Covid-Induced Intimate Partner Violence: Scoping Review from Africa between 2020 – 2022

doi:10.21203/rs.3.rs-3151685/v1

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Systematic Review

Covid-Induced Intimate Partner Violence: Scoping Review from Africa between 2020 – 2022

https://doi.org/10.21203/rs.3.rs-3151685/v1

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Intimate Partner Violence (IPV) gained global notoriety as a preventable public health menace affecting 30% of females worldwide. The IPV which is implicated as a significant cause of premature mortality and morbidity worldwide has increased during the pandemic. Therefore, the purpose of this review is to synthesis evidence of the impact of the SARS-Cov-2 pandemic on incidence of IPV in Africa, occurring from 1st January, 2020 to 31st December, 2022. Using Tricco et al. procedure, thorough literature search was done in PubMed, Cochrane Library, ScienceDirect, Dimensions, Taylor and Francis, Chicago Journals, Emerald Insight, JSTOR, Google Scholar, and MedRxiv. Consistent with the inclusion and exclusion protocols, 10 peer reviewed articles were eligible and used for this review. We report that : i) the SARS-COV-2 pandemic escalated the vulnerabilities of people to economic hardship, resulting in increased incidence of IPV during 2020–2022 in Africa, ii) psychological/emotional abuse was the most prevalent form of IPV victims suffered, iii) mental health conditions were the most reported effects of IPV on victims. The prevalence of IPV could undermine the achievement of the SDGs 5.2 by Africa, limiting the content’s quest to achieve full eradication of all types of violence against females. We recommend financial supports for females through social schemes like the Livelihood Employment against Poverty, as in Ghana, create sustainable livelihood for females and intensify public sensitisation on IPV and education on help-seeking avenues. It is important that a study is carried out to assess the structures available for dealing with IPV in Africa.

Other Public Policy

Partner violence

spousal abuse

domestic violence

Covid-19

and economic hardship

Intimate Partner Violence (IPV) has attained global notoriety as a preventable public health menace affecting 30% of women in intimate relationships worldwide (World Health Organisation [WHO], 2017). Global estimates on IPV prevalence reported 23% for high-income countries and 38% for WHO’s regions of South-East Asia, Eastern Mediterranean, and Africa (Anderson, 2021; WHO, 2017). Furthermore, according to global estimates, about one in three, and 13% of females suffer physical and/or sexual violence or non-partners sexual assault in their lifetime annually (WHO, 2019; 2018). The IPV is also implicated as a significant cause of premature mortality and morbidity worldwide (Engda et al., 2022; WHO, 2013).

As a global phenomenon, IPV defies culture, level of development, and religion (Ellsberg et al., 2014). The phenomenon could be defined as violence potentially occurring between two or more individuals in a present/former intimate relationship (Macassa et al., 2022). WHO (2010) defines it as a behaviour within an existing of previous intimate relationship that results in physical, sexual or psychological harm, including acts like physical violence, sexual compulsion, psychological exploitation, and domineering conducts. The term IPV was deliberately crafted to differentiate it from other forms of domestic violence such as elderly and child violations (Macassa et al., 2022). Typically, males are found to be the main perpetrators in most IPV (Teshome et al., 2021). However, there are studies (Adejimi et al., 2014; Centers for Disease Control and Prevention, 2015) that reported females as perpetrators too (Macassa et al., 2022). Though the IPV predated the SARS-Cov-2 outbreak, the pandemic became a significant addition to the predictors of this social menace (Duncan et al., 2020; Gottert et al., 2021; Jarnecke & Flanagan, 2020; John et al., 2020; Mazza et al., 2020; United Nations Women [UNW], 2020a) for various reasons.

The fear of the pandemic ignited a global panic, forcing many leaders across the globe to adopt control measures, largely reactionary (Campbell, 2020; WHO, 2020a; 2020b; Tadesse et al., 2022). These measures included restrictions on human activities, movements, and community lockdowns, in most cases (Gottert et al., 2021; Undie et al., 2020). Evidence on the impact of the pandemic reported disturbing increases in the incidence of IPV, especially against women globally (Sharma & Borah, 2020; Undie et al., 2020). For instance, the stay-at-home orders by leaders resulted in most partners spending longer times together at home and thus, increased the exposure to the IPV. Unfortunately, many people also lost their jobs and became economically impotent, igniting incidence of stress, anxiety, depression, frustration, and hopelessness (Mazza et al., 2020; Roesch et al., 2020). Moreover, there were no avenues for victims to report perpetrators and explore other help-seeking opportunities (Gottert et al.; UNW, 2020a; 2020b). Thus, the SARS-Cov-2 pandemic exacerbated the pre-existing predictors of IPV and its wave was worldwide (Moreira & Da Costa, 2020; Tadesse et al., 2022).

The IPV impacted individuals, families, communities, and society at large, and threatened global efforts at achieving the Sustainable Development Goals (SDGs) 5.2 and 16.1 (Engda et al., 2022; WHO, 2016a; 2016b). The SDG 5.2, specifically charged nations to take steps towards eradicating violence of all forms against women and girls in private and public places (Engda et al., 2022). Additionally, the SDG 16.1 mandates nations to be deliberate about substantially reducing all kinds of violence and associated mortality everywhere.

