{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:44:05Z","timestamp":1790271845432,"version":"4.1.0"},"reference-count":49,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T00:00:00Z","timestamp":1687824000000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,20]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study assessed the prevalence of physical violence against pregnant women and its associated factors in sub-Saharan Africa (SSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We analysed cross-sectional data of 108971 women in sexual unions from the most recent Demographic and Health Surveys of 26 countries in SSA. The predictors of physical violence were examined using a multilevel binary logistic regression. All the results were presented as adjusted odds ratios (aORs) with their corresponding 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Twenty-six countries in SSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>108\u2009971 women who had ever been pregnant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measure<\/jats:title>\n                    <jats:p>Physical violence during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Physical violence was identified in 6.0% of pregnant women in SSA. The highest prevalence (14.0%) was reported in South Africa, while Burkina Faso recorded the lowest (2.1%). Women who had primary (aOR=1.26, 95%\u2009CI=1.15, 1.38) and secondary education (aOR=1.15, 95%\u2009CI=1.01,1.32); those who were cohabiting (aOR=1.21, 95%\u2009CI=1.11, 1.32); those who were working (aOR=1.17, 95%\u2009CI=1.08, 1.28); and those whose partners had primary (aOR=1.15, 95%\u2009CI=1.04, 1.28) and secondary education (aOR=1.14, 95%\u2009CI=1.01, 1.28) were more likely to experience physical violence during pregnancy compared with those who had no formal education; those who were married; those who were not working, and those whose partners had no formal education, respectively. Moreover, women whose partners consumed alcohol (aOR=2.37, 95%\u2009CI=2.20, 2.56); those who had parity of four or more (aOR=2.06, 95%\u2009CI=1.57, 2.72); and those who perceived intimate partner violence (IPV) as a culturally accepted norm (aOR=1.55, 95%\u2009CI=1.44, 1.67) had higher odds of experiencing physical violence during pregnancy compared to those whose partners did not consume alcohol, those with parity zero, and those who did not perceive IPV as culturally accepted, respectively. On the contrary, women who were aged 35-39, those who were of the richest wealth index, and those in rural areas had reduced odds of experiencing physical violence during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on the findings, community leaders are encouraged to liaise with law enforcement agencies to strictly enforce laws on gender-based violence by prosecuting perpetrators of IPV against pregnant women as a deterrent. Also, intensifying education on what constitutes IPV and the potential consequences on the health of pregnant women, their children, and their families will be laudable. Improving the socioeconomic status of women may also help to eliminate IPV perpetration against women at their pregnancy stage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-059236","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T12:16:13Z","timestamp":1687868173000},"page":"e059236","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Physical violence during pregnancy in sub-Saharan Africa: why it matters and who are most susceptible?"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7415-895X","authenticated-orcid":false,"given":"Bright Opoku","family":"Ahinkorah","sequence":"first","affiliation":[{"name":"School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3498-2909","authenticated-orcid":false,"given":"Richard Gyan","family":"Aboagye","sequence":"additional","affiliation":[{"name":"Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9734-9054","authenticated-orcid":false,"given":"Abdul-Aziz","family":"Seidu","sequence":"additional","affiliation":[{"name":"Department of Population and Health, University of Cape Coast, Cape Coast, Ghana"},{"name":"College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia"},{"name":"Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9416-1176","authenticated-orcid":false,"given":"James","family":"Boadu Frimpong","sequence":"additional","affiliation":[{"name":"Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3530-6133","authenticated-orcid":false,"suffix":"Jr","given":"John Elvis","family":"Hagan","sequence":"additional","affiliation":[{"name":"Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana"},{"name":"Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Budu","sequence":"additional","affiliation":[{"name":"Department