Melissa Hidrobo, Harold Alderman, Negussie Deyessa, Dan Gilligan, Parthu Kalva, Jessica Leight, Michael Mulford, and Abaydar Workie REGIONAL WORKSHOP SPIR II Learning Event Co-organized by IFPRI, USAID, CARE, ORDA, and World Vision MAY 16, 2023 - 9:00AM TO MAY 17, 2023 - 5:00PM EAT

1. SPIR II RFSA | 2023 Learning Event
IPV outcomes from
gPM+ intervention
Melissa Hidrobo, Harold Alderman, Negussie Deyessa, Dan Gilligan, Parthu Kalva, Jessica
Leight, Michael Mulford, and Abaydar Workie,
2023

2. Introduction
• Food insecurity, common mental illness, and intimate partner
violence are inter-related in complex ways.
• Food insecurity can contribute to common mental illnesses such
as depression and anxiety.
• Common mental illnesses can increase vulnerability to intimate
partner violence, and IPV on the other hand can worsen mental
health issues.
• These inter-relationships are influenced by socioeconomic factors
and cultural norms.
• Addressing these issues requires a comprehensive approach
considering their interconnected nature.
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3. Objectives
General Objective
• To assess the relationship of IPV with common mental health problems and
their comorbidity among women of the Productive Safety Net Program
(PSNP) in the regions of Amhara and Oromia.
Specific objectives
• To assess the magnitude of IPV, and common mental health
problems among women supported by safety net program
• To determine the association between IPV with common mental
health problems,
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4. Methods
Study setting
• This study serves as the baseline for evaluating the effectiveness of the Group
Problem Management Plus (gPM+) psychotherapy program.
• The study was conducted in 13 Woredas, with 5 Woredas (Oromia region) and 8
Woredas (Amhara region).
• The targeted areas have implemented support measures for vulnerable
households, such as providing food or cash transfers through payments for
seasonal labor on public works.
• Unfortunately, these Woredas have faced numerous adverse events that have
significantly impacted their communities, including
• Political conflicts, + The COVID-19 pandemic,
• Fall armyworm outbreaks, + Drought conditions, and
• Infestations of desert locusts.
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5. Cont…
Study design
• It used a cross-sectional design as a baseline for the Group Problem
Management Plus intervention.
Source/ target population
• Source population were women of reproductive age of 18 or more who
lived and are supported by safety net.
• Individuals who had symptoms of depression (PHQ-9 score of 5-19) or
dysfunction (WHO-DAS-12 score of 17 or more).
• Women who are in a marital union, and main decision-maker or spouse
of a household
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6. Cont…
Sample size
• As part of GPM+ the study planned to include study participants from 272
villages Sampling 15 individuals per village leading to a total sample of 4,080.
• The study assumed magnitude of common mental problem or dysfunction would
be higher among women to give higher precision of 0.035.
• Magnitude of IPV of one in three with design effect of 2.0 for clustered
distribution of women, the study needs a total of 1386.
• The study took a total of 1230 women were included in the study
Sampling.
Multistage sampling,
First: testing for Eligibility of being head or spouse of head
Second, Screening for depression status and functional disability
Baseline assessment for sociodemographic and IPV and others
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7. Sampling
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8. Data collection
• Data collected using a face to face interview, of which women were
interviewed by female data collectors
• IPV was measured using the WHO-multi-country study questionnaire
• Common mental illness, including
• Depressive disorder [by PHQ-9],
• Functional dysfunction [WHO-DAS-12]
• Generalized anxiety disorder [GAD-7],
• Post traumatic Stress Disorder (PCL-5, civilian version)
• Socio-emotional characteristics
• Perceived Stress [PSS-10]
• Perceived Social Support [Friend, Family, and others]
• General Self-efficacy
• Brief Coping Scale 8

