Investigating the Relationship Between Structural Determinants of Health and Domestic Violence against Pregnant Women based on the World Health Organization Model

Abstract

Background: Domestic violence is recognized as a global health problem. In recent years, understanding the factors affecting violence against women has become one of the most prominent issues. Objectives: This study aimed to identify the relationship between the structural determinants of health and domestic violence against pregnant women. Methods: This descriptive cross-sectional study was conducted on 560 volunteer pregnant women, aged 28 - 35 weeks, who were referred to healthcare centers affiliated with Shahid Beheshti University of Medical Sciences in Tehran, Iran, during 2021 - 2022, using a multistage cluster sampling method. The data collection tools used in this research included questionnaires on demographic and gynecologic/obstetric factors, socioeconomic status, and domestic violence. The collected data were analyzed by measuring descriptive and inferential statistics using the chi-square test and multivariate logistic regression analysis. Results: Based on the results, more than 50% of women were subjected to domestic violence during pregnancy (66.3% emotional violence, 10.2% physical violence, and 9% sexual violence). Domestic violence showed a significant relationship with the majority of the structural determinants of health (P < 0.005). Based on the logistic regression model, demographic/obstetric and socioeconomic factors explained 73% and 85.3% of the variance in domestic violence, respectively. Certain structural social determinants of health acted as protective factors against domestic violence toward pregnant women, as the possibility of domestic violence was lower in women with high school education, working spouses, and high income (OR = 0.310, 0.217, and 0.255, respectively). Conclusions: This study showed that more than half of Iranian women experienced domestic violence during pregnancy. To prevent adverse maternal and neonatal consequences, it is necessary to identify these women and introduce them to support centers.