Intimate Partner Violence Against Indigenous Women and Association with Stunting and Anemia in Children: A Mixed Approach in Chimborazo-Ecuador.

Abstract

Objectives: This study aimed to describe intimate partner violence in Indigenous women and assess its association with stunting and anemia among children less than five years of age in Chimborazo, Ecuador.

Methods: This study used a mixed-methods research design with two components: A cross-sectional study was conducted among 317 children under 5 years of age and their mothers. Structured questionnaires were used to collect data on Spousal Index Abuse, family socioeconomic characteristics, and alcohol consumption. Data on children's anthropometric measurements and hemoglobin were quantified. Bivariate and multivariate Poisson regressions were performed to determine the association of stunting and anemia with intimate partner violence. Additionally, a qualitative study was conducted with focus groups in 28 indigenous women from rural communities in Chimborazo.

Results: 31.5% (n = 100) of women were exposed to nonphysical IPV and 18% (n = 57) to physical IPV. Spousal alcohol consumption frequency of twice a month or more was associated with a probability 4.2 times greater of being a victim of IPV (95% CI 1.14-12.6). Physical and non-physical IPV was 2.71 (95% CI 1.36-5.39) and 3.48 times (95% CI 1.4-8.6) more prevalent in households without drinking water supply or sewerage network, respectively. There was not a statistically significant association between IPV and stunting in children. Maternal physical and nonphysical IPV was associated with a higher prevalence of anemia, 2.1 times higher for physical (95% CI 1.8-5.0) and 2.6 for nonphysical IPV (95% CI 1.1-5.8). The focus group discussions revealed a relationship between violence, age, religion, poverty, lack of education, and limited access to public services. For mothers, violence is related to sadness, which affects the health and nutrition of their children.

Conclusions: This study suggests that children of women exposed to IPV are at greater probability of suffering from anemia. Therefore, an integral approach to IPV prevention is required, through social protection and healthcare policies for mothers and children, considering the intercultural context.