Top

Open Access 11-05-2024 | Original Article

Multilevel determinants of physical violence among ever-partnered women in South Africa

Authors: Dikago Puoeng, Mluleki Tsawe

Published in: Archives of Women's Mental Health

Abstract

Background

Violence against women continues to be a challenge in many countries. Many women suffer physical violence at the hands of their intimate partners and sometimes this leads to their deaths. This study aimed to examine the multilevel determinants of physical violence among ever-partnered women in South Africa.

Methods

We used data from the 2016 South Africa Demographic and Health Survey. The study has a weighted sample size of 4169 ever-partnered women aged 18–49 years, based on the domestic violence module. We included univariate, bivariate and multilevel logistic regression analysis. We included a two-level model to measure the relationship between the selected background characteristics and physical violence.

Results

The prevalence of physical violence among ever-partnered women was 20.6%. The bivariate findings showed that educational status, employment status, witness to inter-parental violence, partner’s drinking habits, household wealth, educational difference, and province were statistically associated with physical violence. The multilevel analysis showed some evidence of between-cluster variation in physical violence. We found that age, education, employment status, witness to inter-parental violence, partner’s drinking habits, household wealth, education difference, place of residence, and province were key predictors of physical violence. The odds of physical violence were more than two-fold in the Eastern Cape and Mpumalanga compared to Gauteng.

Conclusion

The study highlighted various key factors explaining physical violence. The findings suggest the need for targeted interventions aimed at specific communities of women, such as those from the Eastern Cape and Mpumalanga, as well as interventions that will empower women and address gender inequalities.

Aboagye RG, Seidu A-A, Peprah P, Asare BY-A, Addo IY, Ahinkorah BO (2022) Exposure to interparental violence and risk of intimate partner violence among women in sexual unions in sub-saharan Africa. Int Health 15(6):655–663. https://doi.org/10.1093/inthealth/ihac075CrossRefPubMedCentral

Abrahams N, Mhlongo S, Chirwa E, Dekel B, Ketelo A, Lombard C, Shai N, Ramsoomar L, Mathews S, Labuschagne G, Matzopoulos R, Prinsloo M, Martin LJ, Jewkes R (2024) Femicide, intimate partner femicide, and non-intimate partner femicide in South Africa: an analysis of 3 national surveys, 1999–2017. PLoS Med 21(1):e1004330. https://doi.org/10.1371/journal.pmed.1004330CrossRefPubMedPubMedCentral

Adebowale AS (2018) Spousal age difference and associated predictors of intimate partner violence in Nigeria. BMC Public Health 18(1):1–15CrossRef

Afe TO, Emedoh TC, Ogunsemi O, Adegbohun AA (2016) Intimate partner violence, psychopathology and the women with schizophrenia in an outpatient clinic South-South, Nigeria. BMC Psychiatry 16(1):1–8CrossRef

Ahinkorah BO, Dickson KS, Seidu AA (2018) Women decision-making capacity and intimate partner violence among women in sub-saharan Africa. Arch Public Health 76:5. https://doi.org/10.1186/s13690-018-0253-9CrossRefPubMedPubMedCentral

Alangea DO, Addo-Lartey AA, Sikweyiya Y, Chirwa ED, Coker-Appiah D, Jewkes R, Adanu RMK (2018) Prevalence and risk factors of intimate partner violence among women in four districts of the central region of Ghana: baseline findings from a cluster randomised controlled trial. PLoS ONE 13(7):e0200874. https://doi.org/10.1371/journal.pone.0200874CrossRef

Angaw DA, Melesse AW, Geremew BM, Tesema GA (2021) Spatial distribution and determinants of intimate partner violence among reproductive-age women in Ethiopia: spatial and multilevel analysis. BMC Womens Health 21(1):81. https://doi.org/10.1186/s12905-021-01218-3CrossRefPubMedPubMedCentral

