554287 research-article2014
JIVXXX10.1177/0886260514554287Journal of Interpersonal ViolenceMugoya et al.
Article
Sociocultural and Victimization Factors That Impact Attitudes Toward Intimate Partner Violence Among Kenyan Women
Journal of Interpersonal Violence 2015, Vol. 30(16) 2851–2871 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0886260514554287 jiv.sagepub.com
George C. T. Mugoya, PhD,1 Tricia H. Witte, PhD,1 and Kacey C. Ernst, PhD2
Abstract This study investigates the association between acceptance of intimate partner violence (IPV) and reported IPV victimization among Kenyan women, taking into consideration select sociocultural factors that may also influence acceptance of IPV. Data from a nationally representative, cross-sectional, household survey conducted between November 2008 and February 2009 in Kenya were analyzed. Hierarchical multiple regression was conducted to estimate the effect of select sociodemographic characteristics and reported IPV victimization on acceptance of IPV. The results showed that while both sociodemographic characteristics and reported IPV victimization were significantly associated with IPV acceptance, sociocultural factors had a greater impact. Programs aimed at empowering women and culturally competent IPV prevention strategies may be the key elements to reducing IPV.
1University 2University
of Alabama, Tuscaloosa, AL, USA of Arizona, Tuscon, AZ, USA
Corresponding Author: George C. T. Mugoya, Department of Educational Studies in Psychology, Research Methodology and Counselling, University of Alabama, P.O. Box 870231, Tuscaloosa, AL 35487-0231, USA. Email: [email protected]
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Keywords intimate partner violence, socioculture, attitudes, perceptions, Kenya Intimate partner violence (IPV) is a serious human rights abuse that is perpetrated and experienced by many individuals across all races, cultures, religions, professions, educational backgrounds, and socioeconomic statuses (Rani & Bonu, 2009). The perpetrators of IPV can be men or women with the abuse involving a current or former spouse, boyfriend or girlfriend, and individuals in either heterosexual or homosexual relationships (Johnson & Leone, 2005). Husband-to-wife violence is one of the most prevalent forms of IPV across the world. A World Health Organization (WHO) multicountry study involving more than 24,000 women from 10 countries representing diverse cultural settings found that the prevalence of physical violence by a male partner in the lifetime ranged from 13% in Japan to 61% in provincial Peru (WHO, 2005). In Kenya, the prevalence of physical violence by an intimate partner has been placed between 45% (Fonck, Els, Kidula, Ndinya-Achola, & Temmerman, 2005) and 68% (Lawoko, 2008). In addition to physical violence, sexual and emotional violence have also been reported across the globe; for example, the prevalence of sexual violence ranges from 6% in Japan to 59% in Ethiopia (WHO, 2005). Utilizing data from the 2003 Kenya Demographic Health Survey (KDHS), Emenike, Lawoko, and Dalal (2008) reported the following prevalence rates of IPV among Kenyan women: physical (38%), emotional (24%), and sexual (14%). Violence perpetrated by men against women has been shown to have serious negative effects on women’s health (e.g., García-Moreno & Watts, 2000; Maman, Campbell, Sweat, & Gielen, 2000), their family, and community (Zimmerman, 1994). This type of violence has been associated with poorer physical health (Ellsberg, Jansen, Heise, Watts, & Garcia-Moreno, 2008), poor outcomes for pregnancy and birth (Murphy, Schei, Myhr, & Mont, 2001), and increased risk of sexually transmitted diseases including HIV (García-Moreno & Watts, 2000; Maman et al., 2000). Physical risks are often coupled with negative psychological outcomes. These include lowered self-esteem (Cascardi & O’Leary, 1992), depression (Holtzworth-Munroe, Bates, Smutzler, & Sandin, 1997), and a multitude of poor coping strategies such as learned helplessness (Dutton, 1992; Walker, 1977) and self-blame (Barnett, Martinez, & Keyson, 1996). Women may blame themselves for the violence they endure, blaming it on their actions or even more stable characteristics such as perceiving oneself as being inadequate (Overholser & Moll, 1990). If the abuse is enduring, women may adopt
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internal, stable, and global attributions for the violence, which is consistent with a depressive attribution style (e.g., Coyne & Gotlib, 1983; Peterson & Seligman, 1984). Self-blame, depression, and other psychological factors may lead to a greater tolerance of the abuse, less active forms of coping, and a decreased probability of leaving a relationship (Bergman, Larsson, Brismar, & Klang, 1988; Frisch & MacKenzie, 1991; Griffing et al., 2002; Strube, 1988). Previous studies have shown that experience with violence victimization is positively associated with accepting attitudes toward violence (Callands, Sipsma, Betancourt, & Hansen, 2013, in a sample of Liberian women). Social and cultural acceptance of husband-to-wife violence has a tremendous impact on women’s attitudes toward violence as well. In fact, structural theorists argue that the major causes of IPV are societal norms that promote the subordination of women (Dobash & Dobash, 1979; Garcia-Moreno, 2002). Findings from diverse countries including Bangladesh, Cambodia, India, Mexico, Nigeria, Pakistan, Papua New Guinea, Nicaragua, Tanzania, and Zimbabwe indicate that “wife-beating” is viewed by some individuals as a husband’s right to correct an erring wife (Heise, Ellsberg, & Gottmoeller, 2002; Jejeebhoy, 1998; Visaria, 2000). In addition, some marital customs such as payment of bride wealth as dowry, which are not only common among many African tribes but also viewed as a key pillar in signifying the union of a man and woman in matrimony, may lead to the subordination of women. For example, Ellsberg, Heise, Peña, Agurto, and Winkvist (2001) noted that the marital vows and payment of dowry in some Kenyan tribes are interpreted by some within and among kinship groups as securing a man’s rights over the woman with respect to her household labor and unconditional sexual access. Furthermore, some individuals view the payment