BACKGROUND Domestic violence is a major international public health problem with potentially devastating health consequences for women. Addressing the epidemic of domestic violence is key to achieving Sustainable Development Goal 3: ensure healthy lives and promote wellbeing for all at all ages. We wanted to know whether domestic violence is a significant health problem for women in the Arab world, but published research from this region is limited. We carried out a systematic review and meta-analysis, synthesizing existing data to produce estimates of the prevalence and health outcomes of domestic violence amongst clinical populations in the Arab world. METHODS Using terms related to domestic violence, Arab countries, and date limit > year 2000, we searched seven databases: Medline, EMBASE, PsycINFO, CINAHL, Web of Science: core collection, IBSS, Westlaw, IMEMR. We included observational studies reporting estimates of prevalence or health outcomes of domestic violence amongst women aged >15 years, recruited while accessing healthcare in Arab countries. We included studies looking at all forms of DV (including violence from family members and/or intimate partners) and health outcomes, accepting the definition/measurements used by primary studies. Studies that collected data on/after 1st January 2000 and were published in English, Arabic or French were included. Title/abstract screening, full text screening, quality assessment and data extraction were carried out. Extracted data were summarised and meta-analysis was performed where appropriate. Our protocol was published on PROSPERO: CRD42017071415 RESULTS 6341 papers were screened and 41 papers (29 studies) met inclusion criteria. A total of 19,101 participants from 10 countries were represented in the data. The majority of prevalence data reported experience of intimate partner violence (IPV). Meta-analysis produced pooled prevalence estimates of lifetime exposure to any type of IPV of 73·3% (95% CI 64·1-81·6), physical IPV 35·6% (95% CI 24·4-47·5), sexual IPV 22% (95% CI 13·3-32) and emotional/psychological IPV 49·8% (95% CI 37·3-62·3). Health outcomes were pooled for exposure to all types of domestic violence (family violence and/or IPV). Exposure was associated with increased odds of adverse health outcomes: depression OR 3·3 (95% CI 1·7-6·4), sleep problems OR 3·2 (95% CI 1·5-6·8), abortion OR 3·5 (95% CI 1·2-10·2), pain OR 2·6 (95% CI 1·6-4·1) and hypertension OR 1·6 (95% CI 1·2-2·0). Methodological challenges included varied definitions of types of domestic violence used by the primary studies, a focus on intimate partner violence (and not broader family violence) and diverse definition and measurement of health outcomes. CONCLUSION Domestic violence is common amongst women seeking healthcare in Arab countries . Around one in two women have experienced psychological violence, one in three physical violence and one in five sexual violence from an intimate partner during their lifetime, with over 70% experiencing any form of violence. The poor health outcomes of domestic violence, well documented internationally, also impact women in this region. Our findings are of interest to clinicians and policy makers alike, and are relevant to national and regional plans to achieve SDG3. Further research is required to guide the development of an appropriate and effective healthcare response to domestic violence is the Arab region .
|Publication status||Published - 2019|
|Event||Sexual Violence Research Initiative Forum: Time is now - CTICC, Cape Town, South Africa|
Duration: 21 Oct 2019 → 25 Oct 2019
|Conference||Sexual Violence Research Initiative Forum|
|Period||21/10/19 → 25/10/19|