Exposição à violência entre parceiros íntimos e desnutrição entre mulheres jovens de Bangladesh: um estudo transversal de uma amostra nacional representativa

Ferdos, Jannatul; Rahman, Mosfequr

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Sumário

ARTICLE • Cad. Saúde Pública 34 (7) • 2018 • https://doi.org/10.1590/0102-311X00113916 copiar

Exposição à violência entre parceiros íntimos e desnutrição entre mulheres jovens de Bangladesh: um estudo transversal de uma amostra nacional representativa

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo:

O estudo explora as relações entre desnutrição e violência entre parceiros íntimos (VPI) em uma amostra de 1.086 mulheres adultas jovens (15-24 anos) de Bangladesh, usando dados transversais do Bangladesh Demographic Health Survey (BDHS) de 2007. Cerca de um terço (33,4%) dessas mulheres relataram terem sofrido VPI física e/ou sexual, 14,5% apenas VPI sexual e 29% apenas VPI física praticada pelo marido. Cerca de 32,6% das mulheres adultas jovens eram desnutridas (IMC < 18,5), enquanto 6,2% apresentavam sobrepeso (IMC ≥ 25). As mulheres com baixo peso sofriam mais VPI física (OR = 1,39; IC95%: 1,09-2,71) e VPI física e/ou sexual (OR = 1,48; IC95%: 1,12-2,75) quando comparadas às mulheres eutróficas. Os resultados também indicam uma associação positiva entre sobrepeso/obesidade e todas as formas de VPI. Os achados indicam que a exposição à VPI tem um papel significativo na experiência das adultas jovens de baixo peso e com sobrepeso/obesidade e confirmam que são necessários programas e políticas nutricionais e de saúde para as mulheres jovens de Bangladesh.

Palavras-chave:
Violência por Parceiro Íntimo; Desnutrição; Peso Corporal; Índice de Massa Corporal

Characteristics	n	% (95%CI)
Mean age	1,086	20.0 ± 2.54 (mean ± SD)
Age at marriage (years)
< 18	909	83.7 (81.4-85.7)
≥ 18	177	16.3 (14.2-16.3)
Number of household members
2-4	557	51.3 (48.3-54.3)
5-6	268	24.7 (22.2-27.3)
≥ 7	260	24.0 (21.5-26.6)
Data missing	1
Children ever born
< 2	976	89.9 (87.9-91.5)
≥ 2	110	10.1 (8.4-12.0)
Place of residence
Rural	702	64.6 (61.7-67.4)
Urban	384	35.4 (32.5-38.2)
Wealth quintile
Lowest	190	17.5 (15.3-19.8)
Second	227	20.9 (18.6-23.4)
Middle	218	20.1 (17.8-22.5)
Fourth	225	20.7 (18.4-23.2)
Highest	226	20.8 (18.5-23.3)
Respondents’ education
No education	165	15.2 (13.1-17.4)
Primary	352	32.4 (29.7-35.2)
Secondary and higher	569	52.4 (49.4-55.3)
Currently working
No	826	76.1 (73.4-78.5)
Yes	260	23.9 (21.5-26.5)
Ever used modern contraceptives
No	256	23.6 (21.1-16.1)
Yes	830	76.4 (73.8-78.8)
Mean BMI	1,086	20.0 ± 2.9 (mean ± SD)
Respondents’ BMI
Underweight	354	32.6 (29.8-35.4)
Normal	665	61.2 (58.3-64.0)
Overweight/Obese	67	6.2 (4.9-7.7)
Respondents’ height (cm)
< 145	180	16.6 (14.4-18.9)
≥ 145	906	83.4 (81.1-85.5)
Physical and/or sexual IPV
No	713	65.7 (62.8-68.4)
Yes	372	34.3 (31.5-37.1)
Data missing	1
Physical IPV only
No	770	71.0 (68.4-73.6)
Yes	315	29.0 (26.4-31.8)
Data missing	1
Sexual IPV only
No	928	85.5 (83.2-87.4)
Yes	158	14.5 (12.5-16.7)
Minor physical IPV
No	587	54.1 (51.0-57.0)
Yes	499	45.9 (43.0-48.9)
Severe physical IPV
No	938	86.4 (84.2-88.2)
Yes	148	13.6 (11.7-15.8)