In Africa, the prevalence of IPV is found to be high, yet incidence reporting rate was very low (Meinck et al., 2017). Evidence showed that majority (33%) of the cases of IPV globally occurred in Africa (Tadesse et al., 2022). Meanwhile, the impact of SARS-Cov-2 pandemic on Africa has been disproportionate (Tadesse et al., 2022). Consistent with reports on the Western world regarding the correlation between SARS-Cov-2 pandemic and IPV, the continent of Africa saw a remarkable increase during the pandemic (Duncan et al., 2020; Jarnecke & Flanagan, 2020; John et al., 2020; Mazza et al., 2020). For instance, recent evidence (Shitu, Yeshaneh, & Abebe, 2021), revealed that majority of the female victims of IPV were economically disadvantaged. Moreover, females with low level of formal education, females with domineering, unemployed, and alcoholic partners suffered more IPV during the SARS-Cov-2 (Mazza et al., 2020; Moreira & Da Costa, 2020; Roesch et al., 2020). Data on Africa revealed that a lot more countries such as South Africa, Tunisia, Somalia, Ethiopia, Kenya, and Zimbabwe reported increased incidence of IPV during the SARS-Cov-2 than the pre-pandemic (Plan International, 2020). Given that the continent is still battling with the destructions occasioned by the pandemic, incidences of IPV are projected to become worse (Shitu et al., 2021). Moreover, the socio-cultural factors that discourage victims of IPV in Africa from reporting the perpetrators cloud the true picture of the phenomenon (WHO, 2017).

Consistent with the SDGs 5.2 and 16.2, it is unacceptable that one in three females die every three days due to IPV associated with SARS-Cov-2 lockdown measures (Tochie et al., 2020). Thus, it is incumbent on researchers to expose the ills of IPV and give voice to the victims. Given this background, there is the need to scale up research and garner more evidence on the phenomenon in Africa. Though, studies exist on IPV in Africa, overall, there is not enough literature on the “true” state of the phenomenon (Shitu et al., 2021). Moreover, there is the need for evidence mapping to guide policy and practice that aim to prevent the phenomenon and its associated health, family and social implications. Thus, there is inadequate evidence synthesis about IPV in Africa on how the SARS-Cov-2 pandemic influenced this social canker (Adejimi et al., 2014; Anderson, 2021; McCloskey et al., 2016; Meinck et al., 2017; Sikweyiya et al., 2020; Tsai et al., 2016a; b). Therefore, the purpose of this review is to synthesis evidence to establish the impact of the SARS-Cov-2 pandemic on the incidence of IPV in Africa from 1st January, 2020 to 31st December, 2022.

We used only peer reviewed articles (PRAs) to explore the incidence of IPV during the SARS-COV-2 outbreak from perspective of Africa. Guided by the checklist of Tricco et al. (2018), we examined, synthesized, and analysed relevant PRAs. The technique involved: i) defining and examining the purpose/objective of the review, ii) review questions developed and thoroughly examined, iii) identification and examination of article search terms, iv) identification and exploration of relevant databases and download of articles, v) data mining; vi) summary of data and synthesis of results, and vii) consultation (Tricco et al., 2018). Consequently, five research questions guided the review: i) what is the prevalence of IPV in Africa between 2020–2022? ii) what factors account for IPV in Africa between 2020–2022? iii) what is the gender dynamic to IPV in Africa between 2020–2022? iv) what was the impact of IPV on victims in Africa between 2020–2022? v) what coping strategies were employed by victims of IPV in Africa between 2020–2022?

2.1. Search Strategy

We relied on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to conduct this review (Tricco et al., 2018; Munn et al., 2018). The following databases were sources of thePRAs used in this review; PubMed, Cochrane Library, ScienceDirect, Dimensions, Taylor and Francis, Chicago Journals, Emerald Insight, JSTOR, Google Scholar, and MedRxiv (see Fig. 1 & Table 1). To attain rigour and comprehension in the search strategy, we consulted the PubMed database for MeSH terms on the subject. First level search covered “Partner Violence” OR “Spousal Abuse” OR “Domestic Violence” OR “Covid-19” OR “Economic Hardship” yielding 431 articles. Relying again on the MeSH terms, a more comprehensive and detailed second level search was conducted across 10 virtual databases which also yielded a total of 2686 articles and reports (see Fig. 1 and Table 1). The search covered studies conducted around 1st January, 2020, to 31st December, 2022. Meanwhile, the study itself covered September, 2022, to 28th February, 2023. All duplicate citations were eliminated post-initial search. All downloaded articles were initially screened by all authors using the title and abstract. All articles consistent with the inclusion criteria (described below) went through thorough and complete review. Where the legibility of an article is in doubt, they were referred to authors Edward W. ANSAH, Nkosi N. BOTHA, and Anthoniette ASAMOAH for discussion until a consensus was attained. To ensure that the search was thorough and exhaustive, citation chaining was conducted on all papers that met the inclusion criteria to identify potentially relevant papers for further assessment. Moreover, a Clinical Psychologist, a Social Welfare Officer, Police Officer from the Domestic Violence and Victims Support Unit (DOVSU), and a Senior Officer from the Ministry of Gender, Children, and Social Protection were contacted for their recommendations.

