AMBO UNIVERSITY

COLLEGE OF MEDICINE AND HEALTH SCIENCE

DEPARTMENT OF MIDWIFERY

A RESEARCH PAPER SUBMITTED TO COLLEGE OF MEDICINE AND

HEALTH SCIENCE MIDWIFERY DEPARTMENT, AMBO UNIVERSITY IN
PARTIAL FULFILLMENT FOR THE REQUIREMENTS OF THE BACHELOR
OF SCIENCE DEGREE IN MIDWIFERY

BY:

 Asnake Fikade
 Bacha Ilala
 Bekalish Mesfin
 Beliyu Lemi
 Beshir Obsa

ADVISER: Fikadu Wondimu( Bsc )

ASSESSMENT OF PREVALENCE AND RISK FACTORS OF PHYSICAL VIOLENCE DURING

PREGNANCY AMONG PREGNANT WOMEN VISITING ANC CLINIC IN FITCHE
HOSPITAL, NORTH SHOA ZONE,OROMIA REGIONAL STATE, ETHIOPIA

JUNE: 5/10/07

AMBO ETHIOPIA
ACKNOWLEDGEMENT

At the beginning we would like to express our heartfelt gratitude to Ambo university college of
Medicine and Health Science Department of Midwifery For initiation of this Research.

We would also like to express our heartfelt gratitude to our advisors Fikadu Wondimu for his
constructive comments and guidance during development of this Research paper.

At last but not the least we would like to thank Ambo university computer librarian staff who
helped us in the documentation and searching other reference materials.
 Acronyms
ANC: Ante Natal Care

DHS: Demographic Health Survey

GBV: Gender Based Violence

HIV: Human Immunodeficiency Virus

LBW: Low birth weight

MCH: Mother and Child Health

MOH: Ministry of health

PTB: Preterm birth

PROM: Premature rupture of membrane

TB: Tuberculosis

US: United State

VAW: Violence against Women

WHO: World Health Organization

WHR: Women’s Human Right

LIST OF TABLES AND FIGURES
PAGES

Table 1: shows the socio- demographic Characteristics of the study group.............11

Table 2- Shows the prevalence of physical abuse during pregnancy.......................15

Table 3: Shows that the possible causes which initiate physical Abuse
during pregnancy ......................................................................................................16

List of figure
Figure 1: The educational status distribution of the study Participants ..................13
Figure 2: The prevalence of physical abuse among pregnant Women...................14
Figure 3: Age distribution of physical abused among pregnant women..............14
 ABSTRACT
Physical violence is physical force that results in bodily injury, pain or impairment. It
includes assaults, battery, and inappropriate restraint. Other forms of physical abuse like;
punching, pushing, pulling, slapping, kicking and others have severe life risk for both the
mother and fetus. However, abuse of women during pregnancy is health problem that is
receiving increase attention in both research and clinical practice.

Objective: - The main objective of this study is to assess prevalence and risk factors of
physical violence during pregnancy.
Methods: - Across-sectional descriptive study was conducted on pregnant mothers those
who attend ANC clinic at Fitche hospital from November 12/3/2007-
May28/09/2007.The data was collected by 4th year midwife.
Result:-Regarding to the result of this study the Majority 22(51.16%) of the respondents
who were suffered to physically abused during pregnancy were in the age of 25-29 years
of age ,13(30.23%) was in the age of 20-24 years,6(13.95%) and 2(4.65%) were in age of
30 and above,15-19 respectively. The Majority 8((36.36%) abused during non pregnant
time were in the age group of 20-24 years and 7(31.81%), 5(22.72%), 2(9.09%) were in
the age group of 25-29, 30 and above and 15-19 respectively. The prevalence of
physically abused pregnant women were 43(10.34%) and most of them 27(62.79%) were
suffered on the past pregnancy. Based on the results, different types of risk factors for
physical abuse were reported, among them mistrust, taking alcohol by their spouses

