Intimate Partner Violence (IPV) and Depressive Symptoms Among Currently Married Women In Zambia

Background and Purpose: Intimate partner violence (IPV) is a major public health and human rights concern that disproportionately affects women in sub-Saharan Africa, including Zambia. IPV is associated with a wide range of adverse mental health outcomes, particularly depressive symptoms, which can impair functioning, well-being, and quality of life. Married women may be especially vulnerable due to ongoing exposure to partner-related stressors and gender-based inequalities. Despite growing attention to IPV and mental health, limited nationally representative studies have examined the association between IPV and depressive symptoms among married women in Zambia. Therefore, this study examined the relationship between IPV and depressive symptoms among married women in Zambia.

Methods: This cross-sectional study used data from the 2024 Zambia Demographic and Health Survey (ZDHS), a nationally representative survey of currently married women aged 15–49 years who completed the Patient Health Questionnaire (PHQ-9) and the domestic violence module (N=5,904). The outcome variable included depressive symptoms, measured with the PHQ-9 and dichotomized as none/minimal (0–4) versus mild-to-severe (5–27) during the past two weeks. The primary independent variable included experiencing any IPV, defined as emotional, physical, and/or sexual violence experienced during the past 12 months (yes/no). Covariates included women’s characteristics (marital duration, age group, education level, religion, work status, household wealth index, residence type, health status, health insurance, media exposure, and region) and partner’s characteristics (age group, education, work status, and alcohol use). Weighted descriptive statistics were used to obtain frequencies and percentages. Logistic regression was conducted to estimate the odds ratio (OR) between experiencing any IPV and depressive symptoms, while adjusting for potential confounders using SPSS vs 31.0 (p<.05).

Results: Among 5,904 currently married women, 9.7% reported mild-to-severe depressive symptoms during the past two weeks; 36.6% experienced any IPV; 20.2% experienced emotional violence; 27.8% experienced physical violence; and 9.2% experienced any sexual violence during the past 12 months. After adjusting for other factors in the regression, women who experienced emotional violence (OR=0.69;p<.001) or sexual violence (OR=0.51;p<.001) had significantly lower odds of reporting depressive symptoms during the past two weeks than those without these IPV-related exposures. However, experiencing physical violence was not significantly associated with depressive symptoms during the past two weeks (OR=0.57;p=.260). In addition, women who experienced any of these forms of IPV had lower odds of reporting depressive symptoms during the past two weeks than those without IPV exposures (OR=0.57;p<.001).

Conclusions and Implications: IPV remains widespread among currently married women in Zambia, yet its association with depressive symptoms varies by IPV type and reveals unexpected patterns. The lower likelihood of depressive symptoms among women reporting emotional and sexual violence may reflect underreporting, normalization of violence, or unmeasured protective or contextual factors. These findings underscore the need for careful interpretation and for treating IPV and depression as a multidimensional construct. Social work practice should strengthen culturally responsive mental health support within IPV and mental health services. Policy and research efforts should focus on developing cultural validated measurement assessments of mental health and addressing gender norms to clarify these complex relationships for women in Zambia.