Abstract
Intimate partner violence (IPV) has been identified as a global health problem with increasing mental health consequences. During the COVID-19 pandemic lockdown in Nigeria, couples were compelled to spend more time together, regardless of their pre-existing challenges. Our study aims to determine the prevalence of IPV, its forms, and mental health implications among Nigerian households amid the COVID-19 lockdown. A cross-sectional study was implemented which used the snowball sampling technique to recruit 474 participants across 31 states in Nigeria. A semi-structured online questionnaire was distributed using the WhatsApp platform. The relationship between IPV, its forms, and associated factors were analyzed using descriptive analysis and logistic regression with significant value at p ≤ .05 and confidence interval of 95%. Majority (98.1%) of the participants had at least a college degree and 90.1% were employed. Overall prevalence of IPV ranged from 7.2% to 13.5%. Using the lockdown as the landmark, higher prevalence was found before than during the lockdown across physical, emotional, financial, and sexual forms of IPV. Emotional form had the highest prevalence both before and during the lockdown with 11.4% and 3.8% respectively. Furthermore, 22.6% of participants reported that the lockdown affected their mental health. Hopelessness, feelings of failure, being irritable, and constantly under strain were psychological symptoms significantly associated with IPV amid the lockdown. Decreased prevalence of IPV were found in the early phase of the pandemic, suggesting that couples can experience less partner violence during periods of confinement. Our study supports existing evidence that forms of IPV have negative mental health consequences on abused partners.
Keywords
Introduction
Intimate partner violence (IPV) has been defined as “any behavior within an intimate relationship that causes physical, sexual, or psychological harm, including acts of physical aggression, sexual coercion, psychological abuse, and controlling behaviors” (WHO, 2012). Another recognized form of IPV is financial violence (Abramsky et al., 2019; Postmus et al., 2020). IPV is a multifaceted phenomenon which refers to violence between former or current intimate partners (Patra et al., 2018). As a construct, it looks at violence between cohabiting, divorced, or married couples in which either partner can be the victim or the perpetrator. Although some studies have demonstrated high prevalence of males as victims of IPV (Adejimi et al., 2014; Centers for Disease Control and Prevention, n.d.), it is a gendered phenomenon largely perpetrated against women by male partners (Fulu et al., 2013). It has been established that one in three women will experience physical and/or sexual violence by an intimate partner or sexual violence by a nonpartner regardless of their age (WHO, 2013). Although IPV is recognized as a relatively common phenomenon, Gracia, posited that a substantial number of forms of violence carried out by partners globally would be unreported (Gracia, 2004). The 2018 Demographic and Health Survey (DHS) of Nigeria reports that 7%, 19.2%, and 31.7% of women aged 15-49 years experienced sexual, physical, and emotional violence, respectively (DHS, 2019).
Nigeria is a low middle-income country with an estimated population of over 207 million people, and an adult literacy rate of approximately 62% (Countryeconomy.com, 2018; World Population Review, n.d.). Prior to the COVID-19 pandemic, it was projected that 33.5% of Nigerians would be unemployed by 2020 (Premium Times, 2019). This is against the backdrop of a previous report by DHS which states that 65% of women and 86% of men in Nigeria were employed, with over half of the men and women within the ages of 15-49 residing in rural areas (54%) (DHS, 2019). One major problem faced by over 46% of Nigerians is poverty (Iheonu & Urama, 2019). The above-mentioned indices may account for the wide range of IPV prevalence (2.3%-89.2%) reported in Nigeria (Fawole et al., 2008; Okemgbo et al., 2002). Nigeria along with other countries around the world imposed a total lockdown across the country which commenced on the March 30, 2020 and lasted about six weeks (Ajimotokan et al., 2020). It was thereafter relaxed in phases, although curfews and certain restrictions on social gatherings are still maintained in some states of the country as at the time of writing. During the lockdown, couples had to be in close confines resulting in most couples spending longer time together than usual. There is an overlap between some of the measures enforced to mitigate the spread of the COVID-19 virus during the lockdown with certain factors which predispose to and support abusive relationships, such as physical, geographical, social, functional isolation, and/or control of daily activities (Hagan et al., 2019; van Gelder et al., 2020). Previous studies across the world show that IPV increases during large-scale catastrophic events such as humanitarian crises and natural disasters including pandemics (Parkinson & Zara, 2013; Peterman et al., 2020). Similarly, different forms of IPV have been shown to have negative psychological consequences on abused partners (Bradbury-Jones & Isham, 2020; Ruiz-Pérez & Plazaola-Castaño, 2005). Presently, there is a gap of published literature which assesses the prevalence of IPV among partners in this part of sub-Saharan Africa during periods of restriction and compelled intimacy brought about by natural disasters, or humanitarian crises.
