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Open AccessArticle

Improving Safety Among Pregnant Women Reporting Domestic Violence in Nepal—A Pilot Study

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Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Postbox 8905, 7491 Trondheim, Norway
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Department of Community Medicine, Kathmandu Medical College and Teaching Hospital, PO Box 21266, Sinamangal, Kathmandu 44600, Nepal
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Kathmandu University School of Medical Sciences, Kathmandu University and Dhulikhel Hospital, Dhulikhel 45200, Bagmati, Nepal
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Department of Obstetrics and Gynecology, St. Olavs University Hospital, Postbox 3250, Sluppen, 7006 Trondheim, Norway
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Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu 44600, Nepal
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School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnæus University, 391 82 Kalmar, Sweden
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Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Postbox 4, St. Olavs Plass, 0130 Oslo, Norway
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Department of Health and Social Sciences, University College of Southeast Norway, Postbox 235, 3603 Kongsberg, Campus Vestfold, 3184 Borre, Norway
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Author to whom correspondence should be addressed.
Members are listed at the end of Acknowledgments.
Int. J. Environ. Res. Public Health 2020, 17(7), 2268; https://doi.org/10.3390/ijerph17072268
Received: 25 February 2020 / Revised: 23 March 2020 / Accepted: 24 March 2020 / Published: 27 March 2020
Introduction: Domestic violence (DV) during pregnancy is associated with poor health outcomes for both the mother and newborn, and sometimes death. In a low-income country like Nepal, women have few options to leave abusive situations. Therefore, there is a need for interventions to improve their safety. The aim of our study was to explore the use of safety measures before and after an educational intervention among women who have reported DV during pregnancy. Materials and methods: Of 1010 pregnant women screened consecutively for DV using the Abuse Assessment Screen (AAS) during routine antenatal care, 181 women reported domestic violence. All 1010 participating pregnant women were taught 15 safety measures using a locally developed flipchart. We obtained contact with 80 of the 181 eligible women postpartum, of whom 62 completed the follow-up assessment. We explored and described the use of safety measures at baseline and follow-up, using a standardized instrument called the Safety Behavior Checklist. Results: At follow-up, less than half of the women (n = 30, or 48.3%) reported any form of DV. Of the women who reported DV at follow-up, significantly more reported the experience of both violence and fear at baseline (21.9%, p = 0.01) compared with the women who did not report DV at follow-up (3.3%, p = 0.01). Women reporting DV at baseline and follow-up used more safety measures at baseline (56) and follow-up (80) compared with women reporting DV at baseline only (36 and 46). Women reporting DV at baseline and follow-up used more safety measures for the first time at follow-up, 57 new measures compared with the 28 new measures used by women reporting DV at baseline only. Conclusions: The use of a flipchart teaching session on safety measures within antenatal care may increase the number of safety measures women use to protect themselves during pregnancy and decrease the risks of adverse health effects of DV. View Full-Text
Keywords: domestic violence; pregnancy; safety measures; safety behaviors; intervention; antenatal care; Nepal domestic violence; pregnancy; safety measures; safety behaviors; intervention; antenatal care; Nepal
MDPI and ACS Style

Rishal, P.; Devi Pun, K.; Schei, B.; Bhandari, B.; Kumar Joshi, S.; Swahnberg, K.; Infanti, J.J.; Lukasse, M.; the ADVANCE study group. Improving Safety Among Pregnant Women Reporting Domestic Violence in Nepal—A Pilot Study. Int. J. Environ. Res. Public Health 2020, 17, 2268.

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