Intimate partner violence and unmet need for family planning in the Democratic Republic of the Congo: A secondary analysis of the moderating role of reproductive coercion using performance monitoring for action data

AI Summary

Recent sexual IPV is associated with increased unmet need for family planning (aCoef 0.12, 95% CI 0.04 to 0.21).
Reproductive coercion amplifies the association between sexual IPV and unmet need, yielding a higher adjusted coefficient (aCoef 0.24, 95% CI 0.03 to 0.44).
Findings underscore integrating IPV screening and response into sexual and reproductive health services and policy in the DRC and sub-Saharan Africa.

PLoS One. 2026 May 5;21(5):e0331236. doi: 10.1371/journal.pone.0331236. eCollection 2026.

ABSTRACT

INTRODUCTION: Intimate partner violence (IPV) has harmful effects on women’s physical, mental, and reproductive health. This study investigates the relationship between experiencing IPV and unmet need for family planning in two provinces of the Democratic Republic of the Congo (DRC), emphasizing the potential mediating effect of reproductive coercion. To our knowledge, this is the first examination of the connection between IPV and unmet need for family planning in the DRC, particularly regarding the underlying mechanisms of this association.

MATERIALS AND METHODS: This research utilized secondary data from the third wave of the Performance Monitoring for Action (PMA) surveys carried out in two provinces of the DRC during the period from 2021 to 2022. The analysis focused on a sample comprising 1,387 women in unions aged between 15 and 49 years. To investigate the relationship between IPV and unmet need for family planning, linear probability models were employed and various factors were controlled. Additionally, we explored the moderating influence of reproductive coercion in this context.

RESULTS: The linear probability model indicated that experiencing sexual IPV within the past 12 months was linked to an unmet need for family planning [aCoef = 0.12, CI95% = 0.04-0.21]. When sexual IPV occurred alongside reproductive coercion, a stronger correlation with unmet need was detected [aCoef = 0.24, CI95% = 0.03-0.44].

CONCLUSION: We showed that sexual IPV is associated with an unmet need for family planning in the DRC. While IPV should be considered a policy target, these results emphasize the importance of responding appropriately to IPV when sexual and reproductive health services are provided to women. This was the first study on the DRC and, more generally, on sub-Saharan Africa (SSA) to illuminate the underlying mechanisms of the association, revealing the moderating role of reproductive coercion.

PMID:42085434 | DOI:10.1371/journal.pone.0331236

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