Effect of maternal exposure to intimate partner violence on under-five mortality in Nigeria

Background: The under-5 mortality rate in many developing countries has shown little or no improvement over the years. Ravaged by war and poverty, violence which is now a norm in most African countries (including Nigeria) is on the increase and has condensed into most families with women and children bearing the major brunt of this violence.Aim: Effect of maternal exposure to intimate partner violence on under-5 mortality in Nigeria.Methods: Data from nationally representative sample of mothers (aged 15-49 years) was obtained from the 2008 Nigeria Demoraphic and Health Survey. Cox regression and multiple logistic regressions were used to identify and examine the association between maternal exposure to intimate partner violence and under-5 death and use of maternal and child health services after controlling for potential confounding factors.Results: The prevalence of intimate partner violence (IPV) in Nigeria is 34.9%. This may be lower than the actual prevalence due to under reporting of cases of IPV in most developing countries. Women not exposed to intimate partner violence were 0.77 times less likely to lose a child under-5 compared to women exposed to intimate partner violence (HR=0.77 95%CI 0.64-0.81). Decision making autonomy in family activities significantly affected loss of a child under-5 in the face of IPV. Similarly women not exposed to IPV were 1.74 times more likely to use maternal and child health services compared to exposed mothers (OR=1.74 95% CI 1.65-1.83). Age of mother, educational status of mothers, social class, occupation, marital status, access to media and decision making autonomy were retained as important maternal predictors of use of maternal and child health services when exposed to IPV in multivariate analysis (p<0.05).Conclusion: Intimate Partner Violence has a significant effect on under-5 mortality. Therefore tackling this social menace will not only reduce the effect on child mortality but also address the ill societal effect that results from family collapse following IPV