Background : Intimate partner violence (IPV) is the most common type of violence experienced by women globally. The Middle East has some of the highest IPV prevalence worldwide, in particular, Afghanistan, Egypt, Jordan and Pakistan with prevalence ranging from 39% to 87%. The relationship between IPV and childhood morbidity is not well understood. Nonetheless, poor child health outcomes have been linked to homes with IPV. There also is a general lack of research that considers childcare practices when examining the relationship between IPV and child health. The study aims to investigate the association between maternal exposure to IPV and under-5 childhood morbidity taking into account childcare practices. Study Design: Secondary data analysis utilizing data from Demographic and Health Surveys collected in the 2015, 2014, 2017-2018 and 2017-2018 for Afghanistan, Egypt, Jordan, and Pakistan respectively. The study examined the association between IPV and under-5 years childhood morbidity in Afghanistan, Egypt, Jordan, and Pakistan, taking into account the mediating effect of childcare practices. The IPV exposure was assessed through the DHS domestic violence module while the outcome was defined as diarrhea, fever, or ARI experience by the child in the two weeks preceding the survey. Results: The study identified several contextual and individual level factors associated with IPV. Younger, less educated women, with less educated husbands, who are less wealthy and have more children were more likely to experience IPV. The study identified a strong association between IPV and under-5 child illness signs in Afghanistan (OR 2.32, 95 % CI 2.05-2.63) , Egypt (OR 2.02, 95 % CI 1.65-2.48) and Jordan (OR 2.08, 95 % CI 1.54- 2.83).This relationship was not observed in Pakistan (OR 1.17, 95 % CI 0.93-1.47).Childcare practices were found to have no mediation effect on the association between IPV and child illness.

Conclusion: The study provides evidence that IPV is a major public health problem affecting not only women, but also their children. Our finding supports designing IPV interventions that integrate IPV screening into routine neonatal care and childcare visits. This approach will not only contribute to monitoring and prevention of IPV but could also reduce child morbidity.