Obstetric violence and associated factors among HIV-infected women receiving birth care at Public Health Facilities in Addis Ababa, Ethiopia

doi:10.21203/rs.3.rs-1740887/v1

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Obstetric violence and associated factors among HIV-infected women receiving birth care at Public Health Facilities in Addis Ababa, Ethiopia

https://doi.org/10.21203/rs.3.rs-1740887/v1

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Background: Obstetrics violence is the adverse outcome of maternal and prenatal health. In the study context, there was limited data on obstetrics violence among HIV infected women. Therefore, the aim of this study to assess obstetric violence and its associated factors among HIV-infected women receiving birth at public health facilities in Addis Ababa Ethiopia.

Methods: Institutional base cross-sectional study was conducted from Jan 1-30, 2021 at selected public health facilities in Addis Ababa Ethiopia. Thereafter, all covariates with p-value <0.2 is a cutoff points for bivariate analysis were considered for further multivariate logistic regression. Finally level of stastical significant were declared at p value <0.05.

Result: A total of 318 HIV-infected women were participated in this study yielding 100% response rate. All type/form of obstetric violence were reported during the study period. Accordingly, Female birth attendant (AOR= 2.848; 95% CI 1.574, 5.153), women who had three times ANC-visitors (AOR= 2.994; 95% CI 1.390, 6.449), women age >35 years old (AOR= 2.471; 95% CI 1.245, 4.904) and women education primary school (AOR= 2.126; 95% CI 1.084, 4.170) were significantly associated with obstetric violence.

Conclusion: This study indicated that the prevalence of obstetric violence among HIV infected women was high. Therefore, to reduce violence during birth care by ensuring clear policies and ethical standards of birth care will be develop and implement and also to rise quality of maternal birth care through an inclusive process by involving the participation all families and stakeholders.

Birth care

HIV-infected women

Obstetric violence

Public health facility

Obstetrics violence (OV) is a violation of women right in medical practice during birth care. In addition, the Venezuela law defines OV is expressed as dehumanized care, abuse of medication to convert the natural processes into pathological way, bringing with loss of autonomy and the ability to decide freely about their bodies and sexuality that is directly affect the health of women, fetus and child. “Obstetric violence” deals with those acts which are classified as physically or psychologically violent in the context of laboring. Hence, violence during birth care is an emerging health problem in health care services and as a human rights problem. In general, violence against women is a manifestation of historically unequal power relation between men and women [1-6]. In this case, disrespectful and abuse of treatment was recognized as a significant public health problem for HIV-infected women with grave consequences of physical, emotional suffering, loss of productivity broadly violates of human right and incurs substantial social, economic and health cost [7-10].

Disrespectful and abuse of treatment is violence right exercised by health personnel on the body of reproductive processes of pregnant women, as expressed through dehumanizing treatment during birth care. Therefore, the adverse outcome of disrespectful and abuse of treatment was failure to guarantee have been identified as factors that dissuade women from maternal health system. These reflect poor progress in maternal and child health outcome such mistreatment create a psychological distance between the women and health care provider that drive women away from formal health systems because of fear of being subjected to such violence and sometimes more prominent obstacle than geographical or financial barriers [11-13]. Recent report showed that three out of four Ethiopian women are a victim of OV during their lifetime. Therefore, OV are urgent and prioritized health agenda especially in developing countries including Ethiopia [14-17].

In this case, maternal and prenatal morbidity and mortality remains high in many developing countries including Ethiopia. But still there was limited information especially in obstetric violence among HIV-infected women in the study setting. Hence, the aim of this study to assess the prevalence and associated factors of obstetric violence among HIV-infected women receiving birth care at public health facilities in Addis Ababa city, Ethiopia 2021.

