Prevalence, types, and determinants of gender-based violence among pregnant women in Northern Uganda: A hospital-based cross-sectional study

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Exposure to GBV during pregnancy poses significant health risks to the mother and her foetus, leading to various complications. This study aimed to determine the prevalence, types, and factors associated with GBV among pregnant women in Northern Uganda. Methods A cross-sectional study was conducted at Gulu Regional Referral Hospital's antenatal care clinic from June to August 2023. Data were collected using semi-structured questionnaires in English or Acholi. Participants were selected through systematic random sampling. Information on socio-demographic characteristics, partner attributes, and GBV exposure was collected. Descriptive statistics and modified Poisson regression analyses were performed using STATA 18.0. Associations between variables and GBV were reported as adjusted prevalence ratios (aPR), with p < 0.05 considered statistically significant. Results Among the 339 participants, the mean age (standard deviation) was 26.1(5.5) years. Overall, 73.2% (n = 248) of the participants were exposed to GBV in pregnancy. The most common form of GBV was controlling behaviour by male partners (61.9%, n = 210), followed by emotional violence (34.8%, n = 118), economic violence (29.5%, n = 100), sexual violence (28.9%, n = 98), and physical violence (16.2%, n = 55). Factors associated with GBV included being in a polygynous marriage (aPR: 1.2, 95% CI: 1.03–1.31, p = 0.013), having poor (aPR: 1.6, 95% CI: 1.32–1.89, p < 0.0001) or good (aPR: 1.2, 95% CI: 1.03–1.51, p = 0.026) versus perfect relationship with the husband's family, week of amenorrhea (aPR: 1.01, 95% CI: 1.003–1.02, p = 0.006), and maternal age (aPR: 0.98, 95% CI: 0.97–0.99, p = 0.003). Conclusions GBV during pregnancy, particularly controlling behaviour by male partners, is highly prevalent in Northern Uganda. To mitigate the negative impacts on maternal and foetal health, targeted interventions by the Ministry of Health, development partners, and other stakeholders are urgently needed to prevent and manage GBV in pregnancy. Sexual & Reproductive Medicine Gender Based Violence Pregnancy Antenatal care Northern Uganda Background Gender-based violence (GBV) remains one of the gravest challenges to women’s health and well-being, it is largely driven by inequity and social injustice ( 1 , 2 ). GBV is any sexual, physical, mental, behavioural, and economic harmful act directed at an individual based on their gender inflicted in public or private, in which the female is usually the victim; and which is derived from unequal power relationships between men and women ( 2 , 3 ). GBV is one of the systemic public health problems that is increasingly visible on the global health and development agenda ( 4 ). A recent report showed that an estimated 25% of women aged 15 years and above experience at least one form of GBV in their lifetime ( 5 ). World Health Organisation (WHO) revealed that the prevalence of GBV ranged from 15% in urban areas to 71% in rural areas ( 2 ). Further evidence showed that the problem of GBV is most prominent in developing countries, especially in sub-Saharan African (SSA) countries, where socioeconomic status is low, and education is limited ( 6 ). However, there are knowledge gaps, on the prevalence, types, and perpetrators of violence against adolescent girls and young women of reproductive ages ( 7 , 8 ). In Northern Uganda, a study in a rural setting showed that women were more likely to get exposed to GBV during pregnancy ( 7 ). A primary concern of GBV during pregnancy relates to the serious consequences not only for the woman but also for the foetus and ultimately, the child's growth development ( 9 ). The phenomena have received considerable attention, particularly the adverse consequences of GBV to both the mother and the foetus ( 10 ). Several previous works pointed out several adverse consequences of GBV during pregnancy to the mothers, the foetus, and the newborn baby ( 10 , 11 ). The adverse maternal impacts of GBV in pregnancy include maternal mental health problems including anxiety and depression, sexually transmitted infections in case of sexual violence, poor weight gain during pregnancy, increased risk of operative delivery as well as heightened risk of maternal mortality ( 2 , 12 ). Meanwhile, the adverse health impacts of GBV in pregnancy include low birth weight, preterm delivery, intrauterine foetal death in case of physical violence, and increased risk of neonatal mortality ( 13 ). Despite its importance, far too little attention has been paid to the epidemiology of GBV during pregnancy in Uganda and there is an increase in the prevalence of violence from 26.7–32.3% during pregnancy among women in rural settings ( 7 , 14 ). Conversely, a 2020 National Survey on Violence Against Women and Girls (VAWG) found an overall low prevalence of violence during pregnancy, lower than figures reported in the UDHS (2016), however, the survey only explored physical violence and no other forms of GBV( 15 ). There is regional variation in the prevalence and burden of GBV with Northern Uganda having rates as high as 47% among women attending reproductive health services( 15 ). The within-country variation is attributable to methodological differences, the working conceptual definition and the measure of the various forms of violence ( 15 , 16 ). Besides, the glaring poverty and post-conflict situation in Northern Uganda makes GBV a common place( 17 ). Focusing on the understanding and epidemiology of GBV during pregnancy will help in designing interventions to curb the negative effect on the mothers and their unborn babies( 18 ). This study aims to address this important but under-researched issue by investigating GBV among pregnant women in Northern Uganda. The findings could provide valuable insights for stakeholders on the prevalence, types and factors associated with GBV in this population and guide the development of context-specific and culturally appropriate interventions to prevent and manage GBV. Ultimately, this research seeks to improve maternal and child health outcomes. Methods Study design and setting This facility-based cross-sectional study was conducted at the ANC clinic at Gulu Regional Referral Hospital (GRRH). GRRH is a tertiary hospital for patients from mid-northern Uganda, thus serving both rural and urban populations within the catchment area. GRRH also receives patients from neighbouring countries of South Sudan and the Democratic Republic of Congo. It is also a teaching hospital for the Gulu University, Trainer Centre for Fellowship with East Central and Southern African College of Obstetrics and Gynaecology (ECSACOG) and many other Diploma and Certificate Training Institutions in the region. It is a hospital with both out and in-patient services for an estimated 120,000 patients per year. The hospital has specialised units managed by consultants from GRRH and the Faculty of Medicine, at Gulu University. The Obstetrics and Gynaecology department provides all services ranging from ANC to Postnatal Care (PNC) during pregnancy and after delivery. Due to the quality and free ANC services, a large proportion of pregnant women within the catchment area attend their ANC services at GRRH. Study population This study was conducted among pregnant women attending ANC at GRRH. All pregnant women attending ANC at GRRH were eligible for inclusion, irrespective of gestational age. However, we set to exclude any pregnant woman who would be deemed incompetent to consent due to severe sickness or mental disorder, but none were excluded. Sample size Using the Kish Leslie formula, the prevalence of GBV in pregnancy was 26.7% from a study conducted at two rural health centres in Northern Uganda ( 8 ), and at a 5% significance, the minimum sample size was estimated to be 301. Assuming a conservative non-response rate of 10% (301/0.9), the adjusted sample size was 335 participants. Sampling techniques Based on the average daily attendance at the ANC clinic at GRRH which was approximately 80 women per day, we used a systematic random sampling method aided by the daily ANC attendance register to select every 5th person on the list on any given day. This enables each of the four investigators who participated in data collection to handle at least four participants per day. While on the ground the daily ANC attendance ranged between 60–100 pregnant women and thus, we collected data from between 12 and 20 participants on any given day. Data collection Data were collected from 339 pregnant women attending their ANC at GRRH between June and August 2023. Data were collected using a semi-structured questionnaire which was developed for this study by the authors. Originally, the tool was developed in English and later translated into Acholi language (Luo) and then pre-tested, for consistency in question interpretation and language appropriateness, among 20 pregnant women attending ANC at Laroo Health Centre III. Data were collected using interviewer-administered questionnaires in either Acholi or English language depending on the participant's literacy level and preferences. Study variables Independent variables included socio-demographic characteristics like age, education, being in a union, employment status, partner level of education, partner employment status, age at first sex, age at first marriage, age of the pregnancy in weeks and, living with HIV and partner alcohol use. The outcome variable for this study was the experience of GBV. The participants were asked batteries of questions to identify whether they were exposed to any of the various forms of violence notably physical violence, emotional violence, economic violence, sexual violence or controlling behaviours. Our tool for screening for GBV was adapted from questionnaires previously used to screen GBV among women in the same setting Data management and statistical analysis Data were entered and cleaned in Microsoft Excel 2023 and then exported to STATA 18.0 for analysis. Descriptive statistics were summarised using frequency with corresponding proportions for categorical variables or mean with corresponding standard deviations (SD) for continuous variables. To examine the associations between independent factors and experiencing any form of GBV, we conducted univariate and multivariable modified Poisson regression analyses with robust standard errors. We reported univariate analyses using unadjusted prevalence ratios (uPR) with corresponding confidence intervals (CI) and p-value. All independent variables with p < 0.20 at univariable analysis were considered for inclusion into the multivariable modified Poisson regression model. Since they have a study power of greater than 80%. The results from the multivariable model were reported using the adjusted Prevalence ratios (aPR) with corresponding 95% CIs and p-values. Any p < 0.05 or effect size whose CI did not include the null value (0) was considered statistically significant. Results Baseline characteristics of the participants A total of 339 pregnant women were included in this study. By trimester, the majority (43.6%, n = 136) were in the second trimester, followed by the third trimester (37.5%, n = 117) and first trimester (18.9%, n = 59). The mean age (SD) was 26.1(5.5) years, the mean age (SD) at first sex was 17.8 (2.5) years and the mean age (SD) at first marriage was 20.3 (3.3) years. More than a third of the participants attained an ordinary level of education (33.6%, n = 113), and 28.0%(n = 94) and 20.62%(n = 68) attained an upper primary and tertiary level of education respectively. Most of the participants (89.7%, n = 304) were in union (married or cohabiting), were in a monogamous marriage (75.5%, n = 253) and employed (46%, n = 156). Furthermore, 38.5% (n = 130) of their partners attained a tertiary level of education, and 5.6%(n = 19) had a lower primary or no education. About half (56.7%; n = 190) of the participants ever used contraceptives, 8.3%(n = 28) were living with HIV and 42.4%(n = 143) of their partners take alcohol. The mean gestation age (SD; range) was 23.2 (9.0; 4–38) weeks, and the majority (88.3% (n = 294)) of