Methods and Materials
Study Area and Population
The study was conducted in Nigeria, West Africa. A country with over 250 ethnic groups, comprising 36 states, and a Federal Capital Territory. Eligible participants must be residents of Nigeria, aged 18 years and above, and must be involved in an intimate relationship and confined with their partners during the COVID-19 total lockdown imposed by the Government of Nigeria in March 2020. Participants had to be able to comprehend English, have access to the internet, and were required to give their consent to be part of the study.
Study Design and Sampling Technique
A descriptive, cross-sectional study aimed at measuring the prevalence of IPV, its forms, and the mental health implications among intimate partners residing in Nigeria during the COVID-19 lockdown. The sample size was determined using the formula (n = Z2 pq/d2) (Fisher et al., 1998), and using a prevalence of 37% obtained from a previous study on IPV (WHO, 2013). A total of 474 participants were recruited using the snowball sampling technique through an online survey. This is a relatively new way of conducting and acquiring data for research in Nigeria. The choice of this form of data collection was adopted as a consequence of the COVID-19 lockdown. Participants were drawn from the researchers’ professional and personal networks in the first instance. The researchers used the WhatsApp platform (a widely patronized social media platform in Nigeria) to send out a 7-12 minute online survey which had the details of the study, instructions, consent, and link to their family members, friends, and colleagues. They were asked to help forward to, and intermittently send reminders to their other network of people who met the eligibility criteria. The survey was open for three weeks in the month of May 2020 after participants had experienced at least four weeks of compulsory confinement. The names of the researchers were excluded from the online form to make participants comfortable filling the forms.
Data Collection
Data were collected using the “SurveyMonkey” online software. The survey was voluntary, and participants were assured that all information provided will be treated as confidential and anonymity maintained. Details of what the study was about was stated in a section of the form and consent was sought from the participants before and after filling out the form. Participants could opt out at any time and were given the option of not responding categorically (“yes” or “no”) to questions that they found emotionally tasking and a “not sure” response was provided as an option. Submission of the online survey meant that participants had agreed to be part of the study and had completed the form. Given the sensitive nature of questions asked, access to certain helplines were provided if participants experienced distress and needed assistance. It was difficult to ascertain the total number of individuals who clicked on the study and did not complete it. The study sample is not representative of the Nigerian population and may over-represent employed individuals with high educational attainment. Therefore, findings should be considered in this light. The study protocol was approved by the ethics research committee of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria (Ref: UPTH/ADM/90/S. II/Vol. XI/937) and done in accordance with the WHO Multi-country on Women’s Health and Domestic Violence Against Women and guidelines of Helsinki Declaration 2013.
Study Instruments
The online questionnaire comprised a socio demographic section and adaptations of the computer based IPV questionnaire (Basile et al., 2007), and general health questionnaire (GHQ) (Goldberg, 1992), which has been demonstrated to evaluate general health status and IPV.
Outcome Variables
Using the lockdown as the landmark, participants’ previous and current experiences of physical, emotional, sexual, and financial IPV were measured with questions on specific violent acts by a partner. If “yes” was the response provided for the experience of any violent physical, sexual, emotional, and economic act, they were classified as having experienced the respective form of IPV (see Appendix 1).
Explanatory Variables
Demographic Characteristics of Study Participants (n = 474).
Data Analysis
All information obtained in this study was processed and analyzed using Statistical Package of Social Sciences Version 20 (SPSS-20) software. Quantitative variables were analyzed using percentages, means, standard deviations, and χ2. Logistic regression was used to measure the association between the outcome and explanatory variables. The probability value of < .05 was considered statistically significant at a confidence interval of 95%.
Results
Sociodemographic Characteristics of Participants
The ages of participants ranged from 18 to 65 years with a mean of 40.5 ± 8.3 years. Majority (73.2%) of participants were aged 21-40 years, and only 0.2% were above 60 years with a female predominance of 67.9%. An overwhelming proportion (98.1%) of participants had a minimum of college education and 90.1% of participants were employed. A great majority (83.8%) of the participants were living with their partners during the lockdown and 88% of participants were married. Participants who had been in an intimate relationship with their partners for at least 10-15 years had the highest frequency of 26.4% and few couples (6.8%) were within one year of an intimate relationship with their partners. The sociodemographic characteristics of the participants are summarized in Table 1.
Prevalence of IPV
A higher prevalence of IPV was found before the lockdown than that during the lockdown in the present study. An overall IPV prevalence of 13.5% and 7.2% was found before and during the lockdown, respectively. Similarly, prevalence ranged from 3% to 11.4% and 1.1% to 3.8% before and during the lockdown across the four forms of IPV assessed in the study. Emotional form of IPV had the highest prevalence of the four forms, both before and during the lockdown. Financial violence had the lowest prevalence prior to the lockdown whereas physical violence was the lowest during the lockdown (Figure 1).
The overall prevalence of IPV and the prevalence of different forms of intimate partner violence (IPV) prior and during the COVID-19 pandemic lockdown (n = 474).
The Overall Prevalence of Intimate Partner Violence (IPV) and the Prevalence of Different Forms of IPV Prior and During the COVID-19 Pandemic Lockdown (n = 474).
Relationship Between Sociodemographic Characteristics and IPV Before and During the Lockdown
Logistics Regression Showing Association Between Sociodemographic Characteristics and the Outcome of IPV Among Couples During the Lockdown.
Mental Health Implications of the Lockdown on Partners
Mental Health Implications of the Lockdown on Partners.
Note: *Multiple responses allowed or elicited.
Relationship Between Mental Health Symptoms and Forms of IPV Before and During the Lockdown
Logistic Regression Showing the Association Between Psychological Symptoms and Forms of IPV Prior and During the Lockdown Among Participants.
Discussion
Prevalence of IPV
Decreased prevalence of IPV was found among participants in the present study during the COVID-19 lockdown than before the period of confinement with their partners. This suggests that periods of compulsory confinement of couples can lead to a more harmonious relationship. The complexities and uncertainties of the COVID-19 pandemic may have compelled couples to seek solace in their relationship. Furthermore, partners confined with their children may have explored better ways to resolve their differences. Reduction in previously encountered stressors such as work pressures, traffic, allegations of infidelity, and the financial burden of school fees may have contributed to the lower prevalence of IPV.
Additional factors are the participants’ level of education and employment status. Existing evidence support the inverse relationship between low prevalence of IPV with high levels of education and household income among urban dwellers (Abramsky et al., 2019; Fawole et al., 2008; Heise & Garcia-Moreno, 2002; Makayoto et al., 2013). However, it is possible that some abused partners in this study were unwilling to disclose their realities for fear of additional violence or prejudice (Rose et al., 2011). Similarly, some may be reluctant to disclose their experience in a non-face-to-face online survey (McCloskey et al., 2007; Moreira & Pinto da Costa, 2020). The latter possibility is more so within the “African context” where abused partners would prefer to disclose their experiences to informal support networks such as family, close friends, and religious leaders (Ayodapo et al., 2017; Fawole et al., 2008). The method used and the measured outcome are contributory factors to the variance in results.
Our findings are contrary to reports of increased IPV and use of helplines across Australia, China, Europe, India, the United Kingdom, and the United States of America (Allen-Ebrahimian, 2020; Boserup et al., 2020; Chandra, 2020; Grierson, 2020; Lattouf, 2020; Mahase, 2020). The socioeconomic downturn, psychological distress experienced by perpetrators, and victims and the difficulty or inability of abused partners to access support and safe places to communicate their distress or seek protection consequent on the COVID-19 lockdown are possible explanations for the increase in reported cases (Gupta, 2020; Peterman et al., 2020).
Prevalence of Forms of IPV
Emotional violence had the highest prevalence, both before and during the lockdown. This is consistent with increased emotional violence reported by other authors. It has been argued that abused partners are more likely to disclose this form of IPV (Bikinesi et al., 2017; DHS, 2019; Mendonça & Ludermir, 2017). Conversely, financial violence and physical violence had the lowest prevalence before and during the lockdown, respectively. It is likely that perpetrators of violence in intimate relationships with educated, financially empowered partners seldom employ physical methods but engage in apparently less obvious emotional acts. However, the presence of minors and dependents such as extended family members and aged parents who moved into their children’s homes during the lockdown may account for the decreased prevalence of physical violence. More research in this area may be required to determine factors that influence the use of different forms of IPV among perpetrators of IPV.
IPV and Underreporting
An interesting finding was the high proportion of participants who filled the “not sure” option as their response during the lockdown compared to those who affirmed a history of violence. This finding implies that some participants in this study may not have reported or under-reported their experiences. Previous authors have argued that repressed memories, existing patriarchal systems, cultural practices which condone violence in relationships, and perception by some partners that acts of partner violence are integral to intimate relationships may account for under-reporting (Kritz & Makinwa-Adebusoye, 2006; Ludermir et al., 2008; Ojeahere et al., 2019; Oyediran & Isiugo-Abanihe, 2005). Similarly, the stigma and prejudice associated with IPV and gaps in the Nigerian justice system hinder adequate data collection and sustain under-reporting of IPV (Jewkes et al., 2001; Ogunjuyigbe et al., 2005; Speizer, 2010).
Association of IPV With Sociodemographic Characteristics
Our study shows that the prevalence of IPV varied significantly with marital status. It suggests that partner violence was higher among cohabiting couples. Some of these couples had only been acquainted a few weeks before the lockdown and were still navigating the early phases of an intimate relationship. It has been argued by some authors that feelings of insecurity, discord, interpersonal stress, low commitment, and high constraints associated with such relationships can result in partner violence (Brown & Bulanda, 2008; Manning et al., 2018; Prabhu et al., 2011).
Association Between IPV and Psychological Symptoms
The uncertainties surrounding the pandemic, the imposition of physical and social distancing as measures to mitigate the spread of the virus, deprived access to support systems, and economic consequences are likely reasons participants experiencing IPV in the current study may develop mental health problems. Khalifeh et al. (2015) posit that individuals with mental health problems are at increased risk of IPV. Interestingly though, less than a third of participants who acknowledged that the lockdown affected their mental health indicated interest in accessing forms of mental health interventions.
Recommendations and Limitations
The present study supports the importance of increased awareness and enlightenment campaigns on forms of IPV across all categories of people, especially in Nigeria, where IPV and mental health issues are stigmatized and side-lined. Local and culturally sensitive support systems such as the extended family settings should be empowered with appropriate information on ways to address, in partnership with experts, the unique challenges faced by partners in violent relationships and from the under-reporting of IPV. There is a need to improve education and literacy in Nigeria which would invariably provide opportunities for improved socioeconomic status with the resultant reduction in IPV. Mental health programs and interventions should be incorporated into strategies aimed at addressing IPV. Collaborative and concerted efforts by key stakeholders are required to develop and implement favorable policies and laws which protect abused individuals during and beyond periods of confinement and catastrophe.
It is important to mention that the present survey was carried out during the early phase of restrictions and represents a “snapshot” of early changes in behavior. It is likely that the cumulative impact of living under restrictions and facing social and economic challenges will have had an impact on participants’ responses, if they took the survey later in the year. Other limitations include the study’s cross-sectional nature which makes directionality difficult to establish. Hence, it cannot be used to generalize for all similarly situated couples in Nigeria. The recruitment process of an online survey and snowballing technique, limited participants to individuals who have above average proficiency in the use of the English language and could afford internet access on their electronic devices during the period of lockdown. Another limitation was the unavailability of a response rate with the potential of nonresponse bias.
Conclusion
The present study shows decreased prevalence of IPV across physical, emotional, sexual, and financial forms of IPV during the early phase of the COVID-19 lockdown in Nigeria. The most prevalent form found was the emotional form, and marital status had significant association with IPV. Nonreporting or under-reporting of IPV was highlighted in this study. Our study supports existing evidence which posits that different forms of IPV have negative mental health consequences on abused partners.
Footnotes
Declaration of Conflicting Interests
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Supplemental material
Author Biographies
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
