Traumatic physical health consequences of intimate partner violence against women: what is the role of community-level factors?

Cross-sectional nationally-representative data of women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey was used in this study. Multilevel logistic regression analysis was used to assess the association between IPV and several forms of physical health consequences.Bruises were the most common form of traumatic physical health consequences. In the adjusted models, the likelihood of sustaining bruises (OR = 1.91, 95% CI = 1.05 - 3.46), wounds (OR = 2.54, 95% CI = 1.31 - 4.95), and severe burns (OR = 3.20, 95% CI = 1.63 - 6.28) was significantly higher for women exposed to IPV compared to those not exposed to IPV. However, after adjusting for individual- and community-level factors, women with husbands/partners with controlling behavior, those with primary or no education, and those resident in communities with high tolerance for wife beating had a higher likelihood of experiencing IPV, whilst mean community-level education and women 24 years or younger were at lower likelihood of experiencing IPV.Evidence from this study shows that exposure to IPV is associated with increased likelihood of traumatic physical consequences for women in Nigeria. Education and justification of wife beating were significant community-level factors associated with traumatic physical consequences, suggesting the importance of increasing women's levels of education and changing community norms that justify controlling behavior and IPV.Intimate partner violence (IPV) - "any acts of physical, sexual or emotional abuse by a current or former partner whether cohabitating or not" [1] - is an important cause of morbidity and mortality [2], with adverse effects for women's physical, mental, sexual and reproductive health [2-4]. The relationship between IPV and health is complex; the consequences may be immediate and direct (such as injury or death), longer term and direct (such as disability), indirect or psychosomatic (such as gastrointestinal disorders) or all three [5]. While