respondents conceived of the desire of both husband and wife ( Table 1 ) . Table 1 Baseline characteristics of study participants by GBV during pregnancy. Characteristics Exposed to any GBV All (N = 339) n (%) No (N = 91) n (%) Yes (N = 248) n (%) Age in years (mean, SD) 27.65(5.48) 25.50(5.41) 26.08(5.51) Place of residence Gulu Another district 76(91.6) 7(8.4) 212(88.7) 27(11.3) 288(89.4) 34(10.6) The education level of the participant Lower primary or none Upper Primary Secondary Tertiary 11(12.1) 20( 22 ) 28(30.8) 32(35.2) 24(9.8) 74(30.2) 111(44.6) 36(14.7) 35(10.4) 94(28.1) 139(41.3) 68(20.2) Marital status Not in union In union 6(6.6) 85(93.4) 29(11.7) 219(88.3) 35(10.3) 304(89.7) HIV status Negative Positive 6(6.6) 85(93.4) 29(11.7) 219(88.3) 311(91.7) 28(8.3) Has a co-wife No Yes 77(86.5) 12(13.5) 176(71.5) 70(28.5) 253(75.5) 82(24.5) Employment status Not employed Employed 44(48.4) 47(51.6) 139(56) 109(44) 183(54) 156(46) Employment status of partner Not employed Employed 10(11.1) 80(88.9) 57( 23 ) 191(77) 67(19.8) 271(80.2) Education level of partner Lower Primary Upper Primary O level A level Tertiary 3(3.3) 6(6.7) 25(27.8) 20(22.2) 36(40.0) 16(6.5) 23(9.3) 74(19.8) 41(16.5) 94(37.9) 19(5.6) 29(8.6) 99(29.3) 61( 18 ) 130(38.5) Ever used contraceptive No Yes 24(26.4) 67(73.6) 91(36.7) 157(63.3) 145(43.3) 190(56.7) Was this pregnancy intended? No Yes 24(26.4) 67(73.6) 91(36.7) 157(63.3) 115(33.9) 224(66.1) Pregnancy wanted by husband Husband or both Wife alone 85(93.4) 6(6.6) 209(86.4) 33(13.6) 294(88.3) 39(11.7) Marriage type Married the husband she loves Arranged marriage 69(81.2) 16(18.8) 186(81.6) 42(18.4) 255(81.5) 58(18.5) Relationship with husband’s family Very good Good Poor or fair 43(48.3) 41(46.1) 5(5.6) 57(23.2) 104(42.3) 85(34.6) 100(29.9) 145(43.3) 90(26.9) Husband drink alcohol No Yes 65(73) 24( 27 ) 129(52) 119(48) 194(57.6) 143(42.4) Quartiles of income Lower quartile Second quartile Third quartile Highest quartile 8(16.3) 13(26.5) 16(32.7) 12(24.5) 38(33.3) 30(26.3) 24(21.1) 22(19.3) 46(25.5) 68(27.1) 61(24.3) 58(23.1) Quartile of income of partner Lowest quartile Second quartile Third quartile Highest quartile 15(19.5) 20( 26 ) 20( 26 ) 22(28.6) 49(28.2) 48(27.6) 41(23.6) 36(20.7) 64(25.5) 68(27.1) 61(24.3) 58(23.1) Age (years) at first sexual intercourse (mean, SD) 18.72(2.40) 17.45(2.39) 17.79(2.46) Age (years) of first marriage (mean, SD) 21.27(3.69) 19.98(3.09) 20.32(3.30) Number of children at home (mean, SD) 1.72(1.30) 1.57(1.38) 1.61(1.36) Week of amenorrhea (mean, SD) 21.16(9.40) 23.91(8.75) 23.19(8.99) Prevalence and types of GBV in pregnancy among women in Northern Uganda Almost three in every four (73.2%) pregnant women in Northern Uganda experienced at least one form of GBV during the current pregnancy. The most common form of GBV in pregnancy was controlling behaviours by the male partner (61.9%, n = 210), followed by emotional violence (34.8%, n = 118), economic violence (29.5%, n = 100), and sexual violence (28.9%, n = 98). Meanwhile, physical violence (16.2%, n = 55) was the least common form of violence during pregnancy ( Table 2 ) . Table 2 Prevalence and types of GBV in pregnancy among women in Northern Uganda Different forms of violence Exposed to violence n/N (%) Exposure to physical gender-based violence Slapped or had something thrown at her that could hurt her 46/338 (13.6%) Was pushed or shoved 22/339 (6.5%) Was hit with a fist or something else could hurt 14/338 (4.1%) Was choked or burnt on purpose 10/337 (3.0%) Threatened or hurt by a gun, knife, or other weapon 6/339 (1.8%) Was punched or kicked in the abdomen while pregnant 5/338 (1.5%) Exposed to at least one form of physical violence 55/339 (16.2%) Exposure to sexual gender-based violence Physically forced to have sexual intercourse 77/339 (22.7%) Forced into sexual intercourse 74/339 (21.8%) Forced into sexual acts she found degrading or humiliating 25/339 (7.4%) Exposed to at least one form of sexual violence 98/339 (28.9%) Exposure to emotional violence Insulted or made feel bad about herself 95/336 (28.3%) Belittled or humiliated in front of others 47/339 (13.9%) Scared or intimidated on purpose by looking or yelling at or smashing things 51/338 (15.1%) Threat to hurt someone you cared about 18/339 (5.3%) Exposed to at least one form of emotional violence 118/339 (34.8%) Exposure to economic gender-based violence Destroyed your property intentionally 23/339 (6.8%) Restricted your access to financial resources 43/339 (12.7%) Restricted you from working 45/339 (13.3%) Restricted you from studying 26/339 (7.7%) Did not provide for your pregnancy need 44/339 (13.0%) Exposed to at least one form of economic violence 100/339 (29.5%) Exposed to controlling behaviours Tried to keep you from seeing your friends 111/339 (32.7%) Tried to restrict contact with your family of birth 60/337 (17.8%) Insisted on knowing where she always 106/339 (31.3%) Ignored you and treated you indifferently 66/339 (19.5%) Got angry if you speak with other men 112/339 (33.0%) Suspicious that you were unfaithful 61/339 (18.0%) Expected you to ask permission before seeking healthcare 36/339 (10.6%) Exposed to controlling behaviours as a form of GBV 210/339 (61.9%) Exposed to any GBV 248 (73.2%) Predictors of GBV in pregnancy among women in Northern Uganda At the univariate level, factors associated with GBV in pregnancy were being in a polygyny marriage (uPR: 1.2, 95% CI: 1.07–1.36, p = 0.002), partner not employed (uPR: 1.2: 95% CI: 1.04–1.35, p = 0.009), pregnancy being unwanted by either or both partner (uPR: 1.3, 95% CI: 0.85–1.10, p < 0.0001), having poor (uPR: 1.6, 95% CI: 1.36–1.94, p < 0.0001) or good (uPR: 1.3, 95% CI: 1.03–1.53, p = 0.022) versus perfect relationship with the husband’s family, week of amenorrhea (uPR: 1.01, 95% CI: 1.003–1.02, p = 0.008), participant’s age (cPR: 0.98, 95% CI: 0.96–0.99, p = 0.002), participant’s age at first sex (uPR: 0.95, 95% CI: 0.92–0.97, p < 0.0001), and participant’s age at first marriage (uPR: 0.97, 95% CI:0.95–0.99, p = 0.005) ( Table 3 ) . Table 3 Factors associated with exposure to GBV in pregnancy Variable GBV Crude PR (95% CI) P-value No (n = 91) n (%) Yes (n = 248) n (%) Age in completed years, mean (SD) 27.65(5.48) 25.50(5.41) 0.98(0.96–0.99) 0.002 Level of education Lower primary or none Upper Primary Secondary school Tertiary 11(12.1) 20(22.0) 28(30.8) 32(35.2) 24(9.8) 74(30.2) 111(44.6) 36(15.3) Reference 1.1(0.89–1.44) 1.1(0.91–1.45) 0.8(0.58–1.06) 0.296 0.239 0.114 Married/cohabiting Not in union In union 6(6.6) 85(93.4) 29(11.7) 219(88.3) Reference 0.9(0.74–1.03) 0.102 HIV status Not living with HIV Living with HIV 6(6.6) 85(93.4) 29(11.7) 219(88.3) Reference 0.9(0.78–1.24) 0.918 Husband has other wife or wives No Yes 77(86.5) 12(13.5) 176(71.5) 70(28.5) Reference 1.2(.07-1.36) 0.002 Employment status Not employed Employed 44(48.4) 47(51.6) 139(56) 109(44) 1.02(0.94–1.22) Reference 0.302 Husband employment status Not employed Employed 10(11.1) 80(88.9) 57( 23 ) 191(77) 1.2(1.04–1.35) Reference 0.009 Partner’s level of education Lower primary or less Upper Primary Tertiary 40(44) 6(6.6) 45(49.5) 111(44.6) 23(9.2) 115(46.2) Reference 1.1(0.87–1.33) 0.9(0.85–1.12) 0.477 0.747 Ever used contraceptive No Yes 24(26.4) 67(73.6) 91(36.7) 157(63.3) Reference 0.9(0.85–1.10) 0.642 Partner wanted the pregnancy Both wanted Only one or none 85(93.4) 6(6.6) 209(86.4) 33(13.6) Reference 1.3(1.16–1.46) < 0.0001 Relationship with husband’s family Perfect Good Poor 43(48.3) 41(46.1) 5(5.6) 57(23.2) 104(42.3) 85(34.6) Reference 1.3(1.03–1.53) 1.6(1.36–1.94) 0.022 < 0.0001 Age at first sex 18.72(2.40) 17.45(2.39) 0.95(0.92–0.97) < 0.0001 Age at first marriage 21.27(3.69) 19.98(3.09) 0.97(0.95–0.99) 0.005 Week of amenorrhea, mean (SD) 21.16(9.40) 23.91(8.75) 1.01(1.003–1.02) 0.008 Number of children, mean (SD) 1.72(1.30) 1.57(1.38) 0.97(0.92–1.02) 0.177 After adjusting for being in a union, being in a polygynous marriage (aPR: 1.2, 95% CI: 1.03–1.31, p = 0.013), having poor (aPR: 1.6, 95% CI: 1.32–1.89, p < 0.0001) or good (aPR: 1.2, 95% CI: 1.03–1.51, p = 0.026) versus perfect relationship with the husband's family, week of amenorrhea (aPR: 1.01, 95% CI: 1.003–1.02, p = 0.006), and maternal age (aPR: 0.98, 95% CI: 0.97–0.99, p = 0.003), all remained independently associated with GBV in pregnancy ( Table 4 ) . Table 4 Factors independently associated with GBV in pregnancy Variable Adjusted PR (95% CI) P value Married/cohabiting No Yes Reference 1.04(0.89–1.21) 0.600 Husband has other wife or wives No Yes Reference 1.2(1.03–1.31) 0.013 Relationship with husband’s family Perfect Good Poor Reference e 1.2(1.03–1.51) 1.6(1.32–1.89) 0.026 < 0.0001 How old is the pregnancy in weeks 1.01(1.003–1.02) 0.006 Age in completed years 0.98(0.97–0.99) 0.003 Discussion GBV against women is a global pandemic that affects approximately 1 in 3 women in their life lifetime. GBV during pregnancy is harmful to both the mother and the foetus leading to various complications. In this cross-sectional study, we assessed the prevalence and factors associated with GBV in pregnancy among women attending ANC in GRRH. The self-reported overall GBV among pregnant women was 73.2%. The most common form of GBV in pregnancy was controlling behaviours by the male partner (61.9%), followed by emotional violence (34.8%), economic violence (29.5%), and sexual violence (28.9%,). Physical violence (16.2%) was the least common form of violence during pregnancy. being in a polygyny marriage had a 20% higher likelihood of being exposed to any form of GBV, having a poor or good relationship with the husband's family compared with a perfect relationship with the husband's family members was positively associated with exposure to GBV in pregnancy with likelihood risk of exposure to GBV of 1.6 and 1.2 times respectively. As pregnancy age increases there is a 1% increase in the risk of getting exposed to GBV among the participants, conversely, there was a negative association between maternal age and GBV in pregnancy evidenced by a 2% reduction in the risk of GBV for every one-year increase in maternal age. Overall, the prevalence of GBV in pregnancy stood at 73.2%. This finding is similar to that from a study done in South West (70.3%) ( 4 ), however other studies in Uganda report a relatively lower prevalence, a study reports a 40.6% prevalence of intimate partner violence among teenage mothers in the Lira district, Northern Uganda ( 7 ) and another from eastern Uganda reports 27.8% prevalence of intimate partner violence among pregnant women ( 14 ). Another study outside Uganda also reports the low prevalence of GBV during pregnancy. A study done in Sri Lanka, and Malawi showed the prevalence of violence against pregnant women to be at 38.6% and 39.7% respectively( 11 , 19 ). The prevalence of GBV in this study was in agreement with findings from a study done among women in post-conflict northern Uganda which reports a prevalence of intimate partner violence of 70.6%( 20 ). There is a high prevalence of GBV during pregnancy. This can impose immediate risks to maternal physical and mental well-being but also long-term consequences for both maternal and child health outcomes like adverse birth outcomes like low birth weight, maternal depression and post-traumatic stress disorder. Of all the various forms of GBV, controlling behaviours by the partner (61.9%) was highest, followed by emotional violence (34.8%), economic violence (29.5%) and sexual violence (28.9%). Physical violence (16.2%) was the least common form of violence during pregnancy. This finding is similar to other studies conducted within and outside Uganda ( 8 , 11 , 14 , 21 ). Interviewers spoke with the participants in private rooms nested at the ANC clinics, which was favourable for privacy and greater disclosure. Screening for GBV is not regularly undertaken at the health facility, but the research team applied friendly and active enquiry of GBV may have increased disclosure. Male controlling behaviour targeting women may be attributed to unequal gender norms of patriarchy of male dominance and its worst forms using social tolerance and acceptance of violence. Addressing GBV in pregnancy requires a comprehensive approach that encompasses prevention, intervention, and support