Understanding the Relationship Between Male Gender Socialization and Gender-Based Violence Among Refugees in Sub-Saharan Africa

Abstract

Gender-based violence (GBV) in humanitarian emergencies is progressively recognized as a global public health problem. Detrimental gender norms influence male perpetrated GBV against women, and social and structural contexts of forced migration and camp resettlement contribute to problematic gender norm development. The review sought to elucidate the dynamics that link gender socialization among male youth in sub-Saharan Africa with violent sexual behaviors. Two concepts were explored: (1) male gender socialization in sub-Saharan Africa related to GBV perpetration patterns and (2) the effect of forced migration on male socialization and GBV. We reviewed articles using a standard systematic review methodology, searching academic databases for peer-reviewed articles, and contacting experts for gray literature. Our initial search identified 210 articles. We manually reviewed these, and 19 met the review inclusion criteria. We identified 20 variables from the first concept and 18 variables from the second. GBV perpetration by male youth is positively associated with social pressures as well as cultural and religious beliefs. Amid forced migration, personal, societal, and cultural preexisting gender inequalities are often amplified to encourage GBV perpetration. The literature revealed aspects of culture, language, role modeling, religion, and the context of violence as important factors that shape young men’s perspectives regarding the opposite sex and gender relations as well as sexual desires and dominance. Overall, though, literature focusing on male socialization and GBV prevention is limited. We made recommendations for future studies among refugee male youth in order to better understand these relationships.

Keywords

gender-based violence (GBV)sub-Saharan Africa male gender socialization refugees youth

Background

Gender socialization among male youth in sub-Saharan Africa, particularly among refugees, has the potential to influence gender-based violence (GBV) perpetration behaviors against women. The global public health community is progressively recognizing GBV as a significant issue affecting the health of women. GBV is defined as any form of violence due to one’s gender, which may include physical, sexual, and/or psychological violence such as deprivation or neglect (Andersson, Cockcroft, & Shea, 2008; Kenya National Bureau of Statistics [Nairobi], 2010). Women survivors of GBV face increased morbidity through physical injuries, sexually transmitted infections, reproductive health problems, and psychological trauma (Al Gasseer, Dresden, Keeney, & Warren, 2004; Pavlish & Ho, 2009; Stark et al., 2010; Wirtz et al., 2013). Reported rates of intimate partner violence, one form of GBV whereby women experience physical or sexual assault by intimate partners, range from 24% in Zambia to 31% in Nigeria (Lawoko, 2008). These same rates reach highs of 46% and 48% prevalence in Kenya and Zambia, respectively (Roman & Frantz, 2013). Among adolescent girls 12–19 years of age in Mbarara, Uganda, the sixth largest urban center in the Eastern African nation, 23% reported sexual coercion, or an unwillingness to engage in sexual intercourse, upon first sexual experience (Ybarra, Bull, Kiwanuka, Bangsberg, & Korchmaros, 2012). A variety of social, cultural, and contextual factors influence these rates in sub-Saharan Africa; increased understanding of these dynamics, though diverse and distinct to each nation within the region, may contribute positively to GBV prevention efforts.

Gendered stereotypes and perceptions of GBV in low-income settings appear to perpetuate the above statistics, as sexual relationships are heavily influenced by gender norms within societies (Heslop & Banda, 2013). Violence against women in such settings is often condoned (Jewkes & Morrell, 2010), and the acceptability of such violence alone is arguably among the greatest determinants of GBV in sub-Saharan Africa (Lawoko, 2008). Research shows that women, more often than men, justify GBV among intimate partners, such that 80% of women respondents in a nationally representative survey in Zambia and 66% of women respondents in Kenya defend a man’s use of violence against her because of an erroneous act committed, as per societal expectation (Lawoko, 2008). Among men, justification of GBV among intimate female partners varies from 8% acceptability in Madagascar to 63% in Kenya (Uthman, Lawoko, & Moradi, 2009). The impact of such gender norms may include the continued perpetration and increased incidence of GBV in societies where such acts are condoned.

Indeed, social and structural contexts greatly influence norms affecting GBV, deserving of attention. Gender identity is the relational construct that refers to social expectations and ideas about how men and women are meant to behave (Greig, Peacock, Jewkes, & Msimang, 2008). Gender, not sex, has greater influence over one’s behavior and perceived power in relationships (Jewkes & Morrell, 2010). Culture, religion, and other aspects of society determine these precepts; furthermore, differences in the male and female genders are rooted in power inequalities, traditionally resulting in male domination and female subordination (Greig et al., 2008; Jewkes & Morrell, 2010). The socialization of gender recognizes that both men and women acquire a set of learned behaviors based on social expectations of gender identities. Uthman, Lawoko, and Moradi (2009) researched attitudes associated with GBV in sub-Saharan Africa and based their work on the social learning theory. This theory states that individuals adopt behaviors as observed in role models’ actions. Pertinent to gender socialization in sub-Saharan Africa, norms in patriarchal societies are learned and passed down to the next generation to reinforce potentially harmful ideals of masculinity that are rooted in the control of women and exhibition of power (Dunkle & Decker, 2013; Uthman et al., 2009).

This aspect of male dominance is often referred to as hegemonic masculinity, a construct seen in men who have either adopted it from role models or chosen it out of insecurity (Atwood et al., 2011; Dworkin, Hatcher, Colvin, & Peacock, 2013; Gibbs, Willan, Misselhorn, & Mangoma, 2012; Jewkes & Morrell, 2010). Research states that hegemonic masculine behavior can be adopted if traditional aspects of masculinity are threatened or if one is unable to achieve culturally perceived notions of gendered success (Gibbs et al., 2012; Hampshire, Porter, Mashiri, Maponya, & Dube, 2011). For example, men with “low self-esteem and poor social skills” may desire to cover up their weakness through power and therefore engage in violent sexual behavior (Hampshire et al., 2011, p. 218). Men who adopt this hegemonic masculine identity transition from insecurity to control, thereafter judging their success and the success of other men by physical strength and heterosexual conquest (Dworkin et al., 2013; Jewkes & Morrell, 2010). The position of hegemony among men becomes an accepted ideal in society whereby men exercise their power in sexual relationships, often engaging in violent and controlling behaviors against women. Social control and power imbalances, as exemplified by hegemonic masculinity, cultivate societal norms that justify GBV and therefore encourage male violent behavior among women (Small, Nikolova, & Narendorf, 2013).

