adolescents in Paraguay in order to identify problematic fighting behaviour. We also aim to examine the correlates of physical fighting and the extent to which previously identified factors correlate with physical fighting. METHODS: We used the Paraguay 2017 Global School-based Student Health Survey (GSHS). This survey collects health-related information on school-attending adolescents aged 13-17 years. We defined physical fighting as having participated in at least two physical fights in the previous 12 months. We chose 16 independent variables: 12 individual-level variables and four social-level variables. Multivariable logistic regression models were developed to identify factors associated with physical fighting. One of the limitations of this study is that it only captured the responses of the students who attended school on the day of the survey. FINDINGS: A total of 3,149 students completed the survey questionnaire, with the response rates for the school, student, and total response being 100%, 87%, and 87%, respectively. In 2017, 8% of the survey participants (11.4% of the males, and 4.7% of the females) had been involved in two or more physical fights during the past 12 months. In the multivariable model, having been physically attacked, male gender, physical activity, alcohol use, early sexual debut, and suicide planning were significantly associated with involvement in physical fighting. Having helpful peers and supportive parents was not statistically significant in the model adjusted for all variables. CONCLUSIONS: Although Paraguay shows relatively lower prevalence of physical fighting than other countries, the high association between physical fighting and having been physically attacked is noteworthy. Considering the serious interpersonal violence among Paraguayan adolescents, preventive attributes should be considered, and further assessment of other types of interpersonal violence should be made.

Self-reported involvement in road traffic crashes in Kenya: A cross-sectional survey of a nationally representative sample.

Background: Road traffic crashes (RTCs) are a global public health burden whose resulting morbidity and mortality disproportionately impact low- and middle-income countries with stressed health systems. There is a paucity of published studies that evaluate the sociodemographic distribution of RTCs using nationally representative samples from the African region. Aim: To examine population-wide associations between sociodemographic factors and involvement in RTCs in Kenya. Methods: Data were obtained from the 2014 Kenyan Demographic Health Survey, representing all 47 counties in Kenya, from May to October of 2014. We estimated the prevalence of RTCs and utilized logistic regression for bivariate and multivariable analyses to determine the sociodemographic factors associated with RTCs. Study variables included age, place of residence, household wealth index, educational attainment, and history of alcohol consumption. We computed odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results: A higher prevalence was reported among men (8.76%) versus women (3.22%). The risk factors among men included being 20-34 years of age, living in a rural area (OR 1.38, 95% CI 1.09, 1.74), drinking alcohol (OR 1.33, 95% CI 1.11, 1.59), and having not higher than a primary (OR 1.90, 95% CI 1.19, 3.03) or secondary (OR 1.68, 95% CI 1.04, 2.71) education. The strongest risk factors for women included the being aged 45-49 (OR 2.30, 95% CI 1.44, 3.67) and 20-24 years (OR 1.81, 95% 1.17, 2.79) as well as being in the fourth wealth quintile (OR 1.83, 95% CI 1.15, 2.91). Conclusion: Men and the most economically productive age groups were more likely to report being involved in RTCs. Strategies to reduce the occurrences of RTCs should prioritize the most vulnerable sociodemographic groups.

Spousal violence against women in Afghanistan: Bivariate mapping of correlates.

Spousal violence against women is endemic and owes its genesis to deeply entrenched socio-cultural norms. In this study 2015 Demographic and Health Survey data for Afghanistan was used to calculate the provincial prevalence and two correlates of spousal violence, and their bivariate mapping. Large differences were present in the provincial prevalence of spousal violence, having witnessed their father ever beat their mother, and acceptance of spousal violence by the currently or ever married women aged 15-49 years. In general, bivariate maps showed strong associations between spousal violence against women, its acceptance by women, and having witnessed their father beat their mother by ever married women. In an easily comprehensible manner, these maps underscore ensuring better quality of life in marital settings, higher and more equal social stature of women, and protecting their basic human rights would entail legal, social, and cultural paradigm shift.

Gender differentials in spatial distribution of immunisation status in children aged 12-23 months by district in Punjab - Results from Pakistan Social and Living Standards Measurements Survey 2014-15.

