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Research Article, J Womens Health Issues Care Vol: 6 Issue: 5

Correlates of Sexual and Physical Violence among Female Preparatory School students in Gurage Zone, Ethiopia

Bisrat Zeleke Shiferaw*, Kenzudine Assfa Mossa and Zerihun Hile

Wolkite University, College of Medicine and Health Sciences, Department of Nursing, PO Box07 Wolkite, Ethiopia

*Corresponding Author : Bisrat Zeleke Shiferaw
MSc. in Maternity Nursing, Lecturer Wolkite University, College of Medicine and Health Sciences, Department of Nursing, PO Box 07 Wolkite, Ethiopia
Tel: +251-911037686
E-mail: [email protected] or [email protected]

Received: September 01, 2017 Accepted: September 29, 2017 Published: October 05, 2017

Citation: Bisrat ZS, Kenzudine AM, Zerihun H (2017) Correlates of Sexual and Physical Violence among Female Preparatory School students in Garage zone, Ethiopia. J Womens Health, Issues Care 6:5. doi: 10.4172/2325-9795.1000287

Abstract

Background and Objective: Gender based violence (sexual and /physical), frequently occurs in institutions assumed to be ‘safe’, such as schools, where perpetrators include peers and teachers. School-related gender-based violence includes but is not limited to rape, unwanted sexual touching, unwanted sexual comments, corporal punishment, bullying and verbal harassment that is based on gender stereotypes which targets female students on the basis of their sex. It is a widespread barrier to girls’ attaining educational equity, which also brings with it many health risks. This study aimed the correlates of sexual and physical violence among female preparatory students in Garage zone, Ethiopia.
Materials and Methods: Institution based cross-sectional descriptive study was conducted in preparatory schools of Gurage zone on March 2017. A multi-stage stratified sampling with simple random sampling technique was applied to select the study participant. Data were collected using a pre-tested structured selfadministered questionnaire. The collected data was cleaned and entered in to Epidata3.1 then exported to SPSS version 20:00 for analysis. Finally, a multivariate logistic regression model was created predict the correlates of sexual and physical violence among female students.
Result: A total of 686 female preparatory students participated in the study, giving a response rate of 90.3 %. The finding showed that the prevalence of sexual and physical violence were 15.9% and 47.5% respectively. Forceful/ unwilling sex accounts 42(38.5%) from sexually active female students. Age group (i.e. Age<18
years); [AOR 1.72, 95 % CI=1.02, 2.84] and monthly received pocket money [AOR 1.37, 95 % CI=1.06, 2.78] were statistically significant predictors of sexual violence. Whereas, substance uses (i.e. Khat chewing, drinking alcohol and cigarette smoking) were statistically significant determinants of sexual and physical violence among female students.
Conclusion: The study has shown that the prevalence of both sexual and physical violence among female students is found to be relatively higher. Thus, designing specific strategic activates towards early detection, identification and prevention of school related gender based violence through provision of different regular information and communication and empowerment of female students is implicated.

Keywords: Sexual violence; Physical violence; Preparatory school; Gurage zone

Abbreviations

AOR: Adjusted Odds Ratio; COR- Crude Odds Ratio; ETB: Ethiopian Birr; GBV: Gender Based Violence; HIV: Human Immunodeficiency Virus; NGO: Non-Governmental Organization; RERB: Research Ethical Review Board; SPSS: Statistical Packages for Social Science; STI: Sexually Transmitted Infections; WHO: World Health Organization

Background

Although educational establishments are recognized as places of learning, personal development and empowerment, schools are too often places of discrimination and violence, particularly against girl students. School-related gender-based violence (SRGBV) covers all forms of violence or abuse based on gender stereotypes or aimed at girls on the basis of their gender. It results in sexual, physical and psychological harm to girls [1]. It includes, but is not limited to rape, unwanted sexual touching, unwanted sexual comments, corporal punishment, bullying and verbal harassment that is based on gender stereotypes or that targets female students on the basis of their sex and results in sexual, physical or psychological harm to female students [2].

