The Impact of Violence on Reproductive Health Tanzania and Vietnam (PAVE)

Project summary

This project begins from the assumption that to advance sexual and reproductive health and rights (SRHR), intimate partner violence (IPV) must be addressed. Research shows that violence against women is associated with significant SRH problems and that the most common form of violence is that performed by a male partner. This project takes a two-country comparative approach, aiming to highlight how cultural norms, social forces, and gender relations structure experiences of and responses to violence.
While the overall relationships between violence and SRH are by now well established, there is a lack of knowledge regarding the more specific associations. First, it is not clear HOW IPV affects SRH: there is a lack of prospective studies of the underlying local-level processes through which associations between IPV and SRH are generated.

Second, it is not clear how the primary health care sector can best address this problem, as lack of knowledge about the pathways by which violence impacts SRH hampers health sector capacities to care for women exposed to violence. Viewing violence against women as a human rights abuse, this project aims to produce new interdisciplinary knowledge about the linkages between IVP and SRH with particular emphasis on health sector responses. The research will be conducted in Tanzania and Vietnam, two countries with socialist histories where national surveys show high IPV prevalence and governments express commitment to combat gender inequalities.

Outputs

Project Completion Report:

In Tanzania and Vietnam, all data collection has been carried out according to plan. The PAVE project data sets include detailed epidemiological information about pregnant women’s exposure to intimate partner violence and about the consequences of violence for women’s reproductive health (pre-term birth, low birth weight deliveries, and perinatal depression). The data sets also include ethnographic research on women’s experiences and modes of coping with partner violence. In both countries, data analyses have been conducted and the results have been disseminated in international peer-reviewed journals, in national peer-reviewed journals, in teaching and at conferences (national and international), through research updates and policy briefs, and through the mass media.

The PAVE project has organized training courses and writing workshops according to plan, and all four PhD students have completed and defended their PhDs. The project has also organized a pilot intervention aiming at the provision of informal support for new mothers who experience mental health problems as a consequence of life challenges such as intimate partner violence.

In terms of publication output, the project has produced a total of 20 articles in international peer-reviewed journals (+ additional articles under review); 8 articles in national peer-reviewed journals; 2 book chapters; and 12 research updates/policy briefs.

Brief popularized abstract
The main purpose of the project was to explore the linkages between intimate partner violence (IPV) and women’s reproductive health in Tanzania and Vietnam. More specifically, we studied the linkages between IPV and low birth weight/preterm birth (PhD project 1) and between IPV and maternal mental health (PhD project 2).
The project found strong associations between IPV and reproductive health problems: women who were exposed to IPV had much larger risks of maternal depression than non-exposed women, and a larger risk of giving birth preterm and to infants with low birth weight.

The main challenge has been the sensitive nature of problems associated with intimate partner violence which makes this topic difficult to investigate, as many women hesitate to disclose their experiences. However, with careful interviewer training, it turned out to be possible to overcome this challenge.

The impact of the project are a stronger evidence base and more concerted public attention to the problems associated with IPV in Tanzania and Vietnam. New perspectives include the importance of maternal mental health screening during pregnancy. We hope to obtain further funding to conduct follow-up research on IPV and/or maternal mental health issues.