Specific vulnerability constructs related to violence, oppression, and forced migration may further increase a man’s tendency to adopt hegemonic masculine behaviors and act out in sexual violence (O’Neil, 2008). GBV perpetration in conflict and postconflict settings, though quality data are unreliable to confidently quantify rates, is known to be a clear issue of concern with unusually high levels of abuse, predominantly male violence perpetrated against women and girls (MenEngage-United Nations Population Fund [UNFPA], 2013). The literature reveals an increased psychosocial burden on those who experience trauma, forced displacement, separation from family, loss of basic necessities, and threats to aspirations (Roberts & Browne, 2011). Research also highlights that female vulnerability to GBV increases amid complex humanitarian emergencies, forced migration, and resettlement due to the absence of protection, gender or ethnic discrimination, economic disparity, and limited access to rights (Al Gasseer et al., 2004; Pavlish & Ho, 2009; Perera et al., 2013; Wirtz et al., 2013). These burdens associated with forced migration affect millions in sub-Saharan Africa who have fled their nations of origin and become refugees. According to the United Nations High Commissioner for Refugees (UNHCR) Global Trends Report of 2015, sub-Saharan African countries hosted 4.4 million refugees, the largest sum total of refugees worldwide, compared to other regions’ number of hosted refugees (UNHCR, 2016).

Forced migration and resettlement also influence masculine gender role stress, specifically the added struggle of male refugees to manifest traditional notions of masculinity, thereby contributing to unhealthy coping and socialization patterns (Eisler & Blalock, 1991). Traditional gender norms place men in the role of provider and protector; however, refugee males have not only fled their livelihoods and ambitions upon fleeing conflict, but they have also had to rely on agencies for provision of needs. Most host countries prohibit refugees from gaining employment, as they lack citizenship in their new homeland. This inability to work—along with a variety of other factors associated with forced migration—arguably challenges one’s manhood. The very nature of fleeing danger is seen as weakness (Jaji, 2009). The stress of challenged masculinities can lead to hegemonic masculinity behaviors and a number of detrimental outcomes, including interpersonal violence and aggressive sexual behaviors toward women (Eisler & Blalock, 1991; O’Neil, 2008).

In light of the abovementioned masculinity development patterns and the perpetration of GBV, we undertook a systematic literature review to identify factors linking gender socialization among male youth in sub-Saharan Africa with violent sexual behaviors and GBV incidence. Understanding these factors can help facilitate “gender transformative” GBV prevention, a process that seeks to alter gender norms and foster increased gender equity (Jewkes & Morrell, 2010). Additionally, increased male involvement in GBV prevention strategies has been seen to promote positive male development and increase social pressure against GBV. When given the opportunity, men have been known to reconsider their hegemonic masculinity, altering behaviors to adopt a less harmful gender identity that contributes to improved health outcomes among both males and females (Dworkin et al., 2013). Therefore, a review of male socialization in sub-Saharan Africa is critical to preventing GBV.

This review is structured in two parts: (1) male gender socialization as related to GBV perpetration patterns in the region and (2) male gender socialization among refugees in sub-Saharan Africa to understand how forced migration contributes to this construct.

Methodology for Literature Review

A review of articles was conducted to understand the relationship between gender socialization in sub-Saharan Africa and GBV and also to examine the role of forced migration due to conflict in the context of GBV. We followed standard recommendations for systematic literature reviews (Albanese & Norcini, 2002; Collaboration, 2005), a methodology that is detailed in this section. Web of Science, PubMed, The Cumulative Index to Nursing and Allied Health Literature, Global Health, and Scopus were used in initial searches to identify interventions, evaluations, and other systematic reviews of the subject under study. Among these search engines, only Web of Science produced results matching inclusion criteria. English articles in the Web of Science database were searched on a number of occasions between January 31, 2014, and February 1, 2016. Next, we contacted key experts in the field to provide information on international organizations and renowned researchers who have distinguished themselves in GBV prevention efforts through male-targeted interventions as well as experts in the field of forced migration research. We then pulled additional publications and gray literature from these sources for review—including reports, research, and essays—between February 14, 2014, and February 1, 2016. Finally, references from selected articles were examined to further highlight articles of relevance. The following section outlines the methodology we used for the review process, including eligibility criteria, sources, search terms, and study selection.

Article Inclusion Criteria

Characteristics of articles included in the review can be summarized by study design, population of focus, type of intervention, and outcome measure.

The following study designs were included in the review: peer-reviewed original research, systematic reviews, and performance evaluations. Gray literature was also included, such as education manuals, collections of case studies, advocacy briefs, and expert papers.

Study populations of inclusion were limited to youth and adolescents (i.e., defined differently per country but approximately between 13 and 35 years of age) in sub-Saharan Africa. Articles focusing on populations above 35 years and in countries outside of sub-Saharan Africa were excluded from review. Exceptions included studies that comprised—and separately aggregated—the target age range in the population under study. We also included in the review global research that presented data on sub-Saharan Africa.

Intervention types included those studies focusing on male gender socialization, male involvement in GBV prevention, and forced migration as associated with GBV. Only articles discussing forced migration, refugee populations, or postconflict were included; wartime violence and its affects on masculinity development and GBV were excluded if not also addressing migration. The review included HIV-specific studies that focused on gender and power dynamics associated with male socialization and GBV. HIV-focused studies addressing male socialization without association to GBV were excluded; likewise, HIV-focused studies focusing on association to GBV without insight into male socialization were excluded.

