Browsing by Author "Bantebya, Grace"
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Item Domestic violence as risk factor for unwanted pregnancy and induced abortion in Mulago Hospital, Kampala, Uganda(Tropical Medicine & International Health, 2006) Kaye, Dan K.; Mirembe, Florence M.; Bantebya, Grace; Johansson, Annika; Ekstrom, Anna MiaTo compare pregnancy intention and domestic violence among women with induced and spontaneous abortion. Case-control study in Mulago Hospital, Uganda, from September 2003 to June 2004 of 942 women seeking post-abortion care. Direct inquiry, records review and clinical examination identified 333 with induced abortion (cases) and 609 with spontaneous abortion (controls), who were compared regarding socio-demographic characteristics, contraceptive use, domicile (rural or urban, nuclear or extended families), pregnancy intention, household decision-making and domestic violence. Data was analysed with EPI-INFO and STATA, using Student t-test and analysis of variance for continuous and chi-square for categorical variables. Stratified and multivariate logistic regression analyses were used to adjust for confounding and interaction at the 95% confidence level. Cases significantly differed from controls as they were younger or more often single; had lower parity and education, less household decision-making and fewer living children. They were similar to controls (P > 0.05) regarding employment, spouse’s age, years spent in marital relationship and domicile. Cases more frequently (P < 0.001) had mistimed, unplanned or unwanted pregnancy at conception and presentation. Cases were more likely to have a recent history of domestic violence (physical, sexual or psychological) [OR: 18.7 (95%CI: 11.2–31.0)] after adjusting for age, pregnancy intention and marital status. Domestic violence is a risk factor for unwanted pregnancy and induced abortion among women seeking post-abortion care.Item Domestic violence during pregnancy and risk of low birthweight and maternal complications: a prospective cohort study at Mulago Hospital, Uganda(Tropical Medicine & International Health, 2006) Kaye, Dan K.; Mirembe, Florence M.; Bantebya, Grace; Johansson, Annika; Ekstrom, Anna MiaTo investigate whether domestic violence during pregnancy is a risk factor for antepartum hospitalization or low birthweight (LBW) delivery. A prospective cohort study was conducted in Mulago hospital, Kampala, Uganda, among 612 women recruited in the second pregnancy trimester and followed up to delivery, from May 2004 through July 2005. The exposure (physical, sexual or psychological violence during pregnancy) was assessed using the Abuse Assessment Screen. The relative and attributable risks of LBW and antepartum hospitalization were estimated using multivariate logistic regression analysis. The 169 women [27.7% 95% CI (24.3–31.5%)] who reported domestic violence during pregnancy did not differ significantly from the unexposed regarding sociodemographic characteristics, but differed significantly (P < 0.05) regarding domicile variables (had less household decision-making power, more resided in extended families and more had unplanned pregnancy). They delivered babies with a mean birthweight 2647.5 ± 604 g, on average 186 g [(95% CI 76–296); P ¼ 0.001] lower than those unexposed. After adjusting for age, parity, number of living children, pregnancy planning, domicile and number of years in marriage, the relative risk (RR) of LBW delivery among women exposed to domestic violence was 3.78 (95% CI 2.86–5.00). Such women had a 37% higher risk of obstetric complications (such as hypertension, premature rupture of membranes and anaemia) that necessitated antepartum hospitalization [RR 1.37 (95% CI 1.01–1.84)]. In this pregnancy cohort, domestic violence during pregnancy was a risk factor for LBW delivery and antepartum hospitalization.Item Escaping the triple trap: Coping strategies of pregnant adolescent survivors of domestic violence in Mulago hospital, Uganda(Scandinavian journal of public health, 2007) Kaye, Dan K.; Mia Ekstrom, Anna; Johansson, Annika; Bantebya, Grace; Mirembe, Florence M.Why domestic violence survivors develop adverse outcomes following domestic violence during pregnancy is unclear, but may depend on how survivors cope with the stress of violence. The objective was to describe strategies pregnant adolescents employ in coping with domestic violence. Methods: This was a qualitative study involving 16 in-depth interviews with adolescent domestic violence survivors who attended the antenatal clinic in Mulago hospital, Kampala, Uganda, from January to May 2004. Theoretical sampling, necessitated by the emergent theory from sequential data collection and analysis, further provided diversity of experiences from adolescents of different ages, parity, pregnancy duration, and socioeconomic status until saturation was reached. Data were analyzed using grounded theory. Findings: Survivors described varied experiences of physical, sexual, and psychological violence. Coping strategies employed were analyzed as: Minimizing damage – decreasing impact and severity of violence, withdrawal – physical or social withdrawal, seeking help and retaliation (fighting back). Coping strategies were influenced by adolescence and pregnancy, and are explained in relation to theories of coping with stress. Conclusions: Coping strategies adopted by pregnant adolescent survivors range from problem focused approaches to emotion-focused approaches. Coping strategies are influenced markedly by adolescence and pregnancy.Item The Social Construction and Context of Domestic Violence in Wakiso District, Uganda(An International Journal for Research, Intervention and Care, 2005) Kaye, Dan K.; Mirembe, Florence; Ekstrom, Anna Mia; Bantebya, Grace; Johansson, AnnikaThis study explored community perceptions of factors associated with domestic violence, with an emphasis on events occurring during pregnancy. Ten focus group discussions, 14 key-informant interviews and four case vignettes were conducted in Wakiso district, Uganda between August and December 2003. Data were analyzed using thematic content analysis. Perceived motives and meanings, triggering as well as associated factors, perceived coping mechanisms and community support available for reducing domestic violence, especially that occurring during pregnancy, were identified. Urban migration, changing cultural values and men’s unemployment shift the balance of power in gender relations. Resultant male uncertainty and gender antagonism is associated with domestic violence. Family institutions such as extended family structure, relatives and in-laws were perceived as offering little protection. Factors triggering violence included failed negotiation of sexual relations, disagreement concerning the division of labor within the household and misconceptions about the physical and physiological changes, both dietary and behavioral, which occur in pregnancy.