Intimate partner violence against married and cohabiting women in sub-Saharan Africa: does sexual autonomy matter?

Cohabitation in sub-Saharan Africa: Does women empowerment matter? Insights from the demographic and health survey

BACKGROUND

Cohabitation is increasingly challenging traditional family structures in sub-Saharan Africa (SSA), marking a significant cultural shift in the region. This rise in non-traditional unions prompts an exploration into the underlying factors, particularly the influence of women's empowerment. Despite the growing prevalence of cohabitation, there remains a notable gap in research examining its connection to women empowerment. This study aims to bridge that gap by investigating the intricate relationship between key indicators of women's empowerment and cohabitation in SSA, offering fresh insights into how changing gender dynamics may be reshaping intimate partnerships in the region.

METHODS

The study is a secondary data analysis of the Demographic and Health Survey (DHS) data of 13 SSA countries. A sample of 124,183 women between the ages of 15 and 49 having information on the outcome of interest were included in the analysis. Descriptive and inferential analyses, including proportions, Pearson's Chi-squared test, and multivariable logistic regression models, were employed to examine the association between women's empowerment indicators and cohabitation. The final regression model is presented in adjusted odds ratios (aOR) with 95% confidence intervals (CI).

RESULTS

We found that cohabitation among women varies widely in SSA, with an overall prevalence of 10.9%-ranging from 50.6% in Liberia to just 0.1% in Senegal. We observed that women with higher levels of acceptance of spousal violence, greater decision-making capacity, and increased general knowledge level were more likely to enter cohabiting relationships. In contrast, women aged 25 and above, those residing in rural areas, those from wealthier households, and those with religious affiliations were less likely to cohabit. Additionally, women whose partners had primary or secondary education had higher odds of cohabitation compared to their counterparts whose partners had no formal education.

CONCLUSION

We conclude that women's empowerment plays a significant role in the rising cohabitation rates in SSA. We postulate that addressing adolescent pregnancies could have a significant impact on reducing the practice of cohabitation among women of reproductive age in SSA. Research directions require longitudinal studies to understand the evolving relationship between empowerment and relationship choices, as well as qualitative inquiries to reveal underlying motivations, and comparative analyses across diverse cultural contexts to deepen insights into the interplay between empowerment and cohabitation decisions.

Men's gender role and attitude toward sexual autonomy of women in India

OBJECTIVE

Sexual autonomy is essential to women's empowerment and crucial to human rights. Measurement of women's sexual autonomy from men's perspective is rare in India, though critical for achieving the sexual and reproductive rights of women who continue to exhibit poor sexual and reproductive health (SRH) outcomes. The study assesses Indian men's attitudes toward women's sexual autonomy and associated factors using a nationally representative sample of men.

METHODS

This study involved a total sample of 101,839 men aged 15-54 covered in the fifth round of the National Family Health Survey (2019-21). Descriptive statistics, bivariate analysis, and binary logistic regression were used to determine predictors of men's favorable attitudes toward the sexual autonomy of women. All the statistical analyses were performed using Stata with a 5% significance level.

RESULTS

Sixty-three percent of men hold a favorable attitude toward women's sexual autonomy. Men's support for women's sexual autonomy was positively correlated with their egalitarian views on household decision-making (AOR: 1.45; CI: 1.41-1.49), higher educational attainment (AOR: 1.34; CI:1.20-1.50), currently married status, media exposure (AOR: 1.17; CI: 1.12-1.21), currently working status, and wealthier household strata (AOR: 1.17; CI: 1.11-1.23).

CONCLUSION

Results suggest promoting gender egalitarian norms through educational campaigns, community workshops held by local leaders, grassroots healthcare professionals, and non-governmental organizations, and broadening existing SRH strategies by including younger, non-literates, unmarried, unemployed, and rural men.

Is sexual autonomy a protective factor against intimate partner violence? Evidence from 27 sub-Saharan African countries

BACKGROUND

Though women in sub-Saharan Africa have increased risk of intimate sexual violence, research on the association between sexual autonomy and intimate partner violence among this population has not received the requisite attention. Consequently, we investigated if sexual autonomy is a protective factor against intimate partner violence among women in sub-Saharan Africa.