Included articles in the systematic review documented the following outcomes (Mullen, 2006), as associated with the specific objectives of the review: (1) sexual, physical, and/or emotional GBV among women, as perpetrated by males, and (2) GBV prevention.

Search Terms

The first set of search terms that we used for this systematic review represents terminology searches for Part 1 of the research question, namely, how gender socialization in sub-Saharan Africa contributes to violent sexual behavior among male youth. Multiple searches were conducted in Web of Science to promote a comprehensive collection of publications, as can be seen in Table 1.

Table 1.

Search Terms 1—Male Gender Socialization and GBV in Sub-Saharan Africa.

Population	Youth OR adolescent OR young adult
AND
Population	Male OR masculinity OR man OR men
AND
Outcome	GBV OR violent sexual behavior OR intimate partner violence OR rape OR sexual assault OR sexual violence
AND
Cause	Determinant* OR social* factor OR social*
AND
Location	Sub-Saharan Africa OR east* Africa

Note. GBV = Gender-based violence.

Search Terms 2, as displayed in Table 2, represents search terms for Part 2 of the literature review: forced migration and male gender socialization as contributing to GBV. There was significant overlap between the two search terms; specifically, Search Terms 2 included the context of forced migration to address Part 2 of the research question.

Table 2.

Search Terms 2—Male Gender Socialization and GBV Among Refugees in Sub-Saharan Africa.

Population	Youth OR adolescent OR young adult
AND
Population	Male OR masculinity OR man OR men
AND
Outcome	GBV OR violent sexual behavior OR rape OR sexual assault OR sexual violence
AND
Context	Refugee OR refugees OR forced migration OR postconflict
AND
Location	Sub-Saharan Africa OR east* Africa

Note. GBV = Gender-based violence.

The abovementioned databases were used to conduct multiple searches, with only Web of Science producing articles for inclusion. We intentionally did not include this secondary search element of forced migration in the first search terms in order to gain initial context about male socialization and GBV in sub-Saharan Africa prior to understanding how forced migration adds to this complexity. Nonetheless, Search Terms 1 did turn up one article that addressed forced migration, and it was included in the review for Part 2, as well.

In addition to the provision of recommended references by key experts in the field, of which two were included in the review, we reviewed the following organizational websites for institutional resources and publications as per the counsel of key experts:

Instituto Promundo: http://www.promundo.org.br/en/publications/home-of-publications/

Sonke Gender Justice: http://www.genderjustice.org.za/resources/cat_view/43-journal-articles-book-chapters.html

Engender Health: http://www.engenderhealth.org/pubs/gender/index.php

Raising Voices: http://raisingvoices.org/resources/#reports-articles-essays

Additional references were pulled from selected articles.

Study Selection

Following the strategic searches and added articles from other sources, we screened article abstracts and removed duplicates. We then reviewed full text articles for eligibility and searched relevant references for additional full text review. All articles screened for inclusion by abstract, full text, snowball, and other sources were documented in an Excel spreadsheet, noting the following details: author, date of publication, title, design, population, outcomes, and eligibility criteria. Figure 1 displays the article selection process for Parts 1 and 2 of the review.

Figure 1.

Study selection process.

Results

A total of 19 papers, from 210 articles initially identified, were included in this systematic review. Among these papers, 13 were studies of observational, cross-sectional, and descriptive designs with one study including a thorough systematic review. The remaining papers included one systematic review, one education manual, one collection of case studies, one advocacy brief, and two expert papers.

Description of Included Publications

The papers under review consisted of research design studies, programmatic reviews, and expert reports. Table 3 details the quality and characteristics of all papers included in this systematic review. The majority of studies were observational, cross-sectional, and descriptive studies that assessed the attitudes and experiences of male—and sometimes female—youth in sub-Saharan Africa around male gender socialization as it relates to GBV and, in a few instances, the relationship between forced migration and GBV.

Table 3.

Quality and Characteristics of Papers Included in the Literature Review.