Characteristics	Physical IPV only % (95%CI)	Sexual IPV only % (95%CI)	Physical and/or sexual IPV % (95%CI)	Minor physical IPV % (95%CI)	Severe physical IPV % (95%CI)
Age at marriage (years)
< 18	31.3 (28.3-34.3)	15.0 (12.8-17.4)	36.2 (33.1-39.4)	49.6 (46.3-52.8)	15.0 (12.8-17.4)
≥ 18	17.5 (12.6-23.7)	12.4 (8.3-18.1)	24.3 (18.5-31.1)	27.1 (21.1-34.1)	6.8 (3.9-11.4)
p-value	< 0.001	0.382	0.002	< 0.001	0.004
Number of household members
2-4	34.9 (31.0-38.9)	14.7 (12.0-17.9)	39.2 (37.0-45.1)	52.8 (48.6-56.9)	17.6 (14.6-20.9)
5-6	25.7 (20.8-31.3)	14.6 (10.8-19.2)	30.6 (25.4-36.3)	44.0 (38.2-50.0)	11.9 (8.6-16.3)
≥ 7	19.6 (15.2-24.8)	14.2 (10.5-19.0)	27.3 (22.2-33.0)	33.1 (27.6-39.0)	6.9 (4.4-10.6)
p-value	< 0.001	0.983	0.001	< 0.001	< 0.001
Children ever born
< 2	28.3 (25.5-31.1)	14.4 (12.3-16.8)	33.7 (30.8-36.7)	44.2 (41.0-47.3)	12.8 (10.8-15.0)
≥ 2	35.8 (27.4-45.1)	15.5 (9.8-23.6)	39.4 (30.7-48.8)	61.8 (52.5-70.3)	20.9 (14.3-29.4)
p-value	0.102	0.776	0.231	< 0.001	0.019
Place of residence
Rural	28.5 (25.2-31.9)	15.4 (12.9-18.2)	34.6 (31.2-38.2)	45.0 (41.3-48.7)	12.3 (10.0-14.8)
Urban	30.0 (31.4-41.9)	13.0 (10.0-16.7)	33.7 (29.1-38.5)	47.7 (42.7-52.6)	16.1 (12.8-20.1)
p-value	0.594	0.291	0.757	0.404	0.074
Wealth quintile
Lowest	32.6 (26.3-39.5)	21.6 (16.3-27.9)	41.1 (34.3-48.1)	53.2 (46.0-60.1)	15.3 (10.8-21.0)
Second	34.8 (28.9-41.2)	16.7 (12.4-22.1)	40.5 (34.3-47.0)	52.9 (46.3-59.2)	16.3 (12.0-21.6)
Middle	33.0 (27.1-39.5)	12.4 (8.6-17.4)	35.8 (29.7-42.3)	52.8 (46.1-59.2)	16.1 (11.7-21.5)
Fourth	27.2 (21.8-33.4)	12.4 (8.7-17.4)	31.7 (25.9-3.0)	42.2 (35.9-48.7)	14.2 (10.2-19.4)
Highest	18.1 (13.6-23.6)	10.6 (7.2-15.3)	23.5 (18.4-29.4)	30.1 (24.4-36.3)	6.6 (4.0-10.6)
p-value	0.001	0.012	< 0.001	< 0.001	0.015
Respondents’ education
No education	39.4 (32.2-47.0)	16.4 (11.5-22.7)	44.2 (36.8-51.8)	56.4 (48.3-63.7)	24.2 (18.3-31.3)
Primary	32.8 (28.0-37.8)	17.3 (13.7-21.6)	37.6 (32.7-42.8)	53.1 (47.9-58.2)	16.8 (13.2-21.0)
Secondary and higher	23.7 (20.4-27.4)	12.3 (9.8-15.2)	29.3 (25.7-33.2)	38.5 (34.5-42.5)	8.6 (6.5-11.2)
p-value	< 0.001	0.085	0.001	< 0.001	< 0.001
Currently working
No	28.2 (25.2-31.4)	13.4 (11.2-15.9)	32.5 (29.3-35.7)	43.8 (40.8-47.2)	11.7 (9.7-14.1)
Yes	31.5 (26.2-37.4)	18.1 (13.8-23.2)	40.0 (34.2-46.0)	52.7 (46.6-58.6)	19.6 (15.2-24.8)
p-value	0.307	0.039	0.026	0.012	0.001
Ever use modern contraceptives
No	20.7 (16.2-26.0)	12.9 (9.3-17.5)	25.8 (20.8-31.4)	31.6 (26.2-37.5)	11.7 (8.3-16.2)
Yes	31.6 (28.5-34.8)	15.1 (12.8-17.6)	36.9 (33.7-40.2)	50.4 (46.9-53.7)	14.2 (12.0-16.7)
p-value	0.001	0.389	0.001	< 0.001	0.308
Respondents’ height (cm)
< 145	35.6 (28.9-42.7)	22.8 (17.2-29.4)	43.3 (36.3-50.6)	52.2 (44.9-53.4)	18.9 (13.8-25.2)
≥ 145	27.7 (24.9-30.7)	12.9 (10.8-15.2)	32.5 (29.5-35.6)	44.7 (41.5-47.9)	12.6 (10.5-14.9)
p-value	0.035	0.001	0.005	0.064	0.024
Respondents’ BMI
Underweight	31.6 (27.0-36.6)	15.0 (11.6-19.0)	37.0 (32.1-42.1)	48.3 (43.1-53.5)	16.1 (12.6-20.3)
Normal	28.6 (25.3-32.1)	14.9 (12.4-17.8)	34.0 (30.5-37.7)	45.9 (42.1-49.7)	13.1 (10.7-15.8)
Overweight/Obese	19.4 (11.7-30.4)	9.0 (4.1-18.2)	22.4 (14.0-33.7)	34.3 (24.1-46.2)	6.0 (2.3-14.3)
p-value	0.009	0.407	0.028	0.048	0.039

