Intimate partner violence among pregnant women in Kenya: forms, perpetrators and associations.

BACKGROUND: Intimate Partner violence (IPV) among pregnant women is a significant problem of public health importance. Nevertheless, there are relatively few studies which have examined the phenomenon in sub-Saharan settings. The aim of this study was to provide an overview of the prevalence, perpetrators, and associated factors of IPV during pregnancy in Kenya. METHODS: We were making use of the 2014 Kenyan Demographic and Health Survey (KDHS) data and included women and girls of reproductive age (15-49 years) who have ever been pregnant ([Formula: see text]). A weighted sample of respondents who have experienced violence during pregnancy ([Formula: see text]) were selected for further bivariate and multivariable logistic regression analyses in order to examine the association between IPV and socio-demographic factors. RESULTS: The prevalence of violence among pregnant women in Kenya was 9.2%, perpetrated mostly by the current husband or partner (47.6%), followed by the former husband or partner (31.5%). Physical violence was the most common (78.6%), followed by emotional (67.8%) and sexual (34.8%). Having one or two children ([Formula: see text]; [Formula: see text]), having secondary or higher education ([Formula: see text]; [Formula: see text]) and being 18 years and above at first cohabitation ([Formula: see text]; [Formula: see text]) and at sexual debut ([Formula: see text]; [Formula: see text]) were significantly associated with fewer reports of violence during pregnancy. Pregnant women who were divorced, separated or widowed ([Formula: see text]; [Formula: see text]), who were employed ([Formula: see text]; [Formula: see text]), who had witnessed their fathers beat their mothers ([Formula: see text]; [Formula: see text]) and who had primary education ([Formula: see text]; [Formula: see text]) were significantly more likely to experience violence. CONCLUSIONS: To prevent violence among pregnant women in Kenya, training health care providers should go hand in hand with interventions sensitising and mobilising community members, both addressing the socio-demographic drivers of IPV during pregnancy and directing a particular attention to the most vulnerable ones.

Health and medical care for refugees: design and evaluation of a multidisciplinary clinical elective for medical students.

Objective: Caring for refugee patients places special demands on health professionals. To date, medical students in Germany have rarely been systematically prepared for these challenges. This article reports on the development, conceptualisation, implementation, evaluation, and relevance of a multidisciplinary elective for medical students in the clinical study phase. Methodology: The course content was developed based on a needs-assessment among medical students and in cooperation with medical colleagues working in the field of refugee care. The course consisted of a seminar with medical, legal, administrative and socio-cultural learning content as well as a field placement in the medical outpatient clinic of the local reception centre for asylum seekers, which was accompanied by a systematic reflection process. The evaluation concept contained qualitative and quantitative elements. Results: 123 students completed the elective over six semesters (summer 2016 through to winter 2018). It was continuously evaluated and further developed. The students reported learning progress mainly in the following areas: Legal foundations of the asylum procedure and health care entitlements for asylum seekers; multi-perspectivity through multidisciplinarity as well as professional, ethical, interpersonal, and political insights gained through the practical experience. Summary: To prepare students for the complex challenges to be faced in medical care for refugees, a structured, multidisciplinary teaching programme, which combines theory, practice and reflection helps to foster insights into the many facets of this field of activity. The questions students brought to the seminar, the course contents and evaluation results are intended to inspire the design and implementation of similar courses at other universities.

Physical Fighting among School-Attending Adolescents in El Salvador: An Examination of the 2013 Global School-Based Health Survey.

Background: Violence among school-attending adolescents is an important public health problem worldwide. The present study examined demographic correlates for physical fighting behavior among a nationally representative sample of school-attending adolescents in El Salvador. Methods: Initial cross-tabulations to screen for correlations was then followed by logistic regression to understand the direction and the strength of selected demographic variables for physical fighting behavior, which occurred within a 12 month period of recall. Results: Out of a sample of 1910 school-attending adolescents in El Salvador, 11.5% reported having been involved in two or more physical fights during the recall period. Regression analyses indicated that being male (OR = 3.55; 95% CI = 2.11-6.00); having experienced bullying (OR = 2.16; 95% CI = 1.44-3.24); physical activity (OR 0.61; 95% CI 0.46-0.80); a sedentary lifestyle (OR 1.54; 95% CI 1.05-2.27), suicide planning (OR 2.28; 95% CI 1.46-3.56), and having non-understanding parents (OR = 1.45; 95% CI 1.06-1.98) were significantly associated with physical fighting among the sampled adolescents. Conclusion: Within the limitations of cross-sectional surveys conducted in school settings, the results of the present study suggest that giving attention to preventing bullying behavior among males and involving parents should be components of a multi-pronged strategy to preventing physical fighting in schools in El Salvador.