of dowry as having earned the husband “the right to control his wife as he deemed appropriate” (Kimuna & Djamba, 2008, p. 340). The current study investigates factors that may promote acceptance of violence among Kenyan women: (a) their personal experience with IPV victimization and (b) their sociocultural background, including ethnicity, socioeconomic status, and education. Past research has shown that high education and wealth status is associated with lower husband-to-wife violence (Abuya, Onsomu, Moore, & Piper, 2012; Hindin, 2003). In addition, the current study examines Kenyan women who come from various tribes, each with unique cultural practices especially in relation to marital customs and the status women are accorded within the tribes, which may provide an insight on the role of cultural practices on women’s attitudes toward IPV. Briefly, Kenya is a multiethnic country located in the East African region. The country has about 42 tribes each with its own unique dialect
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and cultural practices. The indigenous tribes of Kenya fall into three ethnic groupings, bantu, cushites, and nilotes, with the bantu being the largest ethnic grouping. Each of the ethnic groupings is subdivided into tribes with the Kikuyu (bantu), Luhya (bantu), and Luo (nilote) being the three largest tribes (Kenya National Bureau of Statistics [KNBS] & ICF Macro, 2010). While each tribe is unique, some tribes are more closely related than others. For example, the Kikuyu, Embu, and Meru tribes are thought to have descended from the mythological figure Mumbi (Kenyatta, 1966; Leakey, 1959). This may partly explain the relative harmony that exists within these communities, especially in regard to elections which have been a source of many inter-ethnic conflicts such as the inter-ethnic violence that occurred between the Kikuyu and Kalenjin communities in the run up to the 2007 presidential elections. Conversely, some customs are specific to certain tribes, for example, among the Luo, marriage was traditionally not viewed as a husband and wife affair only but rather an entire extended family affair, with death not considered as reason for dissolving a marriage (Oluoch & Nyongesa, 2013). When a husband died, his wife was not allowed to remarry but was inherited (Nyarwath, 2012) by one of the husband’s relatives, most commonly the brother. On the other hand, if the wife died, the wife’s family had a responsibility to provide a replacement (Oluoch & Nyongesa, 2013), most commonly the wife’s sister. Among the Maasai community, girls are typically circumcised between ages 11 and 13, after which they are married to a man chosen by her father in exchange for dowry in the form of cows and cash. These early marriages are often quoted as reasons for low formal education among the Maasai, especially girls (e.g., Chege, 1983; Phillips & Bhavnagri, 2002). This study utilizes cross-sectional data from a representative sample of Kenyan women aged 15 to 49 years to evaluate the association between acceptance of IPV and reported IPV victimization, while taking into consideration select sociocultural factors that may also influence acceptance of IPV. The specific hypotheses for this study include the following: Hypothesis 1: Sociocultural factors will influence the acceptance of IPV, such that lower levels of education and wealth indicators will be associated with more accepting attitudes toward IPV. In addition, there will be differential levels of acceptance of IPV based on tribal membership. Hypothesis 2: Personal history with IPV will contribute to more accepting attitudes, beyond what is explained by sociocultural factors.
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Figure 1. Sample selection.
aIn selecting participants for the domestic violence portion of survey, only one eligible woman in a household was administered the questionnaire. In households with more than one eligible woman, the questionnaire was administered to only one woman who was selected randomly using the Kish grid method (Kenya National Bureau of Statistics [KNBS] & ICF Macro, 2010). KDHS = Kenya Demographic Health Survey; DV = Domestic Violence; IPV = intimate partner violence.
Method Data and Participants This study utilizes data from the 2008/2009 KDHS, a nationally representative, cross-sectional, household survey conducted between November 2008 and February 2009 (KNBS & ICF Macro, 2010). Out of the 8,444 women selected to participate in the 2008/2009 KDHS, 6,318 women were chosen to participate in the domestic violence portion of the survey (see Figure 1). Of
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these, 4,906 women who were married (currently or previously) and/or lived with a man as if married were selected to participate in the intimate partner violence (IPV) portion of the survey. Our analyses are thus restricted on these 4,906 women (see Figure 1). Complete details of the design and data collection methods used have been published previously (KNBS & ICF Macro, 2010). Data were completely de-identified and the study was deemed exempt by the Human Subjects Review Committee of the University of Alabama.
Outcome: Acceptance of Wife Beating The outcome of interest was women’s perceptions regarding IPV. This was assessed using the following question: Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she goes out without telling him? If she neglects the children? If she argues with him? If she refuses to have sex with him? and If she burns the food?
The women provided yes, no, or don’t know response for each situation over the lifetime. For analysis purposes, “yes” response was coded as 1, “no” was coded as 0. In all IPV acts, women providing “don’t know” response were less than 2%, these women were eliminated in the construction of a composite index for IPV acceptance. The composite index of IPV acceptance was constructed by adding all values from the five questions leading to six combinations, with scores ranging from 0 (representing individuals who were not accepting of IPV) to 5 (those who were most accepting). The Cronbach’s alpha of the scale was .82. A test for normality showed that both skewness (0.80) and kurtosis (2.2) were within the recommended ranges (West, Finch, & Curran, 1995).
