Background: Intimate Partner violence (IPV) among pregnant women is a significant problem of public health importance. Nevertheless, there are relatively few studies which have examined the phenomenon in sub-Saharan settings. The aim of this study was to provide an overview of the prevalence, perpetrators, and associated factors of IPV during pregnancy in Kenya. Methods: We were making use of the 2014 Kenyan Demographic and Health Survey (KDHS) data and included women and girls of reproductive age (15–49 years) who have ever been pregnant ( $$n=4331$$n = 4331 ). A weighted sample of respondents who have experienced violence during pregnancy ( $$n=397$$n = 397 ) were selected for further bivariate and multivariable logistic regression analyses in order to examine the association between IPV and socio-demographic factors. Results: The prevalence of violence among pregnant women in Kenya was 9.2%, perpetrated mostly by the current husband or partner (47.6%), followed by the former husband or partner (31.5%). Physical violence was the most common (78.6%), followed by emotional (67.8%) and sexual (34.8%). Having one or two children ( $$\hbox {aOR} =0.68$$aOR = 0.68 ; $$\hbox {CI} = 0.53{-}0.88$$CI = 0.53 - 0.88 ), having secondary or higher education ( $$\hbox {aOR} = 0.53$$aOR = 0.53 ; $$\hbox {CI} = 0.40{-}0.69$$CI = 0.40 - 0.69 ) and being 18 years and above at first cohabitation ( $$\hbox {aOR} = 0.75$$aOR = 0.75 ; $$\hbox {CI}= 0.60{-}0.94$$CI = 0.60 - 0.94 ) and at sexual debut ( $$\hbox {aOR} = 0.65$$aOR = 0.65 ; $$\hbox {CI}=0.53{-}0.80$$CI = 0.53 - 0.80 ) were significantly associated with fewer reports of violence during pregnancy. Pregnant women who were divorced, separated or widowed ( $$\hbox {aOR} = 1.91$$aOR = 1.91 ; $$\hbox {CI} =1.47{-}2.47$$CI = 1.47 - 2.47 ), who were employed ( $$\hbox {aOR} = 1.34$$aOR = 1.34 ; $$\hbox {CI} =1.06{-}1.70$$CI = 1.06 - 1.70 ), who had witnessed their fathers beat their mothers ( $$\hbox {aOR} = 1.59$$aOR = 1.59 ; $$\hbox {CI} = 1.28{-}1.97$$CI = 1.28 - 1.97 ) and who had primary education ( $$\hbox {aOR} = 1.53$$aOR = 1.53 ; $$\hbox {CI} = 1.11{-}2.14$$CI = 1.11 - 2.14 ) were significantly more likely to experience violence. Conclusions: To prevent violence among pregnant women in Kenya, training health care providers should go hand in hand with interventions sensitising and mobilising community members, both addressing the socio-demographic drivers of IPV during pregnancy and directing a particular attention to the most vulnerable ones.

We investigated correlates for suicidal expression among adolescents in the Seychelles. Data on 1,432 students (52% females) were derived from the Global School-based Health Survey. Participants were divided into three groups: those with no suicidal behavior (N = 1,199); those with suicide ideation/SI (N = 89); and those reporting SI with a plan to carry out a suicide attempt/SISP (N = 139), each within a 12-month recall period. Using multinomial logistic regression, we examined the strength of associations with social, behavioral and economic indicators while adjusting for covariates. Sixteen percent of school-attending adolescents reported a suicidal expression (10% with a plan/6.2% without). Those reporting SI were younger (relative risk ratio RRR = 0.81; CI = 0.68–0.96), indicated signs of depression (RRR = 1.69; CI = 1.05–2.72) and loneliness (RRR=3.36; CI =1.93–5.84). Tobacco use (RRR = 2.34; CI = 1.32–4.12) and not having close friends (RRR = 3.32; CI = 1.54–7.15) were significantly associated with SI. Those with SISP were more likely to be female (RRR = 0.47; 0.30–0.74), anxious (RRR = 3.04; CI = 1.89–4.88) and lonely (RRR = 1.74; CI = 1.07–2.84). Having no close friends (RRR = 2.98; 1.56–5.69) and using tobacco (RRR = 2.41; 1.48–3.91) were also strongly associated. Having parents who were understanding was protective (RRR = 0.50; CI = 0.31–0.82). Our results suggest that school health promotion programs may benefit from targeting multiple factors associated with suicidal expression. More research, particularly multilevel designs are needed to identify peer and family influences which may modify associations with suicidality.

