Improving the quality of sexual and reproductive health and rights (SRHR) through pre-service training, research, and evidence-based clinical care delivery in Sub-Saharan Africa

ABSTRACT
Background: Intimate Partner Violence (IPV) is a major public health concern in low-resource settings and reduces antenatal care (ANC) utilisation. Despite many interventions in Uganda, IPV remains common, especially in suburban Kampala. While ANC is vital for maternal and fetal health, IPV can hinder its use. This study aimed to investigate the relationship between IPV and utilisation of ANC in the suburbs of Kampala, Uganda.
Methods: A cross-sectional study involved women aged 15 to 49 who delivered in the last 12 months and accessed ANC services during their recent pregnancy. A total of 398 participants were selected through random sampling at Kawaala Health Centre IV and Kiswa Health Centre III in the Rubaga and Nakawa divisions. Data were collected using a structured questionnaire adapted from validated tools. Analysis was performed, summarising participant characteristics with descriptive statistics. Bivariate and multivariate analyses used Poisson regression, with significance at p<0.05.

Results: Participants were aged 25–34 years (49.7%), married (89.3%), and 77.5% had formal education. While 96.2% of women had at least one ANC visit, only 34.4% completed the recommended four or more. IPV prevalence was 53.3%, with emotional violence (52.6%) most common, followed by physical (38.1%) and sexual violence (2.5%). Women experiencing IPV were less likely to attend four or more ANC visits (AOR 0.6862, 95% CI 0.6054–0.7779). Sexual violence linked to reduced ANC attendance (AOR 0.8475, 95% CI 0.7584–0.9472), while emotional violence was associated with higher ANC use (AOR 1.3355, 95% CI 1.1989–1.4877). Education, marital status, and access to ANC services influenced utilisation.
Conclusions: Lower ANC utilisation is evident among women experiencing IPV in Kampala's suburbs. Sexual violence significantly hinders access to essential care. Policymakers and providers must collaborate to create safer environments and promote equitable maternal healthcare.

Keywords: Intimate Partner Violence, Antenatal Care, Utilisation, Suburbs.