An examination of physical violence against women and its justification in development settings in Uganda

Using Vignettes to Gain Insights Into Social Norms Related to Voluntary Family Planning and Gender-Based Violence in South Sudan

Social norms are the shared expectations about behaviors that are held within collective groups. These differ from attitudes and beliefs, which are individually held. In South Sudan, social norms can affect the use of voluntary family planning and reproductive health (FP/RH); some of these norms even present risks for women seeking FP/RH care and their FP/RH providers. This cross-sectional, descriptive study conducted in 5 counties in South Sudan used vignettes as a qualitative method to explore social norms related to FP/RH and decisions related to contraceptive use and gender-based violence. Participants were asked to respond to vignettes about a fictional couple during various life stages of care-seeking. Vignettes allow respondents to share their opinions and feelings without directly speaking about their own experiences. Respondents included community members, FP/RH providers, and key influencers (e.g., religious leaders, traditional leaders, elders). The study identified restrictive social norms related to FP/RH, including entrenched, dominant gender roles (i.e., requiring male consent to use contraceptives) and risk for the woman and her provider if she accesses FP/RH services. Of note, supportive social norms are gaining acceptance regarding women's voice and agency; it was found that some women can negotiate their reproductive choice with their partners and participate in planning their families, which has not always been a widely accepted norm. The use of vignettes can lead to a better understanding of the challenges and provide insights on effective implementation approaches. It is essential for programs working to promote the use of FP/RH services in South Sudan to consider the challenges presented by social norms. Findings from this study were shared with stakeholders and communities to codesign interventions aimed at increasing the use of FP/RH services. Additionally, the dialogue stimulated by this study should lead to an organic transformation toward supportive social norms through collective agency.

Changing the mindsets? Education and the intergenerational spread of tolerance for physical violence against women in Zimbabwe

We investigate the relationship between childhood exposure to interparental violence and adult tolerance for violent beliefs against women. For individuals who have witnessed parental violence in childhood, our analysis suggests a 14.3-15.2 percentage point (pp) increase in tolerance, highlighting the transmission of violent beliefs across generations. Leveraging Zimbabwe's 1980 education reform as a natural experiment through a regression discontinuity design, we explore the potential of increased education to disrupt this intergenerational transmission. The reform led to an approximately two-year increase in female education, with a more pronounced impact in rural areas. This educational boost is associated with an estimated 4.1-7.9 pp reduction in tolerance for violence, especially among those who witnessed parental violence in childhood. We identify four primary mechanisms contributing to this reduction in tolerance: enhanced access to information, increased help-seeking behaviours, improved labour market outcomes, and higher educational levels among partners. Our findings underscore the effectiveness of educational policies in reducing tolerance for violence against women within low-income contexts such as Zimbabwe, thereby disrupting its intergenerational transmission. Moreover, these results emphasise the potential of education-based interventions in addressing the broader issue of violence against women in low-income countries.

A qualitative quantitative mixed methods study of domestic violence against women

BACKGROUND

Violence against women is one of the most widespread, persistent and detrimental violations of human rights in today's world, which has not been reported in most cases due to impunity, silence, stigma and shame, even in the age of social communication. Domestic violence against women harms individuals, families, and society. The objective of this study was to investigate the prevalence and experiences of domestic violence against women in Semnan.

METHODS

This study was conducted as mixed research (cross-sectional descriptive and phenomenological qualitative methods) to investigate domestic violence against women, and some related factors (quantitative) and experiences of such violence (qualitative) simultaneously in Semnan. In quantitative study, cluster sampling was conducted based on the areas covered by health centers from married women living in Semnan since March 2021 to March 2022 using Domestic Violence Questionnaire. Then, the obtained data were analyzed by descriptive and inferential statistics. In qualitative study by phenomenological approach and purposive sampling until data saturation, 9 women were selected who had referred to the counseling units of Semnan health centers due to domestic violence, since March 2021 to March 2022 and in-depth and semi-structured interviews were conducted. The conducted interviews were analyzed using Colaizzi's 7-step method.

RESULTS

In qualitative study, seven themes were found including "Facilitators", "Role failure", "Repressors", "Efforts to preserve the family", "Inappropriate solving of family conflicts", "Consequences", and "Inefficient supportive systems". In quantitative study, the variables of age, age difference and number of years of marriage had a positive and significant relationship, and the variable of the number of children had a negative and significant relationship with the total score and all fields of the questionnaire (p < 0.05). Also, increasing the level of female education and income both independently showed a significant relationship with increasing the score of violence.

CONCLUSIONS

Some of the variables of violence against women are known and the need for prevention and plans to take action before their occurrence is well felt. Also, supportive mechanisms with objective and taboo-breaking results should be implemented to minimize harm to women, and their children and families seriously.