Explanatory Factors Reported IPV was the main explanatory factor. This factor was measured using the Conflict Tactics Scale (Straus, 1979), that had been modified and shortened for easy adaptation to different cultures such as the situation in Kenya. The procedures involved in the modification of the Conflict Tactics Scale have previously been published (KNBS & ICF Macro, 2010; Kishor, 2005). The following questions were used to assess women’s experience of IPV in reference to current husband (for women currently married) or last husband (for those not currently married) over the lifetime:
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Does/Did your (last) husband/partner ever: (a) Push you, shake you, or throw something at you? (b) Slap you? (c) Twist your arm or pull your hair? (d) Punch you with his fist or with something that could hurt you? (e) Kick you or drag you or beat you up? (f) Threaten or attack you with a knife, gun, or any other weapon? (g) Tried to strangle or burn you? (h) Physically force you to have sexual intercourse even when you did not want to? (i) Force you to perform any sexual acts you did not want to? (j) Say or do something to humiliate you in front of others? (k) Threaten to hurt or harm you or someone close to you? (l) Insult you or make you feel bad about yourself?
Women provided a “yes” (coded 1) or “no” (coded 0) response to each question. Each of these items corresponded to one of the four subscales, according to the Conflict Tactics Scale (CTS) literature: severe violence, less severe violence, sexual violence, and emotional violence. We conducted a factor analysis to determine whether these items loaded as expected on each of these subscales. All items for the physical violence corresponded with the groupings in the original CTS except for being punched and kicked/dragged, which grouped in less severe violence and not in the severe violence as proposed in the original scale. For analysis purposes in the current study, severe and less severe physical violence were combined into one variable (physical violence). In addition, the following explanatory factors which have been shown by past research to be related to IPV and for which data were available were also evaluated: (a) household wealth index which was available in the data set and had been constructed by assigning weights to various household assets such as type of flooring, sanitation facilities used, electricity, source of water supply, and ownership of various assets (e.g., radio, television and vehicle) using the principal components analysis (Filmer & Pritchett, 1998; Rutstein & Johnson, 2004); (b) education attainment (respondent and partner); and (c) ethnic background.
Analysis Statistical analyses were performed using STATA version 12 software. Descriptive statistics were conducted to determine the characteristics of respondents and weighted frequency of reported IPV in a lifetime and over the preceding 12 months. Weighted bivariate analyses were used to ascertain the relationship between reported IPV and various perceptions of IPV. To determine whether there were significant differences in acceptance of IPV by the various predictor variables, the distribution of the variables was
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first assessed using the Shapiro–Francia test (Shapiro & Francia, 1972). The test showed that the data for predictor variables were not normally distributed. Thus, the non-parametric Kruskal–Wallis test was utilized to evaluate differences among the predictor variables on median change of the acceptance of IPV. Finally, hierarchical multiple regression analysis was conducted with acceptance of IPV as the dependent variable in two stages. In Stage 1, wealth, education, and ethnicity were entered to control for sociodemographic variables. Reported IPV was then entered in Stage 2. Prior to conducting the hierarchical multiple regression analysis, multicollinearity of the independent variables was examined. The tests for multicollinearity (Variance Inflation Factor [VIF]: 1.1-4.0; Tolerance: 0.3-0.9) were all within acceptable limits (Coakes, 2005; Stevens, 2002).
Results The average age of the participants was 32.0 years, with 85% and 15% of them being currently and formerly married, respectively. A total of 71.5% of the women resided in rural area. The proportion of women accepting husband-to-wife violence for the different situations were as follows: 32.7% for going out without permission, 43.0% for neglecting children, 33.6% for arguing with husband, 25.0% for refusing sex, and 13.8% for burning food (no table). Table 1 presents the prevalence of reported acts of IPV victimization (note, these categories are not mutually exclusive). Over the lifetime, the most frequently reported acts of IPV were husband or significant other slapping (32.3%) and insulting/making the woman feel bad about herself (22.8%). Conversely, severe forms of physical violence including tried/actually strangled or burned the respondent, were the least reported acts of IPV over the lifetime (3.1%). Of those reporting acts of IPV victimization in the lifetime (n = 2,191), 78.6% to 90.4% of the women reported at least one of the acts occurring in the preceding 12 months, and 55.4% of the women did not report any acts of IPV. The bivariate relationship between reported IPV victimization and perceptions of IPV are presented in Figure 2. Among women reporting various forms of IPV, neglect of children was the most acceptable situation for husband-to-wife violence (49.1%-54.6% reporting acceptance), while burning food was the least acceptable reason for IPV (16.6%-18.2% reporting acceptance). With the exception of going out without permission whereby women reporting physical violence were the most accepting of husband-to-wife violence (40.0%), women reporting sexual violence were most accepting of
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Table 1. Prevalence of Reported IPV Acts by Spouse or Significant Other in the Lifetime and Preceding 12 Months Among Kenyan Women, KDHS 2008-2009. Individuals Reporting Acts of IPV Spouse or Significant Other Ever Physical violence Less severe Pushed, shook, or thrown something Slapped Punched Kicked or dragged Twisted arm or pulled hair Severe Tried/actually strangled or burned Threatened/attacked with weapon Sexual violence Physically forced to have sex Forced other sexual acts Emotional violence Humiliated Threatened to harm Insulted/made to feel bad about self Never experienced IPV
In the Lifetime
Preceding 12 Monthsa
%
SE
n
%
SE
900
19.7
0.01
735
80.9
0.02
1,553 568 680 420
32.3 12.9 15.4 10.0
0.01 0.01 0.01 0.01
1,249 471 531 354
78.6 81.3 79.3 85.9
0.02 0.03 0.02 0.02
156
3.1
0.01
137
86.7
0.02
198
4.6
0.01
167
89.2
0.02
626 200
12.8 4.1
0.01 0.01
554 179
88.5 89.5
0.02 0.02
809 713 1,036
17.2 15.2 22.8
0.01 0.01 0.01
708 612 925
90.4 84.1 89.3
0.02 0.02 0.02
2,715
55.4
0.01
—
—
—
n
aOf those reporting IPV acts in lifetime, proportion reporting occurrence of the acts 12 months preceding the interview. Values adjusted for weights; n = 4,906. IPV = intimate personal violence; KDHS = Kenya Demographic Health Survey.
