Socioeconomic Factors and Patterns of Intimate Partner Violence among Ever-Married Women in Uganda: Pathways and Actions for Multicomponent Violence Prevention Strategies

Intimate partner violence (IPV) is a severe public health problem in sub-Saharan Africa (SSA) with harmful effects on the physical, psychological, and socioeconomic wellbeing of survivors and their families. In SSA, IPV is associated with mental health disorders, high-risk behaviors, and HIV vulnerability, especially among women. In Uganda, poor socioeconomic status increases women's vulnerability to IPV. Yet there is limited evidence on the association between socioeconomic factors and IPV severity in Uganda. Our study used population-based data to (a) establish different patterns describing the severity of IPV experiences, (b) explore associations between socioeconomic factors and severity of IPV experiences among Ugandan ever-married women, and (c) examine direct and indirect pathways from socioeconomic factors to severity of IPV experiences. Data were drawn from the 2016 Uganda Demographic and Health Survey's sample of 7,536 ever-married women aged 15-49 years. A latent class analysis examined distinct patterns of IPV severity among this sample, yielding a four-class solution: low violence (n = 5,059; 67.1%); high physical violence, low sexual violence (n = 1,501; 19.9%); high sexual violence, moderate physical violence (n = 535; 7.1%); and high sexual and severe physical violence (n = 441; 5.9%). Using the low violence group as the reference category, we conducted a multinomial logistic regression that found significant associations between secondary education (aOR 2.35, 95% CI: [1.06, 5.24]), poorest on the wealth index (aOR 2.00, 95% CI: [1.13, 3.54]), and severe IPV experiences. Decision-making (aOR 0.81, 95% CI: [0.68, 0.96]) played a protective role against membership in the high sexual and physical violence class compared to the reference category. Using path analysis, we found that labor force participation partially mediated the path from wealth index and education to IPV severity. Findings indicate the need for interventions that aim to keep girls in school and target schools, communities, and media platforms to address gender norms, economic vulnerability, and comprehensive screening for multiple forms of violence.