Joint effect of maternal depression and intimate partner violence on increased risk of child death in rural Ethiopia
- 1School of Public Health, Addis Ababa University, Ethiopia
- 2Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- 3Epidemiology, Department of Public Health and Clinical Medicine, Sweden
- 4International Center for Research on Women, Washington DC, USA
- 5Psychiatry, Department of Clinical Sciences, Umeå University, Sweden
- 6Obstetrics & Gynaecology, Department of Clinical Sciences, Umeå University, Sweden
- Correspondence to Ulf Högberg, Epidemiology and Public Health, Umeå University, Umeå, SE-901 87, Sweden;
- Accepted 22 December 2009
- Published Online First 24 August 2010
Objectives To assess independent and interaction effect of experience of intimate partner violence and depression on risk of child death.
Design Community-based cohort design.
Setting The study was conducted within the demographic surveillance site of Butajira Rural Health Program in south central Ethiopia.
Participants Women (n=561) who gave birth to a live child.
Main outcome measures Exposure status comprising physical, sexual and emotional violence by intimate partner was based on the WHO multi-country questionnaire on violence against women. Depression status was measured using the Composite International Diagnostic Interview. Risk of child death and its association with maternal exposure to violence and/or being depressed was analysed by incidence, rate ratios and interaction.
Results The child death in the cohort was 42.1 (95% CI, 32.7 to 53.5) children per 1000 person years, and maternal depression is associated with child death. The risk of child death increases when maternal depression is combined with physical and emotional violence (RR=4.0; 95% CI, 1.6 to 10.1) and (RR=3.7; 95% CI, 1.3 to 10.4), showing a synergistic interaction.
Conclusion An awareness of the devastating consequences on child survival in low income setting of violence against women and depression is needed among public health workers as well as clinicians, for both community and clinical interventions.
Funding This study was funded by Swedish International Development Agency/Swedish Agency for Research Cooperation with Developing Countries (Sida/SAREC), Program for Appropriate Technology in Health (PATH) and Swedish Council for Working Life and Social Research (FAS).
Competing Interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
Ethics approval This study was conducted with the approval of the Addis Ababa University and Umeå University.