Determinants of Sexual Violence Against Married Women: Qualitative Evidence From Ghana

Abstract

Some evidence suggests that in sub-Saharan Africa, sexual violence is commonplace among married women, yet this problem is underresearched. Using qualitative methods and applying Heise’s social-ecological model, this study examined the experiences of 15 Ghanaian women suffering sexual violence in their marriages. Results from the thematic analysis indicate several determinants of sexual violence. Whereas some participants identified macro-level and exosystem factors, including poverty, others pointed to micro-level and ontogenic factors, such as husbands’ substance abuse. The results corroborate the core idea of Heise’s framework, namely, that structural- and individual-level factors make women vulnerable to violence. The study concludes that Ghanaian legal and policy frameworks must be enforced and strengthened to address the etiology of sexual violence and abuse.

Keywords

married women sexual violence violence Ghana Eastern Region Africa

Introduction

Sexual violence is defined as “any sexual act, attempt to obtain a sexual act, or other act directed against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting including but not limited to home and work” (Jewkes et al., 2002, p. 149).

It is a common public health problem that violates the fundamental human rights of victims and exposes them to other risks and vulnerabilities. It occurs in various forms, including but not limited to rape, sexual slavery, forced abortion, and sexual harassment (World Health Organization [WHO], 2013). Although men and boys experience sexual violence, the majority of victims are females, with males as perpetrators (WHO, 2003). Globally, one third of women are likely to report severe forms of sexual violence from male partners and more than one third of young female adolescents experience forced sexual initiation (Fried, 2003; Heise et al., 2002; WHO, 2013).

Although it is a global problem, sexual violence against women is rampant in sub-Saharan Africa. Analyzing data from the recent Demographic and Health Survey on domestic violence in several African countries, Alesina and colleagues (2016) found that 29% of women aged 15 years and above experienced either sexual or physical violence; furthermore, 46% of the study’s female participants and 34% of the male participants said intimate partner abuse was widespread and acceptable. As in other African countries, in Ghana, sexual violence against women is common (Adu-Gyamfi, 2014; Amoakohene, 2004; Issahaku, 2017; Tenkorang et al., 2013). National data indicate that approximately one third of women directly experience sexually violent incidents in their lifetime (Institute of Development Studies [IDS], Ghana Statistical Services [GSS], & Associates, 2016). Similarly, the 2008 Ghana Demographic and Health survey reported that 38.7% of women between the ages of 15 and 49 years experienced intimate partner violence, including sexual abuse, at some point in their lives (Ghana Statistical Service et al., 2009). Another report showed that the total number of rape cases increased from 292 in 2012 to 315 in 2013 (Domestic Violence and Victim Support Unit [DOVVSU], 2013). Other empirical studies in Ghana found that more than one third of women experienced forced sex and other forms of sexual violence from their husbands (Adinkrah, 2011; Amoakohene, 2004; Chirwa et al., 2018; IDS, GSS, & Associates, 2016). These grim statistics demonstrate the prevalence of male sexual violence against women in Ghana, explained in part by social structures and family and community norms (Amu, 2005; Archampong & Baidoo, 2011; Halcón et al., 2000; Jewkes et al., 2002; Stafford, 2008).

Whereas evidence suggests that sexual violence against women is prevalent in Ghana, empirical research remains scant, and very few studies explore male partner sexual violence from the perspective of married women (Tenkorang et al., 2013). This research gap is problematic as sexual violence may be more common among married than single women and, as such, requires research and policy attention (García-Moreno et al., 2013; United Nations Children’s Fund [UNICEF], 2018). To address the gap in the research, our qualitative study used Heise’s social-ecological framework to examine the reasons for sexual violence against married women in the Eastern Region of Ghana, an area with a high prevalence of male partner violence.

Theoretical Perspective

Heise’s (1998) adaptation of the social-ecological model (SEM) theorized by Bronfenbrenner (1989) guided this study. SEM is a “theory-based framework for understanding the multifaceted and interactive effects of personal and environmental factors that determine behaviors” (Centers for Disease Control and Prevention, 2014, n.p.). Heise (2012) applied SEM to the study of domestic abuse and violence. The application of the model was widely embraced as it provided a coherent and fresh theoretical approach to understanding male violence toward women.

