A total of a hundred and fourteen (n=114) respondents took part in the study, but different numbers of respondents answered different questions across the questions. The socio-demographics of the study participants are also presented.
3.1 Socio-demographic characteristics of the study participants
Respondents were from all six geo-political zones of Nigeria; majorly from South-Western (28.3%), North-Central, (27.4%), and South-Eastern, