Maternal intimate partner violence and under five mortality in India: The effect modifying role of caste

In a country such as India where caste systems deeply influence social dynamics, caste systems could modify the association between experiencing intimate partner violence (IPV) and maternal and child health and wellbeing. This study aimed to investigate the association between IPV and child mortality across various caste groups.

The study has a cross-sectional design drawn from the two latest available nationally representative National Family Health Surveys data (2015-2021) in India.

This study included 58,685 mother-child pairs. In the study, the main exposure variable was IPV, measured by women's experiences of emotional, physical, and sexual violence perpetrated by a partner, with caste considered as an effect modifier in the analysis. The outcomes of the study included under five mortality. By accounting for women's and child demographics, logistic regression analysis was used to estimate adjusted odds ratios (aOR) for the association between IPV and infant, neonatal, and under-five mortality stratified by caste.

Women who had experienced IPV had 16 % greater odds of neonatal mortality (1.16, 95 % CI: 1.10-1.23), 17 % greater odds of infant mortality (1.17, 95 % CI: 1.03, 1.33), and 12 % greater odds of under-five mortality (1.12; 95 % CI: 0.98, 1.18). When stratified by caste, IPV exposure among women from upper castes had a 68 % greater in the odds of neonatal mortality (aOR: 1.68, 95 % CI: 1.22, 2.29), 24 % greater odds of infant mortality (1.24, 95 % CI: 1.02, 1.80), and 40 % greater odds of under-five mortality (aOR: 1.40, 95 % CI: 1.09, 1.81). Notably, among lower-caste groups, we observed greater odds of under-five mortality among women who experienced IPV in STs group compared to SCs and OBCs.

IPV is associated positively with neonatal, infant, and under-five mortalities with greater effect in upper than lower caste women. Our findings suggest that addressing IPV in caste-specific situations may be crucial for reducing under-five mortality in India.