2.2. Inclusion and Exclusion Criteria

Studies conducted in Africa and examined IPV in relation to the SARS-Cov-2 pandemic outbreak using quantitative, qualitative, and mixed methods qualified for admission. In addition, studies conducted around 1st January, 2020 to 31st December, 2022, were admitted. Also, the papers must provide details on author(s), purpose/aim, methods/setting, forms of violation/factors, gender dynamics, impact on victims, coping strategies, and conclusion/recommendation. However, all studies conducted before 1st January, 2020 were dropped. In addition, studies conducted outside of Africa, and devoid of details on author(s), purpose/aim, methods/setting, forms of violation/factors, gender dynamics, impact on victims, coping strategies, and conclusion/recommendation were dropped. All commentaries, grey literature, opinion pieces, and media reports were excluded from this review.

2.3. Quality Rating

Consistent with the protocol designed by Tricco et al. (2018), each paper that agreed with the inclusion criteria was assigned a quality rating. This checklist describes a systematic scale for papers to be included in systematic/scoping reviews. To qualify for admission, each paper must contain research background, aims and objectives, context, appropriateness of design, sampling, data collection and analysis, reflectivity, value of research, and ethics. The papers were assessed and total scores were assigned based on the majority of sections. Studies scoring “A” have few or no limitations, “B” have some limitations, “C” have substantial limitations but carry some value, and “D” contain significant flaws that could undermine the study as a whole. Therefore, papers scoring “D” were excluded from the review (Tricco et al., 2018).

2.4. Data Extraction and Thematic Analysis

The Authors Anthoniette ASAMOAH, Bernice BIMPEH, Laurenda F. ANANI-ADZOE, and Nkosi, N. BOTHA independently extracted the data. The authors Anthoniette ASAMOAH and Laurenda F. ANANI-ADZOE extracted data on authors, purpose or aim, methods or setting, forms of violations, factors of violations, and forms of violations. Also, authors Bernice BIMPEH and Nkosi N. BOTHA extracted data on the predictors of IPV, gender dynamic, impact of IPV on victims, and coping strategies, and conclusions (see Table 2). Using Braun and Clarke (2006), thematic analysis was conducted by authors Edward W. ANSAH and Nkosi N. BOTHA. Thus, data were coded and themes emerged directly from the presented data, devoid of pre-conceived themes and yet consistent with the research questions (Braun & Clarke, 2006). The stages of analysis included repeated reading of text to familiarise with data, developing initial codes, exploring the themes, reviewing the themes, defining and naming themes, and generating the report. In addition, the themes that emerged were exhaustively discussed by authors Edward W. ANSAH, Bernice BIMPEH, Laurenda F. ANANI-ADZOE, Nkosi N. BOTHA, and Anthoniette ASAMOAH, until consensus was attained. The themes were continuously reviewed based on new data until the final themes emerged.

Table 1: Search Strategy

Search Strategy Item	Search Strategy
Databases	PubMed – 453 peer reviewed articles, Cochrane Library – 13, ScienceDirect – 149, Dimensions – 217, Taylor and Francis – 290, Chicago Journals – 260, Emerald Insight – 101, JStor – 434, Google Scholar – 340, and MedRxiv – 429.
Language filter	English
Time filter	1st January, 2020 to 31st December, 2022
Spatial filter	Africa
MeSH terms used	1. Partner Violence – “Partner violence, Intimate” OR “Violence, Intimate Partner” OR “Intimate Partner Abuse” OR “Abuse, Intimate Partner” OR “Partner Abuse, Intimate” OR “Dating Violence” OR “Violence, Dating”. 2. Spousal Abuse – “Abuse, Spouse” OR “Spousal Abuse” OR “Abuse, Spousal” OR “Partner Abuse” OR “Abuse, Partner” OR “Wife Abuse” OR “Abuse, Wife”. 3. Domestic Violence – “Violence, Domestic” OR “Family Violence” OR “Violence, Family”. 4. Covid-19 – “SARS-COV-2”. 5. Economic Hardship – “Poverty” OR “Financial stress” OR “Economic hardship”.
Inclusion criteria	1. Peer reviewed articles (PRAs) on Africa, 2. PRAs on IPV in Africa around 1st January, 2020 to 31st December, 2022. 3. PRAs must provide details on author(s), purpose/aim, methods/setting, forms of violation/factors, gender dynamics, impact on victims, coping strategies, and conclusion/recommendation.
Exclusion criteria	1. Medeia reports on IPV, 2. grey literature, 3. PRAs before 1st January, 2020 to 31st December, 2022, 4. PRAs outside of Africa, 5. articles devoid of details on author(s), purpose/aim, methods/setting, forms of violation/factors, gender dynamics, impact on victims, coping strategies, and conclusion/recommendation, 6. reviewed articles.