Characteristics	Physical IPV only	Sexual IPV only	Physical and/or sexual IPV	Minor physical IPV	Severe physical IPV
	OR (95%CI)	OR (95%CI)	OR (95%CI)	OR (95%CI)	OR (95%CI)
Respondents’ BMI
Normal	1.00	1.00	1.00	1.00	1.00
Underweight	1.39 * (1.09-2.71)	1.41 (0.58-3.43)	1.48 ** (1.12-2.75)	1.31 * (1.03-2.11)	2.11 * (1.40-6.19)
Overweight/Obese	1.45 ** (1.12-2.88)	1.29 * (1.02-3.24)	1.51 ** (1.09-2.88)	1.24 ** (1.01-2.26)	2.39 ** (1.35-7.19)
Age at marriage (years)
< 18	1.00	1.00	1.00	1.00	1.00
≥ 18	0.59 * (0.37-0.91)	0.56 ** (0.41-0.92)	0.65 ** (0.42-0.89)	0.51 ** (0.34-0.74)	0.61 * (0.39-0.98
Number of household members
2-4	1.00	1.00	1.00	1.00	1.00
5-6	1.93 *** (1.33-2.78)	0.89 (0.57-1.39)	1.48 * (1.06-2.07)	1.92 *** (1.39-2.65)	2.46 ** (1.42-4.26)
≥ 7	1.19 (0.78-1.82)	0.92 (0.56-1.52)	1.01 (0.68-1.47)	1.27 (0.87-1.85)	1.36 (0.73-2.56)
Children ever born
< 2	1.00	1.00	1.00	1.00	1.00
≥ 2	1.29 (0.81-2.03)	0.96 (0.53-1.73)	1.18 (0.75-1.84)	1.76 * (1.35-2.75)	1.62 (0.93-2.83)
Place of residence
Rural	1.00	1.00	1.00	1.00	1.00
Urban	1.53 * (1.09-2.13)	0.98 (0.64-1.51)	1.38 * (1.08-1.98)	1.81 *** (1.31-2.50)	1.89 ** (1.24-2.88)
Wealth quintile
Lowest	1.00	1.00	1.00	1.00	1.00
Second	1.08 (0.71-1.65)	0.77 (0.47-1.27)	1.10 (0.67-1.49)	0.94 (0.83-1.40)	1.09 (0.63-1.89)
Middle	1.04 (0.73-1.50)	0.62 (0.38-1.01)	0.86 (0.61-1.22)	1.09 (0.77-1.53)	1.15 (0.71-1.85)
Fourth	0.84 (0.58-1.22)	0.74 (0.45-1.20)	0.80 (0.56-1.14)	0.71 (0.50-1.01)	1.09 (0.67-1.77)
Highest	0.45 ** (0.29-0.71)	0.71 * (0.57-0.98)	0.53 ** (0.35-0.81)	0.37 *** (0.25-0.56)	0.42 ** (0.22-0.80)
Respondents’ education
No education	1.00	1.00	1.00	1.00	1.00
Primary	0.77 * (0.52-0.96)	1.12 (0.67-1.58)	0.79 * (0.54-0.92)	0.65 ** (0.42-0.87)	0.64 ** (0.40.0.96)
Secondary and higher	0.61 * (0.45-0.80)	0.70 * (0.54-0.93)	0.67 * (0.51-0.88)	0.53 *** (0.39-0.75)	0.53 ** (0.35-0.81)
Currently working
No	1.00	1.00	1.00	1.00	1.00
Yes	0.97 (0.71-1.33)	1.35 (0.92-1.98)	1.21 (0.91-1.63)	1.16 (0.86-1.56)	1.52 * (1.03-2.25)
Respondents’ height (cm)
< 145	1.00	1.00	1.00	1.00	1.00
≥ 145	0.76 (0.53-1.08)	0.52 ** (0.35-0.79)	0.67 * (0.48-0.94)	0.81 (0.57-1.14)	0.73 (0.47-1.15)

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[1] * Correspondence Md. M. Rahman Department of Population Science and Human Resource Development, University of Rajshahi. Rajshahi / Northern - CEP 6205 - Bangladesh. mosfeque@gmail.com