Study (Year)	Design	Target Population and Sample Size	Location	Data Collection Process	Data Analysis Process	Limitations and Biases
Part 1
Atwood et al. (2011)	Observational, descriptive, and cross-sectional	Sixth and seventh graders between 13 and 19 years from one school, n = 36 (boys and girls)	Monrovia, Liberia	Five focus group discussions, four same gender and one mixed gender, randomly assigned	Audiotaped and transcribed FGDs, qualitative research coding approach, and themes prioritized	Not generalizable (one school in one city), sample size low, and unknown nationality or age of FGD moderators
Barker and Ricardo, (2005)	Systematic literature review plus observational, cross-sectional, and descriptive study	Young men in sub-Saharan African nations and programs operating within these nations. Botswana (n = 4), Nigeria (n = 20), Uganda (n = 16), and South Africa (n = 18)	Botswana, Nigeria, Uganda, South Africa	Reviewed literature on men and masculinities, conflict and HIV/AIDS in sub-Saharan Africa; consulted with partners; conducted 50 KI interviews with staff working with young men; conducted 23 FGDs; conducted 4 in-depth interviews with young men showing compelling gender-equitable attitudes	Not described	Unknown data analysis methodology
Hampshire, Porter, Mashiri, Maponya, and Dube, (2011)	Observational, descriptive, and cross-sectional	Youth aged 9–17 (boys and girls), selected settlements of relatively poor SES, n = 959	Eastern Cape Province, South Africa	Child Mobility Project as platform for data collection. Phase 1: 30 youth trained to collect mobility data to inform Phase 2. Phase 2: 394 interviews by adult interviewers. Phase 3: Survey questionnaire administered to 959 youth. Administrators were Black South Africans not necessarily from communities of interview	Not described	Unknown data analysis methodology, unknown selection process of included youth in the study—possible selection bias, and communities were targeted as SES for purposes of the study objective but not generalizable to other communities in region or abroad
Heslop and Banda, (2013)	Observational, descriptive, and cross-sectional	Youth aged 16–29, n = 30 (12 male, 18 female)	Chipata District, Eastern Province, Zambia	Adapted “Participatory Ethnographic Evaluation and Research” method. Trained youth interviewers, selected peers, unrandomized, and uncontrolled. Youth were interviewed 4 times, once per theme. Usually same-sex interviewers and interviewees. Authors interviewed youth interviewers after 2 days to gather data; one author took notes. Interviewed community KIs	Feedback workshop (including interviewers, authors, and host program staff) following all interviews. Peer researchers (youth interviewers) and authors conducted their own analysis (unknown method) of main findings, challenges, and recommendations	Unknown of data documentation method by the interviewers and possible recall bias after 2 days from the interview on behalf of the interviewers. Data analysis method is not reliable or valid (unknown method beyond discussion)
Part 2
Jaji (2009)	Observational, descriptive, and cross-sectional	Refugee men from Burundi, DRC, Rwanda, Uganda, and South Africa, living in Kenya. Ages 21–35 years (n = 29)	Kangemi, Nairobi, Kenya	10 Men agreed to individual interviews with 19 engaging in FGDs. FGDs were in three groups, with either six or seven participants in each	Not described	Findings not generalizable to all refugees in Nairobi due to the diverse countries of origin. Unknown data analysis methodology
Jewkes et al. (2006)	Observational, descriptive, and cross-sectional	Rural men in stepping stones program from 70 villages. Ages 15–26 years (n = 1,370)	Rural Eastern Cape Province, South Africa	Most participants recruited from schools. Structured questionnaire administered in face-to-face interview, in Xhosa by young male interviewers. IPV measured by WHO’s 2000 instrument that captures data on perpetration. Stratified two-staged survey with participants clustered within villages	First, analysis of descriptive variables on rape. Then, continuous variables summarized by calculating means (95% CI). Binary and categorical variables summarized by percentages (95% CI). Use of STATA 8.0 and generalized linear mixed model via practical quantification limit checks using Genstat v6	Inability to establish temporal relationships due to point-in-time data collection. Not generalizable due to the volunteer sampling method
MenEngage (2013)	Policy brief	Men and boys	Conflict and postconflict settings. Global	Unspecified. The purpose of this policy brief is to discuss (1) the context of sexual violence in both war and peace, (2) the varied roles of men and boys carry out in conflict and postconflict, and (3) outline policy and programmatic proposals that engage men	Not described	Selection bias, in terms of cases documented. Unknown data analysis methodology
Lary, Maman, Katebalila, and Mbwambo (2004)	Observational, descriptive, and cross-sectional	Youth recruited from venues (sports grounds, marketplaces, bus depots, and bars), aged 16–24, both male (n = 40) and female (n = 20)	Dar es Salaam, Tanzania	Semistructured interviews. Iterative approach. Principal investigator and technical advisors reviewed incoming data for new thematic direction and provided feedback to data collection team. Venues from 1 of 12 wards were mapped, participants screened for inclusion criteria. Interviews tape-recorded, transcribed into Kiswahili text, and translated into English	Data exhaustively reviewed for main themes, coded for retrieval, and analysis using nonnumerical unstructured data indexing searching and theorizing software program. Matrices of three main emergent themes to best condense, organize, and analyze data	Cross-sectional disallows temporal relationship. Not generalizable (limited to men and women who associated at public venues)
Part 3
Lwambo (2013)	Observational, descriptive, and cross-sectional	Men and women in urban, semiurban, and rural settings (n = 231)	North Kivu (Eastern), DRC	Field research in two cycles. Three semistructured questionnaires developed: one for male FGDs, one for female FGDs, and one for in-depth interviews with men. Single male focus group participants chosen for in-depth interviews. Participants could express in French, Swahili, and local languages	Interviews were digitally recorded and later transcribed. During second cycle, participants were given opportunity to discuss results	Not generalizable outside DRC or even perhaps location within DRC (narrowly defined location). Unknown participant selection strategy or analysis methodology
Maganja, Maman, Groves, and Mbwambo (2007)	Observational, descriptive, and cross-sectional	Male urban youth ages 16–24 from one ward (administrative unit) with population 73,978. Recruited from venues (e.g., soccer fields, movie/video rooms, bars). n = 60 (interviews) and n = between 70 and 168 (FGDs)	Dar es Salaam, Tanzania	In-depth interviews and FGDs. Local interviewers were trained in the qualitative instrument used. Recruitment occurred in venues mapped for key concentration of youth least likely to generating income and most likely to engage in HIV risk behaviors. Gender-specific interviews (40 men, 20 women). 14 FGDs (10 with men, 4 with women). Youth participating in interviews were not eligible to participate in FGD	Interviews and FGDs were in Kiswahili, audiotaped, transcribed, and translated into English. Data were reviewed for themes. Codes developed, data coded, and matrices constructed to condense and organize the data to facilitate cross-case analysis	Not generalizable due to small sample size; not generalizable to rural environments, for these youth were urban. Strength: triangulation of data from interviews and FGDs to support findings
Peacock and Barker (2012)	Expert paper prepared for UN Women Expert Group Meeting	Men and boys	Global	Review of data from The International Men and Gender Equality Survey (IMAGES) survey, WHO multicountry study (2005), and other expert authors. Methodology unspecified.	Not described	Unknown data collection and analysis processes. Difficult to generalize globally as various locations are used in research
Petersen, Bhana, and McKay, (2005)	Observational, descriptive, and cross-sectional (ethnographic)	Youth ages 13–16. Volunteer, convenience sample from one community school in semirural Zulu tribal area of 10,000 population. FGDs: 5 male FGs, 5 female FGs (8–10 in each). Interviews: n = 5 girls, n = 5 boys	KwaZulu-Natal Province, South Africa	Young Black South African psychologists were trained and conducted FGDs and interviews (gender-specific). Field notes were also taken for body language and other contextual factors	FGDs and interviews were taped, translated, and transcribed. Nvivo (software) was used for data coding management. Sexual violence data analyzed using Glaser’s constant comparative technique	Not generalizable due to one specific location/community under study
Instituto Promundo (2008)	Programmatic tool for education/training	Boys, young men, and men (all ages)	Global	Data drawn from literature review process and expressed in the manual’s introduction	Not described	Unknown data analysis methodology
Part 4
Roman and Frantz (2013)	Systematic literature review	Literature focusing on families and adolescents (articles of inclusion n = 7)	Africa	Comprehensive search conducted in May 2012 for previous 10 years, using databases such as Ebscohost (Medline, The Cumulative Index to Nursing and Allied Health Literature, PsyArticles), Directory of Open Access Journals, Project Muse and BioMed Central and also specific journals Lancet, and Journal Storage. Two reviewers independently evaluated the methodological quality of the studies reviewed	Methodological quality scores were given to each article prior to inclusion	Studies didn’t review implications of youth exposure to IPV; possible limitation
Sommers (2001)	Expert paper prepared for UNHCR workshop on refugee education in developing countries	Refugee youth (ages 12–30 years) populations	Kenya and Uganda	Review of literature on peace education concepts and programs, pertaining to refugee youth and violent youth. Followed by field research in Kenya and Uganda. Interviews with UNHCR officials in Geneva as well as peace education experts will also be incorporated	Not described	Unknown data collection and analysis processes. Difficult to generalize as various locations are used in research with various nationalities of refugees and camp policies
Stern, Peacock, and Alexander (2009)	Collection of case studies	Men and boys	Africa	Unspecified. The purpose of the case study collection is to showcase some of the innovative programs and policies taking place across the African continent, working with men and boys on issues related to gender, HIV, health, development, and social justice	Not described	Selection bias, in terms of cases documented. Unknown data analysis methodology
Walker (2005)	Observational, descriptive, and cross-sectional	Young men ages 22–35 involved in MFC (a nongovernmental organization) programming (n = 17). Also, counseling staff at MFC (n = 5)	Alexandra Township, South Africa	Author (White female) and research assistant (Black male) conducted formal interviews with men in MFC living in Alexandra. Informal discussions with men who previously worked for MFC. Interviews with MFC clinical counseling staff	Interviews transcribed	Selection bias (all these men had gone through the MFC program); not generalizable (small population size in narrowly defined location). Unknown data analysis method
Part 5
Wood, Lambert, and Jewkes (2007)	Observational, descriptive, and cross-sectional (ethnographic)	Young men (out-of-school) and women in one township, ages 14–25. Interviews female n = 46, males n = 30	Former Transkei region in Eastern Cape, South Africa	Participant observation for 18 months. Data collection taken by young, White female alongside young, local, male (1) and female (1) research assistants. In-depth semistructured interviews. Participants recruited directly through networks, from observation, or from snowballing. Interviews conducted in language of choice	Interviews transcribed and translated. Observational field diary and interview notes were coded thematically using Atlas software.	Limited population and therefore not generalizable. Selection bias may have occurred due to the relationships that were possibly created following the 18 months of observation
Wubs et al. (2009)	Observational, descriptive, and cross-sectional	Students (in relationships) in school-based health education program in three sites (schools selected n = 80). Student ages 10–18. Cape Town n = 3,796, Mankweng n = 2,616, and Dar es Salaam n = 567 (total n = 6,979)	Mankweng and Cape Town, South Africa; Dar es Salaam, Tanzania	Use of baseline data from a randomized control trial taking place. Self-administered questionnaire of 115 items covering sexuality and reproductive health. Pretested questionnaire and adjusted appropriately	Statistical analysis from baseline data only. CTS instrument used to assess assaults by intimate partners. Analyses conducted with Statistical Package for the Social Sciences (v14.0). Statistical analysis cross-tabulation and logistic regression models for cluster effects. Final models included only explanatory variables that were significant (p ≤ .05)	CTS does not take into consideration environmental/ contextual factors. Instrument is not designed to cover a broad range of factors but merely sociodemographic prevalence factors. Overcrowded classrooms may have influenced results (i.e., socially desirably answers, distracting, etc.).