husband-to-wife violence for all the other situations (i.e., neglecting children: 54.6%; arguing with the husband: 45.3%; refusing to have sex: 37.0%; burning food: 18.2%). The results of the Kruskal–Wallis test, which had been corrected for tied ranks (Table 2), indicated that acceptance of IPV was significantly related with all the predictor variables examined: ethnicity, χ2 = 389.7, p < .001; wealth, χ2 = 375.6, p < .001; respondent’s education, χ2 = 312.6, p < .001; partner’s education, χ2 = 253.3, p < .001; emotional violence, χ2 = 70.8, p < .001;
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Percentage acceptable to IPV
50.0
Key 45.3 41.8 40.5
40.0 40.0
36.3
Physical (N=1,787)
38.3
Emotional (N=1,399)
37.6
Sexual (N=649)
37.0
None (N=2,715)
31.6 31.8 30.0
28.3
28.6
19.7
20.0
18.2 17.0 16.6 11.9
10.0
0.0 Going out without permission
Neglecting children
Arguing with husband
Refusing to have sex
Burning food
Figure 2. Relationship between perceptions/acceptance of intimate partner violence and reported intimate violence. Note. IPV = intimate partner violence.
physical violence, χ2 = 188.7, p < .001; sexual violence, χ2 = 48.2, p < .001. Follow-up tests conducted to evaluate pairwise differences among the various predictor variables showed significant difference in most of the variables assessed, except between some tribal communities (i.e., Kikuyu and Embu/ Meru; Kalenjin and Kisii; Kamba and Luo; Coastal and “Other”) and between the those in the Middle and Rich wealth categories. The results of the hierarchical multiple regression analysis predicting acceptance of IPV from sociodemographic characteristics and reported IPV are presented in Table 3. The results of Step 1 showed that the sociodemographic characteristics (ethnicity, wealth, and education level for the respondent and her partner) accounted for 18.2% of the variance in the acceptance of IPV, which was statistically significant, F(18, 366) = 29.75, p < .001. Adding reported IPV in Step 2 led to a statistically significant change in variance (ΔR2 = .015), ΔF(21, 363) = 15.91; p < .001. Experience of emotional (β = .04, p < .05) and physical (β = .07, p < .01) violence showed statistically significant independent effects on acceptance of IPV while sexual violence was not as influencing. Considering the sociodemographic factors, in both Steps 1 and 2, we found that compared with Kikuyu women, those from Kalenjin, Kisii, Luhya, Coastal, and “Other” communities were significantly
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No education — 281.0* 694.4* 1,275.0*
Secondary
— 580.6*
— 413.4* 994.0*
— 133.9 504.5*
Middle
— 797.1* 367.0* 17.7 394.1* 222.2 392.8*
Kamba
—
Higher
— 370.6*
Rich
— 430.1* 814.8* 1,191.2* 574.9* 404.4*
Kisii
—
Richest
— 384.6* 761.1* 144.8 25.8
Luhya
Rank Mean Differences
Primary
— 380.6* 514.5* 885.1*
Poor
— 23.1 403.7* 537.5* 908.2*
Poorest
Poorest 1,026 2,763.1 Poor 740 2,740.0 Middle 797 2,359.4 Rich 880 2,225.6 Richest 1,252 1,854.9 χ2(corrected for ties) = 389.70, df = 8, p < .001 Respondent’s education No education 847 2,732.4 Primary 2,561 2,451.4 Secondary 957 2,038.0 Higher 330 1,457.5
— 722.4* 74.7 355.4* 740.0* 1,116.5* 500.2* 329.6*
— 1,062.9* 340.5* 1,137.6* 707.5* 322.9* 53.6 562.7* 733.3*
Kikuyu 841 1,851.3 Kalenjin 382 2,914.2 Kamba 357 2,191.8 Kisii 258 2,988.9 Luhya 651 2,558.8 Luo 620 2,174.1 Embu/Meru 300 1,797.7 Coastal 474 2,414.0 Other 810 2,584.5 χ2(corrected for ties) = 389.70, df = 8, p < .001 Wealth
Kalenjin
Kikuyu
n
Rank Mean
Ethnicity
IPV Acceptance Embu/
— 376.5* — 239.8 616.3* 410.4* 786.9*
Luo
(continued)
— 170.6
—
Coastal Other
Table 2. Kruskal–Wallis Non-Parametric ANOVA Test: Associations Between IPV Acceptance and Predictor Variables.
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n
Rank Mean
— 380.7*
Coastal Other
— 528.9*
Embu/
Luo
Luhya
— 344.9*
503.4*
Higher
Kisii
299.6* 802.6*
270.2* 569.8* 1,072.8*
Secondary
Kamba
Rank Mean Differences
No
Primary
Kalenjin
No education
Kikuyu
Note. Values adjusted for weights. IPV = intimate personal violence. *Statistically significant rank mean differences (p < .05).
χ2(corrected for ties) = 389.70, df = 8, p < .001 Partners’ education No education 670 2,751.1 Primary 2,151 2,480.9 Secondary 1,372 2,181.3 Higher 499 1,678.3 χ2(corrected for ties) = 253.33, df = 8, p < .001 Reported IPV Emotional No 3,341 2,247.2 Yes 1,351 2,592.1 χ2(corrected for ties) = 70.75, df = 8, p < .001 Physical No 2,967 2,151.6 Yes 1,724 2,680.5 χ2(corrected for ties) = 188.66, df = 8, p
JIVXXX10.1177/0886260514554287Journal of Interpersonal ViolenceMugoya et al.