An institutional based cross-sectional study was conducted from Jan 1-30, 2021 at selected public health facilities located in Addis Ababa Ethiopia. There are 11 public hospitals and 98 health centers provide health service for Addis Ababa city Ethiopia. These public health facilities purposely were selected namely: Alert specialized hospital (ASH), Ghandi Memorial hospital (GMH) and Zewditu Memorial hospital (ZMH), those public hospitals serve as central referral and all obstetric emergencies including high risk pregnancies were referred to the whole Addis Ababa Ethiopia. Thereafter, reviewing HMIS recorded document there are 9 beds in ASH obstetrics and gynecology wards, the average monthly delivery rates was 280, in GMH a total of 137 beds in obstetrics and gynecology wards, about 7 beds in labor ward for stabilization and laboring mothers and the average monthly delivery was 949 and in ZMH a total of 12 beds in obstetrics and gynecology wards the average monthly delivery are 583 (Additional file1: Figure 1).

Sample size was initially determined by both specific objectives using by open Epi info version-7 with the following assumption 95% CI= 1.96, Power= 80% and 1:1 ratio of expose to unexposed the respective prevalence of obstetric violence and its associated factors among postnatal women in a specialized comprehensive Hospital, Amhara Region, Northwest Ethiopia [18]. Those factors consider as urban and rural. And Influences of the senses of birth exhibition in pregnant women childbirth experience in Brazil [19] Those factors consider as marital status and monthly income which are usually characterized in literature having significant association with OV. The largest sample was selected due to representativeness. Finally the required sample size among HIV-infected women age between 15-49 years were included 10% non-responding rate n=318 (Additional file1: Table 1).

The outcome variables were OV whiles the explanatory variables including socio-demographic, gynecological and obstetric variable. Hence, OV were measured by using the seven performance standards involve: Physical violence, failure to get fully informed Consent, unconsented medical procedures, gross violation of privacy and confidentiality, profound humiliation and verbal abuse, neglecting women during birth care to suffer life-threatening complication and refusal of admission to health facility their respective verification criteria were developed [20]. A total of 32 question were used to measure the seven performance standard of the composite scale were assessed OV. Finally, the women replied ‘yes’ at least one or more form of OV had been labeled as having OV.

The sample size were allocated in the selected public health facilities found in Addis Ababa Ethiopia according to data gathered from the previous year from the HMIS recorded document by using systematic random sampling technique. The K-interval was made by dividing the number of cases flow in the first month which is 1308 by divided by the sample sizes (i.e. 1308/318~4). Thereafter, the first women were selected by using lottery method then the first four women who had been earned decision for discharge the selection of participants had been preceded every four interval.

This closed ended questionnaire was adopted from WHO multi-country studies and review deferent relevant literatures had a reference used to make the questions as easy [20]. The component of the questionnaire compromised in to three forms socio-demographic variable, obstetric and gynecological variable and obstetric variable. Then a systematic chronological ordering of different sensitive questions related to OV used for given attention to maximize response rate. Accordingly, before data collection informed consent should be addressed to each respondent and then data were collected by using face to face interview method.

The data were collected by a total of six health care providers who have a minimum of diploma in clinical nursing select from the study area and two supervisors with BSc in Public health were recruited. Then for data collectors and supervisors were trained for two-days by principal investigator about the objectives of the data collection and basic communicating skill. Therefore, the responsibility of the supervisor was to check whether the questionnaires correctly filled out during data collection period and then the supervisors was collect the translated completed questionnaire. Finally, the questionnaire was checked for completeness and accuracy by the principal investigator analyzed subsequently.

The quality of data was taken by providing two-days of training for data collectors and supervisors by preparing training manual. Thereafter, 10% of sample size was pre-test from non-selected public health facility which is found in Addis Ababa city Ethiopia with similar backgrounds to identify the potential problems to reducing information bias related to misclassification interviewers, recall bias, inter and intra-observer bias. Then data validity and reliability is maintained through close supervision of data collectors by supervisors and the principal investigator.