services. Primary prevention efforts should focus on addressing underlying social norms and attitudes that perpetuate GBV, such as gender inequality. Providing education and awareness programs for both men and women can help challenge these norms and promote healthy relationships. In addition, healthcare provider plays a critical role in identifying and addressing GBV during pregnancy. Routine screening for GBV should be emphasised during prenatal care services allowing identification of individuals at risk and provision of appropriate support and referrals. Training healthcare providers on how to sensitively inquire about GBV and respond to disclosures is essential for ensuring effective intervention. Women in polygamous marriages had 1.2 times the prevalence of GBV in pregnancy compared to women in monogamous marriages. This finding is in agreement with a report from Lira District, Northern Uganda showing that women in a polygamy marriage were more likely to get exposed to intimate partner violence (p = 0.001) ( 7 ). A study in Sub-Saharan Africa ( 22 ), showed that polygyny is associated with intimate partner violence among the general population. Polygyny makes GBV worse during pregnancy because of unfair power differences, society's beliefs and women not having enough to say. Jealousy among wives, not getting enough care and pressure to follow traditional roles can also lead to emotional or physical harm. Changing altitude and laws, spreading awareness, and offering help to women can help make things better by giving them more rights and support. This study also showed that women who had poor or good relationships with their husband's family members had 1.6 and 1.2 times the prevalence of GBV in pregnancy compared to women who had perfect relationships with their husbands’ family members. Associations between sub-optimal relationships with husband's relatives and women’s exposure to GBV was established in this study. Having poor or sub-optimal relationships with the husband's family members compared with having perfect relationships with the husband's family members were all positively associated with exposure to GBV among women largely due to family interference by the in-laws ( 23 – 25 ). There was a 2% reduction in the prevalence of GBV for every one-year increase in age of the pregnant woman. An increase in age, therefore, could potentially have a protective effect on GBV, this finding was in line with findings from conflict-affected areas in northern Uganda ( 20 ) and elsewhere ( 26 – 28 ), reporting that younger age women were more exposed to GBV. There was a 2% decrease in the risk of exposure to GBV in pregnancy for every one-year increase in the age of the mother. Moreover, younger women less than 25.5 years old could be less mature emotionally to navigate relationship dynamics and are generally vulnerable. These results suggest that the younger mothers often experience stressful transitions to parenthood which can trigger violence compared to older mothers. We also found that, for every one-week increase in gestational age, there is a 1% increase in the prevalence of GBV in pregnancy. To the best of our knowledge, there has been no previous report of similar findings. We hypothesise that as pregnancy progresses, the prevalence of GBV in pregnancy might increase due to cumulative time on the risk of GBV in pregnancy. However, there is a possibility that as pregnancy grows pregnancy-related hormonal changes as well as changes in women's demand might be the mechanisms through which GBV in pregnancy increases with an increase in gestational age. It is worth noting that GBV can occur at any stage of pregnancy, therefore midwives and obstetricians should endeavour to screen every pregnant woman for GBV in pregnancy and providing comprehensive support services remains essential to ensure the safety and well-being of pregnant individuals. Limitations of the study Causation cannot be assumed based on these results because this was a cross-sectional study. This being a hospital-based rather than population-based study makes generalizability impossible. In addition, men were not involved, therefore it’s not possible to determine risk factors and reasons for the perpetration of GBV. Conclusion GBV during pregnancy, particularly controlling behaviour by male partners, is highly prevalent in Northern Uganda. Younger women, women in polygamy marriages and those having poor or sub-optimal relationships with the husband's family members were most affected. To mitigate the negative impacts on maternal and foetal health, targeted interventions by the Ministry of Health, development partners, and other stakeholders are urgently needed to prevent and manage GBV in pregnancy. Abbreviations ANC Ante-Natal Care ECSACOG East Central and Southern African College of Obstetrics and Gynaecology GBV Gender Based Violence GUREC Gulu Research Ethical Committee GRRH Gulu Regional referral Hospital PNC Post-Natal Care PR Prevalence Ratio SSA:Sub-Saharan Africa SD Standard Deviation VAW Violence Against Women and Girls WHO World Health Organisation. Declarations Ethics approval and consent to participate The study received ethical approval from the Gulu University Research Ethics Committee (approval number: GUREC-2023-527). Informed consent was obtained from all participants before the start of the study. Participants were informed of their right to withdraw from the study at any time and that their participation was voluntary. All data collected was kept confidential and anonymous. The ethical principles outlined in the Declaration of Helsinki were all adhered to. Availability of data and materials All relevant data are within the manuscript and its supporting information files. Questionnaire has been attached as supplementary file Data are available upon reasonable request from the first author. Funding This study was supported through a seed grant from the Centre for International Reproductive Health Training through Gulu University Sexual and Reproductive Health Resource Centre, Gulu University, Gulu, Uganda. Competing interest The authors declare that there is no conflict of interest. Author contributions JO, JNO, BL, DOA, JEO, BL, IDL, YN, and SO conceptualised the study, and participated in funds acquisition, JO, JNO, IDL and JEO collected data, and JO and SO conducted data analysis and visualization. JO, SO, and CA drafted the manuscript. FB and PFP funding acquisition. ALL authors contributed to the review and approval of the final manuscript. Acknowledgement We extend our deepest gratitude to our study participants, whose invaluable contributions and dedication made this research possible. Their willingness to share their time, experiences, and insights was crucial to the success of this work. References UNFPA. ESARO. 2024 [cited 2024 Feb 20]. Gender Based Violence. Available from: https://esaro.unfpa.org/en/topics/gender-based-violence World Health Organization. 25 March 2024. 2024. Violence agianst women. Ouma S, Ndejjo R, Abbo C, Tumwesigye NM. Client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda: A cross-sectional study. BMJ Open [Internet]. 2021 Sep 13;11(9):e046894. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34518251 Katushabe E, Asiimwe JB, Batwala V. Intimate partner violence disclosure and associated factors among pregnant women attending a city hospital in South-Western Uganda: a cross-sectional study. BMC Pregnancy Childbirth. 2022 Dec 1;22(1). Bank W. Gender Data. 2024. Violence against women and girls. Muluneh MD, Francis L, Agho K, Stulz V. A Systematic Review and Meta-Analysis of Associated Factors of Gender-Based Violence against Women in Sub-Saharan Africa. Int J Environ Res Public Health [Internet]. 2021 Apr 21;18(9):4407. Available from: https://www.mdpi.com/1660-4601/18/9/4407 Auma AG, Ayebare E, Olwit C, Ndeezi G, Nankabirwa V, Tumwine JK. Intimate partner violence among pregnant teenagers in Lira district, northern Uganda: a cross-sectional study. Afr J Midwifery Womens Health. 2020 Oct 2;14(4):1–11. Clarke S, Richmond R, Black E, Fry H, Obol JH, Worth H. Intimate partner violence in pregnancy: A cross-sectional study from post-conflict northern Uganda. BMJ Open. 2019 Nov 1;9(11). Pisoh DW, Moses S, Akumawah BZ, Sama DJ, Atabon AF, Foumane P. Gender-Based Violence among Pregnant Women Consulting at the Antenatal Care Unit of the Bamenda Regional Hospital. Open J Obstet Gynecol. 2020;10(11):1525–43. Ahinkorah BO, Aboagye RG, Seidu AA, Boadu Frimpong J, Hagan JE, Budu E, et al. Physical violence during pregnancy in sub-Saharan Africa: Why it matters and who are most susceptible? BMJ Open. 2023;13(6):1–11. Nwafor JA, Chamdimba E, Ajayi AI, Ushie BA, Munthali AC, Thakwalakwa C, et al. Correlates of intimate partner violence among pregnant and parenting adolescents: a cross-sectional household survey in Blantyre District, Malawi. Reprod Health. 2023 Dec;20(1). Anguzu R, Walker RJ, Babikako HM, Beyer KMM, Dickson-Gomez J, Zhou Y, et al. Intimate partner violence and antenatal care utilization predictors in Uganda: an analysis applying Andersen’s behavioral model of healthcare utilization. BMC Public Health. 2023;23(1):1–13. Workye H, Mekonnen Z, Wedaje W, Sitot A. Prevalence and predictors of gender-based violence among Wolkite University female students, southwest Ethiopia, 2021: Cross-sectional study. Front Reprod Heal. 2023;5. Epuitai J, Udho S, Auma AG, Nabirye RC. Intimate partner violence among pregnant women in Uganda. Afr J Midwifery Womens Health. 2019 Apr 2;13(2):1–5. UBOS VAWG. National Survey on Violence in Uganda. 2021;(November). Opiro K, Pebolo Pebalo F, J Scolding N, Hardy C. Can reproductive health services be used to screen for sexual and gender-based violence in post-conflict Northern Uganda? – a pilot study. Afr Health Sci [Internet]. 2024 Apr 1;24(1):104–11. Available from: https://www.ajol.info/index.php/ahs/article/view/267830 Mootz JJ, Stabb SD, Mollen D. Gender-Based Violence and Armed Conflict. Psychol Women Q [Internet]. 2017 Sep 12;41(3):368–88. Available from: http://journals.sagepub.com/doi/10.1177/0361684317705086 Okurut FN. Determinants of regional poverty in Uganda By Kampala. Teacher. 2020. Muzrif MM, Perera D, Wijewardena K, Schei B, Swahnberg K. Domestic violence: A cross-sectional study among pregnant women in different regions of Sri Lanka. BMJ Open. 2018 Feb 1;8(2). Black E, Worth H, Clarke S, Obol JH, Akera P, Awor A, et al. Prevalence and correlates of intimate partner violence against women in conflict affected northern Uganda : a cross-sectional study. 2019;1–10. Mojahed A, Alaidarous N, Kopp M, Pogarell A, Thiel F, Garthus-Niegel S. Prevalence of Intimate Partner Violence Among Intimate Partners During the Perinatal Period: A Narrative Literature Review. Vol. 12, Frontiers in Psychiatry. Frontiers Media S.A.; 2021. Ahinkorah BO. Polygyny and intimate partner violence in sub-Saharan Africa: Evidence from 16 cross-sectional demographic and health surveys. SSM - Popul Heal [Internet]. 2021 Mar;13:100729. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2352827321000045 Allendorf K. The Quality of Family Relationships and Use of Maternal Health-care Services in India. Stud Fam Plann. 2010;41(4):263–76. Mannell J, Lowe H, Brown L, Mukerji R, Devakumar D, Gram L, et al. Risk factors for violence against women in high-prevalence settings: A mixed-methods systematic review and meta-synthesis. BMJ Glob Heal. 2022;7(3). Clark CJ, Silverman JG, Shahrouri M, Everson-Rose S, Groce N. The role of the extended family in women’s risk of intimate partner violence in Jordan. Soc Sci Med. 2010;70(1):144–51. Decker MR, Lyons C, Billong SC, Njindam IM, Grosso A, Nunez GT, et al. Gender-based violence against female sex workers in Cameroon: Prevalence and associations with sexual HIV risk and access to health services and justice. Sex Transm Infect. 2016;92(8):599–604. Ebert C, Steinert JI. Prevalence and risk factors of violence against women and children during covid-19, germany. Bull World Health Organ. 2021;99(6):429–38. Oladepo O, Yusuf O, OS A. Factors Influencing Gender Based Violence among Men and Women in Selected States in Nigeria. Afr J Reprod Health. 2016;15(4):78–86. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4707070","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":324314243,"identity":"299ff35e-6612-4836-bc3b-0ad5e9ef2c05","order_by":0,"name":"Jerom Okot","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCklEQVRIiWNgGAWjYDACHgglw8ZwAMyQAxEHHuDXwtgAomBajMFaEojRAuMngngM+LTw8xw+/uBnmw0PH+PhYx8+5tikzw87/BBoi52cbgN2LZK9bYmNvW1pQIcdS545c1ta7sbbaQZALcnGZgewazE4z2PYwNt2GKjljDEz77bDuRtnJ4C0HEjchkdL41+wlvOfgVr+pxvOTv+AX8vZHsNmqC3MQC0HEuSlc/DbItlzLHG2zDmwX4wZZ25LNtwgnVNwIMEAt1/4eZIPfHxTZiMnP+PwY4aP2+zk5Wenb/7wocJODpcWMGBkAxISUBUGYNoAj3Iw+AOyrwHClm8gpHoUjIJRMApGGgAAFzxiptuTeKUAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-4160-6418","institution":"Faculty of Medicine, Gulu University, Gulu, Uganda","correspondingAuthor":true,"prefix":"","firstName":"Jerom","middleName":"","lastName":"Okot","suffix":""},{"id":324314244,"identity":"5c2f0b7b-d705-45c0-9b53-40394e63c354","order_by":1,"name":"Cinderella Anena","email":"","orcid":"","institution":"Department of Public Health, Gulu University, Gulu, Uganda","correspondingAuthor":false,"prefix":"","firstName":"Cinderella","middleName":"","lastName":"Anena","suffix":""},{"id":324314245,"identity":"3d06958d-c591-4ec5-947a-981c446c2e5c","order_by":2,"name":"Nelson James Okema","email":"","orcid":"","institution":"Faculty of Medicine, Gulu University, Gulu, Uganda","correspondingAuthor":false,"prefix":"","firstName":"Nelson","middleName":"James","lastName":"Okema","suffix":""},{"id":324314246,"identity":"e7704253-95cc-4f19-b2f7-804662a17262","order_by":3,"name":"Denis Oryem Amuku1","email":"","orcid":"","institution":"Faculty of Medicine, Gulu University, Gulu, Uganda","correspondingAuthor":false,"prefix":"","firstName":"Denis","middleName":"Oryem","lastName":"Amuku1","suffix":""},{"id":324314247,"identity":"b0c7ef65-dca1-4869-bb20-1939a65b7b6c","order_by":4,"name":"Jerry Enock Otunnu","email":"","orcid":"","institution":"Faculty of Medicine, Gulu University, Gulu, 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Uganda","correspondingAuthor":false,"prefix":"","firstName":"Yakobo","middleName":"","lastName":"Nsubuga","suffix":""},{"id":324314251,"identity":"3df73d00-651e-4133-a728-c0cd40439281","order_by":8,"name":"Felix Bongomin","email":"","orcid":"","institution":"3.\tDepartment of Medical Microbiology and Immunology, Gulu University, Gulu, Uganda","correspondingAuthor":false,"prefix":"","firstName":"Felix","middleName":"","lastName":"Bongomin","suffix":""},{"id":324314252,"identity":"55fc1db1-1033-426a-ac5a-c0c2e13a47e3","order_by":9,"name":"Pebalo Francis Pebolo","email":"","orcid":"","institution":"5.\tDepartment of Sexual and Reproductive Health, Gulu University, Gulu, Uganda","correspondingAuthor":false,"prefix":"","firstName":"Pebalo","middleName":"Francis","lastName":"Pebolo","suffix":""},{"id":324314253,"identity":"6a338a2a-3ad1-4f53-ad9e-0cca7b3a5b73","order_by":10,"name":"Simple Ouma","email":"","orcid":"","institution":"6.\tThe AIDS Support Organisation, Kampala, Uganda","correspondingAuthor":false,"prefix":"","firstName":"Simple","middleName":"","lastName":"Ouma","suffix":""}],"badges":[],"createdAt":"2024-07-08 16:50:35","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4707070/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4707070/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":59995971,"identity":"6ae7e624-4f9f-4cf2-9606-9f45d2f5b5b8","added_by":"auto","created_at":"2024-07-10 09:32:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":882184,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4707070/v1/efcd74e7-1cdc-4321-bce4-64dc1cec4764.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003ePrevalence, types, and determinants of gender-based violence among pregnant women in Northern Uganda: A hospital-based cross-sectional study\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eGender-based violence (GBV) remains one of the gravest challenges to women\u0026rsquo;s health and well-being, it is largely driven by inequity and social injustice (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). GBV is any sexual, physical, mental, behavioural, and economic harmful act directed at an individual based on their gender inflicted in public or private, in which the female is usually the victim; and which is derived from unequal power relationships between men and women (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGBV is one of the systemic public health problems that is increasingly visible on the global health and development agenda (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). A recent report showed that an estimated 25% of women aged 15 years and above experience at least one form of GBV in their lifetime (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). World Health Organisation (WHO) revealed that the prevalence of GBV ranged from 15% in urban areas to 71% in rural areas (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Further evidence showed that the problem of GBV is most prominent in developing countries, especially in sub-Saharan African (SSA) countries, where socioeconomic status is low, and education is limited (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). However, there are knowledge gaps, on the prevalence, types, and perpetrators of violence against adolescent girls and young women of reproductive ages (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). In Northern Uganda, a study in a rural setting showed that women were more likely to get exposed to GBV during pregnancy (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA primary concern of GBV during pregnancy relates to the serious consequences not only for the woman but also for the foetus and ultimately, the child's growth development (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The phenomena have received considerable attention, particularly the adverse consequences of GBV to both the mother and the foetus (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Several previous works pointed out several adverse consequences of GBV during pregnancy to the mothers, the foetus, and the newborn baby (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). The adverse maternal impacts of GBV in pregnancy include maternal mental health problems including anxiety and depression, sexually transmitted infections in case of sexual violence, poor weight gain during pregnancy, increased risk of operative delivery as well as heightened risk of maternal mortality (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Meanwhile, the adverse health impacts of GBV in pregnancy include low birth weight, preterm delivery, intrauterine foetal death in case of physical violence, and increased risk of neonatal mortality (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite its importance, far too little attention has been paid to the epidemiology of GBV during pregnancy in Uganda and there is an increase in the prevalence of violence from 26.7\u0026ndash;32.3% during pregnancy among women in rural settings (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Conversely, a 2020 National Survey on Violence Against Women and Girls (VAWG) found an overall low prevalence of violence during pregnancy, lower than figures reported in the UDHS (2016), however, the survey only explored physical violence and no other forms of GBV(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). There is regional variation in the prevalence and burden of GBV with Northern Uganda having rates as high as 47% among women attending reproductive health services(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). The within-country variation is attributable to methodological differences, the working conceptual definition and the measure of the various forms of violence (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Besides, the glaring poverty and post-conflict situation in Northern Uganda makes GBV a common place(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Focusing on the understanding and epidemiology of GBV during pregnancy will help in designing interventions to curb the negative effect on the mothers and their unborn babies(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This study aims to address this important but under-researched issue by investigating GBV among pregnant women in Northern Uganda. The findings could provide valuable insights for stakeholders on the prevalence, types and factors associated with GBV in this population and guide the development of context-specific and culturally appropriate interventions to prevent and manage GBV. Ultimately, this research seeks to improve maternal and child health outcomes.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and setting\u003c/h2\u003e \u003cp\u003eThis facility-based cross-sectional study was conducted at the ANC clinic at Gulu Regional Referral Hospital (GRRH). GRRH is a tertiary hospital for patients from mid-northern Uganda, thus serving both rural and urban populations within the catchment area. GRRH also receives patients from neighbouring countries of South Sudan and the Democratic Republic of Congo. It is also a teaching hospital for the Gulu University, Trainer Centre for Fellowship with East Central and Southern African College of Obstetrics and Gynaecology (ECSACOG) and many other Diploma and Certificate Training Institutions in the region. It is a hospital with both out and in-patient services for an estimated 120,000 patients per year. The hospital has specialised units managed by consultants from GRRH and the Faculty of Medicine, at Gulu University. The Obstetrics and Gynaecology department provides all services ranging from ANC to Postnatal Care (PNC) during pregnancy and after delivery. Due to the quality and free ANC services, a large proportion of pregnant women within the catchment area attend their ANC services at GRRH.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy population\u003c/h2\u003e \u003cp\u003eThis study was conducted among pregnant women attending ANC at GRRH. All pregnant women attending ANC at GRRH were eligible for inclusion, irrespective of gestational age. However, we set to exclude any pregnant woman who would be deemed incompetent to consent due to severe sickness or mental disorder, but none were excluded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSample size\u003c/h2\u003e \u003cp\u003eUsing the Kish Leslie formula, the prevalence of GBV in pregnancy was 26.7% from a study conducted at two rural health centres in Northern Uganda (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), and at a 5% significance, the minimum sample size was estimated to be 301. Assuming a conservative non-response rate of 10% (301/0.9), the adjusted sample size was 335 participants.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSampling techniques\u003c/h2\u003e \u003cp\u003eBased on the average daily attendance at the ANC clinic at GRRH which was approximately 80 women per day, we used a systematic random sampling method aided by the daily ANC attendance register to select every 5th person on the list on any given day. This enables each of the four investigators who participated in data collection to handle at least four participants per day. While on the ground the daily ANC attendance ranged between 60\u0026ndash;100 pregnant women and thus, we collected data from between 12 and 20 participants on any given day.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eData were collected from 339 pregnant women attending their ANC at GRRH between June and August 2023. Data were collected using a semi-structured questionnaire which was developed for this study by the authors. Originally, the tool was developed in English and later translated into Acholi language (Luo) and then pre-tested, for consistency in question interpretation and language appropriateness, among 20 pregnant women attending ANC at Laroo Health Centre III. Data were collected using interviewer-administered questionnaires in either Acholi or English language depending on the participant's literacy level and preferences.