Note. UNHCR = United Nations High Commissioner for Refugees; KI = key informant; SES = socioeconomic status; DRC = Democratic Republic of Congo; WHO = World Health Organization; FGD = focus group discussion; FG = focus group; IPV = intimate partner violence; CI = confidence interval; MFC = Men for Change; CTS = Conflict Tactics Scale.

The remaining articles were systematic reviews (1; Roman & Frantz, 2013), an education manual (1; Instituto Promundo, 2008), a collection of case studies (1; Stern, Peacock, & Alexander, 2009), an advocacy brief (1; MenEngage-UNFPA, 2013), and expert papers (2; Peacock & Barker, 2012; Sommers, 2001), all of which met inclusion criteria. The systematic review focused on Africa more generally, but all but 1 of the 12 studies reviewed in that article were within sub-Saharan Africa. The education manual targeted men of all ages in a global context, addressing issues of young men and GBV, including reference on many occasions to gender norms as related to sub-Saharan African nations. The collection of case studies also addressed both men and boys throughout Africa; however, data were presented in reference to age, and specific sub-Saharan African cases were highlighted: South Africa, Rwanda, Nigeria, Tanzania, Zimbabwe, and Kenya. The advocacy brief and the first of two expert papers were global in focus, with clear reference to nations in sub-Saharan Africa. Finally, the last expert paper addresses peace education in refugee camps in Kenya and Uganda, while highlighting contextual factors of forced migration and male socialization that impact GBV incidence.