METHODS

Secondary data analysis was conducted based on the Demographic and Health Surveys (DHSs) of 27 sub-Saharan African countries from 2008 to 2021. A total of 104,523 married or cohabitating women were included in the study. We applied a multilevel Poisson regression model with robust variance to identify associated factors. Variables with a p-value<0.2 in the bi-variable multilevel Poisson regression analysis were considered for the multivariable analysis. The Adjusted Prevalence Ratio (APR) with its 95% confidence interval (CI) was reported, and variables with a p-value <0.05 were included in the multivariable analysis.

RESULTS

The prevalence of intimate partner violence and sexual autonomy among women in SSA were 32.96% [95% CI: 32.68%, 33.25%] and 88.79% [95% CI: 88.59%, 88.97%], respectively. Women in Sierra Leone had the highest prevalence of IPV (52.71%) while Comoros had the lowest prevalence of IPV (8.09%). The prevalence of sexual autonomy was highest in Namibia (99.22%) and lowest in Mali (61.83%). The MOR value in the null model was 1.26. We found that women who had sexual autonomy are 1.28 times [APR = 1.28, 95% CI: 1.17, 1.40] more likely to experience IPV than women who had no sexual autonomy.

CONCLUSION

This study has demonstrated that sexual autonomy is significantly associated with intimate partner violence, however, it does not necessarily act as a protective factor. The study suggests the need for more education on intimate partner violence targeting women's partners. This can help secure the commitment of the perpetrators to rather become proponents of anti-intimate partner violence and further offer women the necessary support for them to attain their full fundamental rights in all spheres of life.

Trend and spatial pattern of intimate partner rape notifications against women in Northeast Brazil (2013-2022)

OBJECTIVE

To analyze the trend and spatial pattern of intimate partner rape reports against women in Northeast Brazil.

METHODS

Ecological time-series study and spatial analysis with secondary data from the Notifiable Diseases Information System between 2013 and 2022. Gross rape rates were calculated by type of intimate partner and by age group of the victim. Prais-Winsten regression was used to calculate the trend, and the global and local Moran indices were used for spatial analysis.

RESULTS

A total of 5,542 cases of intimate partner rape were reported. Spousal rates ranged from 0.34/100,000 women in 2013 to 0.51/100,000 in 2017, with greater increases between 2018 (1.04/100 thousand) and 2022 (1.28/100 thousand). There was an upward trend in the Northeast as a whole (APC=19.47; 95%CI 15.88-23.22) and in almost all states, except Paraíba and Sergipe. Cases perpetrated by boyfriends (APC=23.90; 95%CI 12.80-36.09) and among women aged 15 to 19 years (APC=22.63; 95%CI 4.18-44.35) showed the highest annual variation. A concentration of high rates was observed in several municipalities in the northwest of Ceará and southeast of Pernambuco.

CONCLUSION

The trend in intimate partner rape rates against women increased in the Northeast, especially among younger women and by boyfriends, with a greater agglomeration of notifications in Ceará and Pernambuco.

Sub-Saharan Irregular Migrant Women's Sexuality: A Qualitative Study in Humanitarian Reception Centers

Irregular female migration to Europe is a growing phenomenon, as more and more women are fleeing their countries of origin due to gender inequality and violence. During the migration process, women experience physical, psychological and social problems that affect their sex lives. The aim of our study is to describe and understand how irregular migrant women living in humanitarian reception centers experience their sexuality at different stages of the migration process. This qualitative phenomenological study collected data through sixteen in-depth interviews with irregular migrant women between January and February 2023. Data analysis was carried out using ATLAS-ti 23.0 software, from which three themes were extracted: (1) The reality of sub-Saharan women's sexuality, (2) In search of a better life: the choice between taking the risk or surrendering, and (3) The sexual revolution among migrants. Sub-Saharan women's sexuality is subject to a complex normative order. The migratory process has severe consequences on migrant women's sex life. The sexual needs of irregular migrant women admitted to humanitarian reception centers undergo a process of change that must be understood by healthcare providers in order to make improvements to care provision.