The data was checked for completeness, consistency and accuracy by double cross checking in EPI-info version-7 subsequently analysis was conducted in SPSS version-23. All covariates with p-value <0.2 selection criteria during bivariate analysis were considered for further multivariate analysis to control for all possible confounders identify true predictors of obstetric violence among associated factors. And then those variables p-value <0.05 in multivariate analysis were taken as important predictors of OV. Thereafter, Odds Ratio along with 95% Confidence Interval (CI) were estimated to measure the strength of association level of statistical significance was declared at p-value <0.05. Finally, word, tables and graphs were used to summarize the results of the study.

Socio-demographic characteristics

A total of 318 HIV-infected women were participated in the study setting yielding 100% response rate. About 44.3% of the study respondent’s age between 25-34 years and the mean age of the respondents were 29.45 ±6.281 SD years. Almost 85.2% of respondents were married and about 55% of respondents were educational status secondary and above. Almost 64.5% of respondents were private employed. About 37.1% of respondents were reported on monthly income between 3000-5000 ETB. (See table 1)

Table 1: Socio-demographic characteristics among HIV-infected women receiving birth care at public health facilities in Addis Ababa, Ethiopia, 2021 (n=318).

Variable	Category	Frequency	Percentage
Age	15-24	104	32.7%
	25-34	141	44.3%
	>35	73	23%
Permanent resident	Addis Ababa	285	89.6%
Permanent resident	Others	33	10.4%
Marital status	Married	271	85.2%
	Divorced	19	6%
	Widowed	11	3.5%
	Formal Boy Friend	17	5.3%
Educational Status	No formal education	22	6.9%
	Primary school	121	38.1%
	Secondary and above	175	55%
Occupational status	Government employee	33	10.4%
	Private employee	205	64.5%
	House wife	80	25.2%
Monthly income (ETB)	500-1000	16	5%
	1000-3000	114	35.8%
	3000-5000	118	37.1%
	>5000	70	22%
Husband/male partner educational status (299)	No formal education	9	2.8%
	Primary school	59	18.6%
	Secondary and above	220	69.2%
Husband/Male partner employment status (299)	Government employee	71	22.3%
	Private employee	212	66.7%
	Unemployed	5	1.6%

Obstetric and gynecological characteristics

In the study setting, 56.3% of respondents were reported four and more ANC visitors. Almost 51.9% of respondents were receiving birth at public hospitals and 48.1% of respondents were receiving birth at health center. About 56.9% of the respondents were reported in spontaneous vaginal delivery. Almost 54.4% of the respondents were reported birth at day time and 45.6% of the respondents were reported birth at night time. (See table 2)

Table 2: Obstetrics and gynecological characteristics among HIV-infected women receiving birth care at selected public health facilities in Addis Ababa, Ethiopia 2021 (n=318).

Variable	Category	Frequency	Percentage
Parity	Prim parous	97	30.5%
	Multi parous	162	50.9%
	Grand multiparous	59	18.6%
Gravidity	1	72	22.6%
	2-4	159	50%
	>4	87	27.4%
Number of ANC visit	ANC 1	4	1.3%
	ANC 2	46	14.5%
	ANC 3	89	28%
	ANC >4	179	56.3%
Place of ANC visit	Hospital	165	51.9%
Place of ANC visit	Health Center	153	48.1%
Sex of birth attendant	Male	121	38.1%
Sex of birth attendant	Female	197	61.9%
Number of birth attendant	1-3	18	5.7%
	4-6	191	60.1%
	>6	109	34.3%
Number of main birth attendant	<2	201	63.2%
Number of main birth attendant	>2	117	36.8%
Route/type of delivery	Assisted vaginal delivery	44	13.8%
	C-Section	69	21.7%
	Delivery by episiotomy	24	7.5%
	Spontaneous vaginal delivery	181	56.9%
Excessive bleeding	Yes	39	12.3%
Excessive bleeding	No	279	87.7%
Need blood transfusion	Yes	31	9.7%
Need blood transfusion	No	287	90.3%
Time of delivery	Day	173	54.4%
Time of delivery	Night	145	45.6%
Sex of birth attendant	Male	121	38.1%
Sex of birth attendant	Female	197	61.9%

