Concordance in attitudes towards violence and reported physical abuse in African couples

Purpose: High rates of IPV have been reported in Africa, however the linkage between spousal attitudes towards violence (ATV) and actual incidence of violence is poorly understood. Therefore we examined the association between African couples' concordance on ATV and risk for IPV. Methodology: 13,837 couples from six Demographic and Health Surveys (DHS) conducted between 2003 and 2007 (Liberia (2007), Kenya (2003), Malawi (2004), Rwanda (2005), Zambia (2007), and Zimbabwe (2005-2006)) were included in analyses. Concordance on ATV was defined as the justification of physical violence by both spouses, while IPV was defined as incidence of a physically violent act against the wife. We determined if an association exists between concordance in ATV and IPV using hierarchical regression modeling that adjusted for multi-level influences on risk estimates. Results: Spousal ATV concordance was associated with higher risk for IPV [Adjusted Odds Ratio (AOR) =2.27, 95% CI (2.01,2.56)]. The level of wealth, educational attainment, rural/urban residence, presence of a co-wife, religion, maternal age and parity were characteristics that predicted the occurrence of IPV within couples. Spousal ATV concordance was significantly associated with violence in every African nation included in the analysis EXCEPT Rwanda (AOR = 1.38, 95% CI (0.99,1.94)). Conclusion: African couples with high rates of ATV concordance experience higher risks for IPV, with some variation in magnitude of risk across countries. In African settings, ATV positive concordance could serve as a supplemental screening mechanism to detect spousal violence.