(intoxication) and unwanted pregnancy are risk factors for this study.
Conclusion: - According to the study of this result the prevalence of physical violence on
pregnant women was 43(10.34%). The major risk factor 27(41.53%) was intoxication for
this study.
Recommendation:- ANC is the opportunity for screening medical or surgical
problems. In addition, it was also a good opportunity for screening physical violence
during pregnancy which was important for preventing obstetric and gynecological
complications such as abortion .IUGR, IUD and etc due to physical abuse.
1. INTRODUCTION

1.1 Background of the study

World report on violence and health define violence as intentional use of physical force or
power, threatened or actual against oneself, another person or against group/community that
either results in or high likelihood of resulting in injury, death, psychological harm, mal
development or depravation (1) Abuse of women during pregnancy is a health problem that is
receiving increased attention in both research and clinical practice. Physical abuse during
pregnancy has been associated with adverse maternal and fetal health outcomes. A better
understanding of epidemiology of physical abuse during pregnancy, including its frequency, risk
factors, adverse maternal conditions and birth outcomes could have clinical implication. Early
identification and intervention to prevent abuse of pregnant women may reduce the adverse
outcomes (2).Intimate partner abuse is not a new phenomenon and usually results in serious
health problems in women. The WHO (2002), reported between 10-69% of the women had
suffered from physical abuse at some point in their life; the violence is not when a women
become pregnant and between 0.9 and 20.1% during pregnancy. In fact, the frequency of
violence against pregnant women increases and become more severe during this period (3).
Violence during pregnancy occurs more frequently than some routinely screened obstetric
complications, including in preeclampsia and gestational diabetes (4). In Ethiopia 85% of women
believes that husband has justified in beating their wife for at least one reason. 81% of women
reported severe physical violence in Ethiopia due to context in which it is acceptable means for
husbands to control or chastise their wives (5), similarly in rural southwest Ethiopia, women are
experienced intimate partner were more likely than non abused women to believe that a man
could be justified to hit by partner when she failed to complete work or when she did not obey
him (6). This indicates the level of acceptance for physical violence in Ethiopia which might
result under reporting of it, while sexual punishment are unacceptable the prevalence(41.1%)
physical violence in life time is lower than previous study(7)
1.2. Statement of the problem
Abuse against women and girls is major health and human right issue. At least one in five of the
world’s female population has been physically or sexually abused by amen at some time in their
life. Many including pregnant women are subject to severe, sustained or repeated attacks.
Worldwide, it has been estimated that violence against women is as serious a cause of death of
incapacity among women of reproductive age as cancer, and a greater cause of ill health than
traffic accidents and malaria combined (8). The world bank has recognized gender based
violence (GBV) as a heavy health burden from women aged 15-44 similar to the risk posed by
HIV, TB, infection during child birth, cancer and heart disease, abuse is an obstacle to the
achievements of quality, development and peace. Though the violence is widespread available
information is fragmented and analyzed. A culture of silence surrounds cases of violence against
women in most countries making it difficult to get a treed picture of its scope (9).

Abuse towards women during pregnancy has many for reaching consequences for a women and
her fetus, including of serious social and health problem. It is clear from the research that
violence towards women during pregnancy is an issue that cuts across countries; however,
prevalence and type varies from country to country, and even with in a country. According to the
majority of clinical- based study in North America, the most common type of violence during
pregnancy in developed country is kicking (boxing) and dragging followed by firing with
corrosive; where as in developing country including Ethiopia, the most common type of violence
is sticking and kicking (boxing) followed by slapping. The prevalence ranges from 4 to
8.5.According to a review of studies from India, China, Pakistan and Ethiopia, the prevalence
ranged 4 to 28%. In general, studies showed as the prevalence of physical abuse during
pregnancy has been greater in developing countries, than the developed once. Ethiopia is one of
the developing country and physical abuse during pregnancy (80%) has been practiced
dangerously .Physical abuse during pregnancy was a dual destruction because both the mother
and the fetus suffered by the violence therefore undertaking a research on physical abuse during
pregnancy and its prevalence cannot be doubted(10)
 1.3. Significance of the study

