Browsing by Author "Moradi, Tahereh"
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Item Are Individual and Community Acceptance and Witnessing of Intimate Partner Violence Related to Its Occurrence? Multilevel Structural Equation Model(PLoS ONE, 2011) Olalekan, A. Uthman; Moradi, Tahereh; Lawoko, StephenIntimate partner violence against women (IPVAW) is a serious and widespread problem worldwide. Much of the research on IPVAW focused on individual-level factors and attention has been paid to the contextual factors. The aim of this study was to develop and test a model of individual- and community-level factors associated with IPVAW. Methods and Findings: We conducted a (multivariate) multilevel structural equation analysis on 8731 couples nested within 883 communities in Nigerian Demographic and Health Survey 2008. Variables included in the model were derived from respondents’ answers to the experience of IPVAW, attitudes towards wife beating and witnessing physical violence in childhood. We found that women that witnessed physical violence were more likely to have tolerant attitudes towards IPVAW and women with tolerant attitudes were more likely to have reported spousal IPVAW abuse. Women with husbands with tolerant attitudes towards IPVAW were more likely to have reported spousal abuse. We found that an increasing proportion of women in the community with tolerant attitudes was significantly positively associated with spousal sexual and emotional abuse, but not significantly associated with spousal physical abuse. In addition, we found that an increasing proportion of men in the community with tolerant attitudes and an increasing proportion of women who had witnessed physical violence in the community was significantly positively associated with spousal physical abuse, but not significantly associated with spousal sexual and emotional abuse. There was a positive correlation between all three types of IPVAW at individual- and community-level. Conclusions: We found that community tolerant attitudes context in which people live is associated with exposure to IPVAW even after taking into account individual tolerant attitudes. Public health interventions designed to reduce IPVAW must address people and the communities in which they live in order to be successful.Item Factors associated with attitudes towards intimate partner violence against women: a comparative analysis of 17 sub-Saharan countries(BMC international health and human rights, 2009) Uthman, Olalekan A.; Lawoko, Stephen; Moradi, TaherehViolence against women, especially by intimate partners, is a serious public health problem that is associated with physical, reproductive and mental health consequences. Even though most societies proscribe violence against women, the reality is that violations against women's rights are often sanctioned under the garb of cultural practices and norms, or through misinterpretation of religious tenets. Methods: We utilised data from 17 Demographic and Health Surveys (DHS) conducted between 2003 and 2007 in sub-Saharan Africa to assess the net effects of socio-demographic factors on men's and women's attitudes toward intimate partner violence against women (IPVAW) using multiple logistic regression models estimated by likelihood ratio test. Results: IPVAW was widely accepted under certain circumstances by men and women in all the countries studied. Women were more likely to justify IPVAW than men. "Neglecting the children" was the most common reason agreed to by both women and men for justifying IPVAW followed by "going out without informing husband" and "arguing back with the husband". Increasing wealth status, education attainment, urbanization, access to media, and joint decision making were associated with decreased odds of justifying IPVAW in most countries. Conclusion: In most Sub-Saharan African countries studied where IPVAW is widely accepted as a response to women's transgressing gender norms, men find less justification for the practice than do women. The present study suggests that proactive efforts are needed to change these norms, such as promotion of higher education and socio-demographic development. The magnitude and direction of factors associated with attitudes towards IPVAW varies widely across the countries, thus suggesting the significance of capitalizing on need-adapted interventions tailored to fit conditions in each country.Item The independent contribution of individual-, neighbourhood-, and country-level socioeconomic position on attitudes towards intimate partner violence against women in sub-Saharan Africa: A multilevel model of direct and moderating effects(Social science & medicine, 2009) Abdulrahman Uthman, Olalekan; Moradi, Tahereh; Lawoko, StephenWe examined associations between country, neighbourhood, and individual socioeconomic position (SEP) and attitudes towards intimate partner violence against women (IPVAW).We applied multivariable multilevel logistic regression analysis on Demographic and Health Survey data for 165,983 women and 68,501 