Spousal Violence and Contraceptive Use among Married Afghan Women in a Nationally Representative Sample
Spousal Violence and Contraceptive Use among Married Afghan Women in a Nationally Representative Sample
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Date
2022-08-09
Authors
Ibrahimi, Sahra
Steinberg, Julia R.
Advisor
Citation
Ibrahimi, S.; Steinberg, J.R. Spousal Violence and Contraceptive Use among Married Afghan Women in a Nationally Representative Sample. Int. J. Environ. Res. Public Health 2022, 19, 9783.
Abstract
Objective: Afghanistan is one of the countries with the highest prevalence of spousal
violence (56%) and a low prevalence of contraceptive use (23%), yet there is no study assessing
how spousal violence is related to contraceptive use, and what methods are most used by women.
Therefore, this study examined the association between the number of types of spousal violence
and contraceptive use. Method: Using data from 18,985 Afghan married women, aged 15 to 49,
who responded to the 2015 Afghanistan Demographic and Health Survey, the current contraceptive
method was grouped into five categories: male-involved methods, pills, injectables, long-acting
reversible contraception, female sterilization, and Lactation Amenorrhea Method. The number
of types of spousal violence in the past 12 months was categorized as none, one type, or two or
more types, based on women’s experiences with verbal, physical, and sexual violence. For analysis,
binary and multinomial logistic regression were used. Results: After adjusting for the covariates,
the experience of any spousal violence was associated with contraception use (adjusted odds ratio
(aOR) = 1.93, 95% CI: 1.64–2.27, p = 0.0001). Among those using contraception, experiencing two or
three types of spousal violence was associated with using pills (adjusted risk ratio (aRRR) = 2.12,
95% CI: 1.63–2.77, p = 0.0001), injections (aRRR = 1.75, 95% CI: 1.26–2.41, p = 0.001), and LAM
(aRRR = 3.27, 95% CI: 2.05–5.20, p = 0.0001), compared to male-involved methods. Conclusions: The
findings of this study may inform policymakers and program implementers in designing interventions
to address the pervasive problem of violence against women, and make pills and injectables more
accessible to Afghan women, since these methods are under women’s control and more often used
in Afghanistan.
Notes
Partial funding for Open Access provided by the UMD Libraries' Open Access Publishing Fund.