of Population and Health, University of Cape Coast, Cape Coast, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4876-6043","authenticated-orcid":false,"given":"Sanni","family":"Yaya","sequence":"additional","affiliation":[{"name":"School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"The George Institute for Global Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"2025121510282520000_13.6.e059236.1","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1080\/17441692.2017.1293126","article-title":"The ethics of researching intimate partner violence in global health: A case study from global health research","volume":"13","author":"Mannell","year":"2018","journal-title":"Glob Public Health"},{"key":"2025121510282520000_13.6.e059236.2","doi-asserted-by":"crossref","DOI":"10.7448\/IAS.17.1.19233","article-title":"Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother-to-child transmission","volume":"17","author":"Hatcher","year":"2014","journal-title":"J Int AIDS Soc"},{"key":"2025121510282520000_13.6.e059236.3","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1037\/ort0000174","article-title":"Psychological health and academic success in rural Appalachian adolescents exposed to physical and sexual interpersonal violence","volume":"86","author":"Martz","year":"2016","journal-title":"Am J Orthopsychiatry"},{"key":"2025121510282520000_13.6.e059236.4","doi-asserted-by":"publisher","DOI":"10.1177\/0886260514553112"},{"key":"2025121510282520000_13.6.e059236.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0200874","article-title":"Prevalence and risk factors of intimate partner violence among women in four districts of the central region of Ghana: baseline findings from a cluster randomised controlled trial","volume":"13","author":"Ogum Alangea","year":"2018","journal-title":"PLoS ONE"},{"key":"2025121510282520000_13.6.e059236.6","doi-asserted-by":"publisher","DOI":"10.2307\/3583257"},{"key":"2025121510282520000_13.6.e059236.7","doi-asserted-by":"crossref","unstructured":"Murshid NS , Lemke M , Hussain A , et al . Combatting gender-based violence: perspectives from social work, education, Interdisciplinary studies, and medical anthropology. In: Transforming Global Health. Cham: Springer, 2020: 83\u201396. doi:10.1007\/978-3-030-32112-3","DOI":"10.1007\/978-3-030-32112-3_6"},{"key":"2025121510282520000_13.6.e059236.8","unstructured":"Violence against women. 2021. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/violence-against-women [Accessed 24 Jul 2021]."},{"key":"2025121510282520000_13.6.e059236.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-040891","article-title":"Physical and mental health of women exposed to intimate partner violence in the 10 years after having their first child: an Australian prospective cohort study of first-time mothers","volume":"10","author":"Brown","year":"2020","journal-title":"BMJ Open"},{"key":"2025121510282520000_13.6.e059236.10","doi-asserted-by":"crossref","first-page":"100730","DOI":"10.1016\/j.ssmph.2021.100730","article-title":"Intimate partner violence against adolescent girls and young women and its association with Miscarriages, stillbirths and induced abortions in sub-Saharan Africa: evidence from demographic and health surveys","volume":"13","author":"Ahinkorah","year":"2021","journal-title":"SSM Popul Health"},{"key":"2025121510282520000_13.6.e059236.11","first-page":"294","article-title":"Intimate partner violence and pregnancy termination in Armenia: evidence from nationally-representative survey data","volume":"11","author":"Samad","year":"2021","journal-title":"Eur J Investig Health Psychol Educ"},{"key":"2025121510282520000_13.6.e059236.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0172540","article-title":"Intimate partner violence during pregnancy and its association with Preterm birth and low birth weight in Tanzania: A prospective cohort study","volume":"12","author":"Sigalla","year":"2017","journal-title":"PLoS One"},{"key":"2025121510282520000_13.6.e059236.13","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.ypmed.2019.01.016","article-title":"The impact of intimate partner violence, depressive symptoms, alcohol dependence, and perceived stress on 30-year cardiovascular disease risk among young adult women: A multiple mediation analysis","volume":"121","author":"Wright","year":"2019","journal-title":"Prev Med"},{"key":"2025121510282520000_13.6.e059236.14","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2020.8875"},{"key":"2025121510282520000_13.6.e059236.15","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1089\/jwh.2014.4872","article-title":"Intimate partner violence during pregnancy: maternal and neonatal