Bikinesi LT, Mash R, Joyner K (2017) Prevalence of intimate partner violence and associated factors amongst women attending antenatal care at Outapi Clinic, Namibia: a descriptive survey. Afr J Prim Health care Family Med 9(1):1–6

Biswas CS (2017) Spousal violence against working women in India. J Family Violence 32(1):55–67CrossRef

Centre for the Study of Violence and Reconciliation (2016) Gender-Based Violence (GBV) in South Africa: A Brief Review. https://www.csvr.org.za/pdf/Gender%20Based%20Violence%20in%20South%20Africa%20-%20A%20Brief%20Review.pdf

Chadambuka C, Warria A (2019) Hurt or help? Understanding intimate partner violence in the context of social norms as practised in rural areas. Soc Work 55:301–310. http://www.scielo.org.za/scielo.php?script=sci_arttext &pid=S0037-80542019000300006&nrm=isoCrossRef

Chernet AG, Cherie KT (2020) Prevalence of intimate partner violence against women and associated factors in Ethiopia. BMC Womens Health 20(1):1–7CrossRef

Chung-Ya O, Masuma Y, Gainel U, Ming-Shinn L, Koustuv D (2021) Prevalence of intimate partner violence against women in Republic of Benin. Afr J Reprod Health, 25(4)

Conroy AA (2014) Gender, Power, and intimate Partner violence:a study on couples from rural Malawi. J Interpers Violence 29(5):866–888. https://doi.org/10.1177/0886260513505907CrossRefPubMed

Elkasabi M, Ren R, Pullum TW (2020) Multilevel modeling using DHS Surveys: A framework to approximate level-weights (DHS Methodological Reports No. 27, Issue. https://www.dhsprogram.com/pubs/pdf/MR27/MR27.pdf

Gage AJ, Thomas NJ (2017) Women’s work, gender roles, and intimate partner violence in Nigeria. Arch Sex Behav 46(7):1923–1938CrossRefPubMed

Geldenhuys K (2018) Femicide - Dying for being a woman. Servamus Community-based Saf Secur Magazine 111(4):10–16. https://doi.org/10.10520/EJC-d8d13fc7cCrossRef

Goldstein H, Browne W, Rasbash J (2002) Partitioning variation in Multilevel models. Underst Stat 1(4):223–231. https://doi.org/10.1207/S15328031US0104_02CrossRef

Greene MC, Kane J, Tol WA (2017) Alcohol use and intimate partner violence among women and their partners in sub-saharan Africa. Global Mental Health, 4

Habamenshi V, Gasana S (2022) Determinants of Gender Based Violence against Women with disabilities in Rwanda. A case of Gakenke District. Int J Res Innov Social Sci 6(11):183–199. https://doi.org/10.47772/IJRISS.2022.61115CrossRef

Heron RL, Eisma MC (2021) Barriers and facilitators of disclosing domestic violence to the healthcare service: a systematic review of qualitative research. Health Soc Care Commun 29(3):612–630. https://doi.org/10.1111/hsc.13282CrossRef

Issahaku PA (2017) Correlates of intimate partner violence in Ghana. Sage Open 7(2):2158244017709861CrossRef

Jabbi A, Ndow B, Senghore T, Sanyang E, Kargbo JC, Bass P (2020) Prevalence and factors associated with intimate partner violence against women in the Gambia: a population-based analysis. Women Health 60(8):912–928CrossRefPubMed

Jeawon R (2023) Masculine norms, Sugar Daddies and Violence Against women in South Africa: exploring the interconnections. South Afr J Social Work Social Dev 35(1):18. https://doi.org/10.25159/2708-9355/9099CrossRef

Jewkes R, Levin J, Penn-Kekana L (2002) Risk factors for domestic violence: findings from a South African cross-sectional study. Soc Sci Med 55(9):1603–1617. https://doi.org/10.1016/S0277-9536(01)00294-5CrossRefPubMed