Results of Included Publications

Two main interlocking themes emerged from the 19 included articles, namely, male socialization and the role of forced migration in the socialization/GBV continuum.

Male socialization and GBV

Table 4 details this first theme and presents 20 variables that surfaced within the represented articles. Many of these variables emerged in a number of articles, and the frequency of variable occurrence is listed in this table to further qualify the variables. Specifically, men in sub-Saharan Africa tend to face social pressure from parents and their community to be sexually active at a young age, hold multiple partners (Atwood et al., 2011; Barker & Ricardo, 2005; Hampshire et al., 2011; Lary, Maman, Katebalila, & Mbwambo, 2004; Maganja, Maman, Groves, & Mbwambo, 2007; Petersen, Bhana, & McKay, 2005), and display manhood by initiating dominance and control over women and girls (Atwood et al., 2011; Barker & Ricardo, 2005; Heslop & Banda, 2013; Maganja et al., 2007; MenEngage-UNFPA, 2013; Petersen et al., 2005; Walker, 2005; Wood, Lambert, & Jewkes, 2007). Hegemonic masculinity as a social construct was examined in many studies and found to be positively associated with GBV. In four reviewed studies, a crisis of masculinities is noted to manifest itself into an overcompensation of this insecurity through sexual conquest, contributing toward sexual violence (Barker & Ricardo, 2005; Hampshire et al., 2011; Jaji, 2009; Lwambo, 2013; MenEngage-UNFPA, 2013; Sommers, 2001; Walker, 2005; Wood et al., 2007). Other social factors among males—such as the role of parenting (Instituto Promundo, 2008; Jewkes et al., 2006), religion (Heslop & Banda, 2013; Jaji, 2009; Wubs et al., 2009), communication (Jewkes et al., 2006; Petersen et al., 2005), and cultural nuances of language and behavior (Heslop & Banda, 2013; Wood et al., 2007)—were commonly associated with GBV.

Table 4.

Variables of Gender Socialization Among Male Youth in Sub-Saharan Africa, as Pertaining to GBV.

Variables of Male Gender Socialization Associated With GBV	No. of Articles Addressing This Variable
Hegemonic masculinity as male gender identity (power, status, control, and dominance) (Atwood et al., 2011; Barker & Ricardo, 2005; Heslop & Banda, 2013; Instituto Promundo, 2008; Lwambo, 2013; Maganja, Maman, Groves, & Mbwambo, 2007; MenEngage-UNFPA, 2013; Petersen, Bhana, & McKay, 2005; Stern, Peacock, & Alexander, 2009; Walker, 2005; Wood, Lambert, & Jewkes, 2007)	11
Crisis of masculinities (traditional masculinities threatened, men overcompensate through sexual conquest) (Barker & Ricardo, 2005; Hampshire, Porter, Mashiri, Maponya, & Dube, 2011; Jaji, 2009; Lwambo, 2013; MenEngage-UNFPA, 2013; Sommers, 2001; Walker, 2005; Wood et al., 2007)	8
Social pressure (parents and/or community) to be sexually active and/or have multiple partners (Atwood et al., 2011; Barker & Ricardo, 2005; Hampshire et al., 2011; Instituto Promundo, 2008; Lary, Maman, Katebalila, & Mbwambo, 2004; Maganja et al., 2007; Petersen et al., 2005)	7
Male socialization amid violence (Barker & Ricardo, 2005; Jaji, 2009; Lwambo, 2013; MenEngage-UNFPA, 2013; Peacock & Barker, 2012; Sommers, 2001; Walker, 2005)	7
Male role models in question (exposure to GBV, self or others, as child, no role model at all) (Lwambo, 2013; Petersen et al., 2005; Roman & Frantz, 2013; Sommers, 2001; Stern et al., 2009; Walker, 2005)	6
Gender socialization influenced by social context, urbanization, politics, and poor social institutions (Barker & Ricardo, 2005; Jaji, 2009; Lwambo, 2013; MenEngage-UNFPA, 2013; Sommers, 2001; Stern et al., 2009)	6
Rites of passage as socialization factor (sexual experience as initiation into manhood) (Barker & Ricardo, 2005; Heslop & Banda, 2013; Instituto Promundo, 2008; Stern et al., 2009; Walker, 2005)	5
Justification for sexual abuse (men unable to control sexual desires; female obligation to control this) (Lwambo, 2013; Petersen et al., 2005; Sommers, 2001; Walker, 2005; Wood et al., 2007)	5
Gender norms and identity shaped by upbringing (Barker & Ricardo, 2005; Instituto Promundo, 2008; Jaji, 2009; Peacock & Barker, 2012)	4
Boys/men are seen as strong, brave, risk-taking, aggressive, and so on (Hampshire et al., 2011; MenEngage-UNFPA, 2013; Stern et al., 2009)	3
Various understanding by males of the meaning of “forced sex” (Instituto Promundo, 2008; Lary et al., 2004; Wood et al., 2007)	3
Father figures don’t engage with their sons on issues of reproduction and fertility (Barker & Ricardo, 2005; Instituto Promundo, 2008)	2
Violence justified to control and discipline female in relationship (Lary et al., 2004; Petersen et al., 2005)	2
Some young men believe violence is not justified (Jaji, 2009; Lary et al., 2004)	2
Poor communication skills associated with high risk of perpetration (Jewkes et al., 2006; Petersen et al., 2005)	2
Cultural nuances of behavior and desire (e.g., no means yes; Heslop & Banda, 2013; Wood et al., 2007)	2
Religion as protective factor against violence (Jaji, 2009; Wubs et al., 2009)	2
Growing up with neither biological parent associated with lower risk of perpetration (Jewkes et al., 2006)	1
Gender inequality and poverty lead to sex for exchange (Atwood et al., 2011)	1
Religion as justification of male dominance (Heslop & Banda, 2013)	1

Note. UNFPA = United Nations Population Fund; GBV = gender-based violence.