Bullying is relatively common and is considered to be a public health problem among adolescents worldwide. The present study examined the risk factors associated with bullying behavior among adolescents in a lower-middle-income country setting. Data on 6235 adolescents aged 11–16 years, derived from the Republic of Ghana’s contribution to the Global School-based Health Survey, were analyzed using bivariate and multinomial logistic regression analysis. A high prevalence of bullying was found among Ghanaian adolescents. Alcohol-related health compromising behaviors (alcohol use, alcohol misuse and getting into trouble as a result of alcohol) increased the risk of being bullied. In addition, substance use, being physically attacked, being seriously injured, hunger and truancy were also found to increase the risk of being bullied. However, having understanding parents and having classmates who were kind and helpful reduced the likelihood of being bullied. These findings suggest that school-based intervention programs aimed at reducing rates of peer victimization should simultaneously target multiple risk behaviors. Teachers can also reduce peer victimization by introducing programs that enhance adolescents’ acceptance of each other in the classroom.

Intimate partner violence (IPV) is one of the most prevalent forms of violence that women suffer globally. Women in Afghanistan have been exposed to high levels of IPV which coincided with high levels of conflict during more than four decades. We cross-sectionally examined the Afghanistan Demographic and Health Survey responses of 21,234 ever-married Afghan women. We first performed the frequency distribution analysis to determine the prevalence of IPV and the basic socio-demographic characteristics of the participants. Subsequently we examined the relationship between the independent and dependent variables followed by the bivariate and survey versions of logistic regression analyses. We report odds ratios in order to depict the strength and direction of the associations between the IPV and selected independent variables. P-values less than 0.05 were considered statistically significant. The analyses showed that 55.54% of Afghan women experienced some form of physical, emotional, or sexual violence by their intimate partners during the recall period partners. The most common form of IPV found was physical violence (50.52%). Factors such as being exposed to inter-parental violence (respondent woman’s father physically abused her mother) (adjusted OR= 3.69, CI= 3.31–4.10) and respondent’s acceptance of IPV (aOR= 1.85, 1.51–2.26) were associated with increased exposure to IPV. Having a spouse with at least a primary education (aOR= 0.76, CI= 0.64–0.91) or a respondent with at least a primary education (aOR= 0.82, CI= 0.68–0.98) was associated with lower exposure to reported IPV. The lifetime experience of IPV occurs to a high extent among Afghan women, and several socio-demographic factors have predisposing attributes. IPV policy formulation and strategizing may benefit from considering these factors.

Introduction: Suicide is a leading cause of adolescent mortality worldwide. We aimed to estimate the prevalence and identify individual-level and country-level factors which might explain the variability in suicidal behavior among students in 53 low to middle income countries. Methods: We used data on adolescents aged 12–16 years from the Global School-based Student Health Surveys from 2009–2016. The suicidal behaviors investigated included suicide ideation, suicidal planning and suicide attempt. The prevalence was estimated for 53 countries, while a multilevel logistic regression analysis (33 countries) was used to investigate the associations of these behaviors with individual and country-level contextual risk factors. The contextual variables included the Gini Coefficient, Gross Domestic Product per capita, pupil-to-teacher ratios, population density, homicide rates, law criminalizing suicide and the night light index. Results: The overall prevalence of suicide ideation, making a plan and suicide attempt were 10.4%, 10.3% and 11.0%, respectively. The highest prevalence rates reported were from the Americas. The strongest risk factors associated with suicidal behavior included anxiety, loneliness, no close friends and the substance abuse. Among the country level variables, the night light index was associated with making a suicide plan and attempting suicide. Conclusion: The non-significant country level findings were not entirely surprising given the mixed results from prior studies. Additional knowledge is thus achieved with regard to country level factors associated with suicidal behavior across adolescent populations.

Introduction: Traumatic Brain Injuries (TBIs) are a significant source of disability and mortality, which disproportionately affect low- and middle-income countries. The Republic of Seychelles is a country in the African region that has experienced rapid socio-economic development and one in which all deaths and the age distribution of the population have been enumerated for the past few decades. The aim of this study was to investigate TBI-related mortality changes in the Republic of Seychelles during 1989–2018.Methods: All TBI-related deaths were ascertained using the national Civil Registration and Vital Statistics System. Age- and sex-standardised mortality rates (per 100,000 person-years) were standardised to the age distribution of the World Health Organisation standard population.Results: The 30-year age-standardised TBI-related mortality rates were 22.6 (95% CI 19.9, 25.2) in males and 4.0 (95% CI 2.9, 5.1) in females. Road traffic collisions were the leading contributor to TBI-related mortality [10.0 (95% CI 8.2, 11.8) in males and 2.7 (95% CI 1.8, 3.6) in females, P > 0.05]. TBI-related mortality was most frequent at age 20–39 years in males (8.0) and at age 0–19 in females (1.4). Comparing 2004–2018 vs. 1989–2003, the age-standardised mortality rates changed in males/females by −20%/−11% (all cause mortality), −24%/+39.4% (TBIs) and +1%/+34.8% (road traffic injury-related TBI).Conclusion: TBI-related mortality rates were much higher in males but decreased over time. Road traffic collisions were the single greatest contributor to TBI mortality, emphasising the importance of road safety measures.