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Iran J Psychiatry Behav Sci. In Press(In Press):e130911.
Published online 2023 July 25.
https://doi.org/10.5812/ijpbs-130911.
Research Article
Investigating the Relationship Between Structural Determinants of
Health and Domestic Violence against Pregnant Women based on the
World Health Organization Model
Sahar Roozbahani
1
, Mahrokh Dolatian
2, *
, Zohreh Mahmoodi
3
, Atefeh Zandifar
3
, Hamid Alavi
Majd
4
and Jamal Shams
5
1
Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2
Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of
Medical Sciences, Tehran, Iran
3
Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
4
Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5
Department of Psychiatry, Behavioral Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*
Corresponding author: Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid
Beheshti University of Medical Sciences, Tehran, Iran. Email: mhdolatian@gmail.com
Received 2022 August 21; Revised 2023 March 25; Accepted 2023 June 27.
Abstract
Background: Domestic violence is recognized as a global health problem. In recent years, understanding the factors affecting
violence against women has become one of the most prominent issues.
Objectives: This study aimed to identify the relationship between the structural determinants of health and domestic violence
against pregnant women.
Methods: This descriptive cross-sectional study was conducted on 560 volunteer pregnant women, aged 28 - 35 weeks, who were
referred to healthcare centers affiliated with Shahid Beheshti University of Medical Sciences in Tehran, Iran, during 2021 - 2022, using
a multistage cluster sampling method. The data collection tools used in this research included questionnaires on demographic
and gynecologic/obstetric factors, socioeconomic status, and domestic violence. The collected data were analyzed by measuring
descriptive and inferential statistics using the chi-square test and multivariate logistic regression analysis.
Results: Based on the results, more than 50% of women were subjected to domestic violence during pregnancy (66.3% emotional
violence, 10.2% physical violence, and 9% sexual violence). Domestic violence showed a significant relationship with the majority
of the structural determinants of health (P < 0.005). Based on the logistic regression model, demographic/obstetric and
socioeconomic factors explained 73% and 85.3% of the variance in domestic violence, respectively. Certain structural social
determinants of health acted as protective factors against domestic violence toward pregnant women, as the possibility of domestic
violence was lower in women with high school education, working spouses, and high income (OR = 0.310, 0.217, and 0.255,
respectively).
Conclusions: This study showed that more than half of Iranian women experienced domestic violence during pregnancy. To
prevent adverse maternal and neonatal consequences, it is necessary to identify these women and introduce them to support
centers.
Keywords: Domestic Violence, Pregnancy, Social Determinants of Health
1. Background
Violent acts are patterns of behavior internalized by
new generations through the socialization process and
transmitted to other generations (1). Domestic violence
is one of the most common forms of violence against
women, which can occur in any intimate relationship.
Domestic violence is mainly perpetrated by men against
women. Due to the high frequency and severity of
this type of violence, it has become a significant public
health issue (2). Intimate partner violence (IPV), often
referred to as domestic violence, can take many forms.
Non-physical violence is classified into four types of
emotional, psychological, social, and economic violence.
Meanwhile, physical and sexual violence against women
Copyright © 2023, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License
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