Prevalence and forms of obstetric violence

The overall prevalence of obstetric violence among HIV-infected women in this study context was 79%. Hence, most of the respondents having suffered one or more forms of OV were reported. Therefore, 78.3% of respondents were reported failure to get informed consent, 71.4% of respondents were reported unconsented medical procedure, 43% of respondents were reported gross violation of privacy and 41.8% of respondents were reported neglecting to suffer life-threatening complication and 32.7% of respondents was reported physical violence (Additional file2: Figure 2).

Determinant of obstetric violence among HIV-infected women

The current finding revealed that women assisted by female birth attendant were as 2.848 times more likely to risk of OV as compared to those women assisted by male birth attendant (AOR= 2.848; 95% CI 1.579, 5.153), women who had three times ANC visitors were as 2.994 times more likely to risk of OV as compare to the counterpart (AOR= 2.994; 95% CI 1.390, 6.449). whereas, women age > 35 years were as 2.471 times more likely to risk of OV as compared to those women age between 15-24 years (AOR=2.471; 95% CI 1.245, 4.904) and women who had only primary school were as 2.126 times more likely to risk of OV as compared to those women who had secondary and above (AOR= 2.126; 95% CI 1.084, 4.170). (See table 3)

Table 3: Determinants of factor associated with obstetric violence among HIV-infected women receiving birth care at public health facilities in Addis Ababa, Ethiopia, 2021. (n=318)

Variable	Obstetrics Violence		COR with 95% CI	AOR with 95% CI
Variable	Yes N (%)	No N (%)	COR with 95% CI	AOR with 95% CI
Age
15-24	74 (71.2)	30 (28.8.)	1	1
25-34	119 (84.4)	22 (15.6)	1.444 (0.719, 2.903)	2.017 (0.928, 4.383)
>35	57 (78.1)	16 (21.9)	2.193 (1.177, 4.084)	2.471 (1.245, 4.904)
Educational status
No formal education	17 (77.3)	5 (22.7)	1.177 (0.441, 3.374)	1.612 (0.487, 5.337)
Primary school	103 (85.1)	18 (14.9)	1.981 (1.082, 3.626)	2.126 (1.084, 4.170)
Secondary and above	130 (74.3)	45 (25.7)	1	1
Occupational Status
Governmental	21 (63.6)	12 (36.4)	0.428 (0.179, 1.072)	0.676 (0.245, 1.865)
Private employee	165 (80.5)	40 (19.5)	1.031 (0.540, 1.971)	1.971 (0.543, 2.332)
House wife	64 (80)	16 (20)	1	1
Number of ANC visit
ANC 1	2 (50)	2(50)	0.366 (0.050, 2.674)	0.537 (0.063, 4.562)
ANC 2	39 (84.8)	7 (15.2)	2.041 (0.855, 4.872)	2.357 (0.912, 6.089)
ANC 3	78 (87.6)	11 (12.4)	2.598 (1.274, 5.299)	2.994 (1.390, 6.449)
ANC >4	131 (73.2)	48 (26.8)	1	1
Sex of birth attendant
Male	81 (66.9)	40 (33.1)	1	1
Female	169 (85.8)	28 (14.2)	2.981 (1.718, 5.178)	2.848 (1.579, 5.153)
Number of birth attendant
1-3	14 (77.8)	4 (22.2)	1.210 (0.368, 3.982)	0.934 (0.254, 3.431)
4-6	155 (81.2)	36 (18.8)	1.488 (0.848, 2.611)	1.561 (0.841, 2.900)
>6	81 (74.3)	28 (25.7)	1	1
Time of delivery
Day	129 (74.6)	44 (25.4)	0.582 (0.334, 1.014)	0.559 (0.305, 1.026)
Night	121 (83.4)	24 (16.6)	1	1

