Reviewer's report
Title:Correlates of intimate partner violence among pregnant women in Rwanda
Version: 1Date:28 March 2008
Reviewer: Fariyal F Fikree
Reviewer's report:
Overall, the paper is an excellent contribution to the body of literature on intimate
partner violence (IPV). I commend the authors on tackling such a sensitive topic.
Major Revisions:
A. The Methods sections needs extensive revisions. Main issues of concern and
clarification include:
1. Sample size calculation. Please describe in detail. Was prevalence of IPV in
the past 12 months the basis for sample size calculation. Why did the authors
decided to recruit equal numbers of HIV+ and HIV- pregnant women. Will this
affect the results regarding HIV status and IPV. If yes, why; if not why not.
2. Pregnant women: Why did the researchers decide to recruit antenatal clinic
attendees. A description of the rationale for such an approach in the methods
section will collaborate well with the limitations discussed under the limitations
section.
3. Recruitment: Please describe in detail. The authors mention that consecutive
clinic patients were approached and that HIV status was known a priori. A step
by step description of the recruitment process to achieve the 600 sample size
including the #'s not recruited and reasons for not included in the final sample
should be elaborated upon.
4. Questionnaire: Please describe how the questionnarie was formulated;
pre-testing, language. For a sensitive topic like domestic violence it is extremely
important that the questionnaire is well designed in the Rwanda cultural context.
What processes did the reasearchers follow to address these concerns. With
regards to the questions ... please describe how the questionnaire addressed
issues of more than two partners in the past twelve months; what was the
definition of sexual abuse; did the questionnaire elicit IPV (and its various forms
as described) as lifetime and in the past twelve months or only in the past twelve
months.
5. Conduct of the interview: where was the interview conducted. Issues of
confidentiality are extremely important when talking to women who have been
physically or and more for those who report being sexually abused.
B. Results and Discussion sections: Please clarify whether the prevalence of IPV
is in the past 12 months or life time. In the first para of the discussion section the
authors mention "Lifetime prevalence was 35.3% while Table 1 describes
physical violence in the past 12 months as 35.1%. The discussion section will
then need to be revised accordingly.
C. Conclusions: The main messages from the results suggest a high prevalence
rate even higher among HIV+ with significant correlations with partner alcohol
consumption, # of sexual partners, and sexual abuse. These findings have been
reported from other studies in sub-Saharan Africa, data from Rwanda is rare and
adds to the body of literature on IPV and its correlates. However, the conclusion
section needs to be elaborated in the context of the next steps - more research
and if so what direction, policy advocacy and if so what direction are a few
elaborations that will strengthen the conclusion section.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests