Description of included countries
Table shows the countries, years of data collection, and sample sizes. It also illustrates the demographic and economic diversity of the selected countries. All the 17 countries were low-income countries. As for gross domestic product (GDP) per capita, Swaziland and Namibia emerged as the most affluent countries with values higher than United States dollar (US$)2000 per capita, whilst by contrast Ethiopia, Malawi and Rwanda were the most deprived with values less than US$250 per capita. Nigeria was the most and Lesotho was the least populated country among the countries studied. Regarding levels of urbanization, the percentage of urban population varied across the countries. The percentage of literacy among women was highest in Lesotho (90%) and lowest in Burkina Faso (17%).
Description of data sets, selected social, economic, and demographic characteristics of the countries included in the study
Table shows the socio-demographic characteristics of the study participants. Most of the respondents were female. The percentage of female ranged from 53% in Ghana to 81% in Mozambique. Most of the respondents (34% to 48%) were aged 15–24. The percentage of respondents with no education varies across the country. The percentage of respondents with no education was lowest in Zimbabwe (3%) and highest in Burkina Faso (76%). With the exception of Lesotho (44%), more than 50% of the respondents were currently working. The percentage of respondents that are currently married ranged from 35% in Namibia to 73% in Benin. Respondents were fairly evenly distributed across the wealth status strata. In most countries, most of the respondents were living in the rural areas. Burkina Faso (11%) had least number of respondents with access to newspaper; Swaziland (68%) had the highest. In all countries studied, more than 50% had access to radio. The percentage of respondents with access to television ranged from 17% in Malawi to 59% in Ghana.
Percentage distribution by selected characteristics
Justification of IPVAW by gender norm transgressed
"Neglecting the children" was the most common reason agreed by both women (Figures ) and men (Figures ) for justifying IPVAW followed by going out without informing husband and arguing back with the husband. The proportion of respondents who agreed with the statement that IPVAW is justified for "neglecting the children" ranged from 5% in Madagascar to 49% in Kenya among men and from 11% in Swaziland to 59% in Ethiopia among women. The justification for IPVAW was relatively low for "refusing sexual relations" among scenarios presented. Women were consistently more likely to justify IPVAW than men in all the countries, with the exception of Lesotho, Swaziland and Kenya (Figure ). The percentage of women who justified IPVAW was lowest in Madagascar (28%) and highest in Ethiopia (74%). Madagascar had also the lowest percentage (8%) of men who justified IPVAW and Kenya the highest (62%).
Percentage of women who believe that IPVAW is justified, by different scenarios.
Percentage of men who believe that IPVAW is justified, by different scenarios.
Sex-difference in attitude toward IPVAW of 17 sub-Saharan countries.
Factors associated with attitudes towards IPVAW
Table presents the adjusted OR for justification of IPVAW (see additional file 1
for full odds ratios, 99% CI and p-values). The diagnosis of multi-collinearity is shown in additional file 1
. The largest VIF ranged from 2.15 to 5.18; and the average VIF ranged from 1.77 to 2.49. Since none of the VIF values exceeds 10 and none of the average VIF exceeds 6, we concluded that there was no multi-collinearity problem. Women were significantly more likely to justify IPVAW than men in all countries studied with the exception of Lesotho. Women were 29% less likely to justify IPVAW than men in Lesotho (OR = 0.71, 99% CI 0.60 – 0.84). The association between sex and justification of IPVAW became non-significant in Namibia, Kenya, and Swaziland after controlling for respondents' socio-demographic factors, decision making autonomy, and access to media. Compared to respondent aged 35 and older, respondent aged 15–24 were consistently and significantly more likely to justify IPVAW in all countries except for Benin and Burkina Faso. Lower educational attainment was positively associated with acceptance of IPVAW. Respondents with no education or primary education were more likely to justify IPVAW compared with those with secondary or higher education in all countries but Liberia, Madagascar, and Nigeria. Relationship between occupation and acceptance of IPVAW was mixed. Respondents not in working force from Burkina Faso, Mozambique and Rwanda were at 20% statistically increased risk of justifying IPVAW. Currently not working respondents from Benin, Liberia, Madagascar, Malawi, Tanzania, and Zimbabwe were less likely to justify IPVAW. The association was not significant in other seven countries.
Factors associated with attitudes towards intimate partner violence against women identified by multiple logistic regression analyses*
Compared with those never married, respondents that were currently married from Benin (OR = 1.44, 99% CI 1.19 – 1.75), Kenya (OR = 1.46, 99% CI 1.21 – 1.77), and Madagascar (OR = 1.35, 99% CI 1.02 – 1.77) were more likely to justify IPVAW. While, those currently married from Malawi, Namibia, Rwanda, and Zimbabwe were less likely to justify IPVAW than those never married. In some countries, such as Benin, Burkina Faso, Ethiopia, Kenya, and Liberia those formerly married were more likely to justify IPVAW. In other countries, such Malawi (OR = 0.56, 99% CI 0.43 – 0.72), Rwanda (OR = 0.78, 99% CI 0.64 – 0.96), and Tanzania (OR = 0.78, 99% CI 0.63 – 0.97) those formerly married were less likely to justify IPVAW than never married. The odds of justifying IPVAW increased with decreasing wealth status in all countries. Living in rural areas increased the odds of justifying IPVAW in most of the countries. However, those living in rural areas in Madagascar (OR = 0.73, 99% CI 0.62 – 0.86) were less likely to justify IPVAW than their counterparts from urban areas. Association of justifying IPVAW with decision making indices were not consistent across the countries studied. Respondents who reported final say in more household decisions than their partners were more likely to justify IPVAW in nine countries and less likely to justify IPVAW in Benin, Burkina Faso, and Mozambique. Respondents were more likely to justify IPVAW in most countries when their partners alone had the final say in more household decisions than they did. When respondents reported more decisions being made jointly than individually, they were significantly less likely to justify IPVAW in most countries.
Access to newspaper reduced the odds of justifying IPVAW in all countries with the exception of Malawi (OR = 1.20, 99% CI 1.06 – 1.37). The association between listening to radio and acceptance of IPVAW was significant in only three countries. As expected, listening to radio reduced the odds of justifying IPVAW in Madagascar (OR = 0.83, 99% CI 0.70 – 0.99) and Rwanda (OR = 0.80, 99% CI 0.72 – 0.90). Counter intuitively, access to radio increased the likelihood of justifying IPVAW in Zimbabwe (OR = 1.23, 99% CI 1.10 – 1.37). The association between watching television and odds of justifying IPVAW was not consistent across countries. In some countries, such as Ethiopia, Ghana, and Madagascar watching television reduced the likelihood of justifying IPVAW. In other countries, such as Mozambique, Namibia and Tanzania watching television increased the odds of justifying IPVAW.
Figure shows the results of pooled odds ratios (weight average) of the determinants of attitudes towards IPVAW (see additional file 2
for forest plots for each variable). The results of meta-analyses confirmed that sex, age, education attainment, wealth status, when partner alone had the final say in household decisions, and access to newspaper were associated with attitudes towards IPVAW in the pooled analyses. Random effect model meta-analysis showed that women were more likely to justify IPVAW than men (pooled OR = 1.98, 99% CI 1.32 to 2.80). The results from the pooled analyses also confirmed that odds of justifying IPVAW increase with decreasing age, decreasing education attainment, decreasing wealth status. Compared those living in the urban areas, those from rural were more likely to justify IPVAW (pooled OR = 1.15, 99% CI 1.02 to 1.30). Random effect model meta-analysis showed respondent were more likely to justify IPVAW when their partners alone had the final say in more household decision that they did (pooled weighted average OR = 1.13, 99% CI 1.08 to 1.18). The pooled OR for the effect of access to newspaper was 0.85 (99% 0.79 to 0.92). The results of pooled analyses for occupation, marital status, when respondents reported more final say in more, when respondents reported more decisions being made jointly, access to radio and television were not significant. Figure also shows magnitude of cross countries variability in the determinants of attitudes towards IPVAW. The Cochran Q's test for heterogeneity for all variables gave p-values which were highly significant (p < .0001). Higgins and Thompson statistics suggested that 79% to 99% of the total variation in the estimated effect of determinants was due to heterogeneity between countries, thus suggesting that between countries heterogeneity were almost certain present.
Forest plot showing pooled odds ratio and 99% confidence for socio-demographic factors.