Article
Sociocultural and Victimization Factors That Impact Attitudes Toward Intimate Partner Violence Among Kenyan Women
Journal of Interpersonal Violence 2015, Vol. 30(16) 2851–2871 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0886260514554287 jiv.sagepub.com
George C. T. Mugoya, PhD,1 Tricia H. Witte, PhD,1 and Kacey C. Ernst, PhD2
Abstract This study investigates the association between acceptance of intimate partner violence (IPV) and reported IPV victimization among Kenyan women, taking into consideration select sociocultural factors that may also influence acceptance of IPV. Data from a nationally representative, cross-sectional, household survey conducted between November 2008 and February 2009 in Kenya were analyzed. Hierarchical multiple regression was conducted to estimate the effect of select sociodemographic characteristics and reported IPV victimization on acceptance of IPV. The results showed that while both sociodemographic characteristics and reported IPV victimization were significantly associated with IPV acceptance, sociocultural factors had a greater impact. Programs aimed at empowering women and culturally competent IPV prevention strategies may be the key elements to reducing IPV.
1University 2University
of Alabama, Tuscaloosa, AL, USA of Arizona, Tuscon, AZ, USA
Corresponding Author: George C. T. Mugoya, Department of Educational Studies in Psychology, Research Methodology and Counselling, University of Alabama, P.O. Box 870231, Tuscaloosa, AL 35487-0231, USA. Email: [email protected]
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Keywords intimate partner violence, socioculture, attitudes, perceptions, Kenya Intimate partner violence (IPV) is a serious human rights abuse that is perpetrated and experienced by many individuals across all races, cultures, religions, professions, educational backgrounds, and socioeconomic statuses (Rani & Bonu, 2009). The perpetrators of IPV can be men or women with the abuse involving a current or former spouse, boyfriend or girlfriend, and individuals in either heterosexual or homosexual relationships (Johnson & Leone, 2005). Husband-to-wife violence is one of the most prevalent forms of IPV across the world. A World Health Organization (WHO) multicountry study involving more than 24,000 women from 10 countries representing diverse cultural settings found that the prevalence of physical violence by a male partner in the lifetime ranged from 13% in Japan to 61% in provincial Peru (WHO, 2005). In Kenya, the prevalence of physical violence by an intimate partner has been placed between 45% (Fonck, Els, Kidula, Ndinya-Achola, & Temmerman, 2005) and 68% (Lawoko, 2008). In addition to physical violence, sexual and emotional violence have also been reported across the globe; for example, the prevalence of sexual violence ranges from 6% in Japan to 59% in Ethiopia (WHO, 2005). Utilizing data from the 2003 Kenya Demographic Health Survey (KDHS), Emenike, Lawoko, and Dalal (2008) reported the following prevalence rates of IPV among Kenyan women: physical (38%), emotional (24%), and sexual (14%). Violence perpetrated by men against women has been shown to have serious negative effects on women’s health (e.g., García-Moreno & Watts, 2000; Maman, Campbell, Sweat, & Gielen, 2000), their family, and community (Zimmerman, 1994). This type of violence has been associated with poorer physical health (Ellsberg, Jansen, Heise, Watts, & Garcia-Moreno, 2008), poor outcomes for pregnancy and birth (Murphy, Schei, Myhr, & Mont, 2001), and increased risk of sexually transmitted diseases including HIV (García-Moreno & Watts, 2000; Maman et al., 2000). Physical risks are often coupled with negative psychological outcomes. These include lowered self-esteem (Cascardi & O’Leary, 1992), depression (Holtzworth-Munroe, Bates, Smutzler, & Sandin, 1997), and a multitude of poor coping strategies such as learned helplessness (Dutton, 1992; Walker, 1977) and self-blame (Barnett, Martinez, & Keyson, 1996). Women may blame themselves for the violence they endure, blaming it on their actions or even more stable characteristics such as perceiving oneself as being inadequate (Overholser & Moll, 1990). If the abuse is enduring, women may adopt
Mugoya et al.
