Social inequalities in women exposed to obstetric and gyneco-obstetric violence in Ecuador: a cross-sectional study

BACKGROUND: Obstetric and gyneco-obstetric violence (OV, GOV) is a concerning public health problem, particularly in Latin America. This study aimed to determine the prevalence of OV and GOV and to assess its socio-geographical distribution in Ecuador. METHODS: This cross-sectional study used data from a national survey conducted in 2019 (n = 17,211) among women aged 15 years and over. Independent variables included age, marital status, education, ethnicity, place of residence and region. The chosen outcomes were lifetime experience of OV and GOV. Frequency tables were calculated and crude and adjusted regression models estimating prevalence ratios and their 95% confidence intervals were computed. RESULTS: Nearly one-third (32.8%) of the participants had experienced OV and two-fifths (41.86%) GOV at least once in their lifetime. Prevalence of OV were particularly common in women 26–35 and 46–55 years old, with primary or middle education and in urban regions. In comparison, GOV had a higher prevalence in women aged > 65 years and with no formal education. Both subtypes of violence were more common among women with current or earlier partners compared with the single ones. Also the two outcomes were more prevalent in the non-white population, OV among the populations of colour (POC), while GOV both, in the POC and Indigenous group. Additionally, women from the Highlands and Amazon reported higher OV and GOV than the Coastal group. CONCLUSION: Our study showed that OV and GOV are common in Ecuador and identified an unequal distribution of their prevalence across different socio-geographical groups. Further studies including more social factors and a continuous monitoring of OV and GOV are recommended. Current policies, laws to protect women and guidelines regarding the treatment of women, particularly in health care settings, need to be constantly advocated for and effectively implemented in the country.