Baatiema Linus, Ameyaw Edward Kwabena, Ahinkorah Bright Opoku, Seidu Abdul-Aziz, Yendaw Elijah, Moomin Aliu
School of Public Health, Faculty of Public Health, University of Port Harcourt, Nigeria.
Ghana Health Service, Upper West Regional Health Directorate, Wa, Ghana.
J Biosoc Sci. 2023 Nov;55(6):1119-1133. doi: 10.1017/S0021932022000487. Epub 2023 Jan 23.
Sexual violence against women is commonly justified in sub-Saharan Africa (SSA) despite international commitments to halt it. This study investigated the association between healthcare decision-making capacity and the justification of sexual violence among women in SSA. We used current datasets of 30 sub-Saharan African countries published between January 2010 and December 2018. The sample included 259,885 women who were in sexual unions. We extracted and analysed the data with Stata version 14. Chi-square test and multilevel logistic regression models were used to analyse the data. Results for the regression analysis were presented as adjusted odds ratios (AOR) with their corresponding 95% confidence intervals (CIs). The results showed that women who decided on their healthcare alone had lower odds [AOR=0.93; CI=0.91-0.96] of justifying sexual violence compared to those who were not deciding alone. We also found that women aged 45-49 [AOR=0.85; CI=0.82-0.89], those with higher education [AOR=0.26; CI=0.24-0.29], cohabiting women (AOR=0.82, CI=0.80-0.85], richest women [AOR= 0.58; CI=0.56-0.60], women living in urban areas [AOR=0.74; CI=0.73-0.76], and Christians [AOR=0.52; CI=0.51-0.54] had lower odds of justifying wife beating if a woman refuses to have sex with her partner. On the contrary, women who engaged in agriculture had higher odds of justifying sexual violence than those who were not working [AOR=1.07; CI=1.04-1.09]. Groups that should be prioritised with anti-sexual violence initiatives are the poor, rural residents, and young women. It is also vital to institute policies and interventions focused on educating men about women's right to make decisions, and why partner violence is unjust and intolerable.
尽管国际社会承诺制止针对妇女的性暴力行为，但在撒哈拉以南非洲地区（SSA），此类行为仍普遍被视为合理。本研究调查了撒哈拉以南非洲地区妇女的医疗保健决策能力与性暴力正当化之间的关联。我们使用了2010年1月至2018年12月期间发布的30个撒哈拉以南非洲国家的现有数据集。样本包括259,885名处于性伴侣关系中的女性。我们使用Stata 14版本提取并分析了数据。采用卡方检验和多层逻辑回归模型对数据进行分析。回归分析结果以调整后的优势比（AOR）及其相应的95%置信区间（CI）呈现。结果显示，与非独自决定医疗保健的女性相比，独自决定医疗保健的女性将性暴力视为合理行为的几率更低[AOR=0.93；CI=0.91 - 0.96]。我们还发现，年龄在45 - 49岁的女性[AOR=0.85；CI=0.82 - 0.89]、受过高等教育的女性[AOR=0.26；CI=0.24 - 0.29]、同居女性（AOR=0.82，CI=0.80 - 0.85]、最富有的女性[AOR=0.58；CI=0.56 - 0.60]、居住在城市地区的女性[AOR=0.74；CI=0.73 - 0.76]以及基督教女性[AOR=0.52；CI=0.51 - 0.54]，如果女性拒绝与伴侣发生性行为，她们将殴打妻子视为合理行为的几率更低。相反，从事农业的女性将性暴力视为合理行为的几率高于非在职女性[AOR=1.07；CI=1.04 - 1.09]。在反性暴力倡议中应优先关注的群体是贫困人群、农村居民和年轻女性。制定政策和采取干预措施，重点教育男性了解女性的决策权，以及伴侣暴力为何不公正且不可容忍，这也至关重要。
