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

ABSTRACT: This paper uses data from a community cross-sectional survey to examine the factors that are associated with justification of physical violence against women. Results indicate that respondents who were married at the time of the survey were less likely (OR = 0.29; CI = 0.17-0.52) to agree that it is justified for a man to physically assault his partner that their counterparts who were single. The likelihood to justify physical violence was less likely to happen among respondents with primary education (OR = 0.49; CI = 0.39-0.62), secondary education (OR = 0.40; CI = 0.31-0.53) and vocation or tertiary education (OR = 0.28; CI = 0.19-0.41) than among respondents with no education. Protestants were less likely (OR = 0.77; CI = 0.64-0.94) to justify physical violence than the Catholics. Respondents who were not formally employed were more likely (OR = 1.66; CI = 1.32-2.08) to justify physical violence than their counterparts who were in formal employment in the last three months preceding the survey. Respondents who agreed that it is okay for a man to control his partner's movements (OR = 1.27; CI = 1.04-1.55), it is okay for a man to have sex with his wife anytime (OR = 2.28; CI = 1.87-2.78), alcohol is the main reason for violence against women (OR = 1.67; CI = 1.33-2.10), men need sex more than women (OR = 1.57; CI = 1.23-1.99) and women know where to obtain support in case of violence (OR = 1.42; CI = 1.00-2.02) were more likely to justify physical violence than respondents who disagreed. The likelihood to justify physical violence was less among respondents who agreed that: violence is not the only way to deal with disagreements (OR = 0.54; CI = 0.33-0.86), it is possible for men to stop violence (OR = 0.62; CI = 0.47-0.82) and it is acceptable for a woman to ask her partner to use a condom (OR = 0.61; CI = 0.51-0.73) than their counterparts who disagreed. There is need to increase investment in social norms change programmes in order to strengthen contestation of tolerance of physical violence among men and women in Uganda.

SUBMITTER: Bukuluki P

PROVIDER: S-EPMC8480831 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Cases of coronavirus disease 2019 (COVID-19) detected, and COVID-19 associated mortality increased since the first case was confirmed in Uganda. While adherence to WHO-recommended measures to disrupt COVID-19 transmission has since been implemented, it has been reported to be sub-optimal. An increase in intimate partner violence (IPV) cases was linked to enforcement of COVID-19 lockdowns and other preventive measures especially in informal settings of Kampala. We determined the association between adherence to COVID-19 preventive measures and intimate partner violence among women dwelling in informal settings in Kampala, Uganda. Between July and October 2020, we conducted a three-month prospective cohort study of 148 women living in informal settlements of Kampala during the COVID-19 lockdown and easing of restrictive measures. Participants were surveyed at baseline, at 3-weeks and 6-weeks (endline). The dependent variable was adherence to COVID-19 preventive measures (remained adherent vs poorly adherent) between baseline and endline surveys. This composite outcome variable was computed from implementing all four variables: social distancing, wearing face masks, frequent hand washing and use of hand sanitizers at baseline and endline surveys. The key independent variable was IPV measured as experiencing at least one form of physical, emotional, or sexual IPV. Covariates were age, education, marital status, household size, occupation, and having problems getting food. Adjusted logistic regression analyses tested the independent association between adherence to COVID-19 preventive measures and intimate partner violence. Among 148 respondents, the mean age (SD) was 32.9 (9.3) years, 58.1% were exposed to at least one form of IPV, and 78.2% had problems getting food. Overall, 10.1% were poorly adherent to COVID-19 preventive measures during the first COVID-19 wave. After controlling for potential confounders, remaining adherent to COVID-19 preventive measures were more likely to experience intimate partner violence when compared to women who were poorly adherent to COVID-19 preventive measures during the first COVID-19 wave in Uganda [OR 3.87 95%CI (1.09, 13.79)]. Proportions of women in informal settlements of Kampala experiencing at least one form of IPV during the first COVID-19 wave is substantial. Remaining adherent to preventive measures for COVID-19 transmission may increase IPV exposure risk among women living in informal settlements in Kampala. Contextualizing COVID-19 interventions to the needs of marginalized and vulnerable women and girls in informal settings of Kampala is warranted. Processes to integrated violence prevention and response strategies into the Uganda COVID-19 prevention strategy are underscored.

