**5. Discussion**

The findings of this study revealed that approximately one-third (29.0%) of currently married Bangladeshi women with children below the age of five years experienced any form of physical or sexual IPV in the past year. In Bangladesh, maternal experience of any physical or sexual IPV was associated with increased risk of diarrhea, ARI, fever, and any illness in children aged younger than five years. The findings of an increased risk of childhood diarrhea and ARI of abused women was in accordance with previous reports in Bangladesh (Silverman et al., 2009) of an association between physical or sexual partner violence and diarrhea and ARI of the child. Other study outside South Asia ( Karamagi et al., 2007) found mixed evidence for an association between maternal lifetime IPV and common childhood illness. The current research expands on these previous two studies by using a large national sample from Bangladesh and added information on the association between maternal physical or sexual IPV and all common childhood illness.

Another important new finding was that a combination of both physical and sexual IPV appeared to have more profound consequences on the outcome measured. Previous studies found that experienced of both physical and sexual IPV are stronger predictors of long-term negative physical and mental health outcomes of mothers (Ferri et al., 2007; Peter, 2004; Cripe et al., 2008; Bizu et al., 2010). Its impact on mental health can be as serious as its physical impact, and may be equally long lasting. Evidence has shown that such negative physical and mental health outcomes reduce a mother's ability to cope with the everyday needs of a small child and diminish the quality of different care-giving behaviors; this in turn leads to the negative health consequences for her children (Marie, Carol, & Armar-Klemesu, 1999; Stewart, 2007). Our results, therefore, indicate that the prevention of both physical and sexual violence from husbands is important for the improvement of childhood morbidity status in Bangladesh.

Currently identified associations of any physical or sexual IPV with all common childhood illness provide a critical context for the elevated rates of infant and early childhood deaths demonstrated in prior work (Jejeebhoy, 1998; Ahmed, Koenig, Stephenson, 2006; Leland & Subramanian, 2009) among women who experience IPV (i.e., the currently documented increased rates of diarrhea, ARI and fever likely relate to increased risk of child death).

Some limitations should be considered when interpreting our findings. First, the current analyses are cross-sectional and, thus, do not allow for assessment of the chronology of the associated events or inferences regarding causality. Longitudinal research regarding the relations of IPV to childhood morbidity outcomes is needed to provide clarity regarding these concerns. Second, though psychological violence is an important fact of IPV (Leland & Subramanian, 2009), this information was not available in the current study. Finally, the possibility of underreporting must also be considered; because IPV is by nature a private phenomenon and one that is often stigmatized, women may be reluctant to reveal their abuse status. However, the personal interview method used in this study is widely used for this type of IPV research (Fried at al., 2006). In addition, to ascertain physical and sexual IPV, this study used multiple, behaviorally-specific questions, which are considered the best, methodologically, for eliciting correct responses (Leland & Subramanian, 2009; Straus, 1979).Moreover, according to the BDHS interviewers were provided training for implementing the domestic violence module based on a training manual specially developed to enable the field staff to collect violence data in a secure, confidential, and ethical manner, in order to create a safe atmosphere in which respondents would feel comfortable discussing this issue (NIPORT, 2009). In addition, the domestic violence module was administered at the end of the interview, so that both interviewers and respondents become well acquainted with each other by the time they reach the section on domestic violence.