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStudy variables\u003c/h2\u003e \u003cp\u003eIndependent variables included socio-demographic characteristics like age, education, being in a union, employment status, partner level of education, partner employment status, age at first sex, age at first marriage, age of the pregnancy in weeks and, living with HIV and partner alcohol use. The outcome variable for this study was the experience of GBV. The participants were asked batteries of questions to identify whether they were exposed to any of the various forms of violence notably physical violence, emotional violence, economic violence, sexual violence or controlling behaviours. Our tool for screening for GBV was adapted from questionnaires previously used to screen GBV among women in the same setting\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData management and statistical analysis\u003c/h2\u003e \u003cp\u003eData were entered and cleaned in Microsoft Excel 2023 and then exported to STATA 18.0 for analysis. Descriptive statistics were summarised using frequency with corresponding proportions for categorical variables or mean with corresponding standard deviations (SD) for continuous variables. To examine the associations between independent factors and experiencing any form of GBV, we conducted univariate and multivariable modified Poisson regression analyses with robust standard errors. We reported univariate analyses using unadjusted prevalence ratios (uPR) with corresponding confidence intervals (CI) and p-value.\u003c/p\u003e \u003cp\u003eAll independent variables with p\u0026thinsp;\u0026lt;\u0026thinsp;0.20 at univariable analysis were considered for inclusion into the multivariable modified Poisson regression model. Since they have a study power of greater than 80%. The results from the multivariable model were reported using the adjusted Prevalence ratios (aPR) with corresponding 95% CIs and p-values. Any p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 or effect size whose CI did not include the null value (0) was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eBaseline characteristics of the participants\u003c/h2\u003e \u003cp\u003eA total of 339 pregnant women were included in this study. By trimester, the majority (43.6%, n\u0026thinsp;=\u0026thinsp;136) were in the second trimester, followed by the third trimester (37.5%, n\u0026thinsp;=\u0026thinsp;117) and first trimester (18.9%, n\u0026thinsp;=\u0026thinsp;59). The mean age (SD) was 26.1(5.5) years, the mean age (SD) at first sex was 17.8 (2.5) years and the mean age (SD) at first marriage was 20.3 (3.3) years. More than a third of the participants attained an ordinary level of education (33.6%, n\u0026thinsp;=\u0026thinsp;113), and 28.0%(n\u0026thinsp;=\u0026thinsp;94) and 20.62%(n\u0026thinsp;=\u0026thinsp;68) attained an upper primary and tertiary level of education respectively. Most of the participants (89.7%, n\u0026thinsp;=\u0026thinsp;304) were in union (married or cohabiting), were in a monogamous marriage (75.5%, n\u0026thinsp;=\u0026thinsp;253) and employed (46%, n\u0026thinsp;=\u0026thinsp;156). Furthermore, 38.5% (n\u0026thinsp;=\u0026thinsp;130) of their partners attained a tertiary level of education, and 5.6%(n\u0026thinsp;=\u0026thinsp;19) had a lower primary or no education. About half (56.7%; n\u0026thinsp;=\u0026thinsp;190) of the participants ever used contraceptives, 8.3%(n\u0026thinsp;=\u0026thinsp;28) were living with HIV and 42.4%(n\u0026thinsp;=\u0026thinsp;143) of their partners take alcohol. The mean gestation age (SD; range) was 23.2 (9.0; 4\u0026ndash;38) weeks, and the majority (88.3% (n\u0026thinsp;=\u0026thinsp;294)) of respondents conceived of the desire of both husband and wife \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics of study participants by GBV during pregnancy.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eExposed to any GBV\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAll (N\u0026thinsp;=\u0026thinsp;339)\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo (N\u0026thinsp;=\u0026thinsp;91)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eYes (N\u0026thinsp;=\u0026thinsp;248)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge in years (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.65(5.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.50(5.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.08(5.51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGulu\u003c/p\u003e \u003cp\u003eAnother district\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76(91.6)\u003c/p\u003e \u003cp\u003e7(8.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e212(88.7)\u003c/p\u003e \u003cp\u003e27(11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e288(89.4)\u003c/p\u003e \u003cp\u003e34(10.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe education level of the participant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower primary or none\u003c/p\u003e \u003cp\u003eUpper Primary\u003c/p\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11(12.1)\u003c/p\u003e \u003cp\u003e20(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e28(30.8)\u003c/p\u003e \u003cp\u003e32(35.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(9.8)\u003c/p\u003e \u003cp\u003e74(30.2)\u003c/p\u003e \u003cp\u003e111(44.6)\u003c/p\u003e \u003cp\u003e36(14.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35(10.4)\u003c/p\u003e \u003cp\u003e94(28.1)\u003c/p\u003e \u003cp\u003e139(41.3)\u003c/p\u003e \u003cp\u003e68(20.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot in union\u003c/p\u003e \u003cp\u003eIn union\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(6.6)\u003c/p\u003e \u003cp\u003e85(93.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(11.7)\u003c/p\u003e \u003cp\u003e219(88.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35(10.3)\u003c/p\u003e \u003cp\u003e304(89.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(6.6)\u003c/p\u003e \u003cp\u003e85(93.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(11.7)\u003c/p\u003e \u003cp\u003e219(88.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e311(91.7)\u003c/p\u003e \u003cp\u003e28(8.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHas a co-wife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77(86.5)\u003c/p\u003e \u003cp\u003e12(13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e176(71.5)\u003c/p\u003e \u003cp\u003e70(28.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e253(75.5)\u003c/p\u003e \u003cp\u003e82(24.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot employed\u003c/p\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44(48.4)\u003c/p\u003e \u003cp\u003e47(51.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e139(56)\u003c/p\u003e \u003cp\u003e109(44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e183(54)\u003c/p\u003e \u003cp\u003e156(46)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment status of partner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot employed\u003c/p\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(11.1)\u003c/p\u003e \u003cp\u003e80(88.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e191(77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67(19.8)\u003c/p\u003e \u003cp\u003e271(80.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level of partner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower Primary\u003c/p\u003e \u003cp\u003eUpper Primary\u003c/p\u003e \u003cp\u003eO level\u003c/p\u003e \u003cp\u003eA level\u003c/p\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(3.3)\u003c/p\u003e \u003cp\u003e6(6.7)\u003c/p\u003e \u003cp\u003e25(27.8)\u003c/p\u003e \u003cp\u003e20(22.2)\u003c/p\u003e \u003cp\u003e36(40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(6.5)\u003c/p\u003e \u003cp\u003e23(9.3)\u003c/p\u003e \u003cp\u003e74(19.8)\u003c/p\u003e \u003cp\u003e41(16.5)\u003c/p\u003e \u003cp\u003e94(37.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19(5.6)\u003c/p\u003e \u003cp\u003e29(8.6)\u003c/p\u003e \u003cp\u003e99(29.3)\u003c/p\u003e \u003cp\u003e61(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e130(38.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEver used contraceptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24(26.4)\u003c/p\u003e \u003cp\u003e67(73.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(36.7)\u003c/p\u003e \u003cp\u003e157(63.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e145(43.3)\u003c/p\u003e \u003cp\u003e190(56.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas this pregnancy intended?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24(26.4)\u003c/p\u003e \u003cp\u003e67(73.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(36.7)\u003c/p\u003e \u003cp\u003e157(63.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115(33.9)\u003c/p\u003e \u003cp\u003e224(66.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePregnancy wanted by husband\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband or both\u003c/p\u003e \u003cp\u003eWife alone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85(93.4)\u003c/p\u003e \u003cp\u003e6(6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e209(86.4)\u003c/p\u003e \u003cp\u003e33(13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e294(88.3)\u003c/p\u003e \u003cp\u003e39(11.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarriage type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried the husband she loves\u003c/p\u003e \u003cp\u003eArranged marriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69(81.2)\u003c/p\u003e \u003cp\u003e16(18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e186(81.6)\u003c/p\u003e \u003cp\u003e42(18.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e255(81.5)\u003c/p\u003e \u003cp\u003e58(18.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship with husband\u0026rsquo;s family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery good\u003c/p\u003e \u003cp\u003eGood\u003c/p\u003e \u003cp\u003ePoor or fair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43(48.3)\u003c/p\u003e \u003cp\u003e41(46.1)\u003c/p\u003e \u003cp\u003e5(5.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57(23.2)\u003c/p\u003e \u003cp\u003e104(42.3)\u003c/p\u003e \u003cp\u003e85(34.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100(29.9)\u003c/p\u003e \u003cp\u003e145(43.3)\u003c/p\u003e \u003cp\u003e90(26.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband drink alcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65(73)\u003c/p\u003e \u003cp\u003e24(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e129(52)\u003c/p\u003e \u003cp\u003e119(48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e194(57.6)\u003c/p\u003e \u003cp\u003e143(42.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuartiles of income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower quartile\u003c/p\u003e \u003cp\u003eSecond quartile\u003c/p\u003e \u003cp\u003eThird quartile\u003c/p\u003e \u003cp\u003eHighest quartile\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(16.3)\u003c/p\u003e \u003cp\u003e13(26.5)\u003c/p\u003e \u003cp\u003e16(32.7)\u003c/p\u003e \u003cp\u003e12(24.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38(33.3)\u003c/p\u003e \u003cp\u003e30(26.3)\u003c/p\u003e \u003cp\u003e24(21.1)\u003c/p\u003e \u003cp\u003e22(19.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46(25.5)\u003c/p\u003e \u003cp\u003e68(27.1)\u003c/p\u003e \u003cp\u003e61(24.3)\u003c/p\u003e \u003cp\u003e58(23.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuartile of income of partner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLowest quartile\u003c/p\u003e \u003cp\u003eSecond quartile\u003c/p\u003e \u003cp\u003eThird quartile\u003c/p\u003e \u003cp\u003eHighest quartile\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15(19.5)\u003c/p\u003e \u003cp\u003e20(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e20(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e22(28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49(28.2)\u003c/p\u003e \u003cp\u003e48(27.6)\u003c/p\u003e \u003cp\u003e41(23.6)\u003c/p\u003e \u003cp\u003e36(20.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64(25.5)\u003c/p\u003e \u003cp\u003e68(27.1)\u003c/p\u003e \u003cp\u003e61(24.3)\u003c/p\u003e \u003cp\u003e58(23.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years) at first sexual intercourse (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.72(2.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.45(2.