After we determine prevalence and risk factors in our study we give health information about
ANC utilization, effect of home delivery and some psychological aids for pregnant mothers,
because the outcome affects both the mother and her fetus. The result of our study reduces late
ANC attendants, depression coming after violence, addiction, increase institutional delivery and
saves the mother and her fetus’s life (it is un measurable value), Also, it will be come for other
researches that would have seen the future because by this title no enough papers had had done
in our country. In general, the study will provide both measurable and immeasurable functions
for the reductions and prevention of physical abuse during pregnancy.
The study will provide baseline information on ANC utilization and factors affecting it. Such
information will be helpful for concerned governmental bodies, non -governmental organizations
or health service providers to plan and act in minimizing and preventing physical violence during
pregnancy, so that maternal and infant mortality and morbidity will decline
 2. LITERATURE REVIEW
Violence against women is perhaps the most pervasive, but least recognized human right about
in the world. The domestic violence that typically occurs when a man beats his females partner is
the most prevalent form of gender- based violence. Domestic violence is not uncommon
problem. Globally at least one in every three women has experienced some from for gender
based violence during their life time

Millions of girls and women suffer from violence and its consequences because of
misunderstanding of their sex and their unequal status in the society .VAW (often called gender
based violence) is serious violation of women’s human right (WHR). Yet little attention has been
paid to the serious health consequence of abuse and the health needs of abused women and girls.
Women who have experienced physical, sexual, or psychological violence suffer with a range of
health problems, often in silence. They have poorer physical and mental health, suffers more
injuries and uses more medical resources than non- abused (11).There has been limited
investigation of the risk factor for physical abuse during pregnancy and the maternal and fetal
health outcomes associated with it. Stewart and cocotte and other found that past history of abuse
is one of the strongest predictors of abuse in pregnancy, Stewart and cocotte identified other
factors including social instability (young, unmarried, failed to complete high school,
unemployed and having unplanned pregnancy); unhealthy life style (including unhealthy diet,
alcohol use, illicit drug use and emotional problems); and the physical and psychological health
problem (including prescription drug use). On the other hand, the US report indicated that
physical abuse during pregnancy is associated with delayed entry in to or inadequate prenatal
care (17). In Canada (1999), Goss reported that the risk of spousal violence against women in
general is higher among women who are younger, are living in common low relationships, have
a lower house hold income, have a partner who drinks heavily and have a partner who was
exposed to violence against his mother in his" child hood.” Greater understanding of the risk and
protective factors for physical abuse during pregnancy may allow Targeting of interventions and
prevention strategies (18).

Violence by intimate partner including violence during pregnancy is an important human right
and public health issues. Research done in Tanzania report that most physical violence to
pregnant women was blown to abdomen and more than third of women experienced the violence
starting during pregnancy. This was significantly associated with adverse maternal health ,
behaviors and out comes including drinking during pregnancy having had a child that dead and
the partner preventing or discouraging attendance for ANC .factors significantly associated
during pregnancy included being currently unmarried, having had children from different father,
partner unfaithfulness and his refused to use contraceptives(14) of women screened ,26.6%
reported emotional abuse ,18.7% reported physical abuse in the past and 10.3% reported being
beaten, bruised ,threaten with weapon or being permanently injured.

Physical violence during pregnancy reported by 5.9% of women LBW, and preterm birth
occurred in 10.9% and 10.2% of pregnant respectively. The mean birth weight of infant born to
women who were injured due to physical violence was recognized genders based violence as a
heavy health, HIV, TB and infection during child birth significantly lower than the mean birth of
women were not injured (15).

Violence and threaten of violence against pregnant women are main barriers to women
employment and equal participation in society. When stress and violence increase in developing
society, women safety in home, work place and a community often seriously affected. The
prevalence of physical violence and its association between maternal complication and birth
outcome, research indicates that antenatal hospitalization, lab our and delivery complication
where obtained.
Prevalence during pregnancy as 10.7% a women were experienced physical violence compared
with those not reporting abuse were more likely to be smoker and hospitalized before delivery
for maternal complication such as preterm lab our, kidney infection ,PROM ,vaginal bleeding
with pain ,abortion fetal death ,placenta abruption, and fetal injury Such as skull fracture,
intracranial hemorrhage and bone fracture (19).