Heise’s SEM has four significant levels, each with a layer of factors influencing the behavior of individuals and increasing their likelihood of becoming victims or perpetrators of violence. The first level reflects individual or ontogenic factors affecting how a person behaves; otherwise stated, each factor shapes his or her chances of being a victim or a perpetrator. Elements at this level include substance use, past experiences of violence, age, and psychological or personality disorders. The second level includes interpersonal or microsystem factors. This layer is the immediate environment in which abuse occurs, as well as the influence of relationships with family and friends. Factors include family stressors, family interactions, parenting skills, and family environment. For instance, family stress combined with chronic poverty and unemployment is identified as a major problem affecting the ability of family members to function and to cater for children. In this layer, the perpetration of male partner violence is linked to the stress and strains associated with socioeconomic hardships (Ackerson & Subramanian, 2008). The third level emphasizes community or exosystem factors. This is the environment in which social interactions occur, including churches, schools, neighborhoods, and workplaces. Factors contributing to violence in this layer include the community in which the family lives, peer groups of family members, social networks, the justice system, and the availability of and access to community services. For instance, living in poor communities may increase women’s risk of experiencing violence (Cunradi et al., 2000; Gage, 2005). Poverty marginalizes women, undermines their autonomy, and creates a cycle of dependence that nurtures violence. Societal-level or macrosystem factors constitute the last level. Such factors include gender inequality, disregard for women’s rights and status, general acceptance of violence, sexism, male dominance, sex-role stereotyping, and economic disparities, among others.

We employed Heise’s framework because it conceptualizes both structural (macro) and individual (micro) level factors as important determinants of violence. It also considers the complex interactions of macro- and micro-level factors in explaining gender-based violence. We argued that, given its complexity, any analysis of gender-based sexual violence must endeavor to acknowledge factors operating at many levels. For the purposes of this study, we grouped macro-level and exosystem factors together because they operate at a broader or structural level. Similarly, ontogenic and microsystem factors were combined because they focus on micro-level explanations.

Empirical Literature

Macro-Level Factors

The literature has identified various macro-level and exosystem factors as key drivers of male sexual violence against women in African settings. These factors include, but are not limited to, discriminatory sociocultural norms and practices, weak community and societal responses to violence against women, and harsh economic conditions (Heise, 1998; Krug et al., 2002). In many African countries, sociocultural norms (patriarchal systems, religious beliefs, and harmful traditional practices) are said to contribute significantly to women’s vulnerability to sexual violence (Kalra & Bhugra, 2013; WHO, 2002). Harcourt (2013) noted that the “widespread of violence against women, whether physical, sexual or psychological, has its roots in the power of patriarchy” (p. 95) and, in many African countries, men are socialized to believe that they wield authority in partner relations and marriages (Eswaran & Malhotra, 2011). Another sociocultural factor promoting patriarchy and male violence in Africa and Ghana is the payment of bride price. The bride price tradition in many parts of sub-Saharan Africa is interpreted as the transfer of rights from the woman’s family to the husband, allowing men to “own” their wives (Archampong & Baidoo, 2011; Stafford, 2008; Tenkorang et al., 2013). Some authors have argued that this patriarchal entitlement is a strong basis for male partner violence, including sexual violence against women (Amoakohene, 2004; Tenkorang et al., 2013).

Adherence to these types of traditional masculine norms exposes women to sexual and domestic violence (Edström et al., 2014; Freedman & Jacobson, 2012). In fact, some feminists maintain that all forms of male partner violence emanate from rigid traditional gender roles and men’s desire for power and control in the family (Giardino & Giardino, 2010). In a Ghanaian study, Mann and Takyi (2009) found that ideas about masculinity portraying men as breadwinners in the family are connected to the belief that men are justified in using violence in the household under certain circumstances. These findings are consistent with Burt (1980) and Malamuth and colleagues’ (1995) arguments that sex-role stereotypes, adversarial sexual beliefs, and the acceptance of interpersonal violence are key determinants of sexual aggression and violence.

Poverty within families has been identified as another determinant of the abuse of women, including sexual violence (Jewkes, 2002; Jewkes et al., 2011; WHO, 2010). Poorer women are more likely to depend on their husbands or partners and such dependence may be used as a tactic to control their sexuality and sexual behaviors (Adjei, 2016; Issahaku, 2012; Mann & Takyi, 2009). As a result, there have been calls for women’s economic independence and their empowerment as a panacea for gender-based violence. However, some literature shows that economically independent women may also be prone to intimate partner and sexual violence (Alesina et al., 2016; Naved & Persson, 2005). Specifically, in African settings, women’s economic independence may be perceived as a challenge to traditional masculine norms and gender roles, leading to violence (Alesina et al., 2016; Ganle, 2016). In other words, findings on the relationship between poverty and violence are inconclusive.

