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Try out PMC Labs and tell us what you think. Learn More. This present study was of a qualitative de, with participants information presented in form of full transcripts. The transcripts contain information on disclosure of experiences of partner violence. Intimate partner violence IPV is a global health and human rights problem. Despite the benefits of social support to women victims of violence during pregnancy, a majority of women hesitate to seek help and, if they do, they mainly turn to their natal relatives for support. However, this process of help-seeking and the type of support received is not well documented and needs to be explored with a view to future interventions.
Eighteen participants who experienced physical IPV during pregnancy were purposively selected from a cohort of 1, pregnant women enrolled in a project that aimed at assessing the impact of intimate partner violence on reproductive health. In-depth interviews were used to explore the social support received from the natal family among women who experienced partner violence during pregnancy. All interviews were audio recorded, transcribed, coded and analyzed. Women who experienced severe IPV during pregnancy were more likely to seek help from natal relatives.
Emotional support was the commonest form of support and included showing love and empathy and praying. Information provided to victims aimed mainly at advising them to maintain their marriage. Practical support included direct financial support and building their economic base to reduce dependency on their partners. When the couple was on the verge of separation, mediation was provided to save the marriage.
Women who experienced partner violence preferred to seek help from their natal relatives. The support provided by natal relatives was beneficial; however, maintaining the marriage for the care of children and family was given the highest priority, over separation. As a consequence, many women continued to live with violence. Stakeholders supporting victims of violence need to understand the priorities of victims of violence and structure intervention to address their needs.
Intimate partner violence IPV is a global health and human rights problem that include physical, sexual and psychological harm [ 1 ]. IPV disproportionately affects women relative to men [ 2 ]. Globally, one in three women report having experienced IPV in their lifetime, with prevalence higher in African countries [ 3 ].
In Tanzania, the prevalence of IPV during pregnancy is high, ranging from 8. In Moshi, Kilimanjaro, from where the sample of this population was drawn, In Tanzania, physical violence is an offence and is covered by criminal laws. Social support is known to be beneficial to women who have experienced partner violence [ 16 — 20 ].
First, social support is associated with decreased risk of experiencing IPV during pregnancy [ 8 ]. Social support reduces the levels of stress and distress caused by violence [ 16 ]. Social support has also been reported to have positive health benefits among women who experience IPV during pregnancy [ 1819 ]. A study conducted in Iran showed that women who experienced IPV but had adequate social support during pregnancy delivered babies with higher birth weights when compared to those who had low levels of social support [ 18 ]. Conversely, lack of social support has been reported to be associated with higher risk of pregnancy complications such as miscarriage, pre-eclampsia and preterm births [ 19 ].
In general, studies show that social support improves the quality of life of women exposed to partner violence [ 20 ]. Research has shown that the majority of victims of IPV seek support from informal support network members e. However, many other authors have observed that the type of support received by the victims of violence when seeking help is not well understood and have recommended further exploration [ 212324 ].
Basing on theoretical framework for help-seeking among victims of intimate partner violence, the Cognitive Theory puts forward three stages which are important for someone experiencing violence to seek help [ 23 ]. The victim defines violence as a problem followed by deciding that help should be sought and finally, selects source of support. Qualitative interviews will have the advantage of building trust with interviewees, enabling the participants to share their personal experiences and describe their perceptions and decisions in their own words.
In Moshi town, Tanzania, where this study was conducted, the declining economic activities in the rural areas, especially the once robust economy from coffee, has increased the urban migration to Moshi and creates further constraints for the residents of the municipality. Moshi Municipality is known for its tourism industry due to being in the vicinity of the Kilimanjaro Mountain and Ngorongoro and Serengeti national parks.
Most women who have been rearing cattle and growing bananas in rural areas are now trying to engage in small businesses or stay as housewives without income. Unmarried young mothers, together with their children, continue to live with and depend on their natal parents. The Chaga men are known in most Tanzanian towns for their business skills. Traditionally, men would leave their wives and children in the village to rear cattle and coffee while they went to establish businesses far away. However, this pattern is now changing because most women also live in town and are actively engaged in small businesses or employment [ 26 ].
Women do increase their reliance on natal relatives, from what is common for women in this cultural setting, to seek the advice of their natal mothers and sisters during pregnancy and childbearing. However, it is not clear what support the natal family provides to women who are victims of partner violence. This article therefore aims to explore the support provided by natal relatives to women experiencing IPV during pregnancy in Moshi, Tanzania.
