亲密伴侣暴力(IPV)和儿童营养不良是全球公共卫生问题。评估IPV与儿童人体测量学失败(发育迟缓,体重不足,和浪费)在29个撒哈拉以南非洲(SSA)国家可以提供重要的全球卫生解决方案。一些研究发现IPV对妇女和儿童营养不良之间存在关联,但是结论不一致。身体和心理状况,生活环境,可能涉及母亲的权利。
■我们收集并分析了29个SSA国家的人口和健康调查数据(2010-2021年)。主要暴露变量是各种类型的IPV,归类为物理,性,和情感暴力。结果是孩子的发展指数,可以大致分为发育迟缓,浪费,和体重不足。采用调整后的二元logistic回归模型检验IPV与儿童营养状况的关系。
■共有186,138名5岁以下儿童纳入分析;其中50,113名(27.1%)儿童发育迟缓,浪费了11,329(6.1%),39,459人(21.3%)在所有地区体重不足。孩子的性别,年龄,母乳喂养的持续时间,补充喂养,在过去的6个月中,维生素A补充剂的摄入量与他们的营养状况有关(p<0.001)。性暴力是与发育迟缓相关的最强因素,在控制所有变量后仍然具有统计学意义(AOR=1.11;95%CI:1.02,1.21;p=0.012)。我们还发现消瘦与IPV之间存在小的负相关。对于体重不足,控制所有变量后,IPV与IPV无相关性(p>0.05).
■IPV与SSA国家的儿童发育迟缓呈正相关。性暴力与发育迟缓有很强的正相关。浪费与IPV出乎意料地负相关。体重不足和暴力之间没有明显的相关性。
Intimate partner violence (IPV) and child malnutrition are global public health issues. Assessing the association between IPV and child anthropometric failures (stunting, underweight, and
wasting) in 29 Sub-Saharan African (SSA) countries can provide significant global health solutions. Some studies have found an association between IPV against women and child malnutrition, but the conclusions are inconsistent. The physical and psychological conditions, living environment, and rights of the mother may be involved.
We collected and analyzed the Demographic and Health Surveys data (2010-2021) of 29 SSA countries. The main exposure variables were various types of IPV, classified as physical, sexual, and emotional violence. The outcome was the child\'s development index, which can be roughly divided into stunting,
wasting, and underweight. An adjusted binary logistic regression model was used to test the relationship between IPV and children\'s nutritional status.
A total of 186,138 children under 5 years of age were included in the analysis; 50,113 (27.1%) of the children were stunted, 11,329 (6.1%) were wasted, and 39,459 (21.3%) were underweight in all regions. The child\'s gender, age, duration of breastfeeding, complementary feeding, and vitamin A supplements intake in the past 6 months were associated with their nutritional status (p < 0.001). Sexual violence was the strongest factor associated with stunting, which remained statistically significant after controlling all variables (AOR = 1.11; 95% CI: 1.02, 1.21; p = 0.012). We also found a small negative association between
wasting and IPV. For underweight, there were no associations with IPV after controlling for all variables (p > 0.05).
IPV is positively associated with child stunting in SSA countries. Sexual violence showed a strong positive correlation with stunting.
Wasting was unexpectedly negatively associated with IPV. There was no clear correlation between underweight and violence.