Micro-Level Factors

Individual and interpersonal factors contribute to sexual violence as well. Commonly cited factors are alcohol use, drug use, and witnessing family violence during childhood (Faramarzi et al., 2005; Foran & O’Leary, 2008; Obi & Ozumba, 2007; Wenzel et al., 2006). In a review of possible causes of male violence against women, the European Commission (2010) reported that 95% of participants mentioned alcohol use. Similarly, studies in Ghana found men’s excessive alcohol consumption contributed to the sexual, physical, and verbal abuse of women (Bashiru, 2012; Chirwa et al., 2018; Ganle, 2016; IDS, GSS, & Associates, 2016). It has also been argued that violence deployed by aggressors to control their victims has consequences for survivors (Roberts, 2007; Shannon, 2009), with children who are exposed to violence in early childhood more likely to experience or perpetrate violence later in life (Bobonis et al., 2013; Clark et al., 2010; Wareham et al., 2009). Employing a life course perspective, Tenkorang and Owusu (2018) showed that compared to those with no such experiences, Ghanaian women with experiences of childhood violence were significantly more likely to be victims and/or perpetrators. These findings support the idea that violence may be intergenerational and learned over the life course. In this article, we explore both macro- and micro-level factors influencing Ghanaian women’s experiences with sexual violence.

Method

Study Setting

The empirical data for this study were obtained from a larger research project led by the second author on gender-based violence against married women in Ghana, with an emphasis on the roles of culture and patriarchy in perpetuating violence. The lower Manya Krobo District (LMKD), one of the areas in which the qualitative data were collected for the project, was selected for this particular study. The district has a total landmass of about 304.4 sq. km and represents about 1.7% of the Eastern Region of Ghana (IDS, GSS, & Associates, 2016). The municipality is bordered to the north by upper LMKD, to the south by Dangme West, to the west by Yilo Krobo Municipality, and to the east by Asuogyaman District. The main towns are Krobo Odumase, Agomanya, Akuse, Kponyokorpe, Paterwonya, Kpong, and Atua (Ghana Statistical Service, 2010). The municipality is more than 80% urban; in 2010, it had a reported population of about 89,246 (IDS, GSS, & Associates, 2016). There are more women (53.5%) than men (46.5%; Ghana Statistical Service, 2014). The people are predominantly Krobos, with a few other ethnic groups, including Ewes, Akans, Hausas, and Guans (Ghana Statistical Service, 2014). While agriculture, specifically farming, is the mainstay of the local economy, trading activities are common; those involved are mainly petty traders because the money required to establish large-scale business is scarce. The Krobo people practice patrilineal inheritance, where men exclusively inherit landed properties (Kissi-Abrokwah et al., 2015). Created in 2008 from the Manya Krobo Municipality, the LMKD lacks educational facilities, law enforcement institutions, and employment and credit opportunities. It has the highest unemployment rate in the Eastern Region, with women more affected than men (Ghana Statistical Service, 2013). A recent report indicated that the LMKD is one of the areas with the highest prevalence of HIV/AIDs in the Eastern Region of Ghana (Ghana Statistical Service, 2013). The LMKD is also associated with higher illiteracy levels than other areas in the region and people generally have little knowledge of human rights or gender mainstreaming (Ghana Statistical Service, 2010; Otoo et al., 2009).

Although there are no separate data for the LMKD, the Eastern Region, in which the LMKD is situated, has a high prevalence of intimate partner violence (IDS, GSS & Associates, 2016). In 2013, the region recorded about 1,929 cases compared with 1,502 cases in 2012, a dramatic increase in only a year (Ghana News Agency, 2014). Data from the Ghana Family Life and Health Survey show that sex without consent in the Eastern Region is about 0.7%, the second highest after the Central Region (1.2%; Ghana Family Life and Health Survey [GFLHS], 2015, cited in IDS, GSS & Associates, 2016). The same survey reported that other forms of sexual violence in the Region include inappropriate sexual comments (0.8%), sexual touching (0.8%), sex without protection (0.6%), and sex because of fear (0.6%).

Sample

The target population for this study was married women in the LMKD. Participants were purposively recruited after consultation with the local chief and his elders, who welcomed the idea of domestic violence as an issue to be studied and documented. While seeking entry permission was important, the researchers and one of the female research assistants had ties with the community, making it much easier to build trust and establish good interpersonal relations. The gatekeepers were informed about the purpose of the study and the participants required for the research. After gaining approval, the researchers made a series of contacts through local opinion leaders; a few survivors of male partner violence were identified and were asked to participate in the study. The snowballing method was used to access other participants through referrals from the initial contacts (Penrod et al., 2003). Eligibility criteria included women who were 18 years or older, who had been victims of domestic abuse, and who were legitimately married or had been cohabitating for a minimum of 1 year. The topic was male partner violence; thus, being a victim of such violence was a key requirement of participation. Ultimately, 15 survivors of male partner violence, including sexual violence, participated in face-to-face in-depth interviews.

