Meeting the needs of women experiencing violence in low and middle-income countries: Assessing and addressing reproductive coercion and intimate partner violence in Nairobi, Kenya

Publication Date


Document Type


Publication Title

Annual Public Health Association (APHA) 2018 Annual Meeting & Expo

Conference Location

San Diego, CA


Background: Reproductive coercion (RC), describes a specific set of behaviors associated with, but independent of, intimate partner violence (IPV), that attempt to control women’s fertility decisions and contraceptive use. Previous studies found RC to be prevalent in the U.S. but few have evaluated RC in low and middle-income countries (LMICs). This study assesses the prevalence of RC and IPV among family planning clients in Nairobi, Kenya. Methods: We analyzed formative data collected to inform adaptation and evaluation of a clinic-based intervention to reduce RC, Addressing Reproductive Coercion in HEalth Settings (ARCHES). Data were collected from female clients (n = 150, 15 – 49 years) seeking family planning at four community-based clinics in Nairobi, Kenya. Initial prevalence estimates for lifetime and past 12-month experiences of RC and IPV were calculated along with associated demographic and reproductive health characteristics. Results: We found higher RC prevalence than previous studies, with 40% of women reporting lifetime experience of RC and 17% in the past year. Over half of women reported experiencing physical IPV. Experiencing RC was positively and significantly associated with IPV (physical and sexual), but these forms of GBV were not collinear. Conclusions: RC appears to be extremely prevalent in this context, indicating a need for interventions that directly address this threat to women’s reproductive autonomy. Screening for IPV only, one of the common clinic-based interventions to address GBV, would miss 26.4% of cases of RC in this sample. Models to address RC should be adapted to and evaluated in these high-need settings.


Domestic Violence, Reproductive Health


Social Work