Is intimate partner violence vertically transmitted among women in sub-Saharan Africa? Evidence from demographic health surveys between 2010 and 2019

BACKGROUND

Violence against women is a major human rights violation, and the continuous occurrence of this can have many implications for women's social and health outcomes. The experience of violence from an intimate partner could be more intriguing, especially if such women experienced their mother's intimate partner violence (IPV) issues. Thus, this study examined the vertical transmission of IPV among women in sub-Saharan Africa (SSA).

METHODS

A total of 97,542 eligible women were drawn from 27 countries in SSA using a retrospective secondary dataset from Demographic Health Surveys conducted between 2010 and 2019. Multivariable analysis was employed to determine the association between the vertical transmission of IPV from mother to daughter and the covariates associated with IPV in SSA at p < 0.05.

RESULTS

The results showed that 40% of the respondents had experienced lifetime IPV, whilst 25% of those women reported that their mothers experienced it in childhood in SSA. Country-specific variations showed the highest prevalence of IPV experienced in Sierra Leone (60%) and the lowest in Comoros (9%). Results from model 1 showed that women who reported that their mothers experienced IPV were found to be significantly more than two times more likely to have experienced any form of IPV compared to those whose mothers did not (aOR = 2.66; 95% CI: 2.59-2.74), after adjusting for cofounders in Model 2, the result still showed that women who reported that their mothers experienced IPV were found to be significantly more than two times more likely to have experienced any form of IPV compared to those whose mothers did not (aOR = 2.56; 95% CI: 2.48-2.63). On the other hand, women with higher-educated partners, women in rural areas, and those from female-headed households were less likely to experience IPV.

CONCLUSION

This study concluded that women whose mothers experienced IPV were more likely to have experienced IPV. Our study also identified that education, rural areas, and female-headed households were protective factors against experiencing IPV. To address the groups of women at higher risk for experiencing IPV, we recommend ensuring that girls complete their education to promote greater wealth and resources.

Intimate partner violence and malnutrition among women of reproductive age in Western Africa: A geostatistical analysis

Intimate partner violence (IPV) is a public health issue, and the experience varies among population sub-groups in Africa. In the West African sub-region, IPV perpetrated against women remains high and is exacerbated by the pertaining cultural milieu. It affects women's health, wellbeing, and nutritional status. We examined the association between women's lifetime experiences of physical, sexual, and emotional IPV and undernutrition by quantifying the association at smaller geographical settings in West African countries. We used a bivariate probit geostatistical technique to explore the association between IPV and undernutrition, combining data from the latest Demographic and Health Survey conducted in ten Western African countries. Bayesian inference relies on Markov chain Monte Carlo simulation. The findings demonstrate spatial clustering in the likelihood of experiencing IPV and being underweight in the regions of Mali, Sierra Leone, Liberia and neighboring Cote d'Ivoire, Ghana, Togo, Benin, Cameroon, and Nigeria. The pattern of clustering was somewhat similar when physical violence was combined with underweight and emotional violence combined with underweight. The findings also indicate protective effects of education, wealth status, employment status, urban residence, and exposure to mass media. Further, the likelihood of experiencing IPV and the likelihood of being underweight or thin declined with age and age-gap between the woman and her partner. The findings provide insight into the location-specific variations that can aid targeted interventions, and underscore the importance of empowering women holistically, in the domains of education, socio-economic and socio-cultural empowerment, in addressing women's vulnerability to IPV and malnutrition (underweight and thinness). Furthermore, IPV prevention programmes will need to address gender inequality and cultural factors such as male dominance that may heighten women's risk of experiencing IPV.

Mapping the disparities in intimate partner violence prevalence and determinants across Sub-Saharan Africa

Objective

This study aimed to map disparities in prevalence and associated factors across countries in Sub-Saharan Africa.