Permission was sought from the Executive Director of Moshi Municipality to carry out research in the district. We followed the WHO ethical and safety recommendations when doing research on violence against women. All participants were informed about the study and approved participation through ed consent.
Support services were available for women who needed further help and were provided after their approval to be referred. Support services included those related to legal, health, child support and police issues. In-depth interviews were used to explore the social support received from the natal family among victims of partner violence during pregnancy. The cohort study included 1, pregnant women and formed part of PAVE project, a multi-country study that aimed at generating insights into the prevalence, forms, and consequences of intimate partner violence.
In Tanzania, the study was conducted in Moshi municipality, which is one of the seven districts in Kilimanjaro region, in the northern part of the country. It has an estimated population ofpeople, with annual population growth of 2. Polygamy is not commonly practiced except by the few Muslims in the area. After the marriage ceremonies, the woman usually moves to live with her partner together with or near his family. Eighteen participants were purposively selected among the 1, pregnant women enrolled in the cohort study.
The study was conducted from March to May Details of this cohort study is described elsewhere [ 8 ] but briefly, pregnant women were enrolled from two antenatal care clinics before the 24 th week of gestation, followed at the 34 th week of pregnancy and within 48 hours of delivery. Women who participated in the cohort were aged 18 years or above, with a singleton pregnancy, who delivered within Moshi Municipality and who were willing to be followed for the entire period of the study. Enrolled to the present qualitative study were women who reported having experienced physical IPV during pregnancy.
Building on the from the cohort study, the present qualitative study aimed to further explore the life situations of women who had experienced physical violence during pregnancy. Experiencing physical violence during pregnancy was associated with unwanted birth outcomes of preterm birth and low birth weight [ 13 ]. Victims of physical violence during pregnancy were also more likely to disclose their experience to natal relatives than those with other forms of partner violence [ 22 ]. This sample was therefore selected to understand their experiences with partner violence, their decision-making process for disclosure to natal relatives and support received.
Data were collected through in-depth interviews conducted by two researchers, one male and one female. Prior to conducting the field research, the research team had carefully considered whether a male researcher would be able to establish the necessary rapport with women living with partner violence.
During data collection, comparisons between the interviews conducted by the male and female researcher soon indicated that respondents offered their stories in as much detail and depth to the male as to the female interviewer. Similar conclusions regarding use of male interviewers have been documented in other gender based violence studies [ 2530 ]. Further, prior to conducting the qualitative interviews, both researchers had received targeted training in the conduct of research on sensitive topics.
A semi-structured interview guide with open-ended questions was used during the interview.
The interview guide included questions on the forms of partner violence experienced by the participant, what compelled them to seek help, and details of the social support they received from natal relatives and others. After every interview, the collected information was reviewed and discussed by research team so that any new issue raised could guide the next interview. Most of the interviews were done in a separate room at the clinic to ensure privacy and confidentiality.
For women who preferred to be interviewed at home, it was made sure that no one other than the participant and children under two years of age were present during the interview. All interviews were audio recorded with participant approval. The interviews were conducted in Swahili language, the language spoken by all participants. Baseline interviews lasted for a period of one to two hours and aimed to explore the experience of violence during pregnancy, help-seeking and support received from natal relatives.
After interviewing the fifteenth participant, we felt that saturation was reached, a situation where additional information would not result into a new insight.
To confirm that, three additional participants were interviewed, and review of the interviews resulted in generating no new information. Follow-up interviews were conducted with fourteen selected participants about two to three months after their first interview and lasted for about half an hour.
These participants had reported experiencing repeated episodes of violence and therefore the follow up interview assessed their progress on the status of the violence they had reported, child care and support. In the cohort study, the assessment of the experience of IPV was done using the WHO questionnaire that had been used ly in Tanzania [ 3132 ].
To assess physical violence, the women were asked if, during the index pregnancy, their partner had slapped, pushed, hit, kicked, choked or threatened to use or actually used any object that could hurt them. Emotional violence was defined as being insulted, humiliated, intimidated or threatened by the partner while sexual violence included being physically forced to have sexual intercourse, having sexual intercourse without consent or being forced to do a humiliating or degrading sexual act.Married women in Natal
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The changing relationship of women with their natal families