Spatial variation and factors associated with women's injury due to intimate partner violence in Madagascar: Evidence from the 2021 demographic and health survey.

BackgroundIntimate partner violence (IPV) is a violation of human rights that affects the physical, mental, and social well-being of women. It reduces their productivity and quality of life and results in injuries. Despite its serious impact, there is limited evidence about the magnitude, spatial variation, and determinants of women's injury in Madagascar.ObjectiveThis study aimed to find the spatial variation of women's injury due to IPV and its determinants in Madagascar.DesignCommunity-based cross-sectional.MethodsThis study was conducted using the Madagascar Demographic and Health Survey 2021. A total of 1515 women (weighted) aged 15-49 who experienced IPV were included. The data were cleaned and analyzed using STATA version 17. ArcGIS version 10.8 software was used for mapping the special variation, hot spot analysis, and spatial autocorrelation. Spatial cluster detection of injury was conducted through SaTScan version 10.1 software. A multi-level binary logistic regression model was used to determine factors associated with injury.ResultsWomen's injury due to IPV showed geographical variations in Madagascar. The prevalence of injury was 37.4% (95% CI, 34.97, 39.85). The strongest hot spots were identified in the central and northern regions of Madagascar. The multi-level logistic regression analysis identified several factors associated with women's injury due to IPV, including old age category [AOR = 1.49 (95% CI, 1.003, 2.21)], husband drinking alcohol [AOR = 2.36 (95% CI, 1.64, 3.39)], the husband's jealousy or anger when she talks to other men [AOR = 2.08 (95% CI, 1.47, 2.95)], the husband's attempts to limit her contact with family members [AOR = 2.16 (95% CI, 1.50, 3.11)], and high community poverty [AOR = 1.47 (95% CI, 1.01, 2.14)].ConclusionThis study identified significant geographical variation in the IPV-related injury of women in Madagascar. In addition, husband's alcohol drinking, old age, community poverty and marital control behaviors were risk factors. Therefore, interventions that address the spatial variation of women's injury, community-based awareness and behavioral change programs that reduce marital-controlling behaviors, promote and strengthen social networks and support for old-age women, reduce poverty and alcohol-use reduction strategies are advised.