Research done by Pea dicayil A reported that the life time experience of physical violence during
pregnancy being slapped was 16%,hit 10%,beat 10% kicked 9% ,use weapon 5%,and harmed in
any other way 6%. 80% of experienced at least one of these behaviors and 3% experienced all
six. The overall prevalence of moderate to severe violence during pregnancy was 13 % (20)

Sarkar has reported that physical violence on pregnant women increases the risk for low birth
weight infants, pre-term delivery and neonatal death and negatively affects breast-feeding
postpartum. HIV itself results in similar maternal and neonatal outcomes. There is need to
explore if there are joint effects of HIV and IPV on the maternal and child health outcomes.
The adverse health consequences of IPV have been documented in previous reports and include:
mental disorders such as suicidal ideation, suicide and post-traumatic stress disorders;
gynecological and obstetric disorders such as chronic pelvic pain and preterm deliveries; and
infectious diseases such as HIV infection and other sexually transmitted infections (21)
A study done in Northwest Ethiopia in Gojam at Gozaman woreda and the life time prevalence
of physical violence was found to be 43.7 % (16)
 3. OBJECTIVES

3.1. General Objective

 To assess the prevalence and risk factors of physical violence during pregnancy among
pregnant women visiting ANC clinic in Fitche Hospital from November 12/3/2007-
May28/09/2007

3.2. Specific objective

 To determine the prevalence of physical violence among pregnant women in the above
specified time
 To identify risk factors associated to physical violence among pregnant women in the
above specified time
4. METHODS AND MATERIAL

4.1. Study area and period

The study was conducted on pregnant mothers those who attend ANC clinic at Fiche hospital
from November 12/3/2007- May28/09/2007.The data was collected by 4 th year midwife. Fiche is
the capital city of North shoa which is one of 18 zones in Oromia regional state, Ethiopia. It is
located 112 km far from Addis Ababa (Capital city of the country) to the Northern direction.
According to 2007 national population and housing census the total population of Fitche town
50000. From which, males and females accounts 25520(51.042%) and 24480 (48.96%)
respectively. The town has one Zonal hospital and 2 Health center and many private clinics.
Fitche town has a weyna dega climate

4.2. Study Design

Cross sectional descriptive study was conducted to assess the prevalence and risk factors of
physical violence during pregnancy among pregnant women visiting ANC clinic in Fitche
Hospital.

4.3. Population
 Source population
All reproductive age group of mothers attending MCH clinics
 Study population
All pregnant women attending A NC care services.

4.4. Inclusion and Exclusion criteria

 Inclusion criteria
All pregnant mothers who attend ANC clinic during study period
 Exclusion criteria
All seriously ill and disabled (deaf and blind) were excluded
4.5. Sample size determination
All pregnant women attending ANC clinic in Fitche Hospital was interviewed during study
period.

4.6. Sampling Technique

A convenient sampling technique was employed to identify the study subject.

4.7. Procedure for data collection

The structured and well organized questionnaires that were prepared after reviewing similar
literature and modified to context were used to collect data. The questionnaires were prepared
by English language and translated to the language that our study subject speaks {Amharic &
Afan Oromo). It was implemented to collect related to the socio- demographic variable of the
study population and data related to the variables elicited in there literature reviews associated
with the study under consideration .Data was collected with the pretested structured
questionnaires which are compared of open and closed ended questions and done by the assigned
4th year midwifery students. The questionnaire was cleared from vague, offensive and boring

