Social determinants of violence against women in Panama: results from population-based cross-sectional studies and a femicide registry

BACKGROUND: We aimed to investigate the prevalence of violence against women (VAW) in Panama and its association with social determinants of health (SDH) and to estimate the femicide rates from 2014 to 2017. METHODS: Data were derived from three cross-sectional population-based studies. Logistic regression models were used to estimate the association between SDH and VAW, expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Age-standardized femicide rates were estimated using data from the Public Ministry. RESULTS: Compared to the reference categories, women in the lowest quintile (Q) of income distribution (Q1: OR 4.0 [95% CI 1.4–11.7], Q2: OR 3.0 [95% CI 1.1–7.9]), divorced/separated women (OR 1.5 [95% CI 1.0–2.1]) and those in the age categories 25–33 y and 34–49 y (OR 1.9 [95% CI 1.2–3.1]) were more likely to have experienced violence in the past year. Indigenous ethnicity (OR 2.3 [95% CI 1.3–4.1]), age 15–19 y (OR 1.8 [95% CI 1.1–2.9]) and lowest education levels (very low: OR 4.7 [95% CI 1.4–15.5]; low: OR 4.5 [95% CI 1.4–14.6]) were associated with permissive attitudes towards violence. Indigenous (OR 2.7 [95% CI 1.3–6.1]), Afro-Panamanians (OR 3.1 [95% CI 1.3–7.6]) and education level (low: OR 2.5 [95% CI 1.2–4.9]; medium: OR 3.0 [95% CI 1.4–6.6]) were associated with physical/sexual intimate partner violence. Standardized adjusted femicide rates (×100 000) from 2015 to 2017 were 1.5, 0.9 and 0.8, respectively. CONCLUSIONS: Our findings highlight the importance of prevention programmes.