SRGBV has a long-lasting negative impact on students’ academic performance as well as their physical health and mental wellbeing. Several studies point out that the consequences of SRGBV adversely affect girls’ educational attainment. Girls report losing their concentration in class, feeling bad about themselves, missing school, and even dropping out (often causing them to leave school after actual gender-based violence or for fear of it). It also has health related consequences in terms of increased exposure to sexually transmitted infections (STIs), including HIV/AIDS, and unwanted pregnancies are also devastating [3].

Sexual and physical violence are the most commonly identified form of SRGBV. Global estimates indicate that almost half of all female students experience some form of sexual and physical violence in the educational context [4]. Studies from around the world, including Africa, south Asia, and Latin America, have documented that substantial proportions of female students report experiencing sexual harassment and abuse on the way to and from school by peers and by teachers [5]. This type of violence is less documented than violence in general, and it even seems to be trivialized. Yet despite such trivialization, school-related sexual abuse often remains a taboo issue, making it difficult to be identified, recognized, dealt with and prosecuted [6].

Generally speaking, evidences related to gender based violence in our country especially in preparatory school settings is scarce. The prevalence, frequency and intensity of violence among girls found in preparatory schools have not yet been the subject of research in Gurage zone. To the best of the researcher knowledge, there is no comprehensive research conducted in the region for reporting acts of school-related violence. Therefore, this study was conducted to assess the correlates of sexual and physical violence among female preparatory students in Garage zone, Ethiopia.

Materials and Methods

A cross sectional institution based descriptive study was conducted among female students of preparatory schools found in Gurage zone on March 2017. The zone is composed of 13 woreda and 2 city administration. According to the 2017 zonal educational affairs office report a total of 16 preparatory schools are found in Gurage zone, one in each woreda. In the 2017 academic year a total of 9838 students were attended preparatory school among these, 4,282 of them were female.

The sample size was calculated using a single population proportion formula with confidence interval of 95% and margin of error 5%. In the calculation, the prevalence of sexual violence was considered to be 34.4% [7]. Then, by considering 10% non-response rate and design effect of 2, the final sample size was 760 female students.

A multi-stage stratified sampling technique was used; where first 8 preparatory schools were selected from the total 16 schools using lottery method, then, the total sample size was allocated to each preparatory school proportional to the number of female students in the preparatory schools. Finally, participant students were selected from each preparatory school proportional to their grade of study (i.e. grade 11 & 12) using simple random sampling technique students’ attendance list was used as a sampling frame.

Data was collected using eight data collectors and four supervisors through pre-tested, structured and self -administered questionnaires. The questionnaire was developed after thorough review of various literatures relevant to the study and prepared in English language. Before the actual data collection, the questionnaire was pre-tested on 5% (38subjects) in one of unselected preparatory school. Finally, filled questionnaires were checked for completeness and consistency of the data by the principal investigator on daily basis.

Before conducting the study, the proposal was publicly presented, defended and letter of ethical clearance approval was obtained from Wolkite University, Research Ethical Review Board (RERB). The purpose of the study was explained to the study participants, anonymity and privacy and confidentiality was ensured. Prior to data collection, informed written consent was obtained from the study participants. While obtaining consent from each participant, information related to publishing the study finding were addressed. The respondents’ right to refuse or withdraw from participating in the study was also fully acknowledged.

Data processing and analysis

The collected data was cleaned, coded and entered into Epi-data software version 3.1 and then exported to Statistical Package for Social Sciences (SPSS) version 20:00 for analysis. First, descriptive analysis was carried out for each variable. Variables with a p value <0.25 in bivariate analysis were entered into the multivariable logistic regression, and then those variables with a p value <0.05 were considered to be statistically significant in multivariate analysis.

Results

Socio demographic characteristics

A total of 686 female preparatory students participated in the study, making a response rate of 90.26 %. The mean age of the respondents was 17.8 (± 1.6) years, the youngest being 12 and the oldest 35 years old. More than half 357 (52.0%) of the respondents were Orthodox Christian by religion followed by Muslim 181 (26.4%) and protestant 94 (13.7%). Regarding their ethnicity, Majority of the respondents 496 (72.3%) were Gurage followed by Amhara 86 (12.5%) and kebena 64 (9.3%).About 216 (31.5%) of the respondents are living in rental house far from their family home and. concerning the respondents academicals status more than half of them 387 (56.4%) were grade 12 and the rest were grade 11 (Table 1).