Data Collection

The study used face-to-face in-depth interviews for data collection as this type of interview provided a more relaxed atmosphere for interviewers and participants to discuss issues of domestic abuse in detail (Boyce & Neale, 2006). Women who agreed to participate were given the opportunity to voluntarily narrate their experiences or share their thoughts on violence against women. The individual interviews were conducted at a convenient time and in safe locations as suggested by the participants. The interviews began with an informed consent sheet outlining the purpose of the study, a discussion of issues of anonymity and confidentiality, an explanation of the right to withdraw from the study, and participants’ consent. Trained female research assistants moderated the interviews in a conversational manner to ensure they were less intimidating. The more relaxed atmosphere allowed the interviewers and participants to discuss issues of male partner violence in detail and avoided the problem of social desirability bias. All participants responded to the same set of questions and interviewers probed for details, clarification, and a closer examination of key issues when necessary to ensure the validity and reliability of the data. A semi-structured interview guide directed the interviews; it contained questions to be posed by the interviewer, prompting participants to share their experience or thoughts on domestic violence. The guide included open-ended questions on the sociodemographic characteristics of participants, the prevalence and forms of intimate partner violence, the perceived causes and consequences, responses to violence, and survivors’ support-seeking behaviors. The interview guide was designed in English but was interpreted in Twi and Krobo (widely spoken local dialects) by the research assistants for participants who found it difficult to understand questions in English or who did not understand English at all. Each interview lasted an average of an hour to allow optimal and meaningful conversation. With the participants’ approval, individual interviews were audio-recorded.

Ethical Considerations

The data for this study were part of a bigger research project approved by Memorial University’s Interdisciplinary Committee on Ethics in Human Research and the University of Ghana’s Ethics Committee for Humanities. After receiving ethical clearance, the research team worked in accordance with the WHO’s (2001) ethical and safety recommendation on intimate partner violence.

Data Analysis

The data were analyzed using reflexive thematic analysis, “a method for identifying, analyzing and reporting patterns (themes) within data” (Braun & Clarke, 2006, p. 79). Specifically, the use of thematic analysis helped researchers organize and code the qualitative data, following clearly defined criteria to find patterns and develop themes. The data were analyzed manually because this method of analysis has “the advantage of remaining true to the analysis” (Warren & Karner, 2015, p. 216).

In the first step, the transcripts were read multiple times to allow researchers to become familiar with the data, ascertain their limitations, and determine the kind of analysis to undertake. The data were then coded or indexed in relation to the research objective using colored pens to highlight the text for easy identification of each code. All authors were involved in the coding process to ensure intercoder agreement and subsequent interpretations of the results. Codes relating to the same issue were highlighted in the same color. The generated codes helped researchers organize the data in categories and subcategories using descriptive labels. These categories/subcategories were synthesized into themes; the themes were refined, and the final themes were supported by statements and quotations from the participants, some of which appear in the following sections.

Results

Participants

As shown in Table 1, the majority of participants were Krobos. The women’s average age was 42.86 years, and it ranged from 25 to 65 years. All women were Christians; this is not surprising because Christianity is the dominant religion in the Eastern Region of Ghana. While some women married early, others married late; the number of biological children born to each woman at the time of data collection ranged from one to 10. The educational level of participants varied significantly: only one woman had tertiary education, two attained primary education, four left school after the Form 4 level, and the rest were uneducated. This educational variation reflects the harsh socioeconomic conditions of the municipality. One woman was a teacher by profession, and a few were subsistence farmers, but the majority were petty traders.

Table 1.

Participants’ Demographic Information.

Pseudonames	Age	Occupation	Education	Children
Abena	25	Petty trader	Primary	3
Adjoa	50	Petty trader	Form 4^a	4
Afia	65	Farmer	None	10
Akua	38	Petty trader	Undeclared	4
Ama	47	farmer	None	8
Araaba	48	Petty trader	Form 4	5
Kukua	56	Petty trader	Form 4	2
Maafia	28	Storekeeper	Tertiary	1
Maame	43	Petty trader	Form 4	3
Nyamekye	32	Teacher	Secondary	2
Oforiwaa	26	Petty trader	Primary	3
Ohemaa	55	Petty trader	Form 4	3
Serwaa	37	Petty trader	None	3
Teckyiwaah	28	Petty trader	Secondary	3
Yaa	60	Farmer	None	9

The equivalence of secondary school education before the 1987 educational reforms in Ghana.

Causes of Male Partners’ Violence: Macro-Level and Exosystem Factors

Cultural beliefs about traditional gender roles

Participants identified cultural beliefs about rigid traditional gender roles as reasons for sexual violence against married women. They indicated that people (i.e., both men and women) strongly believed in the sexual division of labor. To make women conform to their perceived family responsibilities, men often used physical force and aggression. The cultural emphasis on male sexual entitlement allowed husbands to control women’s sexual behaviors and sexuality. One participant said,

Some women must listen to their husbands when they tell them to do something. Some women disrespect their husbands, and this sometimes makes the men abuse them. When she reports to the elders, they will say she was wrong, and that called for the beating. I am not trying to say that wife abuse is justified, but the women must learn to perform their responsibilities to avoid some of these things. (Yaa, 60 years old).