In Pakistan routine immunisation for children is offered free of cost in the public sector and several studies have been conducted analysing coverage at the village, city, district, and provincial levels that show wide variation in immunisation coverage rates. Using the district level Pakistan Bureau of Statistics 'Pakistan Social and Living Standards Measurements' survey data for 2014-15, various immunisation indices were analysed and mapped for Punjab province. The mapping of gender disaggregated, three immunisation indices at the district level illustrate that immunisation of 12-to-23-month children is wide spread in the Punjab province. In the southern and central districts, immunisation coverage was not at par with the northern districts. Gender-based immunisation coverage proportions does show differentials that is a cause of concern. Disease mapping brings out these immunisation coverage and differences in an easily understandable format that could help better plan, target, and deliver childhood routine immunisations in the province.

Cross-national examination of adolescent suicidal behavior: a pooled and multi-level analysis of 193,484 students from 53 LMIC countries.

INTRODUCTION: Suicide is a leading cause of adolescent mortality worldwide. We aimed to estimate the prevalence and identify individual-level and country-level factors which might explain the variability in suicidal behavior among students in 53 low to middle income countries. METHODS: We used data on adolescents aged 12-16 years from the Global School-based Student Health Surveys from 2009-2016. The suicidal behaviors investigated included suicide ideation, suicidal planning and suicide attempt. The prevalence was estimated for 53 countries, while a multilevel logistic regression analysis (33 countries) was used to investigate the associations of these behaviors with individual and country-level contextual risk factors. The contextual variables included the Gini Coefficient, Gross Domestic Product per capita, pupil-to-teacher ratios, population density, homicide rates, law criminalizing suicide and the night light index. RESULTS: The overall prevalence of suicide ideation, making a plan and suicide attempt were 10.4%, 10.3% and 11.0%, respectively. The highest prevalence rates reported were from the Americas. The strongest risk factors associated with suicidal behavior included anxiety, loneliness, no close friends and the substance abuse. Among the country level variables, the night light index was associated with making a suicide plan and attempting suicide. CONCLUSION: The non-significant country level findings were not entirely surprising given the mixed results from prior studies. Additional knowledge is thus achieved with regard to country level factors associated with suicidal behavior across adolescent populations.

Prevalence and Correlates of Intimate Partner Violence against Women in Liberia: Findings from 2019-2020 Demographic and Health Survey.

BACKGROUND: Intimate partner violence is a global public health crisis and a human rights issue. The objectives of the study were to conduct secondary analysis of the most recent Liberia Demographic and Health Survey (2019-2020) to determine the descriptive and analytical epidemiology of intimate partner violence (IPV) and its correlates in 15-49 year old ever-married women. METHODS: Association of physical, emotional, sexual, and having experienced any type of IPV with 10 explanatory socio-demographic, attitudinal, and experiences were analyzed using simple and multiple logistic regression models. RESULTS: 55.29% of women reported having ever experienced some form of IPV perpetrated by their current or most recent husband/partner, with the most common type being physical violence. Having been slapped, insulted, made to feel bad, and physically forced into unwanted sex were the most common types of physical, emotional, and sexual IPV. The multivariable analysis showed statistically significant association with IPV for number of living children, women's acceptance of IPV, husband/partner's use of alcohol, and having witnessed parental physical IPV. CONCLUSIONS: The prevalence of having experienced physical and/or sexual intimate partner violence in Liberia was much higher than the prevalence for the WHO Africa region of 33%, highlighting the need for better women empowerment and gender equality in Liberia.

Intimate partner violence among ever-married Afghan women: patterns, associations and attitudinal acceptance.