outcomes","volume":"24","author":"Alhusen","year":"2015","journal-title":"J Womens Health (Larchmt)"},{"key":"2025121510282520000_13.6.e059236.16","doi-asserted-by":"publisher","DOI":"10.1037\/vio0000156"},{"key":"2025121510282520000_13.6.e059236.17","doi-asserted-by":"crossref","DOI":"10.3402\/ejpt.v5.24794","article-title":"Adult experience of mental health outcomes as a result of intimate partner violence Victimisation: a systematic review","volume":"5","author":"Lagdon","year":"2014","journal-title":"Eur J Psychotraumatol"},{"key":"2025121510282520000_13.6.e059236.18","doi-asserted-by":"crossref","DOI":"10.1007\/s11920-015-0644-3","article-title":"New developments in intimate partner violence and management of its mental health sequelae","volume":"18","author":"Stewart","year":"2016","journal-title":"Curr Psychiatry Rep"},{"key":"2025121510282520000_13.6.e059236.19","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1177\/1524838020906560","article-title":"Intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa: a mixed-method systematic review and meta-analysis","volume":"22","author":"Tenkorang","year":"2021","journal-title":"Trauma, Violence, & Abuse"},{"key":"2025121510282520000_13.6.e059236.20","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17030903","article-title":"Gender-based violence against women in sub-Saharan Africa: a systematic review and meta-analysis of cross-sectional studies","volume":"17","author":"Muluneh","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2025121510282520000_13.6.e059236.21","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1186\/s12978-018-0637-x","article-title":"Intimate partner violence and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis","volume":"15","author":"Alebel","year":"2018","journal-title":"Reprod Health"},{"key":"2025121510282520000_13.6.e059236.22","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1080\/10926771.2020.1854913","article-title":"Physical intimate partner violence justification and female genital mutilation in Kenya: evidence from the demographic and health survey","volume":"30","author":"Sano","year":"2021","journal-title":"Journal of Aggression, Maltreatment & Trauma"},{"issue":"Suppl 1","key":"2025121510282520000_13.6.e059236.23","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s12978-021-01077-z","article-title":"Intimate partner violence against adolescents and young women in sub-Saharan Africa: who is most vulnerable?","volume":"18","author":"Wado","year":"2021","journal-title":"Reprod Health"},{"key":"2025121510282520000_13.6.e059236.24","doi-asserted-by":"crossref","first-page":"100729","DOI":"10.1016\/j.ssmph.2021.100729","article-title":"Polygyny and intimate partner violence in sub-Saharan Africa: evidence from 16 cross-sectional demographic and health surveys","volume":"13","author":"Ahinkorah","year":"2021","journal-title":"SSM Popul Health"},{"key":"2025121510282520000_13.6.e059236.25","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0230508","article-title":"Correlates of intimate partner violence among urban women in sub-Saharan Africa","volume":"15","author":"Izugbara","year":"2020","journal-title":"PLoS One"},{"key":"2025121510282520000_13.6.e059236.26","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4103\/2230-8229.149577","article-title":"Physical violence against pregnant women by an intimate partner, and adverse pregnancy outcomes in Mazandaran province, Iran","volume":"22","author":"Delavar","year":"2015","journal-title":"J Fam Community Med"},{"key":"2025121510282520000_13.6.e059236.27","unstructured":"UN . Transforming our world: the 2030 agenda for sustainable development. Available: https:\/\/sustainabledevelopment.un.org\/post 2015\/transforming ourworld; 2015"},{"key":"2025121510282520000_13.6.e059236.28","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys184"},{"key":"2025121510282520000_13.6.e059236.29","unstructured":"Aliaga A , Ruilin R . Cluster optimal sample size for demographic and health surveys. In 7th International Conference on Teaching Statistics\u2013ICOTS; July 2006:2\u20137"},{"key":"2025121510282520000_13.6.e059236.30","doi-asserted-by":"crossref","unstructured":"Pool MS , Otupiri E , Owusu-Dabo E , et al . Physical violence during pregnancy and pregnancy outcomes in Ghana. BMC Pregnancy Childbirth 2014;14. doi:10.1186\/1471-2393-14-71","DOI":"10.1186\/1471-2393-14-71"},{"key":"2025121510282520000_13.6.e059236.31","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1177\/0886260517730029","article-title":"Exploring the prevalence and correlates associated with intimate partner violence during pregnancy in Bangladesh","volume":"36","author":"Islam","year":"2021","journal-title":"J Interpers