Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis

Abstract

IntroductionViolence against women (VAW) affects one in three women globally. In some countries, women are at much higher risk. We examined risk factors for VAW in countries with the highest 12-month prevalence estimates of intimate partner violence (IPV) to develop understanding of this increased risk.MethodsFor this systematic review, we searched PUBMED, CINAHL, PROQUEST (Middle East and North Africa; Latin America and Iberia; East and South Asia), Web of Science, EMBASE and PsycINFO (Ovid) for records published between 1 January 2000 and 1 January 2021 in English, French and Spanish. Included records used quantitative, qualitative, or mixed-methods, reported original data, had VAW as the main outcome, and focused on at least one of 23 countries in the highest quintile of prevalence figures for women’s self-reported experiences of physical and/or sexual violence in the past 12 months. We used critical interpretive synthesis to develop a conceptual model for associations between identified risk factors and VAW.ResultsOur search identified 12 044 records, of which 241 were included for analysis (2 80 360 women, 40 276 men, 274 key informants). Most studies were from Bangladesh (74), Uganda (72) and Tanzania (43). Several quantitative studies explored community-level/region-level socioeconomic status and education as risk factors, but associations with VAW were mixed. Although fewer in number and representing just one country, studies reported more consistent effects for community-level childhood exposure to violence and urban residence. Theoretical explanations for a country’s high prevalence point to the importance of exposure to other forms of violence (armed conflict, witnessing parental violence, child abuse) and patriarchal social norms.ConclusionAvailable evidence suggests that heightened prevalence of VAW is not attributable to a single risk factor. Multilayered and area-level risk analyses are needed to ensure funding is appropriately targeted for countries where VAW is most pervasive.PROSPERO registration numberThe review is registered with PROSPERO (CRD42020190147).

Mechanisms for the prevention of adolescent intimate partner violence: A realist review of interventions in low- and middle-income countries

“…Similarly, there is a skew towards focusing on transforming gendered social norms and attitudes for adolescent IPV prevention, when norms and attitudes are only one of many drivers of IPV [1,85,86]. We only identified one intervention that had a central focus on an important and broadly recognised protective factor for IPV: education [1,87].…”

“…Similarly, there is a skew towards focusing on transforming gendered social norms and attitudes for adolescent IPV prevention, when norms and attitudes are only one of many drivers of IPV [1,85,86]. We only identified one intervention that had a central focus on an important and broadly recognised protective factor for IPV: education [1,87]. Providing girls and their families with cash payments for school attendance significantly reduced girls' experience of IPV in rural South Africa in the SwaKoteka intervention [44], highlighting the potential of mechanisms beyond gender transformation in the prevention of adolescent IPV, such as increasing agency and autonomy among girls.…”

“…Intimate partner violence (IPV) affects approximately one in three women globally, although with wide variation within and between countries [1], and has detrimental consequences for physical and mental health [2]. Adolescent girls are among those at greatest risk of experiencing IPV.…”

Mechanisms for the prevention of adolescent intimate partner violence: a realist review of interventions in low- and middle-income countries

“…Similarly, there is a skew towards focusing on transforming gendered social norms and attitudes for adolescent IPV prevention, when norms and attitudes are only one of many drivers of IPV (1,86,87).…”

“…We only identified one intervention that had a central focus on an important and broadly recognised protective factor for IPV: education (1,88). Providing girls and their families with cash payments for school attendance significantly reduced girls' experience of IPV in rural South Africa in the SwaKoteka intervention (44), highlighting the potential of mechanisms beyond gender transformation in the prevention of adolescent IPV, such as increasing agency and autonomy among girls.…”