Table 2

Extracted data
Author(s)	Purpose/Aim	Methods/Setting	Forms of violation/Factors	Gender Dynamic	Impact on victims	Coping Strategies	Conclusion/ Recommendations
Engda et al. (2022)	Prevalence of Intimate Partner Violence (IPV) and predictors during SARS-COV-2 among childbearing-age residents.	Quantitative (Cross-sectional survey), 1 May to 1 July, 2020 700 respondents Ethiopia.	Emotional abuse (19.9%), physical abuse (9.4%), sexual abuse (10.9%). Poor body image, depression, and overweight, and SARS-COV-2.	Women of childbearing-age	Not mentioned	Not mentioned	About 1 out of 5 women suffered IPV. Women with poor body image, depression, and overweight reported higher IPV than others. However, there was no correlation between economic hardship, alcohol use, abortion, unemployment, suicidal attempt, and stressful events and IPV. Prevention, treatment, and legal services to be made available to reduce incidence of IPV.
Fawole et al. (2021)	Scenarios of IPV reported by women during the SARS- COV-2 pandemic in Nigeria	Qualitative content analysis of secondary data. April and May, 2020. Records of an organisation serving victims of IPV and 7 media reports. Nigeria	Physical violence (beating, hitting, choking), sexual violence (spousal rape), psychological violence (humiliation, threat), and economic (refusal to support family financially, forcefully taking wife’s money/economic resources). SARS-COV-2 and economic hardship.	Females	Inability to report violation, stress, fear, hunger, depression, frustration.	Run away from the house, relocate with children.	Women with history of IPV more exposed to during the SARS-COV-2 outbreak. It was more difficult coping with IPV related challenges during the SARS-COV-2 outbreak. The lockdown accelerated incidence of IPV and undermined the personal security of women and their protection from the pandemic. Innovative approaches to support victims of IPV needed.
Gebrewahd et al. (2020)	Prevalence of IPV against reproductive age women during the SARS-COV-2 pandemic.	Quantitative (cross-sectional survey) 682 respondents. April to May, 2020. Ethiopia	Psychological violence (13.3%), physical violence (8.3%) and sexual violence (5.3%). SARS-COV-2 induced economic hardship.	Women in childbearing age	Dehumanisation, fear, restricted movement, conflicting decision power in parenthood administration	No mentioned	Women most likely to suffer IPV include: housewives (95%), age less than 30 (95%), arranged marriages (95%), and husband’s age “between” 31–40 (95%). Prevalence of IPV high during SARS-COV-2 outbreak. Public reporting of IPV critical and vital to mitigate the problem.
Gottert et al. (2021)	Magnitude, forms, and causes of IPV during SARS-COV-2.	Quantitative (cross-sectional survey). Reports from Community Health Workers. 1,385 respondents. September-December, 2020. Kenya	Multiple forms of violations. Loss of employment/income (80%), partners spending more time together (59%), increased alcohol/substance use (38%), and conflict over childcare/housework responsibilities (33%).	Males and females.	Not mentioned	Not mentioned	Incidence of IPV increased during SARS-COV-2, Prevention and timely response to IPV key. Response to IPV must cover the economic and childcare needs of families.
Ojeahere et al. (2022)	Prevalence of IPV, its forms, and mental health implications among Nigerian households amid the SARS-COV-2 lockdown.	Quantitative (cross-sectional survey), 474 respondents, Nigeria	Physical, financial, emotional, financial, and sexual violations	Male and female	Hopelessness, feelings of failure, being irritable, and repeated strain	Not mentioned	No significant correlation between IPV and SARS-COV-2 found. Incidence of IPV during SARS-COV-2 lower than before the pandemic.
Sediri et al. (2020)	Effects of SARS-COV-2 related lockdown on Tunisian women’s mental health and gender-based violence.	Quantitative (cross-sectional survey), April 25 and May 6, 2020, 751 respondents, Tunisia	Psychological (96%), economic (41), and physical (10%) violence. COVID-19 and economic hardship.	Women	Increased depression, anxiety, stress, and social media addiction.	Smartphone and internet use.	Incidence of IPV accelerated during the SARS-COV-2 outbreak. Almost 90% of IPV victims failed to seek assistance. Women with a history of abuse reported higher incidence of IPV (73%). Need to intensify education and forged stronger collaboration with civil society and government agencies to promote long lasting changes.
Shitu et al. (2021)	Assess the magnitude and associated factors of IPV against women during SARS-COV-2.	Quantitative (cross-sectional survey), September 20 to October 10/2020, 462 respondents, Ethiopia	Physical (18.2%), psychological (36%), and sexual violence (29.6%). Women 35years and above, rural residence, husband’s with high level of formal education, SARS-COV-2, and low social support.	Women of childbearing -age	Not mentioned	Culture normalized IPV	Strong association between SARS-COV-2 and IPV. Women’s age, environment, husband’s level of formal education, SARS-COV-2, and low social support predictors of IPV. Appropriate policies towards a zero tolerance for IPV in society needed.
Tadesse et al. (2022)	Prevalence and associated factors of IPV against women during the SARS-COV-2 pandemic restrictions.	Quantitative (cross-sectional survey), 617 respondents, June 26, 2020 to July 10, 2020, Ethiopia	Physical (11%), psychological (20%), and sexual (13.8%). Illiterate, substance use (alcohol, chat or cigarettes) husbands, and normalisation of IPV by communities.	Women	Not mentioned	Not mentioned	Increased prevalence of IPV among women. National and regional authorities must collaborate to towards enhancing gender equality. Dealing with risk factors at multiple levels, using community- and institution-based approaches to prevent IPV. Pursuit of the SDG 5 of eliminating violence against women by 2030 is urgent. Sustainable fight against social, cultural and religious barriers inhibit women’s autonomy needed.
Teshome et al. (2021)	Incidence and predictors of IPV during pregnancy amidst the SARS-COV-2 pandemic.	Quantitative (cross-sectional survey), 31 August to 2 November 2020, 464 respondents, Ethiopia	Emotional violence (72.7%), sexual violence (48.5%), and physical violence (30.3%). Alcohol drinking partners, loss of income.	Pregnant women	Not mentioned	Not mentioned	There was no strong association between SARS-COV-2 and incidence of IPV. Women who make decisions together with husbands less likely to suffer IPV. Prenatal care was ideal time to screen women for IPV, as women can be connected with services to protect them and their babies.
Turner et al. (2022)	Referral of sexual violence against children.	Qualitative design (analysis of secondary data) October-November, 2020. 74 children/ adolescents victims, Zimbabwe	Sexual abuse. SARS-COV-2 and economic hardship.	Adolescent girls suffered more and male partners were perpetrators.	Depression, pregnancy, shame, and stigma.	Refusal to report, isolation, and crying.	Female caregivers were most likely to report sexual violence. Adolescent girls suffer blame and shame for being sexually assaulted. Sexual assault against boys, among intimate partners, by public figures hardly reported. Barriers to reporting include gendered stigma, shame, and fears of institutional authority. Existing policy frameworks must be strengthened around age of maturity, adolescent sexuality, ignoring boy survivors, and the role of schools in child protection.

