Published in PLOS One on 2026-04-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Zelalem Nigussie Azene, Berihun Dachew, Nicole Reilly, Solomon Abrha Damtew, Catherine MacPhail
Source: PLOS One • DOI 10.1371/journal.pone.0347323
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Intimate partner violence (IPV) is a widespread public health concern that disproportionately affects women of reproductive age, particularly during pregnancy. Antenatal IPV (AN-IPV) is associated with adverse maternal and infant health outcomes, including poor breastfeeding practices. In Ethiopia, despite the high prevalence of AN-IPV, its association with breastfeeding outcomes remains poorly understood. Therefore, this study aimed to investigate the relationship between AN-IPV and breastfeeding indicators in Ethiopia.
Data from the Performance Monitoring for Action (PMA) Ethiopia, a nationally representative survey conducted between November 2021 and October 2022, were used. A total weighted sample of 1, 610 postpartum mother-child pairs was included. Data collected at baseline (during enrolment) and six weeks postpartum were used for this analysis. We fitted multilevel binary logistic regression models to estimate the associations between any AN-IPV, as well as physical and sexual AN-IPV separately, and early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF), accounting for clustering within enumeration areas. Adjusted Odds Ratios (AORs) with 95% Confidence Intervals (CIs) were calculated to examine associations, and two-sided p-values (<0.05) were used to determine statistical significance.
The prevalence of AN-IPV among mothers was 10.2%, with 6.9% reporting sexual AN-IPV and 4.4% reporting physical AN-IPV. Mothers exposed to any form of AN-IPV had a lower likelihood of initiating breastfeeding within the first hour of birth (AOR = 0.60, 95% CI: 0.36–0.99). Sexual AN-IPV was also associated with a reduced likelihood of EIBF (AOR = 0.50, 95% CI: 0.26–0.95, Model 2); however, this association did not remain in the fully adjusted model (AOR = 0.54, 95% CI: 0.28–1.04, Model 3). We found no evidence of an association between AN-IPV and EBF at six-weeks postpartum.
Our study revealed that maternal exposure to any form of AN-IPV (physical or sexual) was associated with reduced EIBF. However, no association was observed between AN-IPV and EBF at six weeks postpartum. The findings highlight the need for routine identification of women who have experienced or are experiencing AN-IPV, and for the development and provision of targeted, trauma-informed interventions aimed at supporting optimal breastfeeding practices.
Introduction
Intimate partner violence (IPV) is a significant public health issue involving physical, sexual, or psychological harm, stalking, or reproductive control by a current or former partner [1,2]. It is the most common form of violence against women, affects about one in three women globally, and spans all ethnic, economic, religious, and sexual backgrounds [3]. The prevalence of IPV is particularly high in sub-Saharan Africa, where 46.5% of women have experienced at least one form of violence [4]. In Ethiopia, IPV remains a pervasive issue in both urban and rural communities [5]. A systematic review conducted in the country reported that the lifetime prevalence of physical violence ranged from 31% to 76.5%, sexual violence from 19.2% to 59%, and emotional violence at 51.7% [5].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Zelalem Nigussie Azene, Berihun Dachew, Nicole Reilly, Solomon Abrha Damtew, Catherine MacPhail. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Exploring the association between home delivery and under-five mortality in Ethiopia: A bivariate multilevel mixed-effects analysis
- Evidence brief: Prevalence and associated factors of intimate partner violence against reproductive-age women in Africa and Asia regions: Insights from 2022–2024 DHS datasets
- Evidence brief: Assessment of trends and determinants of under-five mortality among children born to older women: Evidence from Ethiopian demographic and health surveys