Traditional marriage practices

Traditional marriage rites opened the door to later sexual violence, with women advised during the ceremony that under no circumstances should they refuse sexual intercourse with their husbands. Women in such marriages said their husbands were more likely to sexually abuse them when there were disagreements over sexual relations. One participant said,

During marriage ceremonies, relatives and parents advise that as the woman prepares to enter into marriage, she should be prepared to give her husband sex whenever he demands it. They say he is the head of family, and therefore, he must be treated as such. (Ohemaa, 55 years old)

Another concurred, “In the Krobo culture, a woman is advised to satisfy her husband sexually anytime. Therefore, the men take advantage of this and force the women to have sex with them” (Abena, 25 years old).

Participants identified the payment of the bride price as another factor motivating sexual violence against married women. More than 10 participants explained that men who pay the bride price to their wife’s family feel entitled. Akua was clear when he stated,

In the Krobo culture, when they are performing marriage rites, there is money (called “sefiam”) the man pays, which gives him the right to have sex with you and to have children with you. So when he pays that money, he has the right to demand sex anytime, and if you deny him, he can force you. (Akua, 38 years old)

Most participants concluded that husbands became aggressive and behaved violently after completing the final marriage rites. Kukua said,

Before marriage, these men behave like angels and will go to any extent to make you [women] happy. But after he marries you, he thinks and behaves violently, because he thinks he owns you and is at liberty to do whatsoever with you, even if it means beating you. (Kukua, 56 years old)

Ohemaa said much the same thing: “What I know is when they [husbands] complete the marriage rite, they get the power to do anything to you” (Ohemaa, 55 years old).

In short, a common perception was that the formal marriage ceremony, including the payment of the bride price, gave husbands the right to have sexual intercourse with their wife without consent. In cases when women denied their husbands sex, force and violence were more likely to be deployed by husbands as a tactic to satisfy their sexual demands and to discipline the wife.

Traditional masculine norms

Another driving force in abuse was the husband’s desire to dominate domestic interactions, including sexual matters. Husbands who adhered to traditional notions of masculinity perceived their wife as passive. Ten of the 15 interviewed women said that their husbands believed that they should always be in charge and control domestic affairs. The women suspected that they were battered and forced to have sexual intercourse when they challenged their husband’s authority:

He will tell you he is the head of the family, he was the one who married you, and not the other way; therefore, you have no right to tell him you are not ready to have sex with him, and he is the one who takes care of you. The days I am not in the mood for sex, he forces me and tells me that do I think he is small boy to choose when to have or not to have sex. (Maafia, 28 years old)

Poverty within families

Participants also attributed women’s experiences of sexual violence to acute poverty. They said that the lack of income and resources made married women vulnerable to all kinds of threats, including sexual abuse. They felt that when women were economically dependent on their husbands, they were unable to make independent decisions in domestic relations and this increased their vulnerability. Many of the women interviewed recounted occasions where they were not in the mood for sex but did not refuse their husbands. Others said they were physically forced to have sex if they resisted sexual contact. One participant commented,

He [husband] can refuse to give me housekeeping money for days just because I denied him sex. Alternatively, he starts to maltreat me in a way like shouting at me or insulting me publicly, disgracing me, and every little thing I do he gets irritated. So sometimes, when you think of all these consequences, you just allow him when he wants to have sex with you. (Adjoa, 50 years old)

It wasn’t just women’s economic status that mattered, however. Participants also reported that men’s poor economic status contributed to violence. Husbands who were unable to provide for their families as expected used violence to express negative emotions and to maintain control in the household. Some participants reported that the joblessness and the accompanying lack of income of their husbands generated conflicts, leading to physical and sexual abuse. Explaining this situation, Ohemaa stated,

He forces me sometimes to have sex with him when he has no money and all his numerous girlfriends have abandoned him. When my husband has money, you hardly see him at home. He is always with another woman. (Ohemaa, 55 years old)

Araaba shared a similar perception: When a woman is providing for the family, some husbands become very jealous and start to maltreat the woman. But it is not good for a man to abuse his wife just because she is helping to take care of the family (Araaba, 48 years old).

Overall, the women’s narratives showed that the role of poverty in women’s experiences of sexual violence could be bidirectional. On one hand, poverty among women made them directly vulnerable to sexual abuse as they depended on their husbands for financial support. On the other hand, husbands’ low-income status could trigger violence as a tactic to command respect and maintain power and control in the family.