We conducted a retrospective investigation, from 2020 to 2022 into the incidence of IPV during the SARS-COV-2 outbreak in Africa. Out of the 10 articles that were used for this review, eight employed the quantitative design and two qualitative. Specifically, included articles covered 2020–2(20%), 2021 and 2022–4(40%) each. Moreover, we found that the continental distribution of IPV seems to be concentrated around Ethiopia. Thus, Ethiopia 5(50%) (Engda et al., 2022; Gebrewahd et al., 2020; Shitu et al., 2021; Tadesse et al., 2022; Teshome et al., 2021), Nigeria 2(20%) (Fawole et al., 2021; Ojeahere et al., 2022), Kenya 1(10%) (Gottert et al., 2021), Tunisia 1(10) (Sediri et al., 2020), and Zimbabwe 1(10%) (Turner et al., 2022).

3.1. Forms of violations

We report that three main types of IPV occurred during the SARS-COV-2 pandemic in Africa, like physical violence, psychological violence, and sexual violence. From the 10 articles reviewed, 9(90%) (Engda et al., 2022; Fawole et al., 2021; Gebrewahd et al., 2020; Gottert et al., 2021; Ojeahere et al., 2022; Sediri et al., 2020; Shitu et al., 2021; Tadesse et al., 2022; Teshome et al., 2021), reported all three main forms of violations including emotional, physical, and sexual violations. However, Turner et al. (2022) reported only sexual abuse.

3.2. Predictors of IPV

We report that the SARS-COV-2 outbreak-induced economic hardship in Africa may have significantly influenced the incidence of IPV. Review of the 10 PRAs revealed a number of predictors of IPV including the SARS-COV-2, economic hardship, substance abuse by partners, age of victim, body image of victim, level of formal education of partner, depression, spending more time together, domestic duties, social status, and normalisation of IPV by community members. Thus, 5(50%) (Engda et al., 2022; Fawole et al., 2021; Gebrewahd et al., 2020; Sediri et al., 2020; Turner et al., 2022), reported SARS-COV-2, 6(60%) (Fawole et al., 2021; Gebrewahd et al., 2020; Gottert et al., 2021; Sediri et al., 2020; Teshome et al., 2021; Turner et al., 2022; economic hardship, 3(30%) (Gottert et al., 2021; Tadesse et al., 2022; Teshome et al., 2021; substance abuse by partners, 2(20%) (Shitu et al., 2021; Tadesse et al., 2022), level of formal education of partner, 1(10%) (Shitu et al., 2021), age of victim, 1(10%) (Engda et al., 2022), body image of victim, 1(10%) (Engda et al., 2022), depression, 1(10%) (Gottert et al., 2021), spending more time together, 1(10%) (Gottert et al., 2021), domestic duties, 1(10%) (Shitu et al., 2021), social status, and 1(10%) (Tadesse et al., 2022), normalisation of IPV by community contributed to increase IPV in Africa during the pandemic.

3.3. Gender

We further report that far more females suffered IPV during the SARS-COV-2 outbreak in Africa than did the males. The PRAs showed that 7(70%), (Engda et al., 2022, Fawole et al., 2021, Gebrewahd et al., 2020, Sediri et al., 2020, Shitu et al., 2021, Tadesse et al., 2022, & Teshome et al., 2021), reported violence against females. Moreover, the problem was reported in 3(30%) studies (Gottert et al., 2021; Ojeahere et al., 2022; Turner et al., 2022) involving both males and females.