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internal, stable, and global attributions for the violence, which is consistent with a depressive attribution style (e.g., Coyne & Gotlib, 1983; Peterson & Seligman, 1984). Self-blame, depression, and other psychological factors may lead to a greater tolerance of the abuse, less active forms of coping, and a decreased probability of leaving a relationship (Bergman, Larsson, Brismar, & Klang, 1988; Frisch & MacKenzie, 1991; Griffing et al., 2002; Strube, 1988). Previous studies have shown that experience with violence victimization is positively associated with accepting attitudes toward violence (Callands, Sipsma, Betancourt, & Hansen, 2013, in a sample of Liberian women). Social and cultural acceptance of husband-to-wife violence has a tremendous impact on women’s attitudes toward violence as well. In fact, structural theorists argue that the major causes of IPV are societal norms that promote the subordination of women (Dobash & Dobash, 1979; Garcia-Moreno, 2002). Findings from diverse countries including Bangladesh, Cambodia, India, Mexico, Nigeria, Pakistan, Papua New Guinea, Nicaragua, Tanzania, and Zimbabwe indicate that “wife-beating” is viewed by some individuals as a husband’s right to correct an erring wife (Heise, Ellsberg, & Gottmoeller, 2002; Jejeebhoy, 1998; Visaria, 2000). In addition, some marital customs such as payment of bride wealth as dowry, which are not only common among many African tribes but also viewed as a key pillar in signifying the union of a man and woman in matrimony, may lead to the subordination of women. For example, Ellsberg, Heise, Peña, Agurto, and Winkvist (2001) noted that the marital vows and payment of dowry in some Kenyan tribes are interpreted by some within and among kinship groups as securing a man’s rights over the woman with respect to her household labor and unconditional sexual access. Furthermore, some individuals view the payment of dowry as having earned the husband “the right to control his wife as he deemed appropriate” (Kimuna & Djamba, 2008, p. 340). The current study investigates factors that may promote acceptance of violence among Kenyan women: (a) their personal experience with IPV victimization and (b) their sociocultural background, including ethnicity, socioeconomic status, and education. Past research has shown that high education and wealth status is associated with lower husband-to-wife violence (Abuya, Onsomu, Moore, & Piper, 2012; Hindin, 2003). In addition, the current study examines Kenyan women who come from various tribes, each with unique cultural practices especially in relation to marital customs and the status women are accorded within the tribes, which may provide an insight on the role of cultural practices on women’s attitudes toward IPV. Briefly, Kenya is a multiethnic country located in the East African region. The country has about 42 tribes each with its own unique dialect
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and cultural practices. The indigenous tribes of Kenya fall into three ethnic groupings, bantu, cushites, and nilotes, with the bantu being the largest ethnic grouping. Each of the ethnic groupings is subdivided into tribes with the Kikuyu (bantu), Luhya (bantu), and Luo (nilote) being the three largest tribes (Kenya National Bureau of Statistics [KNBS] & ICF Macro, 2010). While each tribe is unique, some tribes are more closely related than others. For example, the Kikuyu, Embu, and Meru tribes are thought to have descended from the mythological figure Mumbi (Kenyatta, 1966; Leakey, 1959). This may partly explain the relative harmony that exists within these communities, especially in regard to elections which have been a source of many inter-ethnic conflicts such as the inter-ethnic violence that occurred between the Kikuyu and Kalenjin communities in the run up to the 2007 presidential elections. Conversely, some customs are specific to certain tribes, for example, among the Luo, marriage was traditionally not viewed as a husband and wife affair only but rather an entire extended family affair, with death not considered as reason for dissolving a marriage (Oluoch & Nyongesa, 2013). When a husband died, his wife was not allowed to remarry but was inherited (Nyarwath, 2012) by one of the husband’s relatives, most commonly the brother. On the other hand, if the wife died, the wife’s family had a responsibility to provide a replacement (Oluoch & Nyongesa, 2013), most commonly the wife’s sister. Among the Maasai community, girls are typically circumcised between ages 11 and 13, after which they are married to a man chosen by her father in exchange for dowry in the form of cows and cash. These early marriages are often quoted as reasons for low formal education among the Maasai, especially girls (e.g., Chege, 1983; Phillips & Bhavnagri, 2002). This study utilizes cross-sectional data from a representative sample of Kenyan women aged 15 to 49 years to evaluate the association between acceptance of IPV and reported IPV victimization, while taking into consideration select sociocultural factors that may also influence acceptance of IPV. The specific hypotheses for this study include the following: Hypothesis 1: Sociocultural factors will influence the acceptance of IPV, such that lower levels of education and wealth indicators will be associated with more accepting attitudes toward IPV. In addition, there will be differential levels of acceptance of IPV based on tribal membership. Hypothesis 2: Personal history with IPV will contribute to more accepting attitudes, beyond what is explained by sociocultural factors.
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Figure 1. Sample selection.
aIn selecting participants for the domestic violence portion of survey, only one eligible woman in a household was administered the questionnaire. In households with more than one eligible woman, the questionnaire was administered to only one woman who was selected randomly using the Kish grid method (Kenya National Bureau of Statistics [KNBS] & ICF Macro, 2010). KDHS = Kenya Demographic Health Survey; DV = Domestic Violence; IPV = intimate partner violence.
Method Data and Participants This study utilizes data from the 2008/2009 KDHS, a nationally representative, cross-sectional, household survey conducted between November 2008 and February 2009 (KNBS & ICF Macro, 2010). Out of the 8,444 women selected to participate in the 2008/2009 KDHS, 6,318 women were chosen to participate in the domestic violence portion of the survey (see Figure 1). Of
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these, 4,906 women who were married (currently or previously) and/or lived with a man as if married were selected to participate in the intimate partner violence (IPV) portion of the survey. Our analyses are thus restricted on these 4,906 women (see Figure 1). Complete details of the design and data collection methods used have been published previously (KNBS & ICF Macro, 2010). Data were completely de-identified and the study was deemed exempt by the Human Subjects Review Committee of the University of Alabama.
Outcome: Acceptance of Wife Beating The outcome of interest was women’s perceptions regarding IPV. This was assessed using the following question: Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she goes out without telling him? If she neglects the children? If she argues with him? If she refuses to have sex with him? and If she burns the food?
The women provided yes, no, or don’t know response for each situation over the lifetime. For analysis purposes, “yes” response was coded as 1, “no” was coded as 0. In all IPV acts, women providing “don’t know” response were less than 2%, these women were eliminated in the construction of a composite index for IPV acceptance. The composite index of IPV acceptance was constructed by adding all values from the five questions leading to six combinations, with scores ranging from 0 (representing individuals who were not accepting of IPV) to 5 (those who were most accepting). The Cronbach’s alpha of the scale was .82. A test for normality showed that both skewness (0.80) and kurtosis (2.2) were within the recommended ranges (West, Finch, & Curran, 1995).