Ontogenic and Microsystem Factors

Substance use

Some participants’ indicated that their husbands sexually abused them after drinking alcohol or using drugs. A young woman recounted her experience as follows:

When he is drunk, the urge to have sex increases, but his mouth smells so much, making it difficult to have sex with him. Sometimes, I get angry because I have advised him on several occasions to stop drinking, but he would not stop, so I just do not feel like having sex with him. I thought doing that could make him stop drinking. He slapped me, pushed me, and I pushed back. He got angry and started beating me. I managed to run from the room because there was no one around. I slept outside for the rest of the night because he had locked the door. I knocked on the door several times, but he never minded me. Sometimes too he will hit me with anything around him. He forces me to sleep with him when he is drunk, even when am not willing to have sex with him. (Maafia, 28 years old)

Extramarital sexual affairs

Participants described husbands’ extramarital sexual affairs as another salient reason for sexual violence. Some women who suspected or knew that their husbands had girlfriends or were involved in sexual relations outside the relationship tried refusing sex because of their jealousy, frustration, and anger, but this only contributed to forced sex and battery. The following quotations tell the personal stories of women who tried refusing sex because of their husband’s extramarital sexual activities:

He forces me to sleep with me sometimes because I refuse to have sex with him, especially when he goes to town and his girlfriend ignores him. He only forces me to have vaginal sex with him. (Maafia, 28 years old)

I did not want to have sex with him because I was angry that he left me at home and went to chase other women, but because he did not meet them, he has now come to have sex with me. I wanted to punish him by preventing him from having sex with me, but he forced me to have sex with him. (Kukua, 56 years old)

Past experiences of violence

Participants thought their husbands were sexually violent because they had experienced or witnessed violence during childhood. Some associated husbands’ sexually aggressive behavior to witnessing family violence and having emotionally detached and uncaring fathers. Other participants said that their husbands were raised in families with strong patriarchal ideologies and thus had a higher chance of behaving violently and using sexual coercion than men who grew up in less patriarchal homes. They said boys who grow up thinking violence is appropriate for resolving conflict in the domestic space are more likely to engage in similar behavior to address family feuds in adult family life. Oforiwaa shared her opinion as follows:

Some men in certain families are noted for beating and abusing their wives when they marry them. This is because some boys grow up and see their fathers threatening and molesting their mothers, and they think it is a good thing. Therefore, they grow to become violent later in life. (Oforiwaa, 26 years old)

Some participants believed that young women and girls who grow up witnessing their fathers abusing their mothers are more likely to think that the use of violence and threats is normal in intimate partner relationships:

What I think is that some girls grow up to see to their fathers using violence against their mothers when there are misunderstandings. Some mothers in turn, do nothing when they are beaten or molested by their husbands. The girl child will see this as normal, and when she grows to experience the same thing in her relationship, she will accept it and do nothing about it. I can tell you that many women in this community are abused by their husbands, but they accept it in good faith. (Araaba, 48 years old)

Discussion

Previous research suggests that sexual violence is more common among married women than single women globally, yet this aspect of sexual violence is underresearched, especially in developing countries, including Ghana. By applying Heise’s SEM to examine the reasons for sexual violence against married women, this study fills a significant research gap in the intimate partner violence literature. The findings indicate that sexual violence is a serious issue among married women in Ghana and suggest several driving forces. These include macro-level and exosystem factors, such as poverty and adherence to traditional masculine norms, as well as micro-level and ontogenic factors, such as substance abuse and extramarital sexual affairs. To a large extent, the findings parallel those reported in previous studies and corroborate the core idea of Heise’s (1998) SEM proposing that women’s experience of violence is driven by several factors at different levels of the social environment.

Macro-Level and Exosystem Factors

Consistent with previous research (Jewkes, 2002; Jewkes & Morrell, 2012; WHO, 2013), this study found that cultural beliefs about gender division of labor expose married women to sexual violence. As explained by the SEM, strict adherence to social and cultural norms within a community and the broader society is likely to influence the acceptance or perpetration of violence against women (Heise, 1998). Throughout Ghanaian society, deep-seated religious and cultural norms have nurtured a perception that a woman must be sexually available to her husband without restraint although sex may sometimes be proscribed, especially during the postpartum period or menstruation (Adinkrah, 2011; Ampofo, 2001; Stafford, 2008). Women are socialized from childhood to be submissive and subservient (Ampofo, 2001; Archampong & Baidoo, 2011). This places them in a subordinate position, unable to make independent intrafamily decisions and bargain in their marriages. Higher rates of male partner violence are expected in societies that promote the gender role divide in the family (Daley & Noland, 2001). Under the pretext of cultural norms and traditions, some men are more likely to inflict violence against their wives when they attempt to resist sexual contact. In other words, some core elements of Ghanaian culture help perpetuate violence against women.