3.4. Impact of IPV on victims

We also report that victims of IPV during the SARS-COV-2 period in Africa suffered more symptoms of mental health than any other form of IPV-related impact. It is evident from the PRAs that 5(50%) (Fawole et al., 2021; Gebrewahd et al., 2020; Ojeahere et al., 2022; Sediri et al., 2020; Turner et al., 2022) reported symptoms of mental health as impact of IPV on victims, 2(20%) (Ojeahere et al., 2022; Sediri et al., 2020), social media addiction, 1(10%) (Fawole et al., 2021) accepting abuse as normal, and 1(10%), (Turner et al., 2022) unwanted pregnancy.

3.5. Coping strategies

Furthermore, we report that victims of IPV during the SARS-COV-2 period in Africa have adopted very few strategies in containing the abuse. We found that 1(10%) of the article, Sediri et al. (2020), reported over reliance on social media as a coping strategy by victims of IPV, 1(10%), (Fawole et al., 2021), reported running away from IPV perpetrators, 1(10%), (Shitu et al., 2021), considered IPV as part of culture (normalisation), and 1(10%), (Turner et al., 2022), refusal to report in the name of peace.

Intimate partner violence predates the SARS-Cob-2 pandemic, but its rise during the outbreak cause for a grave public health concern. In a pre-pandemic study among women in 30 countries across Africa between 2008–2018, the Democratic Republic of Congo reported the highest prevalence of IPV (Ssentongo et al., 2020). Similarly, Izugbara et al. (2020) reported that the Democratic Republic Congo has the highest prevalence of IPV in Africa, between 2010–2018. In contrast, in the current study, Ethiopia emerged with the highest prevalence where 50% of the IPV during the SARS-Cov-2 outbreak in Africa were reported. This is also inconsistent with another pre-pandemic study, Wado et al. (2021), that investigated the prevalence of IPV among females in sub-Saharan Africa, between 2010–2018. Wado et al. reported Gabon as the country with the highest incidence of IPV. We are of the view that a lot of the cases went unreported and studied. Furthermore, the finding could mean that the Ethiopia has effective IPV reporting systems that enabled victims to share their stories. However, findings of the current study should be understood within the context of the SARS-Cov-2 outbreak, where countries adopted various strategies in containing the pandemic including lockdowns, where partners who hitherto never spent such long time together, now have to spend considerable amount of time together.

4.1. Forms of violations

Psychological/emotional abuse was the most prevalent form of IPV suffered during the SARS-Cov-2 pandemic, and accounting for over 60% of all forms of IPV reported. Moreover, apart from the three commonest forms of IPV (psychological, sexual, and physical abuse), economic/financial abuse also emerged during the pandemic period. This finding upholds previous studies (Dwarumpudi et al., 2022; Izugbara et al., 2020; Peterman et al., 2022; Tiruye et al., 2020) that reported emotional abuse as the most prevalent form of abuse employed by perpetrators of IPV. However, the current study contradicts pre-pandemic studies (Ssentongo et al., 2020; Wado et al., 2021), which found sexual and physical abuse as the only forms of IPV employed by perpetrators. From the foregoing, emotional violence appears to be the most prevalent form of IPV, pre- and during-pandemic. Therefore, there appears to be a correlation between emotional violence and other forms of IPV. Additionally, it is safe to say that emotional violence could be both a cause and consequence of other forms of IPV, which were evident during the global pandemic. Thus, the findings bring the issue of mental health to the fore with implications for the victims and the close relations. Victims may have to leave with post-traumatic stress disorders (PTSD) leading to loss of concentration at work and home, alcohol dependency, hypertension, divorce, and pregnant victims could suffer miscarriage and other complications.

4.2. Predictors of IPV

The SARS-COV-2 pandemic and economic hardship mutually and independently predisposed people to IPV during the period under review, 2020–2022. Though, other predictors like substance abuse by perpetrators, spending more time together, and domestic duties were well reported, the pandemic-induced economic hardship triggered and escalated these pre-existing factors. This compares favourably with existing evidence (Gordon & Sauti, 2022) implicating the pandemic and economic hardship in the occurrence of IPV. Though, there is adequate pre-pandemic evidence which (Dwarumpudi et al., 2022; Izugbara et al., 2020; Peterman et al., 2022) reported a strong association between economic hardship and the occurrence of IPV. The current study suggests that the pandemic escalated the vulnerabilities of people to economic hardship which in turn resulted in the high incidence of IPV. This also validates recent studies, (Macassa et al., 2022; Tochie et al., 2020) that found SARS-Cov-2 as the main trigger of IPV because it leads to loss of job and income, increased fear, frustration, depression, hopelessness, and left many highly vulnerable. Consistent with current evidence, the findings of Gordon and Sauti (2022), Izugbara et al. (2020), Peterman et al. (2022) revealed the interdependence of the factors that trigger IPV and how their combine effect worsened the exposure and limits avenues for coping by victims. However, the current study departs significantly from Morris et al. (2020) which reported that the lockdown measures during the pandemic actually led to a reduction in the incidence of IPV in South Africa. Therefore, governments may have to extend financial aid to especially female victims of IPV during the pandemic.