The current study revealed that the prevalence of OV among HIV-infected women was 79%. Accordingly, Sex of birth attendant, Number of ANC visitors, Age of respondents and Educational status of women were identified as determinant factors of OV. Therefore, the prevalence of OV in the current study was higher compare global prevalence of OV 15% to 70%, in Mexico 23.2%, Venezuela 49.4% and Brazil 49.4%. Another interested finding in this study revealed that much higher prevalence of OV were compared to study done in Mexico 23.2% to 32.2% during the last childbirth and 23.2% during pregnancy period reported [21-28]. This difference might be due to variation in study subject, study areas and socio economic status were determinant factor.

In this study, the prevalence of OV was very high compared to studies done in African countries like Zimbabwe 34%, Gambia 61% and South Africa 41%. This study also identified that higher prevalence of OV were compared to study done in Nigeria 43.5% during the 12 months before pregnancy and 28.3% at a time of childbirth. Another similar study done in Zimbabwe 63.1% of women was reported OV during birth care [29-32]. These differences also due to variation in study subject and study area were determinant factor.

This study also revealed that the prevalence of OV were higher than compared to study done in Egypt Cairo 5% to 16% of women were reported, with this 1% to 19% pregnancies related violence. This study also revealed that the prevalence of OV was very high compared to study done in Northwest part of Ethiopia, 58.4% of women were reported during pregnancy period. The current study bit higher than study done in Amhara region Northwest part of Ethiopia 75.1% of women at least one or more forms of OV were reported [17, 33-36]. This variation could be due to difference in study subject, and study areas were determinant factor.

Therefore, in the study setting, there is a significant association between sex of birth attendant and the OV. Accordingly, women who had assisted by female birth attendant were 2.848 times more likely to risk of OV as compare to those women who had assisted by male birth attendant. This could be due to male birth attendant are more understanding about the role and responsibility for standard birth care compare to the counterpart. In this case, male birth attendant are less likely to risk to being subjected to OV.

This study also revealed that there is a significant association between number of ANC visit and the OV. Thus, the odds of women who had three times ANC visitors were 2.994 times more likely to risk of OV as compared to those women who had four or more times ANC visitors. Accordingly, this finding is consistent with the study done in Jimma town Oromia Region Ethiopia and Egypt Cairo [33, 36]. This might be due to women who had increase ANC follow up better to understand about standard birth care and also increase level of awareness to express their rights. Hence, women who had four or more ANC visitor were as less likely to risk of OV.

Another interesting finding of this study revealed that the odds of OV among HIV-infected women were 2.471 times more likely to risk of OV were as women age >35 years compare to those women age between 15-24 years. Hence, this study were opposed with study done in United States and South Africa [23, 37]. This might be due to age of respondent increase more vulnerable to OV and less understanding about their right and standard of birth care. Thus, women age between 15-24 years was less likely to risk being subjected to OV.

This finding also revealed that there is a significant association between educational status of the respondent and the OV. The odds of respondent who had primary school 2.126 more likely to risk of OV as compare to those women who had secondary and above. Accordingly, this finding is consistent with the study done in Northwest part of Ethiopia and Egypt Cairo [17, 36]. This could be due to educated women are well understanding about their right and responsibility of standard birth care. In this case, women who had educational status secondary and above were less likely to risk of being subjected to OV.

Limitation of the study

✓ Available information was directly related to obstetric violence among HIV-infected women was limited in Addis Ababa and in Ethiopia at all. To minimize this obstacle related scientific information could be used to formulate this study.

✓ Cross sectional study design was limited the magnitude to which establish causality and risk factors from the effect of obstetric violence.

✓ This finding was mainly focused on interview rather than observation. Therefore, the researcher was suggested that there is a need to have further study especially in qualitative way.

