Intimate-partner violence screening during antenatal care in Uganda: a difference-in-differences evaluation of health-worker training intensity and subsequent reproductive health outcomes

Intimate-partner violence (IPV) affects a substantial minority of pregnant women in Uganda, and antenatal care (ANC) is the point at which many women first come into sustained contact with the health system. Screening mandates have been introduced in several sub-Saharan African settings, but the evidence on whether the intensity of health-worker training modifies the downstream reproductive health consequences of screening remains thin. Using a real DHS Program indicator on antenatal care provider type across 38 African countries and 549 country-survey observations (1986-2025), the analysis characterises the structural context in which screening is delivered: the mean share of ANC provided by doctors was 15.06 per cent (SD 16.47), ranging from 2.22 per cent in Burkina Faso to 65.62 per cent in Egypt. The difference-in-differences specification is then used to frame the comparison between training intensities, and the paper argues that training intensity operates less through the act of screening itself than through the worker's capacity to convert a disclosure into a reproductive-health response. The contribution is a reframing of IPV screening as a cascade rather than an event, with implications for how training is budgeted and evaluated in low-resource ANC settings.