Methods

We used National Demographic and Health Survey (DHS) data from 26 countries in the region with 114,340 participants. Women and girls in the reproductive age group of 15 to 49 years were included in the study. To map disparities across countries and their provinces, we employed the kriging interpolation technique. We used STATA for data management.

Result

The prevalence of physical, emotional and sexual IPV in Sub-Saharan Africa was 30.58, 30.22, and 12.6% respectively, and at least one form of IPV was 42.62%. Disparities were observed across the countries and provinces in each country. Younger age, secondary-level education and above, moderate participation in decision-making, not working out of home, not afraid of the spouse, rich (wealth index), not having a child, high maternal literacy, and rural residence relatively decreased the odds of IPV. The husbands' lower education, alcohol consumption, and high controlling behavior increased the probability of IPV.

Conclusion

The prevalence of Intimate Partner Violence in Sub-Saharan Africa is the highest in the world, a signal that the global agenda to end all forms of violence against women will be difficult to achieve. There is a large gap across countries and provinces in each country. Area-specific intervention packages that focus on modifiable factors should be strengthened.

Exposure to interparental violence and intimate partner violence among women in Papua New Guinea

INTRODUCTION

Evidence suggests that childhood exposure to interparental violence increases the risk of intimate partner violence (IPV) experience or perpetration in adolescence or adulthood. However, it is unclear if exposure to interparental violence increases the risk of IPV among women in Papua New Guinea. This study, therefore, seeks to fill this gap in the literature by examining the association between childhood exposure to interparental violence and IPV among women in Papua New Guinea.

METHODS

We used data from the most recent 2016-18 Papua New Guinea Demographic and Health Survey. We included 3,512 women in our analyses. Past-year experience of IPV was the outcome variable in this study. Exposure to interparental violence was the key explanatory variable. We used a multilevel binary logistic regression to examine the association between exposure to interparental violence and IPV.

RESULTS

We found a higher probability of experiencing IPV among women exposed to interparental violence [aOR = 1.45, 95% CI = 1.13, 1.86] relative to women who were not exposed. Furthermore, we found that women living in rural areas had a lower likelihood of IPV experience [aOR = O.50, 95% CI = 0.32, 0.80] compared to those in urban settings. Finally, a greater odd of IPV experience was found among women staying in the Highlands Region [aOR = 1.44, 95% CI = 1.06, 1.96] compared to those staying in the Southern Region.

CONCLUSION

Exposure to interparental violence was found to be significantly associated with IPV among women in Papua New Guinea. The findings of this study suggest the need for proven operational strategies to reduce IPV, such as improving anti-IPV laws in Papua New Guinea. We recommend the development and implementation of intercession strategies to reduce the experience and justification of violence among women exposed to interparental violence. In addition, health professionals should implement counseling and health education initiatives to tackle the consequences of IPV on women's well-being.

Prevalence, Correlates, and Trends of Intimate Partner Violence Against Women in Gambia: Results From 2 National Cross-Sectional Health Surveys

No country is immune from intimate partner violence (IPV). The objectives of this study were to analyze the prevalence, correlates and trends of this global public health menace perpetrated by men against women using the most recent nationally representative Gambia Demographic and Health Survey (GDHS) 2019-20; with analysis of levels and trends of IPV perpetrated by current/former husbands/partners from ever-married women, from GDHS conducted in 2013, at the 8 subnational regions. IPV association with 12 covariates entailing socio-demographic, experiential and attitudinal characteristics was analyzed in bivariate and multivariable models, using simple and multiple logistic regression. Physical, emotional, and sexual IPV was reported by 29.09%, 24.03%, and 5.52% respectively. While prevalence of having experienced any type of IPV was39.23%. Statistically significant association of IPV with various covariates computed in univariate analysis were used in the multivariable logistic regression model. Women's and husband's educational attainment, wealth status, having witnessed father physically beat mother, and marital control exhibited by the husband were statistically significantly associated with IPV, in the final model. Physical, emotional, and sexual IPV increased from 2023 to 2019-20 in all 8 regions, with the exception of sexual IPV in Kanifing region. However, not all these changes were not statistically significant. Physical and sexual IPV prevalence in Gambia was slightly lower compared with the African region. The disturbing finding of increase in all 3 types of violence in all regions-with one exception-paints a dire scenario that augurs the imperative of women empowerment and revisiting of cultural norms for protecting women.