Kapiga S, Harvey S, Muhammad AK, Stöckl H, Mshana G, Hashim R, Hansen C, Lees S, Watts C (2017) Prevalence of intimate partner violence and abuse and associated factors among women enrolled into a cluster randomised trial in northwestern Tanzania. BMC Public Health 17(1):1–11CrossRef

Kebede SA, Weldesenbet AB, Tusa BS (2022) Magnitude and determinants of intimate partner violence against women in East Africa: multilevel analysis of recent demographic and health survey. BMC Womens Health 22(1):74. https://doi.org/10.1186/s12905-022-01656-7CrossRefPubMedPubMedCentral

Khan S, Klasen S (2018) Female employment and spousal abuse: a parallel cross-country analysis of developing countries

Kieselbach B, Kress H, MacMillan H, Perneger T (2021) Prevalence of childhood exposure to intimate partner violence and associations with mental distress in Cambodia, Malawi and Nigeria: a cross-sectional study. Child Abuse Negl 111:104807. https://doi.org/10.1016/j.chiabu.2020.104807CrossRefPubMed

Kumar S, Jeyaseelan L, Suresh S, Ahuja RC (2005) Domestic violence and its mental health correlates in Indian women. Br J Psychiatry 187(1):62–67CrossRefPubMed

Lacey KK, West CM, Matusko N, Jackson JS (2016) Prevalence and factors associated with severe physical intimate partner violence among US black women: a comparison of African American and Caribbean Blacks. Violence against Women 22(6):651–670CrossRefPubMed

Mahaba C (2022) Intimate partner femicide decreasing. The Star, 2

Mahlangu P, Gibbs A, Shai N, Machisa M, Nunze N, Sikweyiya Y (2022) Impact of COVID-19 lockdown and link to women and children’s experiences of violence in the home in South Africa. BMC Public Health 22(1):1029. https://doi.org/10.1186/s12889-022-13422-3CrossRefPubMedPubMedCentral

Matlhare A (2021) Call to take action on SA’s ‘second pandemic’. The Citizen, 3. https://l1nq.com/MEa5B

Matseke G, Peltzer K, Mlambo G (2012) Partner violence and associated factors among pregnant women in Nkangala district, Mpumalanga. South Afr Med J 18:77–81

Matseke MG, Ruiter RAC, Rodriguez VJ, Peltzer K, Lee TK, Jean J, Sifunda S (2021) Prenatal and Postnatal Intimate Partner Violence and Associated factors among HIV-Infected women in Rural South Africa: a longitudinal study. Violence against Women 27(15–16):2855–2881. https://doi.org/10.1177/1077801221992872CrossRefPubMedPubMedCentral

Matshili R (2018) Survivors show scars, tell emotive stories. Pretoria News, 5. https://l1nq.com/MeOYf

Mbandlwa Z (2022) Women’s day, women’s month for who? For South African women or South African government and politicians? J Pharm Negat Results 13(9):269–275. https://doi.org/10.47750/pnr.2022.13.S09.032CrossRef

Merlo J, Chaix B, Ohlsson H, Beckman A, Johnell K, Hjerpe P, Råstam L, Larsen K (2006) A brief conceptual tutorial of multilevel analysis in social epidemiology: using measures of clustering in multilevel logistic regression to investigate contextual phenomena. J Epidemiol Commun Health 60(4):290. https://doi.org/10.1136/jech.2004.029454CrossRef

Mesatywa NJ (2014) Validating the evidence of violence in Partner relationships with regard to Xhosa African women. Soc Work 50:235–257. http://www.scielo.org.za/scielo.php?script=sci_arttext &pid=S0037-80542014000300005&nrm=isoCrossRef

Mills S (2005) Spiral of Entrapment: abused women in conflict with the Law. Agenda 19(66):75–78. https://doi.org/10.1080/10130950.2005.9674654CrossRef

Mkhize S, Sibisi NN (2022) Locked in abuse: intimate Partner violence against women during the COVID-19 pandemic. Afr J Gend Soc Dev (Formerly J Gend Inform Dev Africa) 11(2):157–179. https://doi.org/10.31920/2634-3622/2022/v11n2a8CrossRef