Like previous research (Chireshe, 2015; Ellison et al., 2007), the study found that, among the Krobo people, the payment of bride price is a driving force in sexual violence and other forms of domestic abuse. This finding is not surprising as there is a common belief in this ethnic group that the moment a woman is married she automatically consents to sex with her husband. In traditional Ghanaian marriages, a man pays a bride price to the woman’s family. Some men consider this payment to be a contract, giving them ownership of the woman as if she is “property bought and paid for” (Archampong & Baidoo, 2011). Some scholars have argued that the payment of bride price during the marriage ceremony symbolizes the loss of rights of the woman’s family and the transfer of rights to the husband (Nwabunike & Tenkorang, 2017; Takyi & Gyimah, 2007). This cultural norm empowers men to have unlimited sexual contact with their wife, while disempowering women from taking part in the sexual decision-making process (Chireshe, 2015).

In line with past research (Edström et al., 2014; Freedman & Jacobson, 2012; Mann & Takyi, 2009), adherence to traditional masculine norms was identified by the study’s participants as a central reason for sexual violence. The social-ecological framework theorizes adherence to traditional masculine norms as crucial to intimate partner violence. This situation is certainly true in the Ghanaian context. For instance, in Ghana, a man is expected to maintain power and be in control of his family (Ampofo, 2001). He is recognized as the head of the family and an authority figure in the household. Many women accept husbands’ superiority because of the patriarchal culture in which they have been socialized. However, adhering to rules of male supremacy exposes women to all kinds of risks, including violence. In the view of Langhinrichsen-Rohling et al. (2012), the most frequent motivation for men’s use of violence is the desire to control their partners. Violence emanates from a man’s need to enforce power and to prove that he is in control of his relationship (Jewkes & Morrell, 2012; WHO, 2013). Most of the married women in this study mentioned their husband’s desire for control in domestic interactions, underscoring how certain understandings of masculinity are associated with power, dominance, control, and domestic violence.

Like previous studies (Amoakohene, 2004; Haj-Yahia, 2000; Hindin & Adair, 2002; Krug et al., 2002; WHO, 2005), this study found that lack of income and resources makes married women vulnerable to sexual abuse. Access to and control of economic resources facilitate stable relationships, whereas the “lack of resources can lead to stress, frustration and conflict that can degenerate into violence between a husband and wife” (Dutton, 1988, and Gelles, 1974, quoted by Macmillan & Gartner, 1999, p. 949). Lack of access to resources, such as cash, credit, and employment, is a significant factor in male partner violence. For instance, an unemployed woman is more likely to depend on her husband and may not be able to promote her interests in domestic interactions, rendering her vulnerable to violence (Heise et al., 2002; Jewkes, 2002). The Lower Manya Krobo Municipality has a number of sociocultural and economic problems, including limited employment opportunities, especially among women. Those who participate in the formal economy earn below the minimum wage, and the patrilineal system of inheritance deprives women of owning property. Such conditions increase women’s financial pressures, making married women financially dependent on their husbands and ultimately at risk of experiencing violence. As the study’s participants made clear, some men exploit the financial weakness of women and perpetrate sexual and domestic violence.

Previous studies have reported that poverty among men can trigger marital violence and domestic abuse (Faramarzi et al., 2005; Fulu et al., 2013; Krug et al., 2002; Obi & Ozumba, 2007), and the relationship between poverty and violence may also be understood through the concept of masculinity. According to this explanation, economic hardships and the accompanying lack of income make it difficult for husbands to live up to their culturally expected role as breadwinners. Such circumstances can cause extreme stress and lead to feelings of inadequacy, with some likely to resort to alcohol use and other means to suppress frustration, and this, in turn, can lead to conflict and violence against the spouse. Some participants reiterated that the lack of job opportunities and the associated poor financial status of their husbands promoted marital conflicts, leading to sexual violence and other forms of domestic abuse. Given these findings, it is possible that the relationship between poverty and women’s vulnerability to sexual violence is bidirectional. Therefore, empowering both men and women economically could be instrumental in reducing marital violence and domestic abuse.

Ontogenic and Microsystem Factors

For the study’s participants, various individual and relational characteristics, such as substance use, contributed to their husband’s use of sexual violence. Alcohol use is known to contribute to male partner violence, including sexual abuse (Krug et al., 2002; WHO, 2013). The social-ecological framework posits that substance abuse is a situational factor that increases an individual’s chances of becoming a victim or a perpetrator of partner violence. Alcohol use, for example, may undermine the ability to control negative emotions. Excessive alcohol intake can further limit understanding, sympathy, and opportunity for resolution without violence. Moser and Winton (2002) reported that substance abuse, specifically alcohol, creates conflicts and misunderstandings between intimate partners who assault each other, with women the most frequent victims. Previous researchers link alcoholism with aggressive behavior, finding men are more likely to behave violently and abuse women, especially intimate partners, when intoxicated (Arpapirom, 2000; Chirwa et al., 2018; Graham et al., 2017; Hongthong, 2000; Jewkes, 2002; Sarakarn & Kammanat, 2009). According to some participants of this study, excessive alcohol intake was a way of life for some husbands and a major reason for their use of sexual violence.

