Association of Intimate Partner Physical and Sexual Violence with Childhood Morbidity in Bangladesh

Abstract

Although Bangladesh is on track to achieve Millennium Development Goal 4 (MDG4: reduce child mortality, approximately less than 50 per 1000 live births by 2015) (International Center for Diarrheal Disease Research, Bangladesh [ICDDR, B], 2007), child mortality rate still remains very high in this country. In Bangladesh, the mortality rate of under-five children was 65 per 1000 live births in 2007 and diarrhea (20%), acute respiratory infections (ARI) (18%) accounted for 38 % of the under-five deaths (United Nations International Children’s Emergency Fund [UNICEF], 2010). Fever, is another symptom of acute infections and malaria among children in Bangladesh and contributes to high levels of malnutrition and mortality (National Institute of Population Research and Training [NIPORT], 2009; Rayhan, Khan, & Shahidullah, 2007). Although clinical (Haque et al., 2003), nutritional (Daniel et al., 2008; Tomkins, Dunn, & Hayes, 1989), household environmental (Gasana et al., 2002; Cairncross et al., 2010) and socio-demographic (Barros et al., 2010; Rayhan, Khan, & Shahidullah, 2007) risk factors of ARI, diarrhea, and fever are well documented, research has only begun to investigate the influence of other aspects of the social environment. Intimate partner violence (IPV) is defined as the range of sexually, psychologically, and physically coercive acts used against women by current or former male intimate partners (World Health Organization [WHO], 1997). Intimate partner violence is considered to be one of the psychosocial factors that might influence child morbidity status (Campbell 2002). It can affect child morbidity status through psychological stress of the child, resulting from observing IPV; stress in turn can exert an effect on immune reactivity and link to increase vulnerability to illness (Friedman & David, 2002). Besides, IPV can affect child health outcome through direct violence, injury, and mistreatment of children from fathers who abuse their female partners (Herrenkohl et al., 2008; Christian et al., 1997), or through physical or psychological maternal health outcomes such as stress and depression, suicidal thoughts and infectious diseases including HIV/AIDS (Ellsberg et al., 2008; Sutherland, Bybee, & Sullivan, 1998; Coker et al., 2002; Silverman et al., 2007; Silverman et al., 2008) or through diminishing mother’s autonomy, social isolation, and lack of control over financial resources (Ellsberg et al., 2008; Smith & Martin, 1995; Forte et al., 1996), that can prevent proper care of the child.