Mniki B (2020) Pule’s death has traumatised a brutalised nation. Dly Dispatch, 13. https://encr.pw/YAsEZ

Mshweshwe L (2020) Understanding domestic violence: masculinity, culture, traditions. Heliyon 6(10). https://doi.org/10.1016/j.heliyon.2020.e05334

Mthembu J, Mabaso M, Reis S, Zuma K, Zungu N (2021) Prevalence and factors associated with intimate partner violence among the adolescent girls and young women in South Africa: findings the 2017 population based cross-sectional survey. BMC Public Health 21(1):1160. https://doi.org/10.1186/s12889-021-11183-zCrossRefPubMedPubMedCentral

Muluneh MD, Stulz V, Francis L, Agho K (2020) Gender based violence against women in Sub-saharan Africa: a systematic review and Meta-analysis of cross-sectional studies. Int J Environ Res Public Health 17(3). https://doi.org/10.3390/ijerph17030903

Muluneh MD, Francis L, Agho K, Stulz V (2021) A Systematic Review and Meta-Analysis of Associated Factors of Gender-Based Violence against Women in Sub-Saharan Africa. International Journal of Environmental Research and Public Health, 18(9), 4407. https://www.mdpi.com/1660-4601/18/9/4407

Nadeem M, Malik MI (2021) The role of social norm in acceptability attitude of women toward intimate partner violence in Punjab, Pakistan. J Interpers Violence 36(21–22):NP11717–NP11735CrossRefPubMed

Nakitto R, Nzabona A, Wandera SO (2023) Risk factors for intimate partner emotional violence among women in union in Uganda. Front Sociol 8. https://doi.org/10.3389/fsoc.2023.840154. Original Research

National Department of Health, Statistics South Africa, South African Medical Research Council, & ICF (2019) South Africa Demographic and Health Survey 2016. http://dhsprogram.com/pubs/pdf/FR337/FR337.pdf

Ntoimo LFC, Eimuhi KE, Omonkhua A, Okonofua FE (2021) Intimate partner violence: a global challenge to sustainable development. Afr J Reprod Health 25(4):11–16. https://doi.org/10.29063/ajrh2021/v25i4.1CrossRefPubMed

Oram S, Khalifeh H, Howard LM (2017) Violence against women and mental health. Lancet Psychiatry 4(2):159–170. https://doi.org/10.1016/S2215-0366(16)30261-9CrossRefPubMed

Palermo T, Bleck J, Peterman A (2014) Tip of the iceberg: reporting and gender-based violence in developing countries. Am J Epidemiol 179(5):602–612CrossRefPubMed

Pallitto CC, García-Moreno C, Jansen HA, Heise L, Ellsberg M, Watts C (2013) Intimate partner violence, abortion, and unintended pregnancy: results from the WHO Multi-country Study on women’s Health and domestic violence. Int J Gynecol Obstet 120(1):3–9CrossRef

Parrott DJ, Eckhardt CI (2018) Effects of alcohol on human aggression. Curr Opin Psychol 19:1–5CrossRefPubMedPubMedCentral

Pengpid S, Peltzer K (2014) Sexual assault and other types of intimate partner violence in women with protection orders in Vhembe District, South Africa. Violence Vict 29(5):857–871CrossRefPubMed

Peremore J (2017) Sixteen days of denialism. Mail & Guardian. https://tinyurl.com/2u99cdt6

Phiri M, Namayawa S, Sianyeuka B, Sikanyiti P, Lemba M (2023) Determinants of spousal physical violence against women in Zambia: a multilevel analysis. BMC Public Health 23(1):934. https://doi.org/10.1186/s12889-023-15927-xCrossRefPubMedPubMedCentral

Ross C, Smith JG, Manenzhe T, Netshiongolwe R, Johnson T, Caldwell A, Maphula A, Ingersoll KS (2021) South African university women’s perspectives on intimate partner violence: a qualitative study of reactions to a tailored vignette. Cult Health Sex, 1–17

