Intimate Partner Violence as a Predictor of Antenatal Care Services Utilization in Rwanda

Abstract Background: Although compelling evidence shows that the experience of intimate partner violence (IPV) during pregnancy is detrimental to both physical and mental health of the victims and their offspring, studies on negative impact of IPV on antenatal care (ANC) services utilization are scarce. Methods: The aim of the current study was to determine the impact of IPV exposure on ANC services utilization indicators such as (i) initiation of care within the first three months of pregnancy, (ii) receipt of at least four ANC visits and (iii) receipt of care from skilled providers among reproductive age women in Rwanda. This study used the data from the 2014-15 Rwanda Demographic and Health Survey. Multiple logistic regression was used to estimate the effects of physical and sexual IPV on the antenatal care (ANC) services utilization indicators. Results: Among married women living with their partners with at least one child aged 5years or under (N=5116), 17% of them reported physical violence, 22.8% reported psychological violence and 9.2% reported sexual violence. We found that there was a significant negative relationship between physical IPV and both early ANC and sufficient ANC. Women who had experienced physical violence by their partners during the preced­ing 12 months were less likely to receive more than four ANC visits, (O.R) = 0.6151 confidence interval (CI) [0.417-0.908] and they were less likely to attend the first ANC visits within the first three months (O.R) =0.656 confidence interval (CI) = [0.445-0.967] . Conclusion: In this study, the prevalence of IPV is still high and there is evidence that it does have significant impact on ANC. Therefore, the results provide support for continued efforts to reduce intimate partner violence, through the improvement of screening for IVP during ANC visits.