Explanatory Factors Reported IPV was the main explanatory factor. This factor was measured using the Conflict Tactics Scale (Straus, 1979), that had been modified and shortened for easy adaptation to different cultures such as the situation in Kenya. The procedures involved in the modification of the Conflict Tactics Scale have previously been published (KNBS & ICF Macro, 2010; Kishor, 2005). The following questions were used to assess women’s experience of IPV in reference to current husband (for women currently married) or last husband (for those not currently married) over the lifetime:
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Does/Did your (last) husband/partner ever: (a) Push you, shake you, or throw something at you? (b) Slap you? (c) Twist your arm or pull your hair? (d) Punch you with his fist or with something that could hurt you? (e) Kick you or drag you or beat you up? (f) Threaten or attack you with a knife, gun, or any other weapon? (g) Tried to strangle or burn you? (h) Physically force you to have sexual intercourse even when you did not want to? (i) Force you to perform any sexual acts you did not want to? (j) Say or do something to humiliate you in front of others? (k) Threaten to hurt or harm you or someone close to you? (l) Insult you or make you feel bad about yourself?
Women provided a “yes” (coded 1) or “no” (coded 0) response to each question. Each of these items corresponded to one of the four subscales, according to the Conflict Tactics Scale (CTS) literature: severe violence, less severe violence, sexual violence, and emotional violence. We conducted a factor analysis to determine whether these items loaded as expected on each of these subscales. All items for the physical violence corresponded with the groupings in the original CTS except for being punched and kicked/dragged, which grouped in less severe violence and not in the severe violence as proposed in the original scale. For analysis purposes in the current study, severe and less severe physical violence were combined into one variable (physical violence). In addition, the following explanatory factors which have been shown by past research to be related to IPV and for which data were available were also evaluated: (a) household wealth index which was available in the data set and had been constructed by assigning weights to various household assets such as type of flooring, sanitation facilities used, electricity, source of water supply, and ownership of various assets (e.g., radio, television and vehicle) using the principal components analysis (Filmer & Pritchett, 1998; Rutstein & Johnson, 2004); (b) education attainment (respondent and partner); and (c) ethnic background.
Analysis Statistical analyses were performed using STATA version 12 software. Descriptive statistics were conducted to determine the characteristics of respondents and weighted frequency of reported IPV in a lifetime and over the preceding 12 months. Weighted bivariate analyses were used to ascertain the relationship between reported IPV and various perceptions of IPV. To determine whether there were significant differences in acceptance of IPV by the various predictor variables, the distribution of the variables was
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first assessed using the Shapiro–Francia test (Shapiro & Francia, 1972). The test showed that the data for predictor variables were not normally distributed. Thus, the non-parametric Kruskal–Wallis test was utilized to evaluate differences among the predictor variables on median change of the acceptance of IPV. Finally, hierarchical multiple regression analysis was conducted with acceptance of IPV as the dependent variable in two stages. In Stage 1, wealth, education, and ethnicity were entered to control for sociodemographic variables. Reported IPV was then entered in Stage 2. Prior to conducting the hierarchical multiple regression analysis, multicollinearity of the independent variables was examined. The tests for multicollinearity (Variance Inflation Factor [VIF]: 1.1-4.0; Tolerance: 0.3-0.9) were all within acceptable limits (Coakes, 2005; Stevens, 2002).
Results The average age of the participants was 32.0 years, with 85% and 15% of them being currently and formerly married, respectively. A total of 71.5% of the women resided in rural area. The proportion of women accepting husband-to-wife violence for the different situations were as follows: 32.7% for going out without permission, 43.0% for neglecting children, 33.6% for arguing with husband, 25.0% for refusing sex, and 13.8% for burning food (no table). Table 1 presents the prevalence of reported acts of IPV victimization (note, these categories are not mutually exclusive). Over the lifetime, the most frequently reported acts of IPV were husband or significant other slapping (32.3%) and insulting/making the woman feel bad about herself (22.8%). Conversely, severe forms of physical violence including tried/actually strangled or burned the respondent, were the least reported acts of IPV over the lifetime (3.1%). Of those reporting acts of IPV victimization in the lifetime (n = 2,191), 78.6% to 90.4% of the women reported at least one of the acts occurring in the preceding 12 months, and 55.4% of the women did not report any acts of IPV. The bivariate relationship between reported IPV victimization and perceptions of IPV are presented in Figure 2. Among women reporting various forms of IPV, neglect of children was the most acceptable situation for husband-to-wife violence (49.1%-54.6% reporting acceptance), while burning food was the least acceptable reason for IPV (16.6%-18.2% reporting acceptance). With the exception of going out without permission whereby women reporting physical violence were the most accepting of husband-to-wife violence (40.0%), women reporting sexual violence were most accepting of
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Table 1. Prevalence of Reported IPV Acts by Spouse or Significant Other in the Lifetime and Preceding 12 Months Among Kenyan Women, KDHS 2008-2009. Individuals Reporting Acts of IPV Spouse or Significant Other Ever Physical violence Less severe Pushed, shook, or thrown something Slapped Punched Kicked or dragged Twisted arm or pulled hair Severe Tried/actually strangled or burned Threatened/attacked with weapon Sexual violence Physically forced to have sex Forced other sexual acts Emotional violence Humiliated Threatened to harm Insulted/made to feel bad about self Never experienced IPV
In the Lifetime
Preceding 12 Monthsa
%
SE
n
%
SE
900
19.7
0.01
735
80.9
0.02
1,553 568 680 420
32.3 12.9 15.4 10.0
0.01 0.01 0.01 0.01
1,249 471 531 354
78.6 81.3 79.3 85.9
0.02 0.03 0.02 0.02
156
3.1
0.01
137
86.7
0.02
198
4.6
0.01
167
89.2
0.02
626 200
12.8 4.1
0.01 0.01
554 179
88.5 89.5
0.02 0.02
809 713 1,036
17.2 15.2 22.8
0.01 0.01 0.01
708 612 925
90.4 84.1 89.3
0.02 0.02 0.02
2,715
55.4
0.01
—
—
—
n
aOf those reporting IPV acts in lifetime, proportion reporting occurrence of the acts 12 months preceding the interview. Values adjusted for weights; n = 4,906. IPV = intimate personal violence; KDHS = Kenya Demographic Health Survey.