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.79(2.46)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years) of first marriage (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.27(3.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.98(3.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.32(3.30)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of children at home (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.72(1.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.57(1.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.61(1.36)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek of amenorrhea (mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.16(9.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.91(8.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.19(8.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence and types of GBV in pregnancy among women in Northern Uganda\u003c/h2\u003e \u003cp\u003eAlmost three in every four (73.2%) pregnant women in Northern Uganda experienced at least one form of GBV during the current pregnancy. The most common form of GBV in pregnancy was controlling behaviours by the male partner (61.9%, n\u0026thinsp;=\u0026thinsp;210), followed by emotional violence (34.8%, n\u0026thinsp;=\u0026thinsp;118), economic violence (29.5%, n\u0026thinsp;=\u0026thinsp;100), and sexual violence (28.9%, n\u0026thinsp;=\u0026thinsp;98). Meanwhile, physical violence (16.2%, n\u0026thinsp;=\u0026thinsp;55) was the least common form of violence during pregnancy \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence and types of GBV in pregnancy among women in Northern Uganda\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDifferent forms of violence\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eExposed to violence\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003en/N\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eExposure to physical gender-based violence\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSlapped or had something thrown at her that could hurt her\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46/338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(13.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas pushed or shoved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(6.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas hit with a fist or something else could hurt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14/338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(4.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas choked or burnt on purpose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10/337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(3.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThreatened or hurt by a gun, knife, or other weapon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWas punched or kicked in the abdomen while pregnant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5/338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposed to at least one form of physical violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(16.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eExposure to sexual gender-based violence\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysically forced to have sexual intercourse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(22.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForced into sexual intercourse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(21.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForced into sexual acts she found degrading or humiliating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(7.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposed to at least one form of sexual violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(28.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eExposure to emotional violence\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInsulted or made feel bad about herself\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95/336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(28.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBelittled or humiliated in front of others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(13.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScared or intimidated on purpose by looking or yelling at or smashing things\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51/338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(15.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThreat to hurt someone you cared about\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(5.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposed to at least one form of emotional violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e118/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(34.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposure to economic gender-based violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDestroyed your property intentionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(6.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRestricted your access to financial resources\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(12.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRestricted you from working\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(13.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRestricted you from studying\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(7.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDid not provide for your pregnancy need\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(13.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposed to at least one form of economic violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(29.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposed to controlling behaviours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTried to keep you from seeing your friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e111/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(32.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTried to restrict contact with your family of birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60/337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(17.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInsisted on knowing where she always\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e106/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(31.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgnored you and treated you indifferently\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(19.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGot angry if you speak with other men\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(33.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuspicious that you were unfaithful\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(18.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExpected you to ask permission before seeking healthcare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(10.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposed to controlling behaviours as a form of GBV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e210/339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(61.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposed to any GBV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(73.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003ePredictors of GBV in pregnancy among women in Northern Uganda\u003c/h2\u003e \u003cp\u003eAt the univariate level, factors associated with GBV in pregnancy were being in a polygyny marriage (uPR: 1.2, 95% CI: 1.07\u0026ndash;1.36, p\u0026thinsp;=\u0026thinsp;0.002), partner not employed (uPR: 1.2: 95% CI: 1.04\u0026ndash;1.35, p\u0026thinsp;=\u0026thinsp;0.009), pregnancy being unwanted by either or both partner (uPR: 1.3, 95% CI: 0.85\u0026ndash;1.10, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), having poor (uPR: 1.6, 95% CI: 1.36\u0026ndash;1.94, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) or good (uPR: 1.3, 95% CI: 1.03\u0026ndash;1.53, p\u0026thinsp;=\u0026thinsp;0.022) versus perfect relationship with the husband\u0026rsquo;s family, week of amenorrhea (uPR: 1.01, 95% CI: 1.003\u0026ndash;1.02, p\u0026thinsp;=\u0026thinsp;0.008), participant\u0026rsquo;s age (cPR: 0.98, 95% CI: 0.96\u0026ndash;0.99, p\u0026thinsp;=\u0026thinsp;0.002), participant\u0026rsquo;s age at first sex (uPR: 0.95, 95% CI: 0.92\u0026ndash;0.97, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), and participant\u0026rsquo;s age at first marriage (uPR: 0.97, 95% CI:0.95\u0026ndash;0.99, p\u0026thinsp;=\u0026thinsp;0.005) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors associated with exposure to GBV in pregnancy\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eGBV\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCrude PR\u003c/p\u003e \u003cp\u003e(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo (n\u0026thinsp;=\u0026thinsp;91)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eYes (n\u0026thinsp;=\u0026thinsp;248)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge in completed years, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.65(5.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.50(5.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.98(0.96\u0026ndash;0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower primary or none\u003c/p\u003e \u003cp\u003eUpper Primary\u003c/p\u003e \u003cp\u003eSecondary school\u003c/p\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11(12.1)\u003c/p\u003e \u003cp\u003e20(22.0)\u003c/p\u003e \u003cp\u003e28(30.8)\u003c/p\u003e \u003cp\u003e32(35.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(9.8)\u003c/p\u003e \u003cp\u003e74(30.2)\u003c/p\u003e \u003cp\u003e111(44.6)\u003c/p\u003e \u003cp\u003e36(15.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e1.1(0.89\u0026ndash;1.44)\u003c/p\u003e \u003cp\u003e1.1(0.91\u0026ndash;1.45)\u003c/p\u003e \u003cp\u003e0.8(0.58\u0026ndash;1.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.296\u003c/p\u003e \u003cp\u003e0.239\u003c/p\u003e \u003cp\u003e0.114\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried/cohabiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot in union\u003c/p\u003e \u003cp\u003eIn union\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(6.6)\u003c/p\u003e \u003cp\u003e85(93.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(11.7)\u003c/p\u003e \u003cp\u003e219(88.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e0.9(0.74\u0026ndash;1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.102\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot living with HIV\u003c/p\u003e \u003cp\u003eLiving with HIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(6.6)\u003c/p\u003e \u003cp\u003e85(93.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(11.7)\u003c/p\u003e \u003cp\u003e219(88.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e0.9(0.78\u0026ndash;1.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.918\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband has other wife or wives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77(86.5)\u003c/p\u003e \u003cp\u003e12(13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e176(71.5)\u003c/p\u003e \u003cp\u003e70(28.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e1.2(.07-1.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot employed\u003c/p\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44(48.4)\u003c/p\u003e \u003cp\u003e47(51.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e139(56)\u003c/p\u003e \u003cp\u003e109(44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.02(0.94\u0026ndash;1.22)\u003c/p\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.302\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband employment status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot employed\u003c/p\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(11.1)\u003c/p\u003e \u003cp\u003e80(88.