Access to information on gender-based violence prevention during COVID-19 lockdown in Uganda: a cross-sectional study

BACKGROUND

During the lockdowns to contain the COVID-19 pandemic in Uganda, women and girls, disproportionately, had increased exposure to gender-based violence (GBV). Access to high-quality and empowering information or knowledge to minimise the incidences of GBV for women, girls, men and boys, was, therefore, crucial. The purpose of this study was to understand the characteristics of the individuals who were unable to access such information, and if received information, was associated with more awareness in the populace.

METHODS

The data analysed were from a cross-sectional nationally representative phone survey of individuals aged 18 years and above from all four regions of Uganda. The survey was carried out by Uganda Bureau of Statistics using a purely quantitative approach, and all questions were closed-ended. The sample was stratified by sex, age, and geographical region, and executed in November 2020, six months after COVID-19 lockdown restrictions. Binary logistic regression analysis was used for data analysis in STATA software.

FINDINGS

Female respondents with tertiary education (OR = 0.47; 95% CI = 0.26, 0.85) and male respondents with tertiary education (OR = 0.70; 95% CI: 0.49, 1.00) were more likely to receive information on GBV prevention. Both female (aOR = 0.68; 95% CI: 0.52, 0.88) and male (aOR = 0.66; 95% CI: 0.50, 0.87) respondents who were working had about a third the odds of being unable to access information about GBV prevention. Female respondents living in urban areas were associated with less odds of being unable to access the information (aOR = 0.77; 95% CI: 0.59, 1.00), while unmarried male respondents had higher odds of being unable to access the information (aOR = 1.37; 95% CI: 1.00, 1.89). Respondents who reported being vulnerable to GBV were also more likely to know someone who experienced GBV. This was similar for female respondents (PR = 3.00; 95% CI: 2.26, 3.98) and male respondents (PR = 3.01, 95% CI: 2.3, 3.95) (PR = 5.49; 95% CI = 4.12-7.30). Results also indicated that both male (PR = 1.28; 95% CI: 1.14, 1.43) and female respondents (PR = 1.24; 95% CI: 1.11, 1.37) who did not perceive themselves at risk of GBV were less likely to know a GBV survivor.

INTERPRETATION

The individuals who were unable to access information had characteristics associated with GBV perpetration or victimization. Monitoring the dissemination and quality of information empowers individuals and communities to develop local solutions to GBV prevention and protection. The design of GBV prevention messages and delivery channels needs to take into consideration the risk factors at the different levels of the socio-ecological model (individual, community, institutional, and society). Interventions aimed at increasing access to information on GBV prevention should consider the different socio-demographic as well as context-specific factors.

FUNDING

There was no funding source for this study.

Unhealthy alcohol use and intimate partner violence among men and women living with HIV in Uganda

Background

Intimate partner violence (IPV) and alcohol use are interrelated public health issues. Heavy and frequent alcohol use increase the risk of IPV, but the relationship between alcohol use and IPV (including recent and lifetime IPV victimization and perpetration) has not been well described among persons living with HIV (PWH) in sub-Saharan Africa.

Methods

We used baseline data from the Drinker’s Intervention to Prevent Tuberculosis study. All participants were PWH co-infected with tuberculosis and had an Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) positive score (hazardous drinking) and positive urine ethyl glucuronide test, indicating recent drinking. High-risk drinking was defined as AUDIT-C > 6 and/or alcohol biomarker phosphatidylethanol (PEth) ≥ 200 ng/mL. We measured IPV using the Conflict Tactics Scale. We estimated the association between alcohol use level and recent (prior six months) IPV victimization (recent perpetration was too low to study) using multivariable logistic regression models adjusted for gender, age, assets, education, spouse HIV status, religiosity, depressive symptoms, and social desirability. We additionally estimated the interaction of alcohol use and gender on IPV victimization and the association between alcohol use and lifetime victimization and perpetration.

Results

One-third of the 408 participants were women. Recent IPV victimization was reported by 18.9% of women and 9.4% of men; perpetration was reported by 3.1% and 3.6% of women and men. One-fifth (21.6%) of those reporting recent IPV victimization also reported perpetration. In multivariable models, alcohol use level was not significantly associated with recent IPV victimization (p = 0.115), nor was the interaction between alcohol use and gender (p = 0.696). Women had 2.34 times greater odds of recent IPV victimization than men (p = 0.016). Increasing age was significantly associated with decreased odds of recent IPV victimization (p = 0.004).

Conclusion

Prevalence of IPV victimization was comparable to estimates from a recent national survey, while perpetration among men was lower than expected. Alcohol use level was not associated with IPV victimization. It is possible that alcohol use in this sample was too high to detect differences in IPV. Our results suggest that women and younger PWH are priority populations for IPV prevention.