Effect of forced migration on male socialization and GBV

Among the included 19 articles in the review, 6 produced aspects relevant to the second theme under study: forced migration as affecting the male socialization and GBV continuum. Variables from the second theme are listed in Table 5, and the frequency of variable presentation in the included articles is also presented in this table. While forced migration from conflict does not directly lead to increased GBV incidence through negative socialization experiences for young men, the literature reveals that preexisting gender inequalities and power imbalances are amplified under such conditions of distress and displacement (MenEngage-UNFPA, 2013). The context of postconflict environments, including responding to trauma associated with violence exposure and relocation to refugee camps, can encourage and sustain GBV through the strain on masculinities. Specifically, men’s inability to work and the lack of financial independence (Barker & Ricardo, 2005; Jaji, 2009; Lwambo, 2013; Sommers, 2001), along with other frustrations of diminished aspirations and hopelessness (Barker & Ricardo, 2005; Jaji, 2009), are key factors that challenge male notions of masculinity. One’s inability to protect self and/or family (Lwambo, 2013; MenEngage-UNFPA, 2013; Peacock & Barker, 2012; Sommers, 2001), in addition to the fear and defeat that is associated with forced migration (Jaji, 2009), can directly reduce a male’s sense of worth and pride (Barker & Ricardo, 2005; Jaji, 2009; Lwambo, 2013; Sommers, 2001). Such threats to one’s masculinity due to forced migration and resettlement can lead male youth to behave in acts of violence toward women in an effort to reclaim lost dominance, power, and control (Barker & Ricardo, 2005; Lwambo, 2013). In contrast, the literature also highlights cohorts of young men who choose an alternate form of masculinity from the traditional hegemony that is often described amid threats to manhood; positive notions of masculinity are known to be adopted amid the trauma and loss associated with refugee status. Men exhibiting this “benign masculinity” gain endurance and hope from certain protective factors, including education and religion (Barker & Ricardo, 2005; Jaji, 2009).

Table 5.

Variables of Forced Migration Among Male Youth in Sub-Saharan Africa in the Male Socialization/GBV Continuum.

Variables of Forced Migration Affecting Male Socialization and GBV	No. of Articles Addressing This Variable
Employment is a requisite to being publicly recognized as a man; unemployment leads to loss of social status and low self-esteem (Barker & Ricardo, 2005; Jaji, 2009; Lwambo, 2013; Sommers, 2001)	4
Inability to provide and protect loved ones is seen as failure in manhood (Lwambo, 2013; MenEngage-UNFPA, 2013; Peacock & Barker, 2012; Sommers, 2001)	4
Frustration and stress is high among refugee males; often men manifest this frustration and loss of manhood through sexual violence (Barker & Ricardo, 2005; Lwambo, 2013; MenEngage-UNFPA, 2013; Sommers, 2001)	4
Men who witness or experience violence are more likely to report using violence against women (Barker & Ricardo, 2005; MenEngage-UNFPA, 2013; Peacock & Barker, 2012)	3
Men who are engaged in community development as agents of change form positive masculine attitudes (Barker & Ricardo, 2005; Lwambo, 2013; MenEngage-UNFPA, 2013)	3
Sense of idleness and little hope for future; loss of premigration goals and aspirations (Barker & Ricardo, 2005; Jaji, 2009)	2
Because male youth are not economically capable of marrying, they use sexual violence against women (Barker & Ricardo, 2005; Sommers, 2001)	2
With violence and migration comes a loss of manhood, and men feel the need to recover this lost masculinity (Barker & Ricardo, 2005; Lwambo, 2013)	2
Women’s increased agency, often promoted by international influences in refugee camps, can be seen as counteracting traditional notions of manhood, leading to increased violence by men (Barker & Ricardo, 2005; Lwambo, 2013)	2
Young men who migrate face challenges in their new countries, often seen as second-class citizens; they need to conform to new notions of masculinity (Barker & Ricardo, 2005; Jaji, 2009)	2
Education as a protective factor for refugee young men against violence and in promotion of achieving manhood and headship (Barker & Ricardo, 2005; Jaji, 2009)	2
Religion as a protective factor for refugee young men against hegemonic masculine attitudes and behaviors (Jaji, 2009; Lwambo, 2013)	2
Some refugee youth adopt a positive or benign masculinity, which contrasts other dominant and potentially violent masculinities (i.e., hegemonic masculinity) mentioned in literature (Jaji, 2009; Lwambo, 2013)	2
Men who have been displaced are more likely to report physical violence against women (MenEngage-UNFPA, 2013)	1
Weakened ties to land: men fear that others will take their land and they’ll have nowhere to return (Barker & Ricardo, 2005)	1
Refugees often rely on assistance from outside agencies, directly going against the masculine notion of financial independence (Jaji, 2009)	1
Refugee women prefer local (from host population) men who can meet her needs, over refugee men who cannot (Jaji, 2009)	1
Flight or migration is seen as feminine and a sign of weakness, through fear and defeat (Jaji, 2009)	1

Note. UNFPA = United Nations Population Fund; GBV = gender-based violence.

Discussion

This literature review presents data from 19 studies, reviews, programmatic evaluations, training tools, case study collections, advocacy briefs, and expert papers, highlighting key findings for application in the field of GBV prevention. We have understood two main themes from the literature: (1) male socialization in GBV behavior and (2) the role of forced migration in the socialization/GBV continuum. Firstly, young men in sub-Saharan Africa face social pressure to exhibit gender dominance and control over young females of the same age-group. This hegemonic masculinity mentality manifests into one’s gender identity, affecting behaviors that often result in GBV. Secondly, male refugee youth encounter a number of challenges in migration and resettlement that threaten masculinity and influence behaviors. Although positive behaviors may emerge, such traumatic and life-altering experiences often result in an overcompensation of control and power that contributes to GBV perpetration.