Partner alcohol consumption and intimate partner violence against women in sexual unions in sub-Saharan Africa

INTRODUCTION

Intimate partner violence is increasingly gaining attention as the leading form of violence against women globally, particularly sub-Saharan Africa. Given that substance abuse, especially alcohol consumption has long been associated with aggressive behaviour, emotional abuse, and sexual misconduct, it is surprising that studies on the potential association between partner's alcohol consumption and intimate partner violence are scarce. The current study seeks to fill this gap in the literature by examining the association between partner's alcohol consumption and intimate partner violence among women in sub-Saharan Africa.

METHODS

Cross-sectional survey data of 89,229 women aged 15 to 49 in sexual unions from 21 sub-Saharan African countries were pooled from the Demographic and Health Surveys. Percentages with their corresponding confidence intervals (CIs) were used to present the results of the prevalence of partner's alcohol consumption and intimate partner violence. Multivariable binary logistic regression analysis was used to examine the association between partner's alcohol consumption and intimate partner violence. The regression analysis results were presented using adjusted odds ratio (aOR) with 95% CI. Statistical significance was set at p<0.05.

RESULTS

The pooled prevalence of partner alcohol consumption was 36.3% [36.0-36.6]. The highest prevalence of partner alcohol consumption was found in Burundi (67.1%) with Mali (3.9%) recording the lowest prevalence. Similarly, the overall prevalence of physical violence, emotional violence, and sexual violence among the women were 19.7% [19.2-20.2], 25.0% [24.5-25.5], and 9.7% [9.3-10.1], respectively. In the pooled data, women whose partners consumed alcohol were more likely to experience physical violence [aOR = 2.37, 95% CI = 2.24-2.50], emotional violence [aOR = 1.96, 95% CI = 1.86-2.07], and sexual violence [aOR = 2.03, 95% CI = 1.89-2.18] compared to those whose partners did not consume alcohol. In all the 21 countries, women whose partners consumed alcohol had higher odds for physical and emotional violence. The odds of sexual violence was higher among women whose partners consumed alcohol compared to their counterparts whose partners did not in 20 countries, except Namibia.

CONCLUSIONS

We found that partner's alcohol consumption increases women's likelihood of experiencing physical, emotional, and sexual violence in sub-Saharan Africa. There is the need to implement behavioural change interventions targeted at male partners to reduce alcohol consumption. The findings call for the need to effectively create and organize support networks in addressing intimate partner violence among married and cohabiting women.

Women's Autonomy and Intimate Partner Violence in Peru: Analysis of a National Health Survey

To assess the association between women's autonomy and intimate partner violence (IPV) against women of childbearing age. Secondary analysis of the 2019 Demographic and Family Health Survey (ENDES-acronym in Spanish) was carried out. The study population was women aged 15-49 years who are currently married or living with a partner. A Poisson family generalized linear regression model was estimated to calculate adjusted prevalence ratios (aPR) for the association between women's autonomy and IPV with their respective 95% confidence intervals (CI). Data from 18,621 women were analyzed. The highest proportion of women had low autonomy (low: 42%; moderate: 39.2%; high: 18.8%). A prevalence of IPV of 40.1% was found (psychological/verbal: 38.8%; physical: 8.8%; sexual: 2.3%). The adjusted model found that women with a low level of autonomy (aPR: 1.15, 95%CI: 1.01-1.31) had a higher prevalence of IPV compared to women with high autonomy. This association was also found for the specific case of psychological/verbal violence (aPR: 1.15, 95%CI: 1.01-1.31). No association was found between women's level of autonomy and physical or sexual violence by a partner. Four out of 10 women of childbearing age have experienced IPV in the last 12 months. In general, women with lower levels of autonomy are more likely to present IPV compared to women with high autonomy.