A.O. Tella1, C.I. Tobin-West2 and S. Babatunde1,2
- Centre for Health and Development, University of Port Harcourt, Port-Harcourt, Rivers State, Nigeria
- Dept. of Preventive and Social Medicine, University of Port Harcourt, Port-Harcourt, Rivers State, Nigeria
Background: Risk factors and coping strategies employed for domestic violence across rural and urban locales remains a topical public health concern. Geographic locations experiencing other forms of violence may contribute additional risk factors to domestic violence.
Methods: A cross-sectional study design was used to determine and compare the risk factors, help-resources and coping strategies employed by survivors of domestic violence living in rural and urban areas of the Niger-Delta region of Nigeria. Altogether 461 (225 rural, 236 urban) pregnant women participated. Statistical analysis was carried out with SPSS version 21 with p <0.05.
Results: Predictors of violence identified were: geographical location, residing in a rural area (OR 2.052 95% C.I. 1.349 – 3.122) and alcohol intake by pregnant
women (OR 1.691; 95% C.I. 1.022 – 2.798) increased the risk of domestic violence while intimate partner’s occupation, being a professional was a protective factor (OR 0.513 95% C.I. 0.327 – 0.806). Less than half of the respondents in both locations (rural 44.0% versus urban 35.2%) sought for help following incidents of violence. Fewer rural (3.1%) than urban (10.7%) of them sought for formal help from the police. The main coping strategy used was ‘keeping silent’ by 69.4% rural compared to 46.4% urban survivors and the main reason given, was to avoid family disharmony.
Conclusion: There is urgent need for relevant stakeholders to institute measures to reduce domestic violence especially in rural areas of developing countries and establish well-linked help resource centres across both rural and urban localities
Keywords: Rural-urban, Pregnant women, Domestic violence, Niger-Delta
Dr. A.O. Tella
Centre for Health and Development,
University of Port Harcourt,
Domestic violence (DV) is a human rights issue that is increasingly attracting more public health attention. Although it has gained substantial international recognition, considerable silence still exists around the topic especially in sub-Saharan African countries1,2. This may be due to certain cultural practices which limits open discussion on this global health concern1-3. Over the years, domestic violence has become almost synonymous with female based violence because girls and women are often the victims while men are the major perpetrators4,5. A group of women considered to be highly vulnerable to domestic violence are pregnant women and the risk factors for this group of women are often multifactorial6-12.
The burden of domestic violence among pregnant women has been found to be high in previous African and non-African studies3,8,9. In Nigeria, the prevalence of domestic violence during current pregnancy was reported as 7.4% by Iliyasu et al in 2013 and 17.7% by Fawole et al in 2010 in urban settings of the North West and South West respectively8,9. Tella et al, in 2018 reported on domestic violence among pregnant women in South South Nigeria. Physical domestic violence was found to be higher among rural (43.6%) compared to urban (23.7%) respondents (p=0.001); sexual violence was least reported, higher in rural (15.1%) than urban (9.7%) respondents (p=0.08). In all, rural respondents reported higher physical, psychological and sexual violence while the urban respondents reported higher verbal violence13.
Different risk factors predispose to diverse forms of violence including those occurring in domestic settings. The WHO Ecological Framework and Connectedness classified risk factors for domestic violence into individual, family, community and societal strata14 and this enables researchers examine specific and collective risk factors more appropriately. Common individual risk factors identified for pregnant women from previous sub-Saharan African studies include survivors’ young age at first marriage, low level of education, abuse of alcohol and having multiple sexual partners6-12.
Although relationship in the domestic sense includes intimate partners, parents and siblings, majority of the perpetrators of domestic violence among pregnant women are their intimate partners8-10. Over 50% of perpetrators were intimate partners in indigenous studies by Iliyasu et al (58.6%) and Fawole et al (65.8%)8,9. Documented risk factors among perpetrators include alcohol use, substance abuse and exhibition of controlling behaviour by denying victims access to family, friends and health care services8-10,15- 19. Cultural influences especially those that encourage victims to keep silent remain persistent community risk factors for domestic violence in many sub-Saharan African countries1,2,18.
Survivors of violence often seek ways to avoid repeated violence by mitigating against risk factors they have identified. Such ways and means of preventing recurrence of domestic violence has been classified as internal and external coping strategies; and use of formal and informal help-seeking resources2,18. Internal coping strategies includes keeping silent and avoiding perpetrators of violence. Studies from sub-Saharan African region have reported that a considerable number of survivors employ the keeping silent strategy to avoid recurrence of violent scenes especially in the presence of their children and to keep themselves safe from avoidable harm2,18. In recent times, women are encouraged to speak out, however, certain factors such as socio-cultural and geographical location factors still hinders survivors from reporting or making use of formal help-seeking resources. Rural areas for instance are often isolated and the few available help-resources are usually at a far distance from one another, thus survivors are often at a disadvantage20-23. The burden of domestic violence is often more when the rural area is located in an environment prevalent with other forms of violence such as communal clashes and intertribal war18,19. Poverty, anger and transferred aggression prevailing in such areas further heightens the burden of domestic violence18,19. For these reasons, many survivors in rural areas employ ‘keeping silent’, ‘avoiding the perpetrators’ and ‘reporting to family members’ as their other forms of coping strategy2,18. Survivors of violence in the urban areas on the other hand tend to have more help-resource options from the formal sector, such as reporting to police, lawyers and work colleagues2,24. However, studies in certain developing countries have shown that many survivors of domestic violence living in urban areas may have low confidence in formal help as a result of delay in execution of justice and diverse forms of exploitations2,24. As such, other coping methods and informal help resources are also employed by urban survivors of domestic violence.
Two pertinent theories explaining internal coping mechanisms among vulnerable groups are cognitive dissonance and change in gender-role theories17. Cognitive dissonance theory, explained by Festinger identifies the ‘principle of cognitive consistency as an important factor which makes people express an inner but powerful drive that holds all their attitudes and beliefs in harmony just to avoid disharmony’25. In cases of domestic violence, survivors, often women, exhibit this theory although their actions or inactions may not be considered as rational25,26. Change in gender role theory explains that males and females occupy different recognized social roles within the community where they live and they are often judged, whenever they exhibit ‘deviant’ conducts27. This can be seen especially in rural areas of the sub-Saharan African region where women are expected to be tolerant and enduring while men can take up stipulated masculine social roles that may enhance perpetuation of domestic violence.17,27
Although studies on risk factors, help-seeking resources and coping strategies for domestic violence among pregnant women have been carried out globally and locally, majority of these studies have been carried out in urban areas with limited findings from rural areas. Also fewer studies have examined risk factors of domestic violence in areas with other forms of violence and instability. Knowledge of the burden, risk factors, help-resources and coping strategies of domestic violence in these peculiar settings is necessary for policy makers and other stakeholders to enable them develop appropriate intervention programmes that will reduce the burden of domestic violence. In view of these, the authors examined the risk factors, help-resources and coping strategies among rural and urban pregnant women residing in a violence prone region of a developing country.