9. Analysis
• Data retrieved and exported
in IBM-SPSS-V-27
• Descriptive analysis
• Analytic analysis
• Regression [logistic regression]
• Bivariate analysis of
determinants
• Multivariable analysis
• Ethical approval from EPHA
[ref: EPHA/06/875/22, on June 27, 2022, ]
• Response in voluntary basis
• Informed Consent
• Privacy, confidentiality
• Women survivors, informed for service and
referral for those who need it
• Women who had severe depression, or had
suicidal attempt were referred to psychiatric
clinic [with follow up until health facility]
Ethical review
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10. Current and life-time prevalence of IPV
Violent acts Frq Per cent [95% CI]
in a lifetime
Emotional violence 253 20.5 [17.5, 23.8]
Physical violence 199 16.1 [13.5, 19.0]
Sexual violence 113 9.1 [7.2, 11.5]
Physical or sexual
violence
241 19.5 [16.7, 22.5]
in the last 12 months
Emotional violence 227 18.3 [15.5, 21.5]
Physical violence 146 11.8 [9.8, 14.2]
Sexual violence 94 7.6 [6.0, 9.5]
Physical or sexual
violence
190 15.3 [13.1, 17.9]
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11. Overlapping nature
Intimate partner violence lifetime and the 12 months
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12. Magnitude of common mental disorders
Characteristics’ Frequency Percent [95% CI, of %]
Depression status (PHQ-9)
Mild depression [5-9
Moderate to severe [10-19]
744
159
60.1
12.8
[57.3, 64.2]
[10.1, 16.3]
Generalized Anxiety disorder
Mild Anxiety
Moderate to Severe
563
119
45.5
9.6
[42.9, 48.3]
[6.3, 14.6]
Post-traumatic stress disorder
Presence 441 35.6 [32.0, 40.4]
Perceived stress
Moderate stress
High perceived stress
914
165
73.8
13.3
[70.2, 76.3]
[10.9, 16.9]
Comorbidity
One disorder
Two disorders
Three or more disorders
575
392
136
46.4
31.7
11.0
[41.6, 50.4]
[28.6, 35.3]
[8.0, 15.3]
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13. Characteristics Current IPV
n (%)
Crude
OR (95% CI)
Adjusted (Model 1)
OR (95% CI)
Adjusted (Model 2)
OR (95% CI)
Depression status (PHQ-9)
None
Mild depress
Moderate to severe
48 (14.3)
112 (15.1)
190 (18.9)
1.00
1.03 (0.69, 1.52)
1.37 (0.68, 2.79)
1.00
1.10 (0.73, 1.67)
1.35 (0.70, 2.59)
1.00
1.10 (0.73, 1.67)
1.35 (0.70, 2.59)
Generalized Anxiety disorder
None
Mild Anxiety
Moderate to Severe
55 (9.9)
101 (17.9)
34 (28.6)
1.00
1.94 (1.32, 2.90)
3.43 (1.81, 6.49)
1.00
2.22 (1.59, 3.11)
4.07 (2.38, 6.96)
1.00
1.87 (1.32, 2.66)
2.80 (1.66, 4.71)
Post-traumatic stress disorder
No
Yes
90 (11.3)
100 (22.7)
1.00
2.18 (1.45, 3.27)
1.00
2.35 (1.72, 3.21)
1.00
1.84, (1.32, 2.57)
Perceived stress
None or minimal
Moderate stress
High perceived stress
12 (7.5)
136 (14.9)
42 (25.5)
1.00
1.89 (1.09, 3.29)
3.64 (1.77, 7.49)
1.00
1.81 (1.12, 2.92)
3.94 (2.13, 7.27)
1.00
1.51 (0.91, 2.50)
2.37 (1.20, 4.69)
Comorbidity
No disorder
One disorder
Two disorders
Three or more disorders
9 (6.7)
71 (12.3)
71 (18.1)
39 (28.7)
1.00
1.83 (0.95, 3.51)
2.80 (1.29, 6.09)
4.90 (2.16, 11.1)
1.00
1.74 (0.91, 3.33)
2.82 (1.42, 5.59)
5.44 (2.71, 10.9)
1.00
1.59 (0.82, 3.08)
2.15 (1.03, 4.49)
3.59 (1.77, 7.27)
Model 1. Age, region, occupation, and number of members in a household
Model 2 Age, region and number members, number worrying conditions, brief
coping, general self-efficacy, perceived social support (all)
Common
mental
disorder
correlates
of
IPV
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Model 1 Model 2
Model 1
Model 2

14. Conclusion
• The three types of IPV are prevalent but are found in relatively
moderate magnitude.
• Experiencing IPV was relatively higher among women with symptoms
common mental disorders and in their comorbid form.
• Some socio-emotional factors are associated with experiencing IPV,
resembling in a mediator form although needing further investigation.
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15. Recommendation
• Practitioners should consider the impact of IPV on women's mental
health when diagnosing common mental disorders.
• Researchers should investigate the relationship between IPV and
mental health problems in women, focusing on how they interact,
mediate, or modify each other and socio-emotional factors.
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