4.8. Variable
 Dependent variables
 Physical violence during pregnancy
 Independent variables
Socio demographic variables
 Sex
 Age
 Educational of the client
 Educational status of husband
 Religion of the client
 Income status of family
4.9. Operational definition
 Violence: - intentional use of physical force or power against oneself, another
person or against group that either results in or high likelihood of resulting in injury,
death, psychological harm, mal development or depravation.
 Physical violence: is physical force that results in bodily injury, pain or
impairment. It includes assaults, battery, and inappropriate restraint.
 Physical abuse: - Physical abuse can include, but is not limited to kicking, pushing,
throwing, grabbing, biting, choking, slapping, punching and hitting
 Preterm birth:- birth at gestational age above 28 and less than 37 completed weeks
 Low birth weight: - a birth weight <2,500 gm

4.10. Data Quality Assurance

During data collection time data was pretested two weeks prior to data collection and cheeked
for its completeness and missing information at each point by principal investigator and data
collector themselves for accurate collection of data.

4.11. Data analysis and presentation

After the data being collected it was sorted cleaned, coded in to homogenous group for simplicity
and clarity and it was analyzed by using manual scientific calculator and tally sheet and
presented by table, pie chart and graphs

4.12. Ethical consideration

Before the beginning of the data collection there was asking the permission to Ambo University
College of medicine and health science department of midwifery to implement it. Then the data
collectors were orient about the purpose and the procedure of data collection and confidentiality
and privacy was insured.

4.13. Dissemination of results

The result of the study was disseminated to Fitche town administration to distribute for the stake
holders & to the college of medicine and health sciences Department of Midwifery to implement
it.

5. RESULT
Table 1: shows the socio- demographic characteristic distribution of the study, majority
164(39.42%) of the participants were in the age group of 25-29 years of age and the least
participants were in the age group 15-19yrs which accounts 26(6.25% ) only. and also majority
370 (88.94%) ,303(72.83%). 392 (94.23%), 118 (28.36%), 228(54.80%) of the participants were
Orthodox, Oromo, married, illiterate and house wife respectively.
Variable Parameter (No) Percentage (%)
Age of the 15-19 26 6.25%
mother 20-24 150 36.05%
25-29 164 39.42%
30 and above 76 18.26%
Total 416 100%
Orthodox 370 88.94%
Religions Muslim 35 8.41%
Protestant 5 1.20%
Catholic 4 0.96%
Other 2 0.48%
Total 416 100%
Ethnicity Oromo 303 72.83%
Amhara 95 22.83%
 Tigre 9 2.16%
Others 9 2.16%
Total 416 100%
Married 392 94.23%
Single 9 2.16%
Marital status Divorced 15 3.6%
Total 416 100%

Occupational Student 11 2.64%

status
House wife 228 54.80%
Government employee 127 30.52%
Merchant 32 7.69%
Other 18 4.32%
Total 416 100%
Educational status Illiterate 118 28.36%
of Client 1-8 94 22.59%
9-12 15 18.02%
Others 129 31%
Total 419 100%
Educational status Illiterates 100 24.03%
of spouse 1-8 76 18.26%
9-12 71 17.06%
12+ 169 40.6%
Total 416 100%
 Figure 1: The educational status distribution of the study participants at Fitche Hospital.
Based on the result shown in figure -1, concerning of the respondents the educational status
majority 129(31%) of the participants were Above Grade 12 and 94 (22.59%), 75(18.02%),
118(28.36), grade 1-8th, 9-12th and Illiterate respectively.

0.28 0.31

abovergrade12
grade 1-8
grade 9-12
illitrate

0.18 22.6%

Figure 2: The prevalence of physical abuse among pregnant women’s at Fitche Hospital.
According to the result shown in figure -2 the prevalence of physical abuse during pregnancy
were 43(10.34%). 22 (5.28%), 351(84.37%) were physically abused at non pregnant time and
never been physical abused in their life time respectively
 5.30%
10.30%

during pregnancy
during non pregnancy

84.40% never abused

Figure 3: Age distribution of physical abused among pregnant women in Fitche hospital
2015.
Regarding to the result shown in figure 3, The majority 22(51.16%) of the respondents who
were physically abused during pregnancy and 8(36.36% ) non pregnant time were in the age
group 25_29 years and 20-24 years Respectively.
 120

100
100 97

85
80
69
during pregnancy
60
during non pregnancy
never abu
40

22
20
13
8 7 6 5
2 2
0
15-19 20-24 25-29 30& obove

Table 2- Shows the prevalence of physical abuse during pregnancy.