Project description:BACKGROUND:A growing number of complex public health interventions combine mass media with community-based "change agents" and/or mobilisation efforts acting at multiple levels. While impact evaluations are important, there is a paucity of research into the more nuanced roles intervention and social network factors may play in achieving intervention outcomes, making it difficult to understand how different aspects of the intervention worked (or did not). This study applied aspects of diffusion of innovations theory to explore how SASA!, a community mobilisation approach for preventing HIV and violence against women, diffused within intervention communities and the factors that influenced the uptake of new ideas and behaviours around intimate partner relationships and violence. METHODS:This paper is based on a qualitative study of couples living in SASA communities and secondary analysis of endline quantitative data collected as part of a cluster randomised control trial designed to evaluate the impact of the SASA! INTERVENTION:The primary trial was conducted in eight communities in Kampala, Uganda between 2007 and 2012. The secondary analysis of follow up survey data used multivariate logistic regression to examine associations between intervention exposure and interpersonal communication, and relationship change (n =?928). The qualitative study used in-depth interviews (n =?20) and framework analysis methods to explore the intervention attributes that facilitated engagement with the intervention and uptake of new ideas and behaviours in intimate relationships. RESULTS:We found communication materials and mid media channels generated awareness and knowledge, while the concurrent influence from interpersonal communication with community-based change agents and social network members more frequently facilitated changes in behaviour. The results indicate combining community mobilisation components, programme content that reflects peoples' lives and direct support through local change agents can facilitate diffusion and powerful collective change processes in communities. CONCLUSIONS:This study makes clear the value of applying diffusion of innovations theory to illuminate how complex public health intervention evaluations effect change. It also contributes to our knowledge of partner violence prevention in a low-income, urban East African context. TRIAL REGISTRATION:ClinicalTrials.gov # NCT00790959 . Registered 13th November 2008.

Project description:IntroductionIn some communities, rationalization of men's controlling attitudes is associated with the justification of gender norms such as wife-beating as a method of correcting spouse behaviour. In this quasi-experimental study, we investigate the causal effects of the acceptability of gender norms justifying wife-beating on experiences of sexual, emotional, and physical intimate partner violence (IPV) among Ugandan men and women.Methods and materialsWe analysed the 2016 Uganda Demographic and Health Survey data using propensity-score matching. The exposure variable is the acceptability of gender norms justifying wife-beating measured on a binary scale and the outcomes are the respondent's lifetime experiences of sexual, physical, and emotional IPV. We matched respondents who accepted gender norms justifying wife-beating with those that never through a 1:1 nearest-neighbour matching with a caliper to achieve comparability on selected covariates. We then estimated the causal effects of acceptability of gender norms justifying wife-beating on the study outcomes using a logistic regression model.ResultsResults showed that a total of 4,821 (46.5%) out of 10,394 respondents reported that a husband is justified in beating his wife for specific reasons. Among these, the majority (3,774; 78.3%) were women compared to men (1,047; 21.7%). Overall, we found that men and women who accept gender norms justifying wife-beating are more likely to experience all three forms of IPV. In the sub-group analysis, men who justify wife-beating were more likely to experience emotional and physical IPV but not sexual IPV. However, women who justify wife-beating were more likely to experience all three forms of IPV.ConclusionsIn conclusion, the acceptability of gender norms justifying wife-beating has a positive effect on experiences of different forms of IPV by men and women in Uganda. There is, therefore, a need for more research to study drivers for acceptance of gender norms justifying wife-beating to enable appropriate government agencies to put in place mechanisms to address the acceptability of gender norms justifying wife-beating at the societal level.

Project description:BackgroundUganda clinical guidelines recommend routine screening of pregnant women for intimate partner violence (IPV) during antenatal care (ANC). Healthcare providers play a critical role in identifying IPV during pregnancy in ANC clinics. This study explored facilitators and barriers for IPV screening during pregnancy (perinatal IPV screening) by ANC-based healthcare workers in Uganda.MethodsWe conducted qualitative in-depth interviews among twenty-eight purposively selected healthcare providers in one rural and an urban-based ANC health center in Eastern and Central Uganda respectively. Barriers and facilitators to IPV screening during ANC were identified iteratively using inductive-deductive thematic analysis.ResultsParticipants had provided ANC services for a median (IQR) duration of 4.0 (0.1-19) years. Out of 28 healthcare providers, 11 routinely screened women attending ANC clinics for IPV and 10 had received IPV-related training. Barriers to routine IPV screening included limited staffing and space resources, lack of comprehensive gender-based violence (GBV) training and provider unawareness of the extent of IPV during pregnancy. Facilitators were availability of GBV protocols and providers who were aware of IPV (or GBV) tools tended to use them to routinely screen for IPV. Healthcare workers reported the need to establish patient trust and a safe ANC clinic environment for disclosure to occur. ANC clinicians suggested creation of opportunities for triage-level screening and modification of patients' ANC cards used to document women's medical history. Some providers expressed concerns of safety or retaliatory abuse if perpetrating partners were to see reported abuse.ConclusionsOur findings can inform efforts to strengthen GBV interventions focused on increasing routine perinatal IPV screening by ANC-based clinicians. Implementation of initiatives to increase routine perinatal IPV screening should focus on task sharing, increasing comprehensive IPV training opportunities, including raising awareness of IPV severity, trauma-informed care and building trusting patient-physician relationships.

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

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