Our original question sought to interpret how gender socialization in sub-Saharan Africa contributes to GBV perpetration behaviors among male youth and what role forced migration plays in the gender socialization/GBV continuum. Much was uncovered in the abovementioned research to address gender socialization among men in sub-Saharan Africa, specific to its association with GBV. The literature reveals aspects of culture, language, parenting and role modeling, religion, and context of violence that shape a young man’s perspective regarding the opposite sex and gender relations as well as sexual desires and dominance. This understanding is foundational to uncovering the effects of forced migration on the same process. Although minimal research exists in this regard, the literature routinely cites exposure to violence, inability to protect and provide, loss of social status, hopelessness and loss of aspirations, and the stress of adjusting to host community norms as paramount to shaping one’s masculinity and potentially threatening manhood. As recognized in Part 1 of this review, hegemonic masculine tendencies surface when traditional gender norms are at risk, creating an environment whereby sexual violence is both prevalent and justified.

Limitations in the Review Process

Limitations exist in the body of research included in our systematic review. The majority of articles (10 of 19) were conducted in a very specific setting with small subsets of populations (Atwood et al., 2011; Hampshire et al., 2011; Jaji, 2009; Lary et al., 2004; Lwambo, 2013; Maganja et al., 2007; Petersen et al., 2005; Walker, 2005; Wood et al., 2007; Wubs et al., 2009). In addition, many included studies selected participants based on convenience or volunteerism rather than randomization. This may present selection biases to those particular studies and therefore also to this systematic review. As such, these studies are not generalizable to the larger sub-Saharan African community. In addition, the majority of included research (13 of 19 included studies) employed a cross-sectional, descriptive study design, disabling a temporal relationship assessment between gender socialization and GBV, or forced migration and male socialization with GBV, due to point-in-time data collection methodology (Atwood et al., 2011; Barker & Ricardo, 2005; Hampshire et al., 2011; Heslop & Banda, 2013; Jaji, 2009; Jewkes et al., 2006; Lary et al., 2004; Lwambo, 2013; Maganja et al., 2007; Petersen et al., 2005; Walker, 2005; Wood et al., 2007; Wubs et al., 2009). Additionally, although a variety of other databases beyond Web of Science were explored in the process, they had minimal quality results. Also relating to the search process and inclusion of articles, the gray literature included in the review was limited to data that were known through key expert recommendation and to which we had access. Indeed, additional gray literature exists and demands review, but these sources were unknown for purposes of inclusion. Lastly, we faced difficulty in the study selection process, namely, that male socialization was addressed in many additional studies; however, despite the fact that male socialization is by definition a construct of youth, these articles may not have met the age inclusion criteria due to the included study participants. Despite the narrow selection of participants in many studies, however, a variety of common and important themes emerged from the research and important gaps in knowledge remain.

Considerations for Future Research

Limited research addressing male socialization and GBV incidence among male refugee populations exists, and much of the existing literature addressing these topics reveal serious limitations. As such, we see a demand for additional studies to improve the status of the science in this area; therefore, we recommend the following for future research, programmatic implementation, and policy change. First, the greater GBV prevention community must not only look to women’s interventions but should focus on men and male involvement in research and efforts to prevent GBV and promote positive gender relations. Second, particular concentration must be placed in forced migrant communities throughout sub-Saharan Africa, both cross-border migration and internal displacement. This research should be particularly sensitive to issues of masculinity as contributing negatively or positively toward GBV incidence. Priority must be placed on first understanding protective factors that lend to positive masculine development and next building up healthy notions of masculinity among male refugee youth. Examples of such initiatives may include availing male youth with opportunities to protect, provide, and impact communities for positive change.

General knowledge exists, as highlighted in select studies included in this review, to advocate for increased male involvement in positive gender norm development and GBV prevention (Barker & Ricardo, 2005; Instituto Promundo, 2008, 2012; MenEngage-UNFPA, 2013; Peacock & Barker, 2012; Stern et al., 2009). First and foremost, this knowledge must be applied across both the GBV and general development sectors to reduce the risk of GBV, including health sectors, as male behaviors affect health outcomes for both men and women. In addition to applying generalizable knowledge, future efforts need to focus on information and patterns in target areas of high GBV incidence, such as refugee camps. In order to best implement such programming and effectively change behavior through male-focused interventions, further research is needed in the specific locations of proposed programmatic implementation. Specifically, the literature that met our inclusion criteria, and thus those data sets that focus on male socialization and GBV in sub-Saharan Africa, are limited in region and scope. Increased impact in GBV prevention will require additional information in additional settings.

Additional inquiry regarding the relationships between forced migration and male socialization in strategic sub-Saharan Africa locations, specifically those receiving refugees from surrounding nations, may enhance the research findings above. The scant research conducted among male refugee youth demands further understanding of how forced migration affects masculinity development and GBV patterns, specifically to uncover aspects of positive masculinity development that may aid in the response. Future studies in strategic sub-Saharan Africa locations have potential to surface a framework that promotes positive gender socialization in refugee settings.

Defining social, developmental constructs of young men concerning their sexual behaviors of gender dominance can help shape future GBV prevention interventions in the region. A specific focus on gender norm development among forced migrants can present opportunities for behavior change among refugees to promote positive masculinity development and healthy gender relations. This systematic review provides the foundation for future research to inform, and interventions to impact, public health practice in GBV prevention.

Implications for Research, Practice, and Policy.

Increase male involvement in GBV prevention research.

Conduct additional GBV prevention research, specifically related to male socialization, in refugee settings.

Apply GBV prevention research across all development sectors, including health; education; and water, sanitation, and hygiene.

Involve men in efforts to prevent GBV, promote positive gender norm development, and promote positive male/female gender relations.

Increase programming and policies that promote positive male gender socialization among refugee youth.

Involve men in male socialization and GBV-focused policy creation and implementation.

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) received no financial support for the research, authorship, and/or publication of this article.

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