4.3. Gender

As a social canker, both males and females suffered IPV during the SARS-Cov-2 lockdown. However, females were by far the most exposed to pre-existing vulnerabilities to IPV. Some of these pre-existing vulnerabilities include lack of stable job, low-income status, socio-cultural norms, and low level of formal education. This coheres well with other studies, (Gordon & Sauti, 2022; Morris et al., 2020) that reported females as the most vulnerable to IPV during the pandemic lockdown. In addition, the current study is consistent with several pre-pandemic studies (Ekhator-Mobayode et al., 2022; Gibbs et al., 2020; Stern et al., 2020), that found that females were the main victims of IPV in most societies. Therefore, the SARS-Cov-2 pandemic in general and the accompanying lockdown in specific complicated the exposure of females to IPV. This raise the issues of gender equity and calls for pragmatics efforts in empowering women.

4.4. Impact of IPV on victims

Victims of IPV during the SARS-Cov-2 pandemic were impacted in many ways, including mental health conditions like stress, depression, isolation, and hopelessness, unwanted pregnancy, and social media addiction. However, mental health conditions alone accounted for 50% of reported impacts of IPV on victims. This upholds findings from previous studies (Gibbs et al., 2020; Izugbara et al., 2020; Peterman et al., 2022) that found symptoms of mental health conditions as the number one impact of IPV on victims. Though, some pre-pandemic studies, data collected before the pandemic (i.e. Leeper et al., 2021; Temesgan et al., 2021; Tiruye et al., 2020) reported death, body injury, abortion and miscarriage, sexually transmitted diseases such as HIV/AIDS, and divorce as impacts of IPV, none of these emerged in the current study. This was probably the case because during the pandemic, there were limited opportunities for reporting incidence of IPV. Therefore, even if deaths, abortion, and other consequences of IPV occurred, there was no record of them in the literature. Therefore, the victims of IPV could be living with conditions requiring hospitalisation and medical attention. In addition, the African continent is most likely to see an increase in the incidence of sexually transmitted diseases of public importance (HIV/AIDS) in the near future. This may needed further research though.

4.5. Coping strategies

Most of the pre-pandemic studies (Dwarumpudi et al., 2022; Gordon & Sauti, 2022) reported engagement strategies like active resistance, help-seeking, and participation in church activities as common coping strategies employed by victims of IPV. This involves victims openly confronting perpetrators verbally or exploring informal support avenues to demand a change in behaviour, and active participation in church programmes. In contrast to this, the current study reported no clear-cut coping strategy employed by the victims of IPV. However, some few maladaptive emerged and included extended use of social media, running away from the perpetrators, and accepting IPV as part of the culture to manage their pains. We believe that the pandemic and the lockdown limited the options for employing appropriate coping mechanisms with IPV by the victims. Given the limited coping strategies reported, some victims of IPV, females especially, may be living with PTSD that could potentially lead to alcoholism, internet addiction, attempted suicide, prostitution, and further victims of IPV. The resilience of these victims would be broken thus, leaving them more vulnerable to future IPV.

This is the first study to have comprehensively reviewed empirical evidence on how the SARS-Cov-2 pandemic impacted the IPV around 2020–2022 in Africa. Regardless, the review carried some limitations including: i) relying on only peer reviewed articles written in English could have left out some useful findings written in other languages, ii) the use of ten articles in the review limits the literature sample and generalisability of findings, iii) methodological and procedural limitations inherent in the reviewed articles potentially influenced the findings and conclusion reached in this review. To mitigate the effects of these limitations, a water-tight inclusion and exclusion criteria were applied to guarantee a strong synergy among the articles reviewed. Thus, there the need for researchers to investigate the phenomenon in the various countries in Africa. Moreover, elected to take up the study pursuant to the SDGs 5.2 and 16.1, essentially seeking to uphold the rights of all females in Africa.

We deduct that the SARS-COV-2 pandemic escalated the vulnerabilities of people to economic hardship which in turn resulted in the high incidence of IPV during 2020–2022 in Africa. Again, Ethiopia reported the highest prevalence of IPV during the pandemic. Moreover, psychological/emotional abuse was the most prevalent form of IPV suffered, with females reporting the highest incidence of IPV. Mental health conditions like stress, depression, isolation, and hopelessness were the most reported effects of IPV on victims. Unfortunately, many of the victims became addicted to social media and some others run away from the perpetrators of IPV. As a major human right concern, the high prevalence of IPV is undermining the achievement of SDGs 5.2 and 16.1 by Africa. While 5.2 calls for full eradication of all types of violence against all females everywhere, 16.1 seeks to considerably rollback all types of violence and associated death everywhere. Are these achievable with this trend?