Husbands’ extramarital sexual affairs were also identified by participants as a factor in sexual violence. If they declined sex for fear of contracting sexually transmitted diseases or deliberately withheld sex to punish their husbands for indulging in an extramarital affair, their husbands beat them or forced them to have sexual intercourse. This finding is in line with previous studies on the determinants of intimate partner violence (Fleming et al., 2015; Fulu et al., 2013; Jewkes et al., 2001; Koenig et al., 2003; Santana et al., 2006).

Finally, the participants thought their husband’s use of violence could be linked to violence experienced during childhood. The SEM suggests that children socialized in violent family settings are more likely to accept or perpetrate violence in adult life (Heise, 1998). It is well known that having a childhood history of violence increases children’s chances of experiencing or committing violence in adulthood (Hines & Saudino, 2002; Wareham et al., 2009) and domestic violence in the family domain is likely to be transmitted across generations (Pollak, 2004; Yount et al., 2014). It has been argued that individuals learn social behaviors by observing others (Bandura & Walters, 1977). Thus, children who witness one of their parents, especially the mother, subjected to domestic violence may believe that this behavior is acceptable (Bobonis et al., 2013; Clark et al., 2010; Yüksel-Kaptanoğlu et al., 2012). They may learn to use or accept violence as a means of resolving family conflicts and disagreements. A critical look at participants’ narratives revealed that women’s experiences of sexual violence were commonly linked to husbands’ experiences of violence during their childhood. Perpetrators may themselves have been beaten or witnessed their mothers being molested by their fathers when they were children. In other words, violent husbands were more likely to have witnessed or experienced violence when growing up than were nonviolent husbands.

Implications of the Findings

This study, to the best of our knowledge, is among the first known documented evidence of the sexual violence experiences of married women in Ghana. Although the study was exploratory, with a small sample size, the findings will provide policy makers in Ghana specifically and sub-Saharan Africa more generally with a detailed understanding of the reasons underlying sexual violence against married women. The problem requires serious attention and immediate action. The perpetration of sexual violence may be accompanied by other forms of domestic abuse, leading to even more devastating consequences for women victims, not to mention the larger society.

Documenting the personal stories of married women, whose voices are frequently muted or even unheard, may raise awareness of the problem. Like some other countries in Africa, in Ghana, marital sexual violence remains a hidden issue. The cultural expectations are that women will be submissive and obedient to their husbands (Shirwadkar, 2004). A major concern for many of these women is that reporting domestic violence, including sexual abuse, may taint their social status, and the image of their male partners and families. Sexual violence against married women may be overlooked as cases of misconduct if reported. Consequently, victims will remain in abusive relationships and experience endless cycles of abuse. Through heightened awareness, other women experiencing this form of violence in their relationships may be motivated to come forward and openly tell their stories. This, in turn, could motivate change and stimulate interventions.

Strengths and Limitations of the Study

As one of the few to apply Heise’s SEM to document the reasons for sexual violence against married women, this study makes a significant contribution to the scant but burgeoning body of literature on marital and intimate partner sexual violence in Ghana and sub-Saharan Africa. It lays the groundwork for other researchers to undertake nationwide research on sexual violence among married women so that evidence-based preventive strategies can be designed to tackle this pervasive form of abuse.

Despite its strengths, the study has some weaknesses. The limited sample size means the findings cannot be generalized to all Ghanaian married women. While the study has provided an initial understanding of sexual violence among married women, future research should draw on a larger sample across different ethnic groups in Ghana. At the moment, nationally representative data on sexual violence are lacking in Ghana, including few data on prevalence and risk factors. Survey research is urgently needed to allow policy makers to deal more comprehensively with sexual violence in Ghana. We also recommend that future studies employ mixed methods, as these can provide more nuanced evidence.

Conclusion

Sexual violence against married women is underdocumented and underresearched, especially in Ghana and sub-Saharan Africa where this form of abuse is pervasive. This study employed a qualitative approach, using Heise’s SEM to examine the causes of sexual violence against married women in the Eastern Region of Ghana. The detailed examination of the issue through a nested social-ecological lens provides an exceptional and dynamic perspective. The findings clearly show sexual violence against women in marriages is a reality in the Ghanaian sociocultural context. The lived experience of sexual violence is driven by a complex interaction of factors at multiple levels of the biosocial environment. The results show that sexual violence in the lives of Ghanaian married women is chronic and thus provide a compelling rationale for designing broad-based preventive strategies. Campaigns against marital violence and domestic abuse should make sexual violence a top priority in Ghana. Among other things, legal and policy frameworks must be strengthened, including the criminalization of marital rape in the Domestic Violence Act 732.

Footnotes

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) disclosed receipt of the following financial support for the research and/or authorship of this article: Funding for this research was received from the Social Sciences and Humanities Research Council of Canada.

ORCID iD

Eric Y Tenkorang

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