Intimate partner violence during pregnancy in sub-Saharan Africa: a systematic review and meta-analysis.

Abstract

Background: Intimate partner violence (IPV) has health and human rights implications for its victim-survivors. During pregnancy, IPV can be associated with several morbidities, injuries, and mortality among women and their foetuses. Identifying the prevalence and factors associated with IPV during pregnancy is crucial towards developing preventive strategies to curb its occurrence. This review aims to estimate the prevalence of IPV during pregnancy and its associated factors in sub-Saharan Africa.

Methods: This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was conducted in PubMed, Scopus, Web of Science, PsycINFO, Embase, and CINAHL for articles published on IPV experienced during pregnancy in sub-Saharan Africa from January 01, 2011, to May 30, 2025. Grey literature search was also conducted to complement the articles retrieved from the six databases. All the published articles that met the inclusion criteria were included in the final analysis. Stata 18.0 was used for data analysis. Microsoft Excel was utilised for synthesising the factors influencing IPV during pregnancy.

Results: A total of 3988 records were retrieved from the six databases and sixteen from grey literature, of which 65 articles were finally included in the study. The pooled prevalence of IPV was 38.1% [95%CI = 33.3-42.9]. The prevalence of physical, sexual, and emotional violence was 15.7% [95%CI = 13.2-18.3], 18.0% [95%CI = 14.6-21.5], and 27.7% [95%CI = 23.6-31.9], respectively. The risk factors for IPV during pregnancy were substance use, unplanned pregnancy, justification of violence against women, exposure to violence during childhood, experience of controlling behaviour, past experience of IPV and marital conflicts, rural residency, and polygyny. Women's empowerment, social support, and education were identified as key factors that reduce women's likelihood of experiencing IPV during pregnancy.

Conclusion: Our study highlights the prevalence of IPV during pregnancy in sub-Saharan Africa, emphasising the need for targeted strategies that address key risk factors. It advocates for promoting women's empowerment, improving girls' education, and strengthening legal frameworks to effectively prevent IPV. Ministries of Health across sub-Saharan African countries could integrate routine, confidential IPV screening into antenatal care and ensure immediate access to evidence-based interventions with clear referral pathways to supportive services to prevent further violence.