Though, a few studies exist on IPV in Africa, the current study appears to be among the first study that reviewed literature on how the SARS-Cov-2 pandemic influenced IPV. To mitigate the incidence of IPV in Africa due to infectious disease outbreak, we recommend that leadership of the continent provide financial support for females through social intervention schemes like the Livelihood Employment against Poverty (LEAP), as in Ghana to empower women for independency. There is the need to also intensify public sensitisation on IPV and existing help-seeking avenues. Existing legal regimes may have to be more prudent in dealing with perpetrators to compel such persons to good behaviours. There may be the need to restructure the social welfare departments and adequately resourced it with trained personnel and logistics to provide adequate social support services to victims of IPV. For further studies are needed to assess the effectiveness of existing structures and programmes for dealing with IPV in Africa.

The authors declare no competing interests.

Funding: No individual or institution funded this study, either in part or in a whole.

Author contributions: E.W. Ansah, N.N. Botha, and B. Bimpeh Conceptualised and Designed the Review Protocols. A. Asamoah and L.F. Anani-Adzoe Conducted Data Collection and Acquisition. E.W. Ansah, A. Asamoah, L.F. Anani-Adzoe, and N.N. Botha carried out extensive data processing and management. E.W. Ansah, N.N. Botha, B. Bimpeh, and L.F. Anani-Adzoe developed the initial manuscript. All authors edited and considerably reviewed the manuscript, proofread for intellectual content and consented to its publication.

Reviewed Articles Only (10)

Engda, A. S., Wubetu, A. D., Amogne, F. K., & Kitaw, T. M. (2022). Intimate partner violence and COVID-19 among reproductive age women: A community-based cross-sectional survey, Ethiopia. Women’s Health, 18, 1–8. doi: 10.1177/17455065211068980
Fawole, O., Okedare, O. O., & Reed, E. (2021). Home was not a safe haven: Women’s experiences of intimate partner violence during the COVID‑19 lockdown in Nigeria. BMC Women’s Health, 21, 32. https://doi.org/10.1186/s12905-021-01177-9
Gebrewahd, G. T., Gebremeskel, G. G., & Tadesse, D. B. (2020). Intimate partner violence against reproductive age women during COVID-19 pandemic in northern Ethiopia 2020: A community-based cross-sectional study. Reproductive Health, 17, 152. https://doi.org/10.1186/s12978-020-01002-w
Gottert, A., Abuya, T., Hossain, S., Casseus, A., Warren, C., & Sripad, P. (2021). Extent and causes of increased domestic violence during the COVID-19 pandemic: Community health worker perspectives from Kenya, Bangladesh, and Haiti. Journal of Global Health Reports, 5, e2021063. doi:10.29392/001c.24944.
Ojeahere, M. I., Kumswa, S. K., Adiukwu, F., Plang, J. P., & Taiwo, Y. F. (2022). Intimate partner violence and its mental health implications amid COVID-19 lockdown: Findings among Nigerian couples. Journal of Interpersonal Violence, 37, 17-183. doi: 10.1177/08862605211015213
Sediri, S., Zgueb, Y., Ouanes, S., Ouali, U., Bourgou, S., Jomli, R., & Nacef, F. (2020). Women’s mental health: acute impact of COVID-19 pandemic on domestic violence. Archives of Women's Mental Health, 23,749–756. https://doi.org/10.1007/s00737-020-01082-4.
Shitu, S., Yeshaneh, A., & Abebe, H. (2021). Intimate partner violence and associated factors among reproductive age women during COVID‑19 pandemic in Southern Ethiopia, 2020. Reproductive Health, 18, 246. https://doi.org/10.1186/s12978-021-01297-3
Tadesse, A. W., Tarekegn, S. M., Wagaw, G. B., Muluneh, M. D., & Kassa, A. M. (2022). Prevalence and associated factors of intimate partner violence among married women during COVID-19 pandemic restrictions: A community-based study. Journal of Interpersonal Violence, 37, 11-123. doi: 10.1177/0886260520976222
Teshome, A., Gudu,W., Bekele, D., Asfaw, M., Enyew, R., & Compton, S. D. (2021). Intimate partner violence among prenatal care attendees amidst the COVID-19 crisis: The incidence in Ethiopia. International Journal of Gynecology and Obstetrics, 153, 45–50. doi: 10.1002/ijgo.13566
Turner, E., Cerna-Turoff, I., Nyakuwa, R., Nhenga-Chakarisa, T., Nherera, C. M., Parkes, J., Nangati, P. R., Nengomasha, B., Moyo, R., & Devries, K. (2022). Referral of sexual violence against children: How do children and caregivers use a formal child protection mechanism in Harare, Zimbabwe? SSM - Qualitative Research in Health, 2, 100184.
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Covid-Induced Intimate Partner Violence: Scoping Review from Africa between 2020 – 2022

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Abstract

Figures

Introduction

Methods

Materials and Methods

2.1. Search Strategy

2.2. Inclusion and Exclusion Criteria

2.3. Quality Rating

2.4. Data Extraction and Thematic Analysis

Results

3.1. Forms of violations

3.2. Predictors of IPV

3.3. Gender

3.4. Impact of IPV on victims

3.5. Coping strategies

Discussion

4.1. Forms of violations

4.2. Predictors of IPV

4.3. Gender

4.4. Impact of IPV on victims

4.5. Coping strategies

Limitations

Conclusions and Recommendations

Declarations

References

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