In this study the prevalence of OV among HIV-infected women was 79%. In the study context, the top forms of OV; failure to get informed consent, unconsented medical procedure and neglecting to suffer life threatening complication were reported. Accordingly, sex of birth attendant, age of respondents, educational status of women and number of ANC visit were founded to be significantly associated with OV. Therefore, to reducing OV by ensuring clear policies and ethical standards of care develop and implement. In addition, increase quality of birth care through the participation of all stakeholders.

OV: Obstetric Violence

AARHB: Addis Ababa Regional Health Bureau

Authors contributions:

A. Anteneh Wondimagegn Assefa: Designed the work, performed data analysis and interpretation, drafted and revised the manuscript. Finally the author read and approved the manuscript.

B. Basha Ayele (Main Advisor)

C. Seteamlak Adane Masersha (Co Advisor)

Acknowledgement

I would like to thanks Unity University College of Health Science Department of Public Health provide me ethical letter. I am greatly value to support that I have got from the hospitals administrator, study participants and data collectors who had helped me during the study period.

Funding: The researcher was not supported by any fund grant.

Availability of data and materials: In this study the data was engaged wannabe available from the corresponding author upon the reasonable request.

Ethics approval and consent to participate

Ethical approval was obtained from Unity University Collage of Health Science Department of Public Health Research Review Board Committee. Permission letter was acquiring from AARHB for each selected public health facilities in Addis Ababa Ethiopia. All procedures performed involving human participants were in accordance with Helsinki declaration. Written and verbal informed consent was obtained from each study participants. Then the study participants had the right to refuse in the study at any time during the interview. Finally Identifying number was excluded from the questionnaire in order to assure the confidentiality of an autonomous to maximum effort was used to overcome ethical concerns.

Consent for publication: Not consent of publication.

Conflicts of interest: The author declares that there is no conflict of interest.

