Who seeks care after intimate partner violence in Cameroon? sociodemographic differences between a hospital and population sample of women

Mark T Yost; Kevin J Blair; McKayla Poppens; Michelle Mallahi; Lauren Eyler Dang; Rasheedat Oke; Melissa Carvalho; Georges Alain Etoundi-Mballa; Alan Hubbard; Marquise Kouo Ngamby; Sithombo Maqungo; Kudzai Chironga; Sandra I McCoy; Alain Chichom-Mefire; Catherine Juillard; Salome Maswime; Fanny Nadia Dissak Delon

doi:10.1371/journal.pgph.0003408

Who seeks care after intimate partner violence in Cameroon? sociodemographic differences between a hospital and population sample of women

PLOS Glob Public Health. 2024 Jul 19;4(7):e0003408. doi: 10.1371/journal.pgph.0003408. eCollection 2024.

Authors

Mark T Yost¹, Kevin J Blair¹, McKayla Poppens¹, Michelle Mallahi¹, Lauren Eyler Dang², Rasheedat Oke¹, Melissa Carvalho¹, Georges Alain Etoundi-Mballa³, Alan Hubbard², Marquise Kouo Ngamby⁴, Sithombo Maqungo^{5

6}, Kudzai Chironga^{5

6}, Sandra I McCoy⁷, Alain Chichom-Mefire⁸, Catherine Juillard¹, Salome Maswime⁵, Fanny Nadia Dissak Delon⁹

Affiliations

¹ Department of Surgery, Program for the Advancement of Surgical Equity, University of California Los Angeles, Los Angeles, California, United States of America.
² Division of Biostatistics, School of Public Health, University of California Berkeley, Berkeley, California, United States of America.
³ Department of Disease Epidemic and Pandemic Control, Ministry of Public Health, Yaounde, Cameroon.
⁴ United Nations Population Fund (UNFPA), Yaounde, Cameroon.
⁵ Department of Surgery, Division of Global Surgery, University of Cape Town, Cape Town, South Africa.
⁶ Division of Orthopaedic Surgery, Orthopaedic Trauma Service, University of Cape Town, Cape Town, South Africa.
⁷ Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California, United States of America.
⁸ Faculty of Health Sciences, University of Buea, Buea, Cameroon.
⁹ University of Bamenda, Bamenda, Cameroon.

Abstract

Introduction: Little is known regarding health care seeking behaviors of women in sub-Saharan Africa, specifically Cameroon, who experience violence. The proportion of women who experienced violence enrolled in the Cameroon Trauma Registry (CTR) is lower than expected.

Methods: We concatenated the databases from the October 2017-December 2020 CTR and 2018 Cameroon Demographic and Health Survey (DHS) into a singular database for cross-sectional study. Continuous and categorical variables were compared with Wilcoxon rank-sum and Fisher's exact test. Multivariable logistic regression examined associations between demographic factors and women belonging to the DHS or CTR cohort. We performed additional classification tree and random forest variable importance analyses.

Results: 276 women (13%) in the CTR and 197 (13.1%) of women in the DHS endorsed violence from any perpetrator. A larger percentage of women in the DHS reported violence from an intimate partner (71.6% vs. 42.7%, p<0.001). CTR women who experienced IPV demonstrated greater university-level education (13.6% vs. 5.0%, p<0.001) and use of liquid petroleum gas (LPG) cooking fuel (64.4% vs. 41.1%, p<0.001). DHS women who experienced IPV reported greater ownership of agricultural land (29.8% vs. 9.3%, p<0.001). On regression, women who experienced IPV using LPG cooking fuel (aOR 2.55, p = 0.002) had greater odds of belonging to the CTR cohort while women who owned agricultural land (aOR 0.34, p = 0.007) had lower odds of presenting to hospital care. Classification tree variable observation demonstrated that LPG cooking fuel predicted a CTR woman who experienced IPV while ownership of agricultural land predicted a DHS woman who experienced IPV.

Conclusion: Women who experienced violence presenting for hospital care have characteristics associated with higher SES and are less likely to demonstrate factors associated with residence in a rural setting compared to the general population of women experiencing violence.

Copyright: © 2024 Yost et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

M.Y. (first author) received salary support through a grant from the LB Research and Education Foundation dispersed through the H & H Lee Research Program (award number N/A). M.Y. (first author) was supported by a fellowship from the University of California Global Health Institute consortium, funded by the Fogarty International Center of the National Institutes of Health under award number D43TW009343. Research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health under award number R21TW010453 (awarded to Dr. C.J.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.