Background rn rnIntimate partner violence against women is a psychological, physical, and sexual abuse directedrntowards spouses. Globally it is the most pervasive yet underestimated human rights violation.rnIntimate partner violence against women is known to undermine the physical, mental andrnreproductive well-being of women and children. Since much of this is hidden inside the home, itrnis difficult to document it and work towards its prevention. Empirical data are needed to takernappropriate measures in curbing the problem. rn rnObjective rn rnThe overall aim is to assess the magnitude, associated factors and adverse health effects ofrnintimate partner violence against women, and explore the communityâ€™s perception towards suchrnviolence in East Wollega Zone, West Ethiopia. rn rnMethods rn rnCommunity-based cross-sectional and case-control studies were conducted from January to June,rn2011 using standard World Health Organization multi-country study questionnaire. To assess thernmagnitude, associated factors, and adverse health effects of intimate partner violence againstrnwomen, a sample of 1540 ever married/cohabiting women aged 15-49 years was randomlyrnselected from urban and rural settings of the study area. To examine the association betweenrnintimate partner violence against women and under-five deaths, a sample of 858 biologicalrnmothers aged 15-49 years (286 cases and 572 controls) was included. Cases were biologicalrnmothers of the under-five deceased within two years preceding the survey, whereas controls werernbiological mothers of live under-five matched by age and sex of the child as well as area ofrnresidence. Data were double-entered into Epi DATA and analyzed using SPSS version 19 andrnSTATA 11 and principally analyzed using logistic regression models. rn rnOnline databases were searched from the earliest entry to December 2010 for systematic reviewrnand meta-analysis to assess the effect of intimate partner violence against women on under-five mortality. On the final search, 11 studies from developing countries were inputted into Metaesyrnadd-in for MS Excel version 1.0.4 software for meta-analysis. Random effect model usingrnDerSimonian and Laird's (DL) estimator was used to calculate the pooled estimates of thernstudies. rn rnIn addition, a total of 12 focus group discussions involving 55 men and 60 women werernconducted from December, 2011 to January, 2012 to explore the perceptions of the communityrntowards intimate partner violence against women. Discussants were purposively selected fromrnthe study area. The analyses followed the procedure for qualitative thematic content analysis. rn rnResults rn rnLifetime and current (last 12 months) prevalence of intimate partner violence against womenrnshowed 76.5%; 95% CI, 74.4 to 78.6% and 72.5%; 95% CI, 70.3 to 74.7%, respectively. Thernjoint occurrences of psychological, physical, and sexual violence were 56.9%. The patterns ofrnthe three forms of violence are similar across the time periods. Rural residents (AOR, 0.58; 95%rnCI, 0.34 to 0.98), literates (AOR, 0.65; 95% CI, 0.48 to 0.88), and women autonomy (AOR,rn0.46; 95% CI, 0.27 to 0.76) were at decreased likelihood to have lifetime intimate partnerrnviolence against women. Yet, older women were nearly four times (AOR, 3.36; 95% CI, 1.27 torn8.89) more likely to report the incident. On the other hand, marriage by abduction (AOR, 3.71;rn95% CI, 1.01 to 13.63), male polygamy (AOR, 3.79; 95% CI, 1.64 to 8.73), spousal alcoholicrnconsumption (AOR, 1.98; 95% CI, 1.21 to 3.22), spousal hostility (AOR, 3.96; 95% CI, 2.52 torn6.20), and previous witnesses of parental violence (AOR, 2.00; 95% CI, 1.54 to 2.56) werernfactors associated with an increased likelihood of intimate partner violence against women. rn rnNearly two-thirds (64.1%) of physically abused women had injuries to their body parts. The vastrnmajority (93.3%) experienced symptom of mental distress. Sixty four percent of the abusedrnwomen compared to 41.7% of the non-abused ever had symptom of sexually transmittedrninfections. Furthermore, 16% and 7.2% of the abused women had unintended pregnancy andrntermination of pregnancy, respectively while only 11.3% and 4.8% of the non-abused had thernsame respectively. On the other hand, 82.2% of the cases and 68.6% of the controls everrnexperienced at least an incident of intimate partner violence against them while 61.9% and 50.9% of the respective groups had ever experienced all forms of intimate partner violence.rnIntimate partner violence against women is independently associated with symptoms of mentalrndistress, sexually transmitted infections, unintended pregnancy and termination of pregnancy. rn rnMothers who have ever experienced controlling behavior in marriage were more than four timesrn(AOR, 4.27; 95% CI, 0.97 to 18.89) as likely as mothers who did not to have under-fivernmortality. In addition, mothers who experienced two forms of violence at the same time werernmore than two times (AOR, 2.24; 95% CI, 1.31 to 3.85) as likely as mothers who did not to havernunder-five mortality. Ever experiences of the three forms of maternal intimate partner violencernwere more than two and half times (AOR, 2.55; 95% CI, 1.66 to 3.92) as likely to have the same.rnSimilar effect was observed in meta-analysis, with the mean effect size, 0.23; 95% CI, 0.16 torn0.32 is significantly different from zero and the value of pooled Odds Ratio, 1.34; 95% CI, 1.12rnto1.46). rn rnIn focus group discussions, most of the discussants confirmed that the community has divergentrnviews on the acceptance of intimate partner violence against women. The act is acceptable inrncircumstances of practicing extra marital sexual affairs and suspected sexual infidelity. Mostrndiscussants perceived that the majority of women in their area tolerate the incident due torntraditional beliefs, norms and attitudes of the community and very few, including victims, defendrnthemselves against violent husbands/partners. Biased arbitration is marked by excluding womenrnfrom reconciliatory local elders. The suggested measures by the community to stop or reducernviolence against women targeted provision of education for individuals, family, community, andrnsociety. rn rnConclusion rn rnIn their lifetime, three out of four women experienced at least an incident of intimate partnerrnviolence against them. In the study area, various socio-demographic and behavioral factors arernassociated with intimate partner violence against women. Moreover, intimate partner violencernagainst women negatively affects the physical, mental and sexual/reproductive health of women.rnFurther, it is independently associated with under-five mortality. Measures suggested by the community to stop or prevent the act were focused on provision of education about womenâ€™srnright to individuals, family, community, and society. rn rnRecommendations rn rnThere are needs for an urgent attention at all levels including policymakers, stakeholders andrnprofessionals to alleviate the situation. Involving men in maternal and child health programsrncould be one strategy to address the issue of intimate partner violence against women. Moreover,rnefforts to dispel myths, misconceptions and beliefs of the community should be strengthened.rnFinally, extensive national studies are encouraged to address the issues of intimate partnerrnviolence against women and under-five mortality.