men nested within 7465 communities from 17 countries in sub-Saharan Africa collected between 2003 and 2007. Contrary to expectation women were 34% more likely to justify IPVAW than men. We found that sex moderates associations of individual-, neighbourhood-, and country-level SEP with attitudes towards IPVAW. There was a significant positive interaction effect between sex and education attainment; women with no education were more likely to justify IPVAW than men with no education. Negative sex interaction with household wealth status indicates that differences in attitude are less pronounced among women. Unemployed men were more likely to justify IPVAW. Interaction effects indicate that the association of neighbourhood socioeconomic disadvantage with attitudes was more pronounced among women than among men. The association of country-level SEP with attitudes towards IPVWA was inconclusive. There was some evidence that neighbourhood modified the association between individual SEP and attitudes towards IPV. Also, there was cross-level interaction between country and neighbourhood SEP. Neighbourhood and individual SEP were independently associated with attitudes towards IPVAW. The relationship with country-level SEP was inconclusive. The findings underscore the need to implement public health prevention/intervention strategies not only at the level of individual SEP but also at the neighbourhood level.Item Sex disparities in attitudes towards intimate partner violence against women in sub-Saharan Africa: a socio-ecological analysis(BMC Public Health, 2010) Uthman, Olalekan A.; Lawoko, Stephen; Moradi, TaherehAttitudes towards intimate partner violence against women (IPVAW) has been suggested as one of the prominent predictor of IPVAW. In this study, we take a step back from individual-level variables and examine relationship between societal-level measures and sex differences in attitudes towards IPVAW. Methods: We used meta-analytic procedure to synthesize the results of most recent data sets available from Demographic and Health Survey (DHS) of 17 countries in sub-Saharan Africa conducted between 2003 and 2007. Pooled odds ratio (OR) and 95% confidence intervals (CI) were computed for all countries. Test of heterogeneity, sensitivity analysis, and meta-regression were also carried out. Results: Women were twice as likely to justify wife beating than men (pooled OR = 1.97; 95% CI 1.53- 2.53) with statistically significant heterogeneity. The magnitude in sex disparities in attitudes towards IPVAW increased with increasing percentage of men practicing polygamy in each country. Furthermore, magnitude in sex disparities in attitudes towards IPVAW decreased monotonically with increasing adult male and female literacy rate, gender development index, gross domestic product and human development index. Conclusion: This meta-analysis has provided evidence that women were more likely to justify IPVAW than men in subSaharan Africa. Our results revealed that country's socio-economic factors may be associated with sex differential in attitudes towards IPVAW.Item Socio-economic determinants in selecting childhood diarrhoea treatment options in Sub- Saharan Africa: A multilevel model(Italian Journal of Pediatrics, 2011) Aremu, Olatunde; Lawoko, Stephen; Moradi, Tahereh; Dalal, KoustuvDiarrhoea disease which has been attributed to poverty constitutes a major cause of morbidity and mortality in children aged five and below in most low-and-middle income countries. This study sought to examine the contribution of individual and neighbourhood socio-economic characteristics to caregiver’s treatment choices for managing childhood diarrhoea at household level in sub-Saharan Africa. Methods: Multilevel multinomial logistic regression analysis was applied to Demographic and Health Survey data conducted in 11 countries in sub-Saharan Africa. The unit of analysis were the 12,988 caregivers of children who were reported to have had diarrhoea two weeks prior to the survey period. Results: There were variability in selecting treatment options based on several socioeconomic characteristics. Multilevel-multinomial regression analysis indicated that higher level of education of both the caregiver and that of the partner, as well as caregivers occupation were associated with selection of medical centre, pharmacies and home care as compared to no treatment. In contrast, caregiver’s partners’ occupation was negatively associated with selection medical centre and home care for managing diarrhoea. In addition, a low-level of neighbourhood socio-economic disadvantage was significantly associated with selection of both medical centre and pharmacy stores and medicine vendors. Conclusion: In the light of the findings from this study, intervention aimed at improving on care seeking for managing diarrhoea episode and other childhood infectious disease should jointly consider the influence of both individual SEP and the level of economic development of the communities in which caregivers of these children resides.