Variables Response N %
Age category < 18 years 561 81.8%
18-22 years 116 16.9%
>=33 years 9 1.3%
     
Religion Orthodox 357 52.0%
Muslim 181 26.4%
Catholic 37 5.4%
Protestant 94 13.7%
Other 17 2.5%
     
Ethnic group Gurage 496 72.3%
Kebena 64 9.3%
Silte 21 3.1%
Amhara 86 12.5%
Other 19 2.8%
     
Initial residence Rural 360 52.5%
Urban 326 47.5%
     
Living condition With family home 470 68.5%
Rent home 216 31.5%
     
If in rental home with whom* Alone 36 16.7%
With female friend 115 53.2%
With husband 6 2.8%
With relatives 55 25.5%
Other 4 1.9%
     
Marital status Yes 97 14.1%
No 589 85.9%
     
Grade attending Grade 11 387 56.4%
Grade 12 299 43.6%
     
Cumulative GPA 50-64 score 183 26.8%
65-79 score 385 56.3%
>=80 score 116 16.0%
     

Table 1: Socio-demographic characteristics of female preparatory school students, Gurage Zone, Ethiopia, March, 2017.

Family socio-economic characteristics

Out of the total 760 female students, only 140 (20.4%) of their mothers and 64 (9.3%) of their father did not attend any formal or informal education. More than half 366 (53.4%) of their family get a monthly income between1001-5000 Ethiopian Birr (ETB) and about 381 (55.5%) of the female students receive a monthly incentives of 101-500 ETB from their family (Table 2).

Variables Response  N  %
Are your parents live together Yes 572 83.4%
No 114 16.6%
     
If not what is the reason Divorced 20 17.5%
Death 23 20.2%
Job 50 43.9%
Other 21 18.4%
     
Which of parents are alive Mother 75 10.9%
Father 18 2.6%
Both are alive 575 83.8%
Both are not alive 18 2.6%
     
Educational status (father) No education 64 9.3%
Able to read and write 201 29.3%
Grade 1-8 134 19.5%
Grade 9-12 118 17.2%
Diploma and above 169 24.6%
     
Educational status (mother) No education 140 20.4%
Able to read and write 194 28.3%
Grade 1-8 174 25.4%
Grade 9-12 78 11.4%
Diploma and above 100 14.6%
     
Family income <=1000 164 23.9%
1001-5000 366 53.4%
5001-10000 129 18.8%
10001-15000 15 2.2%
>15000 12 1.7%
     
Monthly received money (incentive) <=100 242 35.3%
101-500 381 55.5%
>500 63 9.2%
     
Is the received money enough for your expense Yes 402 58.6%
No 284 41.4%
     
How do you perceive the control of your family on you Tight 414 60.3%
Average 241 35.1%
Loose 12 1.7%
No control at all 19 2.8%

Table 2: Respondents Family Socio-Economic Characteristics, Gurage Zone, Ethiopia, March, 2017.

Substance use

With regard to substance use among the respondents, only 45 (6.6%), 27 (3.9%) and 59 (8.6%) of them have chew chat, smoke tobacco and consume alcohol respectively (Table 3).

Variables Response N %
Chat chewing Yes 45 6.6%
No 641 93.4%
     
Frequency of Chat chewing Usually 11 24.4%
Some times 12 26.7%
Occasionally 22 48.9%
     
Tobacco smoking Yes 27 3.9%
No 659 96.1%
     
Frequency of tobacco smoking Usually 12 44.4%
Some times 3 11.1%
Occasionally 12 44.4%
     
Consuming alcohol Yes 59 8.6%
No 627 91.4%
     
Frequency of consuming alcohol Usually 12 20.3%
Some times 10 16.9%
Occasionally 37 62.7%

Table 3: Substance use among female preparatory school students, Gurage Zone, Ethiopia, March, 2017.

