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The influence of family violence and child marriage on unmet need for family planning in Jordan
  1. Cari Jo Clark1,
  2. Rachael A Spencer2,
  3. Inaam A Khalaf3,
  4. Louisa Gilbert4,
  5. Nabila El-Bassel5,
  6. Jay G Silverman6,
  7. Anita Raj7
  1. 1Assistant Professor, Medical School; Adjunct Assistant Professor, School of Public Health, University of Minnesota, Minneapolis, MN, USA
  2. 2Independent Researcher, Atlanta, GA, USA
  3. 3Professor of Maternal Child Health Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan
  4. 4Associate Professor, Co-Director, Social Intervention Group (SIG); Co-Director, Global Health Research Center of Central Asia (GHRCCA) Columbia University School of Social Work, New York, NY, USA
  5. 5Professor, Columbia University School of Social Work; The Willma and Albert Musher Professor of Social Work, Director of the Global Health Research Center of Central Asia; Director of the Social Intervention Group (SIG), New York, NY, USA
  6. 6Director of Research, Center on Gender Equity and Health; Professor of Medicine and Global Public Health, University of California at San Diego, La Jolla, CA, USA
  7. 7Professor, Center on Gender Equity and Health; Division of Global Public Health, Department of Medicine, University of California at San Diego, La Jolla, CA, USA
  1. Correspondence to Dr Cari Jo Clark, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 717 Delaware Street, SE, Ste 166, Room 169 Minneapolis, MN 55414, USA; cjclark{at}umn.edu

Abstract

Background Risk for unmet need for contraception is associated with men's perpetration of intimate partner violence (IPV) against women and may be influenced by violence perpetrated by other family members (family violence, FV). Women who married as minors may be most vulnerable to the potential compounding effect of IPV and FV on unmet need.

Aim Using nationally representative data from the 2012 Jordan Population and Family Health Survey we examined unmet need by exposure to IPV and FV by women's age at marriage (<18, 18+ years).

Design Logistic regression was used to test whether IPV and FV were independently associated with unmet need, by age at marriage. Interaction terms (IPV×FV) were tested in both models. Stratification by FV was employed to clarify the interpretation of significant interactions.

Results IPV increased the odds of unmet need by 87% [adjusted odds ratio (AOR) 1.87; 95% confidence interval (95% CI) 1.13–3.10] and 76% (AOR 1.76; 95% CI 1.30–2.38) among women who married prior to and after the age of 18 years, respectively. Women married as minors who experienced IPV and FV had a four-fold higher likelihood of having an unmet need (AOR 6.75; 95% CI 1.95–23.29) compared to those experiencing only IPV (AOR 1.49; 95% CI 0.84–2.38). No interaction between IPV and FV was detected for women married at or above majority.

Conclusions Laws that prohibit child marriage should be strengthened and health sector screening for violence experience could help identify women at risk of unmet need and improve women's reproductive agency.

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