Multilevel Analysis of Intimate Partner Violence and Associated Factors Among Reproductive-Age Women: Lesotho Demographic and Health Survey 2023 to 2024 Data

Intimate partner violence (IPV) is a major public health issue, particularly in low- and middle-income countries, where factors such as gender inequality, economic dependence, and limited legal protections contribute to its high prevalence. Despite the serious health consequences of IPV for survivors, there is a lack of research on it and its associated factors among women in Lesotho. This study used data from the 2023 to 2024 Lesotho Demographic and Health Survey, a nationally representative cross-sectional survey, to determine the prevalence of IPV among reproductive-age women in Lesotho and its associated factors. A total of 1,687 women aged 15 to 49 who had ever been married were included in the study. To ensure representativeness, weighted estimates were applied in the analysis using STATA version 17. A cross-sectional study design was used, and data were analyzed using descriptive statistics and multilevel logistic regression to examine individual and community-level factors associated with IPV. Statistically significant variables were identified using adjusted odds ratios (AOR) with a 95% confidence interval (CI). The overall prevalence of IPV was found to be 41.68% (95% CI [39.35, 44.05]). Factors associated with IPV included depressive symptoms (AOR = 1.55 [1.04, 2.30]), current tobacco smoking (AOR = 1.71 [1.10, 2.64]), having an alcoholic partner (AOR = 2.07 [1.58, 2.71]), having a jealous partner (AOR = 4.1 [3.13, 5.36]), and women justifying wife-beating (AOR = 1.57 [1.11, 2.21]). The prevalence of IPV among reproductive-age women in Lesotho is high. Individual and partner-related factors contribute significantly to its occurrence. Strengthening legal protections addressing issues such as women’s justification of wife beating, expanding access to mental health services, and implementing community-based education programs on substance use are recommended to reduce IPV in Lesotho.