Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696583944754.pdf (Vanuatu)
Violence Against Women in Vanuatu A quantitative description of intimate partner violence against women who are pregnant in Sanma, Vanuatu Stephanie McKelvie Supervised by Professor Jane Fisher AO¹ and Dr Basil Leodoro² Public Health and Preventive Medicine, Monash University¹ and Northern Provincial Hospital² Background and aim More than 1 in 3 women worldwide have experienced intimate partner violence (IPV)¹. IPV can be classified into psychological, physical and sexual violence¹.
IPV occurs throughout women’s adult life course, including during pregnancy².

All forms of IPV have extensive and deleterious health consequences, including perinatal mental health problems³.

Locally conducted, ethical and methodologically sound research is needed to inform public policies and services4.

Aim To describe the prevalence, patterns and determinants of psychological, physical and sexual IPV and association with mental health in women attending antenatal care in Sanma, Vanuatu.
Methods Study design: Quantitative cross-sectional study using interviewer-delivered questionnaires.

Participants and recruitment: Population-based sampling of adult women who were pregnant and attending Northern Provincial Hospital antenatal clinic.

Data Sources: A modified, translated version of the World Health Organization Women’s Health and Life Experiences questionnaire¹ was used.

Data Analysis: Descriptive analyses and logistic and linear regression models for associations.
Ethics: Approved by MUHREC and Vanuatu Ministry of Health.

All participants were given information about local domestic violence services.
Results Participants Recruitment fraction 36% 192 women of all women who attended antenatal clinic during data collection Mean age Mean gestation 25.7 27.3 Years (Std Dev, range 5.4, 18-42) Weeks (Std Dev, range 8.8, 3-42) First clinic visit Parity 78.2% attended their first antenatal visit in the second or third trimester 37.9% were pregnant for the first time Lifetime Current pregnancy Any pregnancy 8 .

7 5 6 4 7 .

3 3 ) % l ( e p m a s f o e g a t n e c r e P 6 .

9 3 7 .

3 3 9 .

1 2 4 .

9 1 6 .


5 1 4 .

2 1 4 .

4 6 3 .

5 5 6 .

2 4 Psychological N=187 Physical N=187 Sexual N=186 Type of intimate partner violence Psychological, physical or sexual N=188 Figure 1.

Prevalence of psychological, physical and sexual intimate partner violence during the lifetime and pregnancy.

Table 1.

Pattern of intimate partner violence before and during pregnancy.
Experienced at least one violent behaviour by current partner before current pregnancy but not during Experienced at least one violent behaviour by current partner during current pregnancy but not before Experienced at least one violent behaviour by current partner both before and during current pregnancy Experienced at least one violent behaviour in lifetime but not by current partner Psychological Violence (N=108) n 35 % 32.4 Physical Violence (N=74) n 30 Sexual Violence (N=36) % n 40.5 11 % 30.6 15 13.9 10 13.5 5 13.9 55 50.9 34 45.9 19 54.3 28 25.9 21 28.4 9 25.0 In this table N is the number of women who have experienced the type of violence by an intimate partner in their lifetime.
n is the number of women who reported at least one violent behaviour within each violence type following each pattern.

Many women experienced different patterns for different violent behaviours therefore the same woman may be represented in more than one row within the same column and the percentages of the four patterns do not sum to 100.

Partner use of alcohol once a week or more increased risk of all forms of IPV, including IPV during the current pregnancy (OR 3.5, 95% CI 1.4-8.7, p=0.006).
Women’s employment increased risk of experiencing IPV and was strongly associated with physical IPV (OR 6.1, 95% CI 2.2-16.6, p<0.001).

IPV during the current pregnancy increased risk of poor perinatal mental health (Beta 0.39, p<0.001).

IPV during the current pregnancy increased risk of late entry into antenatal care (OR 3.0, 95% CI 1.1- 8.1, p=0.031).

More than 97% of participants said they felt better at the end of the interview.
Left: Myself, Airine Manwo (interviewer) and Marie-Michel Manwo (Head of Antenatal Care).

Right: Jefline Maltery interviewing participant (consent for photo granted).

Contact: Stephanie McKelvie sbmck1@student.monash.edu MUHREC Approval No.

18348 Conclusions This study provides the most comprehensive description of intimate partner violence (IPV) during pregnancy in any low- or middle-income country in the South Pacific.
IPV against women who are pregnant is a significant public health concern in Vanuatu, with more than one in three women experiencing violence during their current pregnancy.

In Vanuatu, IPV during pregnancy most commonly represents a continuation of violence occurring before pregnancy.

IPV against women who are pregnant negatively impacts women’s perinatal mental health and pregnancy care in Vanuatu.
Future Directions Multi-sectoral action targeted at both men and women, aiming to reduce gender inequalities, is needed to address risk factors for IPV.

Strengthening of referral pathways and investment into services delivered by healthcare-providers is needed to prevent and manage IPV against women who are pregnant in Vanuatu.

References 1.

World Health Organization.


WHO multi-country study on women's health and domestic violence against women: initial results on prevalence, health outcomes and women's responses.

Geneva (CH); 2005.

2.

Fisher J, McKelvie S, Rees S. Interpersonal Violence and Perinatal Mental Health.

In: Chandra P, Herrman H, Fisher J, Riecher-Rössler A, editors.

Mental Health and Illness of Women.

Singapore: Springer Singapore; 2019. p. 1-19.

3.

Campbell JC.
3.

Campbell JC.

Health consequences of intimate partner violence.

Lancet (London, England).

2002;359(9314):1331-6.

4.

Taillieu TL, Brownridge DA.

Violence against pregnant women: Prevalence, patterns, risk factors, theories, and directions for future research.

Aggression and Violent Behavior.

2010;15(1):14-35.