Abstract
Gender-based violence (GBV) occurs at alarmingly high rates among college students in a number of countries, including Kenya. To comprehensively address GBV and co-occurring public health issues (e.g., problem drinking), the nonprofit organization Elim Trust has begun to develop a student-led university outreach program (i.e., Vunja Kalabash Campus Project [VKCP]) in Kenya. The purpose of the current study was to examine the perspectives of popular opinion leaders (POLs) on GBV and related public health issues, and on the perceived effectiveness of the VKCP. We conducted a focus group with 16 POLs who lead prevention efforts on their campuses (62.5% women). Content analyses of the focus group suggested that GBV is a serious problem among Kenyan college students; GBV intersects with other problematic health behaviors like problem drinking, and despite some challenges (e.g., resources, time), VKCP is perceived to be effective at preventing GBV and supporting survivors of GBV. These data suggest that peer-led programming holds promise in preventing and responding to GBV.
Gender-based violence (GBV) is a major global public health concern. GBV is violence perpetrated against a person of any gender that results from gender inequality, including but not limited to sexual violence and abuse, domestic and intimate partner violence (IPV), human trafficking, and forced and early marriage (International Federation of Red Cross [IFRC], 2015). Globally, 35% of women have experienced nonpartner sexual violence, sexual IPV, and/or physical IPV (World Health Organization [WHO], 2013). GBV is related to a host of deleterious health outcomes, such as HIV infection, depression, anxiety, and alcohol abuse (WHO, 2013).
Adolescents and young adults in Kenya are no exception to these statistics. Little research has documented the prevalence of GBV among Kenyan college students, with most research focusing on university students in high-income countries in the global North. However, preliminary research suggests that GBV is a major public health problem among adolescents and young adults in Kenya (Kenya Nation Bureau of Statistics [KNBS] 2010; ICF Macro, 2010). In Kenya, like in other countries, GBV co-occurs with other concerning health behaviors, such as reproductive health issues (e.g., HIV, unwanted pregnancy), mental health concerns, and problem alcohol use (Fonck, Els, Kidula, Ndinya-Achola, & Temmerman, 2005; Kimuna & Djamba, 2008). For example, in Kenya, the prevalence of alcohol abuse among university students is as much as 21% (Boitt, 2016), with over 50% of Kenyan college students admitting to binge drinking (five or more drinks in a row) once or twice in the past month, and almost 10% admitting to binge drinking 3 or more times in the past month (Atwoli, Mungla, Ndung’u, Kinoti, & Ogot, 2011).
To comprehensively address these public health issues, the nonprofit organization Elim Trust has begun to develop a new university outreach program (i.e., Vunja Kalabash Campus Project [VKCP]) in Kenya. The ultimate goal of the VKCP is to reduce GBV and related deleterious outcomes, and to promote recovery among victims. Grounded in diffusion of innovation (Rogers, 2010), the VKCP includes identifying and training a core set of popular opinion leaders (POLs) inclusive of students and administrators that seek to change social norms (specific to alcohol use, GBV, and gender roles), increase bystander action to prevent problem drinking and GBV, and provide peer support and resource referral to victims of GBV. During an intensive 5-day training, POLs learn listening and helping skills as well as behavior change communication strategies and how to spread prevention messages and teach new skills to others via diverse methods. Following this training, POLs implement formal prevention activities, such as host events (e.g., “conversations in the dark,” where students can openly discuss GBV), and create social media campaigns to change social norms and teach prevention skills (e.g., bystander intervention). In addition, POLs implement informal prevention through conversations with peers. These POLs—who are early adopters of new and innovative idea (i.e., GBV prevention through creative methods)—recruit additional students and administrators, and through an informal train-the-trainer model pass on their skills. The programming of VKCP is peer-led, meaning that instead of manualized programming, POLs implement strategies tailored to their university and their skills/interests. The role of administrators is to support and mentor students as well as to work to change broader campus climate to be intolerant of GBV.
In addition to goals specific to the prevention of problem drinking and GBV, a secondary goal of VKCP is to promote help-seeking and recovery in individuals (including but not limited to GBV victims) who engage in problem drinking and/or demonstrate other mental and/or behavioral health problems. This promotion of recovery occurs via POLs providing informal/peer support (e.g., emotional support) as well as directly referring students to professional service providers.
The purpose of the current study was to examine the perspectives of POLs on (a) GBV and related problematic behaviors, (b) the perceived influence of VKCP, and (c) challenges associated with VKCP implementation. The current study is important for several reasons. First, although much research documents the association between GBV and other concerning health behaviors, little is known about developing, implementing, and/or evaluating comprehensive, high-impact campus-based prevention in a global context that addresses multiple health behaviors. The current data may be useful to other practitioners and researchers interested in implementing these types of projects. Second, the field of peer-led prevention is growing. Peer-led prevention holds promise of effectiveness because students hold the power to change social norms about GBV and other concerning health behaviors (Edwards, Jones, Mitchell, Hagler, & Roberts, 2016). It is important that we honor the voices and stories of students who implement peer-led prevention. These stories help us support peer-led prevention and ultimately develop more effective prevention efforts. In this study, we highlight the voices of the POLs who are on the forefront of prevention work under VKCP in Nairobi, Kenya. Third, despite requests by administrators of Kenyan universities to implement VKCP given widespread concerns about problem GBV, to date this comprehensive prevention initiative has not been rigorously evaluated. Prior to conducting a large-scale study of the VKCP to determine its impact on reducing GBV and problem drinking, more foundational work is needed to gather data from POLs on perceived impacts and lessons learned.
Method
Participants
Participants were 16 young adults in Nairobi, Kenya, who were recently recruited (n = 5; 31.3%) or experienced (n = 11; 68.7%) POLs in the VKCP. Twelve (75%) individuals were current undergraduate students and four (25%) individuals recently graduated. The majority were women (n = 10, 62.5%) and the average age was 25.20 (range = 19-27, SD = 3.06). Regarding nationality, 14 (87.5%) were Kenyan and two (12.5%) were Zimbabwean.
Procedure
The third and fourth authors called and/or emailed potential participants and informed them about the two focus groups, one for new recruits that took place in a coffee shop by a college campus and one for experienced POLs that took place in a private office in Nairobi. The focus groups were conducted by the first and second authors using a detailed interview script. The focus groups were recorded and a series of questions were used to gauge (a) perceptions of the intersection of GBV and related health behaviors (e.g., problem drinking) and (b) perceptions of the VKCP, specifically challenges, strengths, and perceived influence on students. Snacks were provided at the focus groups, and participants each received 500 Kenyan Shillings (equivalent to US$5).
The qualitative data were analyzed by the first two authors using content analyses (Bauer, 2000; Hsieh & Shannon, 2005; Krippendorff, 2004;). First, we read the transcripts and/or listened to the recording to obtain the gestalt of the data. Second, words, phrases, and sentences that answered the questions were highlighted. Third, we noted similarities and differences in the responses to each of the questions that led to the emergence of categories of similar responses. After coding the transcripts, we read through them again and compared transcripts with our written results to ensure the accuracy of our coding. Given that we interviewed the majority of VKCP POLs and that there was great overlap in responses across the groups, we believe that the data were likely saturated. In general, to qualify as a reportable coding category, the response had to be mentioned by at least two individuals within the same focus group and/or by an individual in both focus groups. We protected against bias by using low inference analysis and two coders (who reached consensus) in addition to considering alternative explanations and discussing/reviewing our findings with stakeholders (i.e., VKCP program developers and implementers).
Results
GBV Is a Problem and Relates to a Host of Other Deleterious Health Behaviors
When asked about problems that students face, participants identified GBV and gave examples of GBV that took the form of rape, sexual harassment, and dating violence. One particular type of GBV that participants identified was “sexually transmitted degrees” (i.e., pressure from lecturers to perform sexual favors in exchange for passing grades). For example, one participant said, My friend was doing a project and her supervisor was harassing [her]. I was like, “Don’t give him sexual favors, then you’ll never graduate,” and she proceeded to report [it] to [the] university and it became a case. And this lecturer came and told her if it went ahead, you’ll never graduate . . . And for sure she never ever graduated.
Participants noted several additional problems that students faced (e.g., drug use and alcohol misuse) and described how these issues intersected with GBV. For example, participants said in reference to men getting women drunk before sex, “it’s called marinating . . . they get you drunk . . . people are just so used to it.” Another participant said, “you know, when you’re drunk . . . sometimes you don’t get to a place where you can give consent to what’s happening.” In conjunction with alcohol and drug use, party culture was described as contributing to GBV: You want to try everything on that particular night, so if you haven’t had sex before you want to try it out, if you haven’t taken [drugs] before you want to try it out. Liquor, you want to try it out . . . then the next day you realize, “oh my God.”
Another contributor to GBV was early cohabitation with one’s partner. For example, one participant said, in reference to moving in together: I also feel like it’s a major contributor to rape. There’s rape in marriage, right? But then, this setting is not a marriage per say. But since you’re living with this guy, then he probably feels like automatically that you guys should have sex. Without consent, then it’s rape. So, I feel like it happens a lot in this setting.
Cohabiting, especially when there is financial dependence, was perceived to increase risk for GBV. For example, one participant stated, I also think some people cohabit for financial reasons. [If] you [are] from a poor family, you’re not getting enough pocket money. But if you share things with this guy, he also gives you some money here and there . . . And also, girls on campus or even guys on campus have sugar mommies and sugar daddies. And they end up being violated because they’re getting money from this person.
Participants said that violence was often learned in families. For example, one participant said, Men do not understand “no” from a woman because even our fathers, our grandfathers, would [force sex upon] their wives when they would say no . . . So even if it’s your boyfriend and you tell him that, “No, I don’t want to,” they don’t understand . . . I don’t think the concept “no” from a woman makes sense in their heads.
Participants also felt violence was normalized on campus: “But it is really normalized, sexual harassment at universities. It has become something of a culture, where if you don’t experience it, you’re the odd one out.”
Toxic masculinity was also seen as a contributor to GBV and something that programming needs to address: “Toxic masculinity [is] a deep issue, like it’s deep rooted in how people were raised and all that . . . so like educating them on how it’s not right to look down on a female.” Another participant said, Teaching people before they even get to where they can actually be violent . . . the way you are raised affects the way you associate with other people. For example . . . if you are a boy child and people are telling you, a boy should not cry, a boy should not do certain things, as you grow up you have that bitterness about all that anger that you have bottled up.
VKCP Is Perceived as Being Impactful
Regarding the perceived influence of VKCP, participants believed that the program first and foremost gave a platform to survivors and aided in their healing process. As one participant said, “My favorite part was giving a platform to people who have gone through gender-based violence to speak up.” Another participant noted, Someone has an issue that they need to sort, or they need assistance with, and they come to you. And, if it were not for (VKCP) I would have been in a very in a catch-22 situation, ’cause I would not know how to assist a lot of people.
In addition, participants felt that VKCP helped to prevent perpetration via changing of norms to be intolerant of GBV. For example, one participant remarked, I feel like it has been able to highlight what exactly violence is; and for these people who would have been perpetrators, would now stop being perpetrators or would think twice about the next time they do something close to what they had.
VKCP also helped students raise awareness. One participant said, “I felt like it also brought a reality for me that this happens and we need to address it, like, we need to be more aggressive about how we can address this issue” and another stressed the importance of “just keeping the conversation going.” Participants also thought VKCP enhanced bystander intervention. One participant explained, My last thought would be able to actually reach out to friends and tell them, “Hey, you know what? What you actually did there was not really appropriate.” So, uh, friends could also now shape up. Like, “Oh, thank you for that correction. I think I’ve done this thing unknowingly. But now that I know, I’d approach it in a different way.” So that, getting them to confess that, “Hey, I didn’t know that was violence,” so, uh, I think that was part of the highlight [of my work with VKCP].
VKCP allowed participants to train others (e.g., training pastors to include GBV prevention into their premarital counseling) and to make the connections between GBV and other health issues (e.g., “through Vunja Kimya I have been able to now connect gender-based violence and mental health issues”). Finally, participants discussed the influence that VKCP had had on their own lives, specifically by enhancing their confidence (e.g., “the platform has given me confidence. [Before] I was really shy, I couldn’t handle a crowd”) and self-development and growth (e.g., “For me, Vunja Kimya has been that place where you actually learn not be a perpetrator . . . I don’t want to become a perpetrator, I want to be someone who can actually offer a hand”).
VKCP Is Perceived to Have Challenges
Despite the perceived positive influence of VKCP, participants noted challenges that included limited resources (e.g., “more funds and more resources”) and time (e.g., “you’re still a student, you have assignments to submit, you have deadlines to meet”). Students also mentioned student resistance to prevention messages and programming efforts (e.g., “ignorance from other people, when you’re trying to sell your ideas, sometimes it’s a challenge”), often because issues of violence have stigma attached (“People do not report because of society and stigma”). Finally, students said a major barrier to implementation was that they had little resources for which to refer survivors who approached them (e.g., “. . . we don’t have counselors, and maybe they don’t even trust them because they are fellow students. So what do you do? Who do you refer them to? So, there’s a need for us to have people like counselors”).
Discussion
The purpose of the current study was to examine the perspectives of POLs on GBV, and on the VKCP. Although the prevalence rates of GBV among college students in Kenya are undocumented, these qualitative data provide preliminary evidence that GBV occurs at concerning rates on college campuses. GBV takes many forms, including those similar to what has been documented in other countries such as the United States (Banyard et al., 2020). Moreover, these qualitative data suggest that GBV is related to a host of other deleterious health behaviors, such as problem drinking, party culture, suicide and other mental health issues, early cohabitation with one’s partner, problematic family experiences, and toxic masculinity.
POLs felt that the VKCP was effective in reducing GBV and related deleterious health behaviors given that it gave a platform to survivors and aided in their healing process, which is consistent with some literature, suggesting that negative social reactions to disclosure are harmful to recovery (Sylaska & Edwards, 2014; Ullman, 2010). In addition, participants felt that VKCP helped to prevent perpetration via changing of norms to be intolerant of GBV as well as by enhancing bystander intervention, all of which research suggests are effective violence prevention strategies (Berkowitz, 2010; Coker et al., 2017; DeGue et al., 2014). Finally, consistent with growing speculations in the field of prevention and intervention sciences (Edwards et al., 2016), peer-led programming may be especially impactful and cost-effective in helping to reduce incidence and prevalence of GBV and in the supporting of survivors of GBV.
Indeed, with the field of peer-led violence prevention growing (Edwards et al., 2016), the challenges identified in the current study offer helpful insights. According to the current findings, it is important to provide students who are implementing programming with the appropriate support. Support includes money and other resources that can be used to implement prevention. Students implementing GBV prevention also need to be able to refer peers to counseling services. As noted by the students in the current study, they cannot be counselors to all students due to time restraints, which speaks to the importance of the train-the-trainer model so that more skills are informally diffused to myriad students.
Despite the knowledge gained from the current study, a few limitations should be noted. The sample was relatively small and not inclusive of all POLs. It is possible that POLs with less favorable opinions did not participate in the focus groups, which could have affected the findings. Thus, future research would benefit from utilizing a larger sample of POLs. Moreover, the perceptions of the influence of the VKCP are just that—perceptions. Thus, we need other sources of data to determine the influence of the VKCP in reducing rates of GBV and supporting survivors, such as self-report data from students on campuses before and sometime after receiving VKCP compared with students on campuses over time not receiving VKCP. Research is also needed to establish the incidence and prevalence rates of GBV among Kenyan college students. Finally, campus administrators play an important role in VKCP, but we did not have the opportunity to include them in this study, which should be a focus of future research evaluating this initiative.
In conclusion, data suggest that GBV is a serious problem among Kenyan college students, and that GBV intersects with other problematic health behaviors like problem drinking. Moreover, despite some challenges (e.g., resources, time), VKCP is perceived to be effective at preventing GBV and supporting survivors of GBV. Preliminary qualitative data suggest that the VKCP is an innovative and promising intervention to address GBV and related deleterious health behaviors.
Footnotes
Acknowledgements
We owe a great deal of gratitude to students who participated in our focus groups and shared their voices and expertise.
Authors’ Note
Katie M. Edwards and Emily A. Waterman are now affiliated with the University of Nebraska—Lincoln in Lincoln, NE, USA. Catherine Bikeri is now affiliated with Elim Trust, Nairobi, Kenya and Lifeskills for Behavior Change Center, Nairobi, Kenya.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