Sexual experience history

Regarding respondents sexual history out of the total 686 female students, 118 (17.2%) ever had sex since they entered preparatory school of which 42 (35.6%) had unprotected sex, 23 (54.8%) had been pregnant and the majority 14 (60.9%) experienced unintended pregnancies in which all of them ended in abortion (Table 4).

Variables Response N %
Ever had sex since preparatory school Yes 118 17.2%
No 568 82.8%
     
With whom sexual intercourse Teachers 11 8.3%
Supportive staffs 7 5.3%
Sexual partner 70 52.6%
Class mate 33 24.8%
Other 12 9.0%
     
Frequency of sexual intercourse Once 19 16.1%
Twice 20 16.9%
More than Three 79 66.9%
     
Protected sex* Yes 76 64.4%
No 42 35.6%
     
History of pregnancy Yes 23 54.8%
No 19 45.2%
     
Unintended Pregnancy Yes 14 60.9%
No 9 39.1%
     
Fate of unintended pregnancy Abortion 14 100.0%
Gave birth 0 0.0%
     
Number of  Sexual partners One 82 69.5%
Two 15 12.7%
More than two 21 17.8%
     
Free discussion on sexual & reproductive issues with families Yes 231 33.7%
No 455 66.3%

Table 4: Respondents Sexual history, female preparatory school students, Gurage Zone, Ethiopia, March, 2017.

Sexual Violence and its complications

The result showed that the prevalence of any form of sexual violence (i.e. unwanted sexual touch, harassment, forceful sex) is 109 (15.9%). Forceful/ unwilling sex accounts 42 (35.6%) and 42 (6.1%) from the sexually active and the total female students respectively. Teachers were found to take the first rank performing sexual violence on female students (i.e. 15/ 33.3%). From a total of 42 female students who faced forceful/ unwilling sex, about 19 (45.2%); 20 (47.6%); 22 (52.4%) and 12 (28.6%) of them reported that they were having physical, psychological, academicals and social problems as a result of forced sex (Table 5). Passing exam 19 (41.3%), financial support 11 (23.9%) and being threatened 6 (13.0%) were the three major reasons given by the respondents for having a forced/ unwilling sex (Figure 1).

Variables Responses N %
Any form of sexual violence Yes 109 15.9%
No 577 84.1%
     
Forcefully/ unwillingly sex Yes 42 6.1%
No 644 93.9%
     
Frequency of forcefully/ unwillingly sex Once 18 42.9%
Twice 6 14.3%
More than two times 18 42.9%
     
By whomAny form of sexual violence Teachers 11 8.3%
Supportive staffs 7 5.3%
Individuals out of school 70 52.6%
Male students 33 24.8%
Sexual partner 10 10.0%
Other 2 2.0%
     
By whom forcefully/ unwillingly sex Teachers 15 33.3%
Supportive staffs 3 6.7%
Individuals out of school 7 15.6%
Male students 9 20.0%
Sexual partner 10 22.2%
Other 1 2.2%
     
Physical injury as a result of forcefully/ unwillingly sex Yes 19 45.2%
No 23 54.8%
     
Psychological problem as a result of forcefully/ unwillingly sex Yes 20 47.6%
No 22 52.4%
     
Academicals problem as a result of forcefully/ unwillingly sex Yes 22 52.4%
No 20 47.6%
     
Social problem as a result of forcefully/ unwillingly sex Yes 12 28.6%
No 30 71.4%
     

Table 5: Respondents Sexual history, female preparatory school students, Gurage Zone, Ethiopia, March, 2017.

Figure 1: Reasons given for forceful/ unwilling sex, female preparatory school students, Gurage Zone, Ethiopia, March, 2017.

Anxiety 12 (27.9%), Poor academicals achievement 14 (66.7%) and rejection from friends or peers & Drug dependency 6 (40.0%) were the major forms of psychological, academicals and social problems resulted due to forced/ unwilling sex as reported by the respondents (Table 6).

