背景:基于性别的暴力(GBV)是一个严重影响女性的主要公共卫生问题。在喀麦隆,以及世界其他国家,GBV对女性健康有直接影响,三分之一的女性遭受亲密伴侣的身体或性暴力,影响他们的身体和生殖健康。这项研究的目的是确定雅温得女性与GBV相关的健康风险。
方法:在雅温得(喀麦隆)进行了一项横断面研究,2022年8月至10月。不良健康结果包括精神障碍,身体创伤,妇科创伤,行为障碍,和任何其他疾病。关联测试用于建立定性变量之间的关系。使用粗比值比(OR)进行单变量分析,使用校正比值比(aOR)进行多变量分析,以95%置信区间(CI)进一步量化关联。独立变量包括:身体暴力,性暴力,经济暴力,情感暴力,年龄,儿童人数,和婚姻状况。P值为0.05的变量被认为具有统计学意义。
结果:共有404名17至67岁的女性接受了采访。情绪暴力是最常见的暴力(78.8%),其次是经济暴力(56.9%),身体暴力(45.8%)和性暴力(33.7%)。暴力的主要原因是嫉妒(25.7%),傲慢(19.3%)和拒绝性交(16.3%)。不良健康结局的发生率是身体创伤(90.9%),其次是精神障碍(70,5%),妇科创伤(38.4%),行为障碍(29.7%),和其他(5.5%)。大多数受害者报告至少有一种上述情况(80.2%)。遭受任何暴力行为的妇女更有可能遭受不良健康后果:身体暴力[OR=34.9,CI(10.8-112.9),p<0.001];性暴力[OR=1.5,CI(0.9-2.7),p=0.11];经济暴力[OR=2.4,CI(1.4-3.9),p=0.001];和情感暴力[OR=2.9,CI(1.7-4.9),p<0.001]。使用多元二元逻辑回归,仅身体暴力[aOR=15.4,CI(6.7-22.5),p=0.001]仍然与不良健康结果的可能性增加高度相关。
结论:这项研究强调迫切需要综合干预措施来解决GBV,包括改进案件报告和文件记录,提高医疗保健提供者的认识,为受害者建立支持网络,GBV的一级和二级预防。喀麦隆政府,通过负责卫生和妇女赋权的部委,通过早期识别将GBV对健康的影响降至最低,监测,以及通过向GBV幸存者提供高质量的医疗保健服务来治疗他们。
BACKGROUND: Gender-based violence (GBV) is a major public health problem that disproportionately affects women. In Cameroon, as well as other countries worldwide, GBV has immediate effects on women\'s health, with one in three women experiencing physical or sexual violence from an intimate partner, affecting their physical and reproductive health. The objective of this study was to determine the health risks associated with GBV among women in Yaoundé.
METHODS: A cross-sectional study was conducted in Yaoundé (Cameroon), from August to October 2022. Adverse health outcome included mental disorders, physical trauma, gynaecological trauma, behavioral disorders, and any other disorder. Tests of associations were used to establish relationships between qualitative variables. Associations were further quantified using crude odds ratio (OR) for univariate analysis and adjusted odds ratio (aOR) for multivariate analysis with 95% confidence interval (CI). Independent variables included: Physical violence, Sexual violence, Economic violence, Emotional violence, Age, Number of children, and Marital status. Variables with p-value˂0.05 were considered statistically significant.
RESULTS: A total of 404 women aged 17 to 67 years were interviewed. Emotional violence was the most commonly reported violence (78.8%), followed by economic violence (56.9%), physical violence (45.8%) and sexual violence (33.7%). The main reasons for violence were jealousy (25.7%), insolence (19.3%) and the refusal to have sexual intercourse (16.3%). The prevalences of adverse health outcomes were physical trauma (90.9%), followed by mental disorders (70,5%), gynaecological trauma (38.4%), behavioral disorders (29.7%), and other (5.5%). Most victims reported at least one of the above-mentioned conditions (80.2%). Women who were victims of any kind of violence had a higher likelihood of experiencing adverse health outcomes: physical violence [OR = 34.9, CI(10.8-112.9), p < 0.001]; sexual violence [OR = 1.5, CI(0.9-2.7), p = 0.11]; economic violence [OR = 2.4, CI(1.4-3.9), p = 0.001]; and emotional violence [OR = 2.9, CI(1.7-4.9), p < 0.001]. Using multiple binary logistic regression, only physical violence [aOR = 15.4, CI(6.7-22.5), p = 0.001] remained highly associated with an increased likelihood of having adverse health outcomes.
CONCLUSIONS: This study underscores the urgent need for comprehensive interventions to address GBV, including improved reporting and documentation of cases, increased awareness among healthcare providers, the establishment of support networks for victims, primary and secondary prevention of GBV. It is essential that the Government of Cameroon, through the Ministries in charge of Health and Women\'s Empowerment, minimizes the health effects of GBV through early identification, monitoring, and treatment of GBV survivors by providing them with high-quality health care services.