Intimate Partner Violence and Women’s Self-Reported Physical Health Status: Evidence from the 2024 Zambia Demographic and Health Survey

Background and Purpose: Intimate partner violence (IPV) is a major public health concern that adversely affects women’s physical, mental, and social well-being. In sub-Saharan Africa, including Zambia, IPV remains prevalent despite ongoing efforts to address gender-based violence. Self-reported health status is a key indicator of overall health and quality of life, yet limited research has examined its relationship with IPV in Zambia using nationally representative data. Guided by the social determinants of health framework, this study examined the association between IPV and self-reported
health status among married women in Zambia.

Methods: This cross-sectional study utilized data from the 2024 Zambia Demographic and Health Survey (ZDHS), a nationally representative survey that employed a stratified two-stage cluster sampling design. The analytic sample consisted of women aged 15–49 years who completed domestic violence module (N ≈ 7,358). The outcome variable included self-reported health status, categorized as “very good,” “good,” or “fair/poor.” The primary independent variable included experiencing any IPV (physical, emotional, or sexual violence), dichotomized as “yes” or “no.” Covariates included age, education level, marital status, employment status, residence (urban/rural), household wealth index, number of children, media exposure, and partner-related characteristics (e.g., partner’s education, employment, and alcohol use). Weighted descriptive statistics and ordinal logistic regression analyses were performed using SPSS version 31.0 (p<.05).

Results: Out of 7,358 married women, 35.1% self-reported their physical health status as overall good, and 20.2% experienced emotional violence, 27.8% physical violence, 9.2% sexual violence, and 36.6% any of these forms of IPV. In the adjusted regression model, married women who experienced emotional violence had lower odds of self-reporting very good physical health status compared to those who never experienced emotional violence(B= -0.44; p<.001). However, experiencing physical violence (B=-0.012; p=.857) and sexual violence (B=0.029; p=.749) were not significantly associated with reporting overall good physical health status. While experiencing any IPV was significantly associated with lower odds of self-reported overall good health status (B= -0.26; p<.001).

Conclusions and Implications: This study study has shown that although IPV remains prevalent among women in Zambia, may not be risk factor for poorer self-reported physical health conditions, particularly experiencing emotional violence and any IPV. However, there is still a need to address non-physical forms of violence, which may have substantial impacts on women’s health conditions. Healthcare providers should be trained to recognize non-physical forms of violence and deliver trauma-informed, culturally responsive care services. At the policy level, strengthening GBV prevention programs and integrating IPV services into national health systems are essential. Finally, expanding community-based interventions and public awareness campaigns can further support prevention and early intervention of violence in Zambia.