Variables Response N %
Physical complications Reproductive organ Trauma 17 40.5%
Trauma on other body parts 25 59.5%
     
Psychological complications Self-blame 9 20.9%
Fear 8 18.6%
Anxiety 12 27.9%
Hopelessness 4 9.3%
Depression 6 14.0%
Suicidal ideation/ attempt 2 4.7%
Other 2 4.7%
     
Academicals complications Poor academicals Achievement 14 66.7%
Academicals failure from school 2 9.5%
Academicals dropout 1 4.8%
Other 4 19.0%
My boyfriend or husband 10 22.2%
Other 1 2.2%
     
Social complications Rejection from friends or peers 6 40.0%
Rejection from family 3 20.0%
Drug  dependency 6 40.0%

Table 6: Forms of physical Psychological and social problems due to forced/ unwilling sex among female preparatory school students, Gurage Zone, Ethiopia, March, 2017 (n = 42).

Physical violence and its complications

Regarding the physical violence the prevalence of any form of physical violence among the respondents were about 314 (47%) (Table 7). Psychological disturbance poor academicals achievement and social disturbance were found to be the three major complication reported by the respondents who encountered physical violence (Figure 2).

Variables Response N %
Physical Violence Yes 326 47.5%
No 360 52.5%
     
Forms of physical violence Kicked or Dragged 95 23.4%
Thrown item 77 19.0%
Pushed or Shoved 108 26.6%
Beaten with a fist 32 7.9%
Sharp material 24 5.9%
chocked or Burnt 33 8.1%
Weapon 22 5.4%
Other 15 3.7%
     
By whom physical violence Teachers 79 21.8%
Administrative 27 7.4%
Individuals out of school 116 32.0%
Male Students 99 27.3%
Sexual partner 29 8.0%
Other 13 3.6%

Table 7: Prevalence of physical violence, female preparatory school students, Gurage Zone, Ethiopia, March, 2017.

Figure 2: Complications of physical violence, female preparatory school students, Gurage Zone, Ethiopia, March, 2017 (n = 326).

Predictors of sexual and physical violence

The multivariate analysis results show respondents age category, monthly pocket money received from their parents, and substance use habits (i.e. khat chewing, alcohol consumption and cigarette smoking were found to be the determinants of sexual violence.

Female students whose age is less than 18 years encountered sexual violence more likely as compared to their counterpart [AOR 1.72, 95 % CI=1.02, 2.84]. Similarly, female students who earn a monthly pocket money of less than 500 ETB were found to face sexual violence 1.37 times more likely than those who receive a monthly pocket money of 500 ETB and more [AOR 1.37, 95 % CI=1.06, 2.78]. Concerning substance use habits, respondents who did not chew Khat, drink alcohol and smoke cigarette were found to have less likelihood of encountering sexual and physical violence (Table 8).

Variables  Sexual violence Physical violence
COR (95% CI) AOR (95% CI) COR (95% CI) AOR (95% CI)
Respondents age category        
>=18 years 1.00 1.00
<18 years 2.28 (1.44, 3.65) 1.72 (1.02, 2.84)* 1.40 (1.04, 2.07) 1.21 (0.79, 1.86)
Study level        
Grade 12 1.00 1.00
Grade 11 1.52 (1.01, 2.29) 1.37 (0.88, 2.19) 0.61 (0.45, 0.82) 0.53 (0.39, 1.04)
Currently married        
Yes 1.00 1.00
No 0.37 (0.21, 0.60)  0.68 (0.37, 1.26) 0.44 (0.28, 0.68) 0.69 (0.42, 1.13)
Monthly pocket money        
>=500 ETB 1.00 1.00
<500 ETB 2.13 (1.17, 3.88) 1.37 (1.06, 2.78)* 1.53 (1.08, 2.58) 1.26 (0.72, 2.21)
Chewing Khat        
Yes 1.00 1.00
No 0.18 (0.09, 0.34) 0.42 (0.37, 0. 73)* 0.34 (0.18, 0.68) 0.51 (0.40, 0.81)*
Alcohol consumption        
Yes 1.00 1.00
No 0.15 (0.09, 0.27) 0.27(0.13, 0.57)* 0.25(0.14, 0.47)   0.19 (0.10, 0.38)**
Smoking cigarette        
Yes 1.00 1.00
No 0.09 (0.04, 0.22) 0.35 (0.12, 0.79)* 0.25 (0.09, 0.61) 0.68 (0.17, 0.59)*

Table 8: Predictors of sexual and physical violence, female preparatory school students, Gurage Zone, Ethiopia, March, 2017.

