Quality of Life and Prevalence of Intimate Partner Violence in Women With Infertility Versus Well Women at Kenyatta National Hospital: a Comparative Cross-sectional Study 2020

Abstract

Background: The prevalence of infertility in Kenya is one of the highest in Africa; it is an important aspect of reproductive health. At Kenyatta National Hospital (KNH), over 30% of gynecological consultations are related to infertility, which attests to its burden in the country. However, the effect of infertility on the quality of life (QoL) of women and the prevalence of intimate partner violence (IPV) are poorly documented. Objective: To evaluate the QoL and prevalence of IPV among women with infertility versus well women attending clinic at KNH. Methods: A comparative cross sectional study of women seeking treatment for infertility and well women attending clinic at KNH was conducted in 2020. One hundred and twenty two (122) infertile and 122 well women were recruited from infertility, gynecological outpatient clinics, and well woman clinic (clinic 66) and a structured questionnaire was used to collect primary data. The questionnaire was in three sections. The first recorded the socio demographic characteristics of infertile and well women while the second and third section consisted of a World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) questionnaire for evaluating the quality of life and WAST Screen for Intimate Partner Violence. Questionnaires were administered via telephone interviews, in a secluded area of KNH, scored following the directions of World Health Organization and analyzed using statistical package for social scientists (SPSS) version 24. Summary statistics of independent variables were computed and visualized in tables. Mann-Whitney test was used to compare QoL scores and Chi-square test to compare prevalence of intimate partner violence. P value <0.05 was significant. Results: Two hundred and forty four patients (50% infertile and 50% well women) qualified. Infertile women were older (35.02±6.71 years) than well women (32.90±5.94 years) had fewer viable pregnancies (mean=0.58±0.80) compared to well women (mean=2.10±.94), P=0.000, and had significantly more miscarriages (mean=0.66±1.08) than well women (mean=0.12±0.60) (P=0.000). The differences in education level, religion, employment, employment of spouses, the main financier, and the monthly income of infertile compared to well women were not statistically significant.. The mean quality of life scores for infertile women compared to well women were statistically significantly lower in physical domain (10.69±3.21 versus 16.18±4.02), psychological domain (8.61±3.85 versus 15.67±4.54), and social domain (8.65±4.11 versus 15.53±4.59). The mean scores for the environmental domain was lower among infertile women (9.41±3.43) compared to well women (11.28±5.02) but the difference was not statistically significant (P<0.11). The prevalence of intimate partner violence was 27.5%, and 3.516 fold (95% CI=1.94-6.30) statistically significantly higher among infertile women compared to well women (P<0.01). Conclusion: Infertility was associated with lower scores for physical, psychological and social quality of life domain scores. Intimate partner violence was predominant in infertile women.