Violence"},{"key":"2025121510282520000_13.6.e059236.32","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1080\/03630242.2020.1767264","article-title":"Prevalence and factors associated with intimate partner violence against women in the Gambia: A population-based analysis","volume":"60","author":"Jabbi","year":"2020","journal-title":"Women Health"},{"key":"2025121510282520000_13.6.e059236.33","doi-asserted-by":"crossref","first-page":"10686","DOI":"10.1177\/0886260519888196","article-title":"Prevalence and predictors of intimate partner violence among married women in Egypt","volume":"36","author":"Yaya","year":"2021","journal-title":"J Interpers Violence"},{"key":"2025121510282520000_13.6.e059236.34","doi-asserted-by":"publisher","DOI":"10.1186\/s12914-018-0145-7"},{"key":"2025121510282520000_13.6.e059236.35","doi-asserted-by":"crossref","unstructured":"Abramsky T , Watts CH , Garcia-Moreno C , et al . What factors are associated with recent intimate partner violence? findings from the WHO multi-country study on women's health and domestic violence. BMC Public Health 2011;11. doi:10.1186\/1471-2458-11-109","DOI":"10.1186\/1471-2458-11-109"},{"key":"2025121510282520000_13.6.e059236.36","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181577654"},{"key":"2025121510282520000_13.6.e059236.37","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s10995-014-1528-6","article-title":"Prevalence, rates and correlates of intimate partner violence among South African women during pregnancy and the postpartum period","volume":"19","author":"Groves","year":"2015","journal-title":"Matern Child Health J"},{"key":"2025121510282520000_13.6.e059236.38","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3390\/safety5010005","article-title":"Alcohol drinking by husbands\/partners is associated with higher intimate partner violence against women in Angola","volume":"5","author":"Yaya","year":"2019","journal-title":"Safety"},{"key":"2025121510282520000_13.6.e059236.39","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-020-00897-8","article-title":"Understanding the endorsement of wife beating in Ghana: evidence of the 2014 Ghana demographic and health survey","volume":"20","author":"Dickson","year":"2020","journal-title":"BMC Womens Health"},{"key":"2025121510282520000_13.6.e059236.40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13690-018-0253-9","article-title":"Women decision-making capacity and intimate partner violence among women in sub-Saharan Africa","volume":"76","author":"Ahinkorah","year":"2018","journal-title":"Arch Public Health"},{"key":"2025121510282520000_13.6.e059236.41","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01083.x"},{"key":"2025121510282520000_13.6.e059236.42","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-012-1015-x"},{"key":"2025121510282520000_13.6.e059236.43","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3110-1"},{"key":"2025121510282520000_13.6.e059236.44","doi-asserted-by":"crossref","unstructured":"Das S , Bapat U , Shah More N , et al . Intimate partner violence against women during and after pregnancy: a cross-sectional study in Mumbai slums. BMC Public Health 2013;13. doi:10.1186\/1471-2458-13-817","DOI":"10.1186\/1471-2458-13-817"},{"key":"2025121510282520000_13.6.e059236.45","doi-asserted-by":"publisher","DOI":"10.1177\/0886260514554427"},{"key":"2025121510282520000_13.6.e059236.46","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-013-0127-8"},{"key":"2025121510282520000_13.6.e059236.47","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-020-0892-1","article-title":"Prevalence of intimate partner violence against women and associated factors in Ethiopia","volume":"20","author":"Chernet","year":"2020","journal-title":"BMC Womens Health"},{"key":"2025121510282520000_13.6.e059236.48","doi-asserted-by":"crossref","unstructured":"Kwagala B , Wandera SO , Ndugga P , et al . Empowerment, partner's Behaviours and intimate partner physical violence among married women in Uganda. BMC Public Health 2013;13. doi:10.1186\/1471-2458-13-1112","DOI":"10.1186\/1471-2458-13-1112"},{"key":"2025121510282520000_13.6.e059236.49","doi-asserted-by":"publisher","DOI":"10.1177\/0973174116649148"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-059236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:28:39Z","timestamp":1765823319000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-059236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6,27]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/bmjopen-2021-059236"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-059236","relation":{"is-referenced-by":[{"id-type":"doi","id":"10.1007\/s44155-026-00406-6","asserted-by":"object"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}