Generalized structural equation modeling of intimate partner violence among married women in East Africa using population-based data.

Intimate Partner Violence (IPV) remains a persistent public health and social problem among women in Africa, with severe physical, emotional, and sexual consequences that hinder well-being and socio-economic development. Despite ongoing global and regional efforts, evidence on the prevalence and determinants of IPV across East African countries is limited, fragmented, and often focused on single countries. A more comprehensive, regional-level understanding is crucial to guide targeted interventions and policies This study aimed to provide a comprehensive assessment of IPV among married women in East Africa by (1) estimating the prevalence of physical, emotional, and sexual IPV across 12 countries, and (2) identifying individual-, household-, and community-level factors associated with IPV using a structural equation modeling (SEM) approach. By integrating multi-country data, the study seeks to generate region-wide evidence that can inform prevention strategies and policy responses to gender-based violence in East Africa. A nationwide community based cross-sectional study was conducted in 12 East African countries as part of the Demographic, and Health Survey (DHS) in the region. The study gathered data from 56,657 married women through structured questionnaires. Descriptive findings were presented as percentages with a 95% confidence interval. To identify factors associated with different types of IPV (physical, emotional, and sexual), a Generalized Structural EquationModel was used. Adjusted odds ratios (AOR) with a 95% confidence interval were used to determine the significant factors related to IPV. The pooled prevalence of overall IPV in East Africa countries was 38.03% (95% CI: 33.23, 43.08). The highest prevalence of IPV was found in Uganda (53.24%), whereas the lowest was in Comoros (10%). Older age, secondary/higher education, wealth, current working status, attitude towards wife beating, husband’s educational status, husband’s current working status, and husband’s drinking alcohol were factors associated with physical violence. Regarding emotional violence, older age, primary education, wealth, media exposure, current working status, smoking cigarettes, women’s decision-making autonomy, attitude towards wife beating, husband’s education, and husband’s drinking alcohol were significant factors. Finally, regarding sexual violence, factors such as rural residence, better education, wealth, working status, women’s decision-making autonomy, husband’s education, and husband’s drinking alcohol were associated with it. The findings indicate a high prevalence of IPV among married women in East Africa. Key factors for physical violence include age, education, economic status, and attitudes toward domestic violence, while emotional and sexual violence are linked to women’s decision-making autonomy and their partners’ behaviors. To address IPV, comprehensive education and awareness programs are essential, emphasizing gender equality and healthy relationships. Additionally, policies should focus on enhancing women’s economic empowerment and decision-making autonomy, supported by community initiatives to challenge harmful norms.