Intimate partner violence (IPV) is one of the most prevalent forms of violence that women suffer globally. Women in Afghanistan have been exposed to high levels of IPV which coincided with high levels of conflict during more than four decades. We cross-sectionally examined the Afghanistan Demographic and Health Survey responses of 21,234 ever-married Afghan women. We first performed the frequency distribution analysis to determine the prevalence of IPV and the basic socio-demographic characteristics of the participants. Subsequently we examined the relationship between the independent and dependent variables followed by the bivariate and survey versions of logistic regression analyses. We report odds ratios in order to depict the strength and direction of the associations between the IPV and selected independent variables. P-values less than 0.05 were considered statistically significant. The analyses showed that 55.54% of Afghan women experienced some form of physical, emotional, or sexual violence by their intimate partners during the recall period partners. The most common form of IPV found was physical violence (50.52%). Factors such as being exposed to inter-parental violence (respondent woman's father physically abused her mother) (adjusted OR= 3.69, CI= 3.31-4.10) and respondent's acceptance of IPV (aOR= 1.85, 1.51-2.26) were associated with increased exposure to IPV. Having a spouse with at least a primary education (aOR= 0.76, CI= 0.64-0.91) or a respondent with at least a primary education (aOR= 0.82, CI= 0.68-0.98) was associated with lower exposure to reported IPV. The lifetime experience of IPV occurs to a high extent among Afghan women, and several socio-demographic factors have predisposing attributes. IPV policy formulation and strategizing may benefit from considering these factors.

Spatiotemporal analysis of having been sick or injured and having sought health consultation by district in Punjab province of Pakistan - 2010-2015.

Objectives: To analyse the geospatial and temporal distribution of disease and injury burden and factors that influence health care seeking behaviour in thirty-six districts of Punjab in Pakistan. METHODS: Utilizing the district level-Pakistan Social and Living Standards Measurement survey data for 2010-2015 from the Pakistan Bureau of Statistics and Human Development Index (HDI) data for the years 2011-2015 from the United Nations Development Programme; choropleth maps were created based on the district level proportions of population reporting having been sick or injured and having sought health consultations for all three waves of PSLM surveys and based on HDI for the years 2011, 2013 and 2015 for the Punjab districts. Spatial cluster analysis of having been sick or injured and having sought health consultations for three waves of PSLM was conducted. RESULTS: For the years (2010-11), (2012-13) and (2014-15) respectively; the mean proportions of population that reported being sick or injured were (7.36±2.23), (6.99±2.33), and (5.70±1.72). The corresponding mean proportions that sought health consultation were (96.11±2.92), (96.05±2.26) and (96.82±2.15) respectively. Having sought health consultation in years (2010-11) and (2012-13), having been sick/injured in (2010-11), and human development index of 2013 as well as 2015 were statistically significant determinants of having sought consultation in the last wave of (2014-15) (p<0.05). CONCLUSIONS: Findings show a decline in the reported disease and injury burden between 2010 and 2015 but constant rates of seeking health care. HDI and having sought care previously are the major determinants of subsequent health consultation in Punjab. Future studies need to focus on how these results can be utilized to health inequalities in Pakistan.

Adolescent suicide attempts in three diverse island nations: patterns, contextual differences and demographic associations.

OBJECTIVE: Most epidemiological studies on suicidal behavior have been focused on high-income country settings. This study examine factors associated with suicidal behaviors among school-attending adolescents in three island nations. In this secondary analysis of the publicly available 2015 nationally representative GSHS data, we tested demographic, social, and behavioral attributes using multivariable logistic regression to association with suicide attempts. RESULTS: Within the recall period, 13.6% of participants reported having attempted suicide one or more times in the Cook Islands, 10.8% in Curaçao, and 9.8% in East Timor. In the Cook Islands, suicide ideation (AOR = 19.42, 95% CI = 9.11-41.41), anxiety (AOR = 2.51, 95% CI = 1.08-5.82), physical bullying (AOR = 3.3, 95% CI = 1.10-9.91), and cigarette smoking (AOR = 3.82, 95% CI = 1.38-10.54) were associated with suicide attempts. For Curaçaoo, suicide ideation (AOR = 7.88, 95% CI = 5.20-11.95) and suicide planning (AOR = 7.01, 95% CI = 4.24-11.60) were statistically significant. While for East Timor, suicide ideation (AOR = 4.59, 95% CI = 2.14-9.88), suicide planning (AOR = 3.36, 95% CI = 1.76-6.29), bullying victimization (AOR = 2.69, 95% CI = 1.02-7.12), and serious injuries (AOR = 2.22, 95% CI = 1.31-3.74) were statistically significant. Suicide attempt is relatively common in each of the three island nations. The socioeconomic context of adolescents might play a significant role in moderating suicidal behavior. Therefore, prevention efforts should be grounded in view of geographic, demographic, and socioeconomic contexts of the populations at risk.