husband-to-wife violence for all the other situations (i.e., neglecting children: 54.6%; arguing with the husband: 45.3%; refusing to have sex: 37.0%; burning food: 18.2%). The results of the Kruskal–Wallis test, which had been corrected for tied ranks (Table 2), indicated that acceptance of IPV was significantly related with all the predictor variables examined: ethnicity, χ2 = 389.7, p < .001; wealth, χ2 = 375.6, p < .001; respondent’s education, χ2 = 312.6, p < .001; partner’s education, χ2 = 253.3, p < .001; emotional violence, χ2 = 70.8, p < .001;
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Percentage acceptable to IPV
50.0
Key 45.3 41.8 40.5
40.0 40.0
36.3
Physical (N=1,787)
38.3
Emotional (N=1,399)
37.6
Sexual (N=649)
37.0
None (N=2,715)
31.6 31.8 30.0
28.3
28.6
19.7
20.0
18.2 17.0 16.6 11.9
10.0
0.0 Going out without permission
Neglecting children
Arguing with husband
Refusing to have sex
Burning food
Figure 2. Relationship between perceptions/acceptance of intimate partner violence and reported intimate violence. Note. IPV = intimate partner violence.
physical violence, χ2 = 188.7, p < .001; sexual violence, χ2 = 48.2, p < .001. Follow-up tests conducted to evaluate pairwise differences among the various predictor variables showed significant difference in most of the variables assessed, except between some tribal communities (i.e., Kikuyu and Embu/ Meru; Kalenjin and Kisii; Kamba and Luo; Coastal and “Other”) and between the those in the Middle and Rich wealth categories. The results of the hierarchical multiple regression analysis predicting acceptance of IPV from sociodemographic characteristics and reported IPV are presented in Table 3. The results of Step 1 showed that the sociodemographic characteristics (ethnicity, wealth, and education level for the respondent and her partner) accounted for 18.2% of the variance in the acceptance of IPV, which was statistically significant, F(18, 366) = 29.75, p < .001. Adding reported IPV in Step 2 led to a statistically significant change in variance (ΔR2 = .015), ΔF(21, 363) = 15.91; p < .001. Experience of emotional (β = .04, p < .05) and physical (β = .07, p < .01) violence showed statistically significant independent effects on acceptance of IPV while sexual violence was not as influencing. Considering the sociodemographic factors, in both Steps 1 and 2, we found that compared with Kikuyu women, those from Kalenjin, Kisii, Luhya, Coastal, and “Other” communities were significantly
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No education — 281.0* 694.4* 1,275.0*
Secondary
— 580.6*
— 413.4* 994.0*
— 133.9 504.5*
Middle
— 797.1* 367.0* 17.7 394.1* 222.2 392.8*
Kamba
—
Higher
— 370.6*
Rich
— 430.1* 814.8* 1,191.2* 574.9* 404.4*
Kisii
—
Richest
— 384.6* 761.1* 144.8 25.8
Luhya
Rank Mean Differences
Primary
— 380.6* 514.5* 885.1*
Poor
— 23.1 403.7* 537.5* 908.2*
Poorest
Poorest 1,026 2,763.1 Poor 740 2,740.0 Middle 797 2,359.4 Rich 880 2,225.6 Richest 1,252 1,854.9 χ2(corrected for ties) = 389.70, df = 8, p < .001 Respondent’s education No education 847 2,732.4 Primary 2,561 2,451.4 Secondary 957 2,038.0 Higher 330 1,457.5
— 722.4* 74.7 355.4* 740.0* 1,116.5* 500.2* 329.6*
— 1,062.9* 340.5* 1,137.6* 707.5* 322.9* 53.6 562.7* 733.3*
Kikuyu 841 1,851.3 Kalenjin 382 2,914.2 Kamba 357 2,191.8 Kisii 258 2,988.9 Luhya 651 2,558.8 Luo 620 2,174.1 Embu/Meru 300 1,797.7 Coastal 474 2,414.0 Other 810 2,584.5 χ2(corrected for ties) = 389.70, df = 8, p < .001 Wealth
Kalenjin
Kikuyu
n
Rank Mean
Ethnicity
IPV Acceptance Embu/
— 376.5* — 239.8 616.3* 410.4* 786.9*
Luo
(continued)
— 170.6
—
Coastal Other
Table 2. Kruskal–Wallis Non-Parametric ANOVA Test: Associations Between IPV Acceptance and Predictor Variables.
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n
Rank Mean
— 380.7*
Coastal Other
— 528.9*
Embu/
Luo
Luhya
— 344.9*
503.4*
Higher
Kisii
299.6* 802.6*
270.2* 569.8* 1,072.8*
Secondary
Kamba
Rank Mean Differences
No
Primary
Kalenjin
No education
Kikuyu
Note. Values adjusted for weights. IPV = intimate personal violence. *Statistically significant rank mean differences (p < .05).
χ2(corrected for ties) = 389.70, df = 8, p < .001 Partners’ education No education 670 2,751.1 Primary 2,151 2,480.9 Secondary 1,372 2,181.3 Higher 499 1,678.3 χ2(corrected for ties) = 253.33, df = 8, p < .001 Reported IPV Emotional No 3,341 2,247.2 Yes 1,351 2,592.1 χ2(corrected for ties) = 70.75, df = 8, p < .001 Physical No 2,967 2,151.6 Yes 1,724 2,680.5 χ2(corrected for ties) = 188.66, df = 8, p
