Joint effect of maternal depression and intimate partner violence on increased risk of child death in rural Ethiopia

• Published in: Archives of disease in childhood Vol. 95; no. 10; pp. 771 - 775
• Main Authors: Deyessa, N, Berhane, Y, Emmelin, M, Ellsberg, MC, Kullgren, G, Högberg, U
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.10.2010; BMJ Publishing Group; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Adult; Algorithms; Biological and medical sciences; Body Weight; Child death; Child Mortality; Child Neglect; Child of Impaired Parents - statistics & numerical data; Child Rearing; Child, Preschool; Children; Death; Demographic aspects; depression; Depression (Psychology); Depression - epidemiology; Developmental Delays; Domestic violence; Epidemiologic Methods; Ethics; Ethiopia; Ethiopia - epidemiology; Family Violence; Female; Females; Focus Groups; Health Programs; Humans; Infant; Infant, Newborn; intimate partner violence; Marital Status; Medical sciences; MEDICIN; MEDICINE; Mental Health; Miscellaneous; Mothers - psychology; Physical Health; Postpartum depression; Pregnancy; Prevention and actions; Psychiatry; Psykiatri; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Rural Health - statistics & numerical data; Spouse Abuse - psychology; Spouse Abuse - statistics & numerical data; Violence; Young Adult; Ethiopia; Africa; Human; Mood disorder; Marital relation; Pediatrics; Rural environment; Mortality; Depression; Victimology; Epidemiology; Osteoarticular system; Mistreatment; Risk factor; Child; Public health
• ISSN: 0003-9888; 1468-2044; 1468-2044
• DOI: 10.1136/adc.2009.165571

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.