Changes in Mortality Related to Traumatic Brain Injuries in the Seychelles from 1989 to 2018.

Introduction: Traumatic Brain Injuries (TBIs) are a significant source of disability and mortality, which disproportionately affect low- and middle-income countries. The Republic of Seychelles is a country in the African region that has experienced rapid socio-economic development and one in which all deaths and the age distribution of the population have been enumerated for the past few decades. The aim of this study was to investigate TBI-related mortality changes in the Republic of Seychelles during 1989-2018. Methods: All TBI-related deaths were ascertained using the national Civil Registration and Vital Statistics System. Age- and sex-standardised mortality rates (per 100,000 person-years) were standardised to the age distribution of the World Health Organisation standard population. Results: The 30-year age-standardised TBI-related mortality rates were 22.6 (95% CI 19.9, 25.2) in males and 4.0 (95% CI 2.9, 5.1) in females. Road traffic collisions were the leading contributor to TBI-related mortality [10.0 (95% CI 8.2, 11.8) in males and 2.7 (95% CI 1.8, 3.6) in females, P > 0.05]. TBI-related mortality was most frequent at age 20-39 years in males (8.0) and at age 0-19 in females (1.4). Comparing 2004-2018 vs. 1989-2003, the age-standardised mortality rates changed in males/females by -20%/-11% (all cause mortality), -24%/+39.4% (TBIs) and +1%/+34.8% (road traffic injury-related TBI). Conclusion: TBI-related mortality rates were much higher in males but decreased over time. Road traffic collisions were the single greatest contributor to TBI mortality, emphasising the importance of road safety measures.

Descriptive Epidemiology of the Tuberculosis Service Delivery Project Beneficiaries in Northwest Syria: 2019-2020.

Background: Tuberculosis (TB) is a chronic communicable disease caused by the Mycobacterium tuberculosis that thrives in protracted humanitarian crises. It is an important cause of morbidity and mortality burden in the developing world. Globally, TB is the number one cause of death from any single infectious disease agent that plagued an estimated 10 million (range, 8.9-11.0 million) people in 2019 alone. The Eastern Mediterranean region comprised 8.2% of the worldwide share of TB cases in 2019. Methods: in April 2019, the World Health Organization's (WHO) country office of Turkey started three TB centers in the cities of A'zaz, Idleb, and Afrin in northwest Syria, to provide the population with quality TB treatment curative services. The objectives of the project involved provision of full package of TB services in alignment with WHO TB standards and protocols. Three contractors i.e., national NGOs, were selected after a rigorous process in accordance with WHO policies. These newly established centers were equipped with the essential medical supplies, including well-functioning X-ray and microscopy laboratories run by WHO-trained medical doctors and lab technicians. Results: Based on the quarterly reports submitted by the WHO partners, from the last two quarters of the year 2019, and the four quarters for the year 2020, out of 785 cases diagnosed either by clinical, laboratory, or radiological assessment, 251 cases were bacteriologically confirmed as TB cases against the backdrop of 2236 bacteriological investigations done and a weekly average of 31 sputum specimens processed. A total of 316 smear positive slides were identified during the study period, with the proportion of smear positive slides to be 14.13%. Clinical status determined after 6 months of treatment revealed that out of the 181 patients enrolled in the third quarter of 2019, 128 patients were either cured or successfully completed their TB treatment; with a treatment success rate of 70.7% and in quarter 4, 2019 those figures were respectively: 133, 82 and 61.7%. Conclusion: Despite the challenging and protracted complex humanitarian situation in northwest Syria, the number of patients enrolled and the proportion who successfully completed the TB treatment is acceptable. However, these results are preliminary, as clinical outcomes were available only for the first and second cohorts of patients enrolled. Innovative solutions and flexibility in the execution and continued expansion of this promising project are imperative.