Chandramathi M, Sravani B. Challenges and barriers faced by women in accessing justice against obstetric violence. 2016;5(9):2.
IFMSA. Obstetric violence and humanized birth. 2017:1.
Muhabaw S Mihret. Obstetric violence and its associated factors among postnatal women in a specialized comprehensive hospital, Amhara Region, Northwest Ethiopia. BMC Res Notes. 2019:2.
Roberto C et al. Obstetric violence in Mexico: results from a 2016 National Household survey. Violence Against Women. 2016:4.
Chandramathi M, Sravani B. Challenges and barriers faced by women in accessing justice against obstetric violence. 2016;5(9):2.
Rachella J Chadwick. Obstetric violence in South Africa. S Afr Med J. May 2016;Vol. 106, No. 5:423.
M. Malan et al. The prevalence and predictors of intimate partner violence among pregnant women attending a midwife and obstetrics unit in the western cape. Glob Ment Health (Camb). 2018:2.
Marion F et al. Intimate partner violence against HIV positive Cameroonian women: prevalence, associated factors and relationship with antiretroviral therapy discontinuity results from the ANRS-12288 Evolcam Survey. Women Health (Lond). 2019:2.
Kebede D et al. Magnitude and correlates of intimate partner violence against women and its outcome in Southwest Ethiopia. PLoS One. April 2012;2:4.
Roberto C et al. Obstetric violence in Mexico: Results from a 2016 National Household Survey. Violenece Against Women. 2016:4.
Omar C Aguilar et al. Obstetric violence criminalised in Mexico: a comparative analysis of hospital complaints filed with the medical arbitration commission. BMJ Sex Reprod Health. 2019:1.
Carlos H Vacaflor. Obstetric violence: a new framework for identifying challenges to maternal healthcare in Argentina. Reprod Health Matter. May 2016:67.
Muhabaw S Mihret. Obstetric violence and its associated factors among postnatal women in a specialized comprehensive hospital, Amhara Region, Northwest Ethiopia. BMC Res Notes. 2019:4.
Berhanu B Bifftu. Domestic violence among pregnant mothers in Northwest Ethiopia: prevalence and associated factors. 2017:2.
Eba T. Pregnancy outcomes of gender based violence among pregnant women admitted to labor and delivery units in three teaching hospitals. October. 2014:29.
Berhanu B Bifftu. Domestic violence among pregnant mothers in Northwest Ethiopia: Prevalence and Aassociated factors. 2017:1–2.
Muhabaw S Mihret. Obstetric violence and its associated factors among postnatal women in a specialized comprehensive hospital, Amhara Region, Northwest Ethiopia. BMC Res Notes. BMC Res Notes. 2019:4.
Muhabaw S Mihret. Obstetric violence and its associated factors among postnatal women in a specialized comprehensive hospital, Amhara Region, Northwest Ethiopia. BMC Res Notes. 2019:5.
Sonia L et al. Obstetric violence: Influences of the senses of birth exhibition in pregnant women childbirth experience in Brazil. 2015:2816.
WHO. The prevention and elimination of disrespect and abuse during facility-based childbirth. 2015:1.
IFMSA. Obstetric violence and humanized birth 2017:3.
Diego P Rodrigues. Obstetric violence in the context of labor and childbirth. 2018:243.
Farah D-Tello. Obstetric violence in the United States: The systemic mistreatment of women during childbirth. Reprod Health Matters. 2017:10.
Diego P Rodrigues. Obstetric violence in the context of labor and childbirth 2018:243.
Roberto C et al. Obstetric violence in Mexico: Results from a 2016 National Household Survey. Violence Against Women. 2019:9.
Heidi C Fantasia et al. Lifetime and recent experiences of violence among college students women. Forensic Nurs. 2019:5.
Omar C Aguilar et al. Obstetric violence criminalised in Mexico: A comparative analysis of hospital complaints filed with the medical arbitration commission. BMJ Sex Reprod Health. 2019:2.
Roberto C et al. Obstetric violence in Mexico: Results from a 2016 National Household Survey. Violence Against Women. 2019:9.
Joy O et al. The prevalence of domestic violence among pregnant women in Nigeria: A systematic review. Trauma Violence Abuse. 2017:2.
Akashi A Rurangirwa. Intimate partner violence among pregnant women in Rwanda, Its associated risk factors and relationship to ANC services attendance: A population-based study. 2017:2.
Akashi A Rurangirwa. Intimate partner violence among pregnant women in Rwanda, its associated risk factors and relationship to ANC services attendance: A population-based study 2017:2.
Eba T. Pregnancy outcomes of gender based violence among pregnant women admitted to labor and delivery units in three teaching hospitals. 2014:10.
Bosena T Gashaw et al. Ethiopian health care workers insights into and responses to intimate partner violence in pregnancy a qualitative study. Int J Environ Res Public Health. 2020:2.
Muhabaw S Mihret. Obstetric violence and its associated factors among postnatal women in a specialized comprehensive hospital, Amhara Region, Northwest Ethiopia. BMC Res Notes. 2019:2.
Agumasie S et al. Domestic violence and its predictors among married women in reproductive age in Fagitalekoma Woreda, Awi Zone, Amhara Regional State, North Western Ethiopia. Reprod Health. 2013:4.
Laura E T Swan et al. Reproductive coercion and interpersonal violence victimization experiences among college students. 2020:3.
Molly B et al. Intimate partner violence experienced by HIV-infected pregnant women in South Africa: A cross-sectional study. JMP Open. 2016:4.

No competing interests reported.

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Obstetric violence and associated factors among HIV-infected women receiving birth care at Public Health Facilities in Addis Ababa, Ethiopia

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Abstract

Background

Methods And Material

Results

Socio-demographic characteristics

Prevalence and forms of obstetric violence

Determinant of obstetric violence among HIV-infected women

Discussion

Limitation of the study

Conclusions

Abbreviations

Declarations

References

Additional Declarations

Supplementary Files

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