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e191(77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.2(1.04\u0026ndash;1.35)\u003c/p\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartner\u0026rsquo;s level of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower primary or less\u003c/p\u003e \u003cp\u003eUpper Primary\u003c/p\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40(44)\u003c/p\u003e \u003cp\u003e6(6.6)\u003c/p\u003e \u003cp\u003e45(49.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111(44.6)\u003c/p\u003e \u003cp\u003e23(9.2)\u003c/p\u003e \u003cp\u003e115(46.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e1.1(0.87\u0026ndash;1.33)\u003c/p\u003e \u003cp\u003e0.9(0.85\u0026ndash;1.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.477\u003c/p\u003e \u003cp\u003e0.747\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEver used contraceptive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24(26.4)\u003c/p\u003e \u003cp\u003e67(73.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91(36.7)\u003c/p\u003e \u003cp\u003e157(63.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e0.9(0.85\u0026ndash;1.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.642\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartner wanted the pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoth wanted\u003c/p\u003e \u003cp\u003eOnly one or none\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85(93.4)\u003c/p\u003e \u003cp\u003e6(6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e209(86.4)\u003c/p\u003e \u003cp\u003e33(13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e1.3(1.16\u0026ndash;1.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship with husband\u0026rsquo;s family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerfect\u003c/p\u003e \u003cp\u003eGood\u003c/p\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43(48.3)\u003c/p\u003e \u003cp\u003e41(46.1)\u003c/p\u003e \u003cp\u003e5(5.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57(23.2)\u003c/p\u003e \u003cp\u003e104(42.3)\u003c/p\u003e \u003cp\u003e85(34.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e1.3(1.03\u0026ndash;1.53)\u003c/p\u003e \u003cp\u003e1.6(1.36\u0026ndash;1.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge at first sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.72(2.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.45(2.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.95(0.92\u0026ndash;0.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge at first marriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.27(3.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.98(3.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.97(0.95\u0026ndash;0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeek of amenorrhea, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.16(9.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.91(8.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.01(1.003\u0026ndash;1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of children, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.72(1.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.57(1.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.97(0.92\u0026ndash;1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.177\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAfter adjusting for being in a union, being in a polygynous marriage (aPR: 1.2, 95% CI: 1.03\u0026ndash;1.31, p\u0026thinsp;=\u0026thinsp;0.013), having poor (aPR: 1.6, 95% CI: 1.32\u0026ndash;1.89, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) or good (aPR: 1.2, 95% CI: 1.03\u0026ndash;1.51, p\u0026thinsp;=\u0026thinsp;0.026) versus perfect relationship with the husband's family, week of amenorrhea (aPR: 1.01, 95% CI: 1.003\u0026ndash;1.02, p\u0026thinsp;=\u0026thinsp;0.006), and maternal age (aPR: 0.98, 95% CI: 0.97\u0026ndash;0.99, p\u0026thinsp;=\u0026thinsp;0.003), all remained independently associated with GBV in pregnancy \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors independently associated with GBV in pregnancy\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdjusted PR\u003c/p\u003e \u003cp\u003e(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried/cohabiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e1.04(0.89\u0026ndash;1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.600\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband has other wife or wives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003cp\u003e1.2(1.03\u0026ndash;1.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship with husband\u0026rsquo;s family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerfect\u003c/p\u003e \u003cp\u003eGood\u003c/p\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReference e\u003c/p\u003e \u003cp\u003e1.2(1.03\u0026ndash;1.51)\u003c/p\u003e \u003cp\u003e1.6(1.32\u0026ndash;1.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow old is the pregnancy in weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.01(1.003\u0026ndash;1.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge in completed years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.98(0.97\u0026ndash;0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eGBV against women is a global pandemic that affects approximately 1 in 3 women in their life lifetime. GBV during pregnancy is harmful to both the mother and the foetus leading to various complications. In this cross-sectional study, we assessed the prevalence and factors associated with GBV in pregnancy among women attending ANC in GRRH. The self-reported overall GBV among pregnant women was 73.2%. The most common form of GBV in pregnancy was controlling behaviours by the male partner (61.9%), followed by emotional violence (34.8%), economic violence (29.5%), and sexual violence (28.9%,). Physical violence (16.2%) was the least common form of violence during pregnancy. being in a polygyny marriage had a 20% higher likelihood of being exposed to any form of GBV, having a poor or good relationship with the husband's family compared with a perfect relationship with the husband's family members was positively associated with exposure to GBV in pregnancy with likelihood risk of exposure to GBV of 1.6 and 1.2 times respectively. As pregnancy age increases there is a 1% increase in the risk of getting exposed to GBV among the participants, conversely, there was a negative association between maternal age and GBV in pregnancy evidenced by a 2% reduction in the risk of GBV for every one-year increase in maternal age.\u003c/p\u003e \u003cp\u003eOverall, the prevalence of GBV in pregnancy stood at 73.2%. This finding is similar to that from a study done in South West (70.3%) (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), however other studies in Uganda report a relatively lower prevalence, a study reports a 40.6% prevalence of intimate partner violence among teenage mothers in the Lira district, Northern Uganda (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) and another from eastern Uganda reports 27.8% prevalence of intimate partner violence among pregnant women (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Another study outside Uganda also reports the low prevalence of GBV during pregnancy. A study done in Sri Lanka, and Malawi showed the prevalence of violence against pregnant women to be at 38.6% and 39.7% respectively(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). The prevalence of GBV in this study was in agreement with findings from a study done among women in post-conflict northern Uganda which reports a prevalence of intimate partner violence of 70.6%(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). There is a high prevalence of GBV during pregnancy. This can impose immediate risks to maternal physical and mental well-being but also long-term consequences for both maternal and child health outcomes like adverse birth outcomes like low birth weight, maternal depression and post-traumatic stress disorder.\u003c/p\u003e \u003cp\u003eOf all the various forms of GBV, controlling behaviours by the partner (61.9%) was highest, followed by emotional violence (34.8%), economic violence (29.5%) and sexual violence (28.9%). Physical violence (16.2%) was the least common form of violence during pregnancy. This finding is similar to other studies conducted within and outside Uganda (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Interviewers spoke with the participants in private rooms nested at the ANC clinics, which was favourable for privacy and greater disclosure. Screening for GBV is not regularly undertaken at the health facility, but the research team applied friendly and active enquiry of GBV may have increased disclosure. Male controlling behaviour targeting women may be attributed to unequal gender norms of patriarchy of male dominance and its worst forms using social tolerance and acceptance of violence. Addressing GBV in pregnancy requires a comprehensive approach that encompasses prevention, intervention, and support services. Primary prevention efforts should focus on addressing underlying social norms and attitudes that perpetuate GBV, such as gender inequality. Providing education and awareness programs for both men and women can help challenge these norms and promote healthy relationships. In addition, healthcare provider plays a critical role in identifying and addressing GBV during pregnancy. Routine screening for GBV should be emphasised during prenatal care services allowing identification of individuals at risk and provision of appropriate support and referrals. Training healthcare providers on how to sensitively inquire about GBV and respond to disclosures is essential for ensuring effective intervention.\u003c/p\u003e \u003cp\u003eWomen in polygamous marriages had 1.2 times the prevalence of GBV in pregnancy compared to women in monogamous marriages. This finding is in agreement with a report from Lira District, Northern Uganda showing that women in a polygamy marriage were more likely to get exposed to intimate partner violence (p\u0026thinsp;=\u0026thinsp;0.001) (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). A study in Sub-Saharan Africa (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), showed that polygyny is associated with intimate partner violence among the general population. Polygyny makes GBV worse during pregnancy because of unfair power differences, society's beliefs and women not having enough to say. Jealousy among wives, not getting enough care and pressure to follow traditional roles can also lead to emotional or physical harm. Changing altitude and laws, spreading awareness, and offering help to women can help make things better by giving them more rights and support.\u003c/p\u003e \u003cp\u003eThis study also showed that women who had poor or good relationships with their husband's family members had 1.6 and 1.2 times the prevalence of GBV in pregnancy compared to women who had perfect relationships with their husbands\u0026rsquo; family members. Associations between sub-optimal relationships with husband's relatives and women\u0026rsquo;s exposure to GBV was established in this study. Having poor or sub-optimal relationships with the husband's family members compared with having perfect relationships with the husband's family members were all positively associated with exposure to GBV among women largely due to family interference by the in-laws (\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere was a 2% reduction in the prevalence of GBV for every one-year increase in age of the pregnant woman. An increase in age, therefore, could potentially have a protective effect on GBV, this finding was in line with findings from conflict-affected areas in northern Uganda (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and elsewhere (\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), reporting that younger age women were more exposed to GBV. There was a 2% decrease in the risk of exposure to GBV in pregnancy for every one-year increase in the age of the mother. Moreover, younger women less than 25.5 years old could be less mature emotionally to navigate relationship dynamics and are generally vulnerable. These results suggest that the younger mothers often experience stressful transitions to parenthood which can trigger violence compared to older mothers.