Peer-reviewed article
Examining intimate partner violence as a barrier to childhood immunization in India with focus on maternal and child factors.
Kumari P, Kumar R, Nagarajan R ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines how intimate partner violence (IPV) experienced by mothers affects whether children receive full immunization in India. Using data from 5,106 mothers in the National Family Health Survey, researchers found that children whose mothers experienced sexual violence, emotional violence, or any form of violence were significantly less likely to be fully immunized. The effect of violence on immunization was particularly strong for children in second or third birth order and was moderated by the mother's education level. The findings suggest that violence against women disrupts women's decision-making and access to healthcare services, which can leave children unprotected against preventable diseases.
Key points
- Children of mothers who experienced sexual violence were 25% less likely to be fully immunized (COR: 0.75; 95% CI 0.61-0.83)
- Children of mothers who experienced any form of IPV were 17% less likely to be fully immunized (COR: 0.83; 95% CI 0.70-0.95)
- The association between IPV and immunization was moderated by the mother's secondary level education
- Children in second or third birth order showed significantly stronger association between IPV and lower immunization (AOR = 0.66; p = 0.001)
- IPV impacts maternal decision-making and access to healthcare services, leading to poorer health outcomes for children
Limitations
This is a cross-sectional study using survey data, so it cannot establish causality or determine whether IPV directly prevents immunization or whether other unmeasured factors explain the association. The study cannot explain the mechanisms by which IPV affects immunization decisions or access.
Abstract
Intimate partner violence (IPV) can negatively impact the use of child health services, in addition to causing direct harm and even death to women. IPV is defined as physical, sexual, or emotional abuse and controlling behaviors by a current or former partner or spouse. Evidence points to a connection between the children of violent intimate partners and the children's vaccination status. This study aims to investigate the relationship between women's exposure to intimate partner violence (IPV) and childhood immunization in India. The National Family Health Survey (NFHS-5) 2019-21 is used, and information from 5106 mothers of children selected from the violence module is utilized in this study. Bivariate and multivariate multilevel logistic regression models were used to examine the associations between women's exposure to IPV and the full immunization of children. To assess any moderating effect of the education of the woman, the sex of the child, and the birth order on the association between exposure to spousal IPV and full immunization, interactions were checked. The crude analysis revealed that children of mothers who experienced sexual violence (COR: 0.75; 95% CI 0.61-0.83), emotional violence (COR: 0.91, 95% CI 0.81-0.99) and any forms of violence (COR: 0.83, 95% CI 0.70-0.95) were less likely to be fully immunized than no abused women were. Moderation analysis revealed that sexual, emotional, and any form of IPV are also moderated by a secondary level of education. A significant association between any form of IPV and full immunization was found for children in second or third birth order (AOR = 0.66, 95% CI 0.52-0.84; p = 0.001). Intimate partner violence (IPV) severely impacts maternal and child health, influencing decision-making and access to healthcare services. This leads to poorer health outcomes, including lower immunization rates for children. Addressing IPV through targeted interventions is crucial for improving maternal and child well-being. Increased efforts are needed to reduce IPV prevalence and raise awareness about the importance of reproductive and child health initiatives.