Social Determinants of Intimate Partner Violence (IPV) Among Women In Zambia: Evidence from the 2024 Zambia Demographic and Health Survey

Background and Purpose: Intimate partner violence (IPV) remains a major public health and human rights concern in sub-Saharan Africa, with severe consequences for women’s physical, mental, and social well-being. In Zambia, despite policy and legal frameworks aimed at reducing gender-based violence (GBV), IPV still persists and continued to be shaped by complex social, cultural, and economic conditions, structural inequalities, gender norms, and household dynamics. Therefore, using social determinant of health framework, this study examined several factors associated with IPV among married women using a nationally representative sample in Zambia.

Methods: This cross-sectional study used data from the 2024 Zambia Demographic and Health Survey (ZDHS) and employed a stratified two-stage cluster sampling design. The analytic sample included married women aged 15–49 years (N≈5,904) who participated in domestic violence module. The outcome variable included experiencing any IPV (physical, emotional, or sexual violence), dichotomized as “yes” or “no.” Independent variables were guided by a social determinants framework and included women’s characteristics (age group, education level, religion, employment status, resident type, household wealth index, number of children, and media exposure) and husband-related characteristics (husband’s age, education level, work status, and alcohol use). Weighted descriptive statistics were used to obtain the frequencies and percentages. While multivariate logistic regression analyses were conducted to estimate odds ratios (OR) between predictors and outcome using SPSS vs.31.0 (p<.05).

Results: Out of 5,904 married women, 36.6% of them reported experiencing any IPV. Regression model showed that women in the age groups 20-29 (OR=1.34; p<.038), 30-39 (OR=1.50; p<.012), and 40-49 (OR=1.58; p<.013) had higher odds of experiencing IPV than those aged 15-19. Similarly, women living in rural areas were associated with higher odds of experiencing IPV compared to those living in urban areas, though this was marginally significant (OR=1.18; p>.059). Women who were currently working had higher odds of reporting IPV compared to those not working (OR=1.24; p<.001). Women who had completed at least primary education (OR=1.25; p<.039) had greater odds of reporting IPV, while those with higher education had lower odds of IPV (OR=0.54; p<.001) compared to women without education. Additionally, women with husbands who were older (50+ years) had lower odds of experiencing IPV compared to those with younger husbands (16-29 years; OR=0.72; p<.001). However, women whose husbands were employed had higher odds of experiencing IPV compared to those whose husbands never worked (OR=1.38; p<.001). Finally, women whose husbands frequently used alcohol were associated with higher odds of experiencing IPV compared to those whose husbands never used alcohol (OR=3.76; p<.001).

Conclusions and Implications: This study shows that IPV remains widespread and is affected by social and structural factors, such as age, education, employment, and husband’s alcohol use. Thus, multilevel interventions are needed to promote women’s education, reducing harmful alcohol use among men, and promoting gender-equitable norms and practices. Culturally responsive, multilevel strategies are needed to address IPV within larger public health and socioeconomic settings. Improving community-based prevention and support services is key to lowering IPV and improving women’s safety and well-being, particularly those living in low-resource settings in Zambia.