Shai N, Ramsoomar L, Abrahams N (2022) Femicide Prevention Strategy Development process: the South African experience. Peace Rev 34(2):227–245. https://doi.org/10.1080/10402659.2022.2049001CrossRef

Shefer T, Strebel A (2012) Deconstructing the ‘sugar daddy’: a critical review of the constructions of men in intergenerational sexual relationships in South Africa. Agenda 26(4):57–63. https://doi.org/10.1080/10130950.2012.760837CrossRef

Sibanda-Moyo N, Khonje E, Brobbey MK (2017) Violence against Women in South Africa: A Country in Crisis. https://www.csvr.org.za/pdf/CSVR-Violence-Against-Women-in-SA.pdf

Skandro S, Abio A, Baernighausen T, Lowery Wilson M (2024) Socio-demographic determinants of intimate partner violence in Angola: a cross-sectional study of nationally representative survey data. Arch Women Ment Health 27(1):21–33. https://doi.org/10.1007/s00737-023-01376-3CrossRef

South Africa (1999) Domestic Violence Act 116 of 1998. South Africa: Gazette 20469 of 13 September 1999 Retrieved from https://www.gov.za/sites/default/files/gcis_document/201409/a116-980.pdf

StataCorp (2015) Stata Statistical Software: Release 14. In StataCorp LP. https://www.stata.com/support/faqs/resources/citing-software-documentation-faqs/

Statistics South Africa (2023) Census 2022 Statistical release: P0301.4. https://census.statssa.gov.za/assets/documents/2022/P03014_Census_2022_Statistical_Release.pdf

Tanimu TS, Yohanna S, Omeiza SY (2016) The pattern and correlates of intimate partner violence among women in Kano, Nigeria. Afr J Prim Health care Family Med 8(1):1–6

Tenkorang EY (2018) Women’s autonomy and intimate partner violence in Ghana. Int Perspect Sex Reproductive Health 44(2):51–61CrossRef

Tenkorang EY (2019) Intimate partner violence and the sexual and reproductive health outcomes of women in Ghana. Health Educ Behav 46(6):969–980CrossRefPubMed

Tenny S, Hoffman MR (2017) Odds ratio

Tiruye TY, Harris ML, Chojenta C, Holliday E, Loxton D (2020) Determinants of intimate partner violence against women in Ethiopia: a multi-level analysis. PLoS ONE, 15(4), e0232217

Tu X, Lou C (2017) Risk factors associated with current intimate partner violence at individual and relationship levels: a cross-sectional study among married rural migrant women in Shanghai, China. BMJ open, 7(4), e012264

Warren P (2015) The relationship between religiousness and intimate partner violence risk and protective factors. University of South Carolina]

Wood K, Lambert H, Jewkes R (2008) Injuries are beyond love: physical violence in young South africans’ sexual relationships. Med Anthropol 27(1):43–69. https://doi.org/10.1080/01459740701831427CrossRefPubMed

World Health Organization (2013) Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and nonpartner sexual violence. https://iris.who.int/bitstream/handle/10665/85239/9789241564625_eng.pdf

World Health Organization (2021a) Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. https://iris.who.int/bitstream/handle/10665/341337/9789240022256-eng.pdf?sequence=1

World Health Organization (2021b) Violence against women: Fact sheet. https://www.who.int/news-room/fact-sheets/detail/violence-against-women

Yaya S, Kunnuji MON, Bishwajit G (2019) Intimate Partner violence: a potential challenge for women’s health in Angola. Challenges 10(1):21. https://www.mdpi.com/2078-1547/10/1/21CrossRef

Title: Multilevel determinants of physical violence among ever-partnered women in South Africa
Authors: Dikago Puoeng
Mluleki Tsawe
Publication date: 11-05-2024
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-024-01469-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Multilevel determinants of physical violence among ever-partnered women in South Africa

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content