Discussion

The finding of this study showed that the prevalence of sexual violence among female students was 15.9%. It is nearly similar with the study findings in some African countries such as in Sierra Leone (14%), [8] and Cameroon, (15%), [9]. However, it is lower than the findings of studies conducted in India [10] and Zimbabwe [11]; the difference might be attributed to cultural difference, beliefs and myth about sexual violence between these countries.

Regarding physical violence study finding showed that the prevalence rate of physical violence among female students was about 47.5%; which is relatively higher than other similar studies conducted in Tigray (32.3), [7] and Amhara (20.4%) [12] Regions of Ethiopia; Difference in measure of physical violence scale might be the possible explanation for this.

In line with the finding World Health Organization (WHO) Multi-Country Study [13] on women’s health and domestic violence against women (Ecological Frame Work for Gender Based Violence (GBV)), this study revealed a statistically significant associations between respondents substance use habits (i.e. khat chewing, alcohol consumption and cigarette smoking) with sexual and physical violence. The result indicates that female students who were found to chew khat, drink alcohol and smoke cigarette were more likely to face sexual and physical violence as compared to their counterparts. Similar evidences also observed from other institution and community based surveys in Ethiopia [13].

Similarly, the finding showed that respondent’s age group was also significantly associated with sexual violence; it is consistent with the finding of Ecological Frame Work for GBV developed by WHO [14].

Furthermore, the multivariate logistic regression analysis also indicated a statistically significant association between monthly pocket money and sexual violence; accordingly, sexual violence was found to be higher among female students who earn a monthly pocket money of less than 500 ETB than their counterparts. Inability to fully cover their monthly expenses due to Lower levels of income might be the possible explanation which in its turn exposes these students for facing different forms of sexual violence.

Conclusion

Overall, this research has shown that the prevalence of sexual and physical violence was found to be 15.9% and 47% respectively. The result also showed that from sexually active students, forceful/ unwilling sex accounts about 42 (38.5%). Generally, the finding reviled that female student’s age and monthly earned pocket money were found to be determinants of sexual violence. Moreover, substance use (i.e. Khat chewing, drinking alcohol and cigarette smoking) were found to be the predictors of sexual and physical violence among female students.

Therefore, it is recommended that strategy and policy makers (i.e. zonal educational affair office & school administrative) should develop appropriate evidence-based strategies and curricula in schools to prevent school related gender based violence. Thus, designing specific strategic activates towards early detection, identification and prevention of SRGBV through provision of different regular information and communication programs is implicated. Collaborative action with governmental and nongovernmental organizations whose focus is to address sexual and reproductive health services, with particular emphasis to GBV is also recommended. Finally, we recommend a separate and detailed study on the level and the type of forced/unwilling sex among female students, which accounted the major form of sexual violence.

As the study is conducted at zonal level it has strength of being a representative study. However, social desirability bias on SRGBV could be one of its limitations and also cause and effect relationship cannot be ascertained in this study as it is a cross-sectional data.

Availability of Data and Materials

The datasets used and/or analyzed during the current study available from the corresponding author under the permission of Wolkite University on reasonable request.

Funding

Funding for this research project was gained from Wolkite University Research and Community services office.

Authors’ Contributions

Bisrat Zeleke: The principal investigator designed the study, collect, analyses and interprets the data, and also drafted the manuscript.

Kenzudine Assfa: Equally participated in conceptualization of the study, design, analyses and interpretation of results.

Dr. Zerihun Haile: Participated in in drafting and critical reviewing the manuscript.

Acknowledgments

We would like to thank Wolkite University for funding this research project. Our gratitude goes to Gurage Zone educational affairs office, preparatory schools administrative, supervisors, data collectors and study participants. Finally we thank for language editing Mr. Mark Demos (American Peas corps volunteer, in Ethiopia) and and Dr. Dejene Cheka (English language professor in Wolkite University, Ethiopia) for the support to revise English language of the manuscript.

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