\u003c/p\u003e \u003cp\u003eWe also found that, for every one-week increase in gestational age, there is a 1% increase in the prevalence of GBV in pregnancy. To the best of our knowledge, there has been no previous report of similar findings. We hypothesise that as pregnancy progresses, the prevalence of GBV in pregnancy might increase due to cumulative time on the risk of GBV in pregnancy. However, there is a possibility that as pregnancy grows pregnancy-related hormonal changes as well as changes in women's demand might be the mechanisms through which GBV in pregnancy increases with an increase in gestational age. It is worth noting that GBV can occur at any stage of pregnancy, therefore midwives and obstetricians should endeavour to screen every pregnant woman for GBV in pregnancy and providing comprehensive support services remains essential to ensure the safety and well-being of pregnant individuals.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of the study\u003c/h2\u003e \u003cp\u003eCausation cannot be assumed based on these results because this was a cross-sectional study. This being a hospital-based rather than population-based study makes generalizability impossible. In addition, men were not involved, therefore it\u0026rsquo;s not possible to determine risk factors and reasons for the perpetration of GBV.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eGBV during pregnancy, particularly controlling behaviour by male partners, is highly prevalent in Northern Uganda. Younger women, women in polygamy marriages and those having poor or sub-optimal relationships with the husband's family members were most affected. To mitigate the negative impacts on maternal and foetal health, targeted interventions by the Ministry of Health, development partners, and other stakeholders are urgently needed to prevent and manage GBV in pregnancy.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eANC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAnte-Natal Care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eECSACOG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEast Central and Southern African College of Obstetrics and Gynaecology\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGBV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGender Based Violence\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGUREC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGulu Research Ethical Committee\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGRRH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGulu Regional referral Hospital\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePNC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePost-Natal Care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrevalence Ratio SSA:Sub-Saharan Africa\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStandard Deviation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eVAW\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eViolence Against Women and Girls\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organisation.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study received ethical approval from the Gulu University Research Ethics Committee (approval number: GUREC-2023-527). Informed consent was obtained from all participants before the start of the study. Participants were informed of their right to withdraw from the study at any time and that their participation was voluntary. All data collected was kept confidential and anonymous. The ethical principles outlined in the \u003cem\u003eDeclaration of Helsinki\u003c/em\u003e were all adhered to.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll relevant data are within the manuscript and its supporting information files. Questionnaire has been attached as supplementary file Data are available upon reasonable request from the first author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported through a seed grant from the Centre for International Reproductive Health Training through Gulu University Sexual and Reproductive Health Resource Centre, Gulu University, Gulu, Uganda.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJO, JNO, BL, DOA, JEO, BL, IDL, YN, and SO conceptualised the study, and participated in funds acquisition, JO, JNO, IDL and JEO collected data, and JO and SO conducted data analysis and visualization. JO, SO, and CA drafted the manuscript. FB and PFP funding acquisition. ALL authors contributed to the review and approval of the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe extend our deepest gratitude to our study participants, whose invaluable contributions and dedication made this research possible. Their willingness to share their time, experiences, and insights was crucial to the success of this work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eUNFPA. ESARO. 2024 [cited 2024 Feb 20]. Gender Based Violence. Available from: https://esaro.unfpa.org/en/topics/gender-based-violence\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. 25 March 2024. 2024. Violence agianst women. \u003c/li\u003e\n\u003cli\u003eOuma S, Ndejjo R, Abbo C, Tumwesigye NM. Client-perpetrated gender-based violence among female sex workers in conflict-affected Northern Uganda: A cross-sectional study. BMJ Open [Internet]. 2021 Sep 13;11(9):e046894. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34518251\u003c/li\u003e\n\u003cli\u003eKatushabe E, Asiimwe JB, Batwala V. Intimate partner violence disclosure and associated factors among pregnant women attending a city hospital in South-Western Uganda: a cross-sectional study. BMC Pregnancy Childbirth. 2022 Dec 1;22(1). \u003c/li\u003e\n\u003cli\u003eBank W. Gender Data. 2024. Violence against women and girls. \u003c/li\u003e\n\u003cli\u003eMuluneh MD, Francis L, Agho K, Stulz V. A Systematic Review and Meta-Analysis of Associated Factors of Gender-Based Violence against Women in Sub-Saharan Africa. Int J Environ Res Public Health [Internet]. 2021 Apr 21;18(9):4407. Available from: https://www.mdpi.com/1660-4601/18/9/4407\u003c/li\u003e\n\u003cli\u003eAuma AG, Ayebare E, Olwit C, Ndeezi G, Nankabirwa V, Tumwine JK. Intimate partner violence among pregnant teenagers in Lira district, northern Uganda: a cross-sectional study. Afr J Midwifery Womens Health. 2020 Oct 2;14(4):1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eClarke S, Richmond R, Black E, Fry H, Obol JH, Worth H. Intimate partner violence in pregnancy: A cross-sectional study from post-conflict northern Uganda. BMJ Open. 2019 Nov 1;9(11). \u003c/li\u003e\n\u003cli\u003ePisoh DW, Moses S, Akumawah BZ, Sama DJ, Atabon AF, Foumane P. Gender-Based Violence among Pregnant Women Consulting at the Antenatal Care Unit of the Bamenda Regional Hospital. Open J Obstet Gynecol. 2020;10(11):1525\u0026ndash;43. \u003c/li\u003e\n\u003cli\u003eAhinkorah BO, Aboagye RG, Seidu AA, Boadu Frimpong J, Hagan JE, Budu E, et al. Physical violence during pregnancy in sub-Saharan Africa: Why it matters and who are most susceptible? BMJ Open. 2023;13(6):1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eNwafor JA, Chamdimba E, Ajayi AI, Ushie BA, Munthali AC, Thakwalakwa C, et al. Correlates of intimate partner violence among pregnant and parenting adolescents: a cross-sectional household survey in Blantyre District, Malawi. Reprod Health. 2023 Dec;20(1). \u003c/li\u003e\n\u003cli\u003eAnguzu R, Walker RJ, Babikako HM, Beyer KMM, Dickson-Gomez J, Zhou Y, et al. Intimate partner violence and antenatal care utilization predictors in Uganda: an analysis applying Andersen\u0026rsquo;s behavioral model of healthcare utilization. BMC Public Health. 2023;23(1):1\u0026ndash;13. \u003c/li\u003e\n\u003cli\u003eWorkye H, Mekonnen Z, Wedaje W, Sitot A. Prevalence and predictors of gender-based violence among Wolkite University female students, southwest Ethiopia, 2021: Cross-sectional study. Front Reprod Heal. 2023;5. \u003c/li\u003e\n\u003cli\u003eEpuitai J, Udho S, Auma AG, Nabirye RC. Intimate partner violence among pregnant women in Uganda. Afr J Midwifery Womens Health. 2019 Apr 2;13(2):1\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eUBOS VAWG. 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Bull World Health Organ. 2021;99(6):429\u0026ndash;38. \u003c/li\u003e\n\u003cli\u003eOladepo O, Yusuf O, OS A. Factors Influencing Gender Based Violence among Men and Women in Selected States in Nigeria. Afr J Reprod Health. 2016;15(4):78\u0026ndash;86. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Gulu University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Gender Based Violence, Pregnancy, Antenatal care, Northern Uganda","lastPublishedDoi":"10.21203/rs.3.rs-4707070/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4707070/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eGender-based violence (GBV) against women is a global health issue, affecting one in three women worldwide. Exposure to GBV during pregnancy poses significant health risks to the mother and her foetus, leading to various complications. This study aimed to determine the prevalence, types, and factors associated with GBV among pregnant women in Northern Uganda.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted at Gulu Regional Referral Hospital's antenatal care clinic from June to August 2023. Data were collected using semi-structured questionnaires in English or Acholi. Participants were selected through systematic random sampling. Information on socio-demographic characteristics, partner attributes, and GBV exposure was collected. Descriptive statistics and modified Poisson regression analyses were performed using STATA 18.0. Associations between variables and GBV were reported as adjusted prevalence ratios (aPR), with p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 considered statistically significant.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong the 339 participants, the mean age (standard deviation) was 26.1(5.5) years. Overall, 73.2% (n\u0026thinsp;=\u0026thinsp;248) of the participants were exposed to GBV in pregnancy. The most common form of GBV was controlling behaviour by male partners (61.9%, n\u0026thinsp;=\u0026thinsp;210), followed by emotional violence (34.8%, n\u0026thinsp;=\u0026thinsp;118), economic violence (29.5%, n\u0026thinsp;=\u0026thinsp;100), sexual violence (28.9%, n\u0026thinsp;=\u0026thinsp;98), and physical violence (16.2%, n\u0026thinsp;=\u0026thinsp;55). Factors associated with GBV included being in a polygynous marriage (aPR: 1.2, 95% CI: 1.03\u0026ndash;1.31, p\u0026thinsp;=\u0026thinsp;0.013), having poor (aPR: 1.6, 95% CI: 1.32\u0026ndash;1.89, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) or good (aPR: 1.2, 95% CI: 1.03\u0026ndash;1.51, p\u0026thinsp;=\u0026thinsp;0.026) versus perfect relationship with the husband's family, week of amenorrhea (aPR: 1.01, 95% CI: 1.003\u0026ndash;1.02, p\u0026thinsp;=\u0026thinsp;0.006), and maternal age (aPR: 0.98, 95% CI: 0.97\u0026ndash;0.99, p\u0026thinsp;=\u0026thinsp;0.003).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eGBV during pregnancy, particularly controlling behaviour by male partners, is highly prevalent in Northern Uganda. To mitigate the negative impacts on maternal and foetal health, targeted interventions by the Ministry of Health, development partners, and other stakeholders are urgently needed to prevent and manage GBV in pregnancy.\u003c/p\u003e","manuscriptTitle":"Prevalence, types, and determinants of gender-based violence among pregnant women in Northern Uganda: A hospital-based cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-10 09:24:23","doi":"10.21203/rs.3.rs-4707070/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c34bc781-9dd8-4a47-a539-eb630213fe5f","owner":[],"postedDate":"July 10th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":34301989,"name":"Sexual \u0026 Reproductive Medicine"}],"tags":[],"updatedAt":"2024-07-10T09:24:23+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-10 09:24:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4707070","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4707070","identity":"rs-4707070","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}