Regarding to the respondent majority 32(49.23%) of the pregnant women reported physical
abuse during pregnancy were sticking followed by kicking 12(18.46%), dragging 11(16.96%)
and slapping10 (15.38%). Some of the women were suffered more than one types of physical
abuse and no perpetrator was used weapons for violating the pregnant women.
Variable Parameter No Percentage (%)
Types of Sticking 32 49.23%
violence(multiple Kicking (boxing) 12 18.46%
response were present) Slapping 10 15.38%
Dragging 11 16.92%
Total 65 100%

Table 3: Shows that the possible causes which initiate physical abuse during pregnancy.
According to the participants report, intoxication 27(41.53%) was the leading risk factor
followed by distrust 19(29.23%) however, unwanted pregnancy and others were the least factor
initiating physical abuse during pregnancy for this study.
Variable Parameter No Percentage (%)
Risk factor of Intoxication 27 41.53%
violence(multiple Mistrust 19 29.23%
response were present) Unwanted pregnancy 8 12.30%

Others 11 16,9%
Total 65 100%
 6. DISCUSSION
In this study 65 (15.6%) of the study participants had reported a history of physical abuse in their
life time. From those who were suffered to physical abuse 43(66.15%) of them have been
physically abused during the time of pregnancy and its prevalence was 10.34% and when
compared to other studies, it was Less when compared to the results that had studied at North
West Ethiopia 2013 at Gozaman woreda and the prevalence of physical violence during
pregnancy was found to be 43.7 % (16)
and also it is nearly comparable when we compare to the research done by peadicayil which
states that The overall prevalence of moderate to severe violence during pregnancy was 13 %
(20)
In this study, about one in every ten women had ever been suffered to physical abuse at the time
of pregnancy and the majority 25(58%) of the perpetrators were by her intimate partner including
her husband. this one in every ten is less When we compared to other studies, Ethiopian census
(2007), globally at least one in every three woman had experienced some physical violence in
their life time (15) and also At least one in every five of the world’s female population has been
physically or sexually abused by amen at some time in their life. Many including pregnant
women are subject to severe, sustained or repeated attacks.
Worldwide, it has been estimated that violence against women is as serious cause of death of
incapacity among women of reproductive age as cancer, and a greater cause of ill health than
traffic accidents and malaria combined (8).
On the results, different types of risk factors were identified and -*intoxication was the leading
risk factor which accounts 27(41.53%) from the factors reported. And the violence is due to the
spouse intoxication Based. The Result was comparable with other studies done In Canada
(1999), Goss reported that the risk of spousal violence against women in general is higher among
women who are younger, are living in common low relationships, have a lower house hold
income, Have a partner who drinks heavily and have a partner who was exposed to violence
against his mother in his" child hood.” Greater understanding of the risk and protective factors
for physical abuse during pregnancy may allow targeting of interventions and prevention
strategies (18).

As we see the 1st ANC attendant, majority 29(67.44%) of the abused women were attended at
the 2nd and 3rd trimester but, 14(32.55%) attended at the 1st trimester of their gestational age.
This indicates us delayed attendance of their ANC service that is another outcome which did not
leave easily to the abused pregnant women which is very important to reduce the obstetric
complications due to abusing. The result was comparable with other study’s which had studied in
US that indicate physical abuse during pregnancy was associated with delayed entry in to or
inadequate prenatal care (17).

Regarding to the results, sticking 32(49.23%) was the major types of physical violence followed
by kicking /boxing 12(18.46%) and Slapping is the least 10(15.38%) this was inconsistent with
the study done by peadicayil which state that slapping was leading type of physical violence
during pregnancy (20) and also consistent to the clinical- based study in North America, that
stated the most common type of violence during pregnancy in developed country is kicking
(boxing) and dragging followed by firing with corrosive ; where as in developing country
including Ethiopia, the most common type of violence is sticking and kicking (boxing) followed
by slapping. Physical abuse during pregnancy was a dual destruction because both the mother
and the fetus suffered by the violence therefore undertaking a research on physical abuse during
pregnancy and its prevalence cannot be doubted (10).
According to our study, there was a single girls who were pregnant and physically violence by
her boy friends because the pregnancy was unwanted and unplanned pregnancy.
There were also different forms of factors such as income status of family. Behaviors of different
family members and educational status of family leads to disagreement in the family as we had
seen in our studies 28% of the study participant were illiterate and this was comparable to the
studies done in Canada which stated that risk of spousal violence against women in general is
higher among women who are younger, are living in common low relationships and have a lower
house hold income. (18).
7. CONCLUSION AND RECOMMENDATIONS

7.1. Conclusion
Regarding to the respondents reports the prevalence of physical abuse on pregnant women at
fitche Hospital were 43(10.33%) from those abused about 27(62.79%) of them attacked during
the previous pregnancy and the least account for current pregnancy which is 16(37.02%) .When
we see the risk of physical violence according to the result of our study the dominant risk factors
of physical abuse on pregnant women were, intoxication which accounts 27(41.53%). followed
by distrust 19(29.23%) , unwanted pregnancy 8(12.30%) and others 11(16.9%)were the factors
initiating physical abuse during pregnancy for this study.

7.2. Recommendation
Based on the results, the flowing recommendation was forwarded.
 Care providers who are working at Antenatal care should not be hesitant to screen physically
abused pregnant women, because they need special care than other pregnant women. in
addition to giving special care all health professionals providing ANC care should provide
health information such as the effect of multiple partners, drinking alcohols ,the use of
spacing the children and the use of ANC should be provided to both mothers and her
husbands.
 Male involvement in Reproductive Health including care of pregnant women is very
important. Therefore the spouse should be advised about pregnant mothers care.
 Also the spouse should know about women’s human right issue hence physical violence is
contradictory action to women’s human right issue. And the effects of physical violence
should be clear to the spouse.
 Since, the problem was the most pervasive and limited studies had done; so, individuals
As well as organizations like WHO and MOH recommended doing further studies.
Because, it is important for the reduction and prevention of obstetric and gynecological
complication such as preterm lab our, kidney infection ,PROM ,vaginal bleeding with
pain ,abortion fetal death ,placenta abruption, and fetal injury Such as skull fracture, intracranial
hemorrhage and bone fracture that occur after physical Violence at the time of pregnancy
Limitation - Respondent bias, Shortage of time and Shortage of Resource were the major
limitation we faced during our study.

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15. Negery, et al.effect of domestic violence on preterm birth and low birth weight, Acta obste
Gynecol scan.2004 may; 83(5):455-60
16.Megib Andualem, Gebyaw Tiruneh,Ayu Gizachew and Dube jara prevalence of intimate
partner physical violence against women and associated factors in Gozaman Woreda,Northwest
Ethiopia 2013.
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18. WHO coverage of maternity care, tabulation of available information maternal health and
Safe mother hood programme, 3rd edition 1993, page-11
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on maternal and birth out comes.Acta Medical Iranica,44(2):95-100;2006
20. Peadecayil A, etal. Spousal physical violence against women during pregnancy.BJOG.2004
Jul; 111(7):682
21. Sarkar NN: Impact of intimate physical violence on women reproductive health and
Pregnancy outcomes. Obstetric Gyneacol 2008 28:266-
 AMBO UNIVERSITY
COLLEGE OF MEDICINE AND HEALTH SCIENCE
DEPARTMENT OF MIDWIFERY
Questionnaires on physical violence during pregnancy
My name is _and currently I am undertaking research on the topic of physical violence during
pregnancy at this Hospital on pregnant mothers.
This questionnaire is designed to assess prevalence of physical violence among pregnant women
attending ANC in This Hospital.
I kindly request you to answer the questionnaire with real and complete information accordingly.
All information will be confidential
NB: Don’t write name and any special identification
Part -1 Socio- demographic characteristics.
1Age___________
15-19
20-24
25-29
>30
2. Ethnicity a, Oromo b, Amhara c, Tigre d, other (specify) __
3. Religion a, Orthodox b, Muslim c, Catholic
d, Other (specify) __
4. Educational status a, Illiterate
b, 1-8 c, 9-12 d, other (specify) __
5. Marital status a, Married b, single c, Divorce d, Widow
6. Occupational status a, House wife b, Government employee
C, Farmer d, Merchant e, Student f, others (specify) __
7. Parity a, 2-3 b, >3 c, prim
8. Gestational age a. 1st trimester b, 2nd trimester c, 3rd trimester
9. Length of relationship a, 0-1 b, 2-5 c, >_6yrs
10 .Spouses educational status a, Illiterate
b, 1-8 c, 9-12 d, other specify_____

Part – II Questions related to history of physical violence

11. Have you ever been physically hurt (hit, slapped, kicked, dragged) or abused by someone
Including your husband in the year before pregnant.
Dragged) or physically hurt?
a. Yes b, No
12. Since you become pregnant, have you ever been physically abused (hit, slapped , kicked
a, Yes b, No
13. What was the cause of abusing? Did you know?
a, Yes b, No
1.3.1. If yes: which one?
a, Intoxication b, mistrust c, unwanted pregnancy
d, other specify_____
14. If yes for q. (11/12)
______ by whom you abused?
a. Husband b, Spouse c, Relations d, by other specify
15. Do you have history of disagreement before pregnancy that led to violence?
a, Yes b, No
17. Do you have any habit like chat chewing alcohol ingest, smoking using drugs etc.?
a, Yes b, No
18. Does your spouse have any habit? a, Yes c, No
1.8.1. If yes to q. 17/18, which habit it specify____
 Table of content
Acknowledgement…………………………………………………………………………………………..I
Acronyms………………………………………………………………………………………………………..II
Table of content …………………………………………………………………………………………….III
List of tables and figures ……………………………………………………………………………….IV
Abstract …………………………………………………………………………………………………………V

1. INTRODUCTION …………………………………………………………………………….... ………1

1.1 Background of the study........................................................................................................................1

1.2. Statement of the problem..................................................................................................................2
1.3. Significance of the study..................................................................................................................3
2. LITERATURE REVIEW......................................................................................................................4
3. OBJECTIVES.........................................................................................................................................7
3.1. General Objective.............................................................................................................................7
3.2. Specific objective.............................................................................................................................7
4. METHODS AND MATERIAL...............................................................................................................8
4.1. Study area and period.......................................................................................................................8
4.2. Study Design....................................................................................................................................8
4.3. Population.........................................................................................................................................8
4.4. Inclusion and Exclusion criteria........................................................................................................8
4.5. Sample size determination................................................................................................................9
4.6. Sampling Technique..........................................................................................................................9
4.7. Procedure for data collection...........................................................................................................9
4.8. Variable............................................................................................................................................9
4.9. Operational definition.....................................................................................................................10
4.10. Data Quality Assurance................................................................................................................10
4.11. Data analysis and presentation......................................................................................................10
4.12. Ethical consideration....................................................................................................................10
4.13. Dissemination of results................................................................................................................11
5. RESULT............................................................................................................................................11
6. DISCUSSION.......................................................................................................................................17
7. CONCLUSION AND RECOMMENDATIONS...................................................................................19
7.1. Conclusion......................................................................................................................................19
7.2. Recommendation................................................................................................................................19
REFERENCES..........................................................................................................................................20
Assurance of Investigator

The under signed agrees to accept responsibility for the scientific, ethical and technical
conduct of the research project and for provision of required progress reports as pre terms
and conditions of the research and publications office of the Ambo University.

Name of students: Asnake Fekade

: Bacha Ilala
:Bekelish Mesfin
:Beliyu Lami
:Beshir Obsa

Date: ___________________ Signature____________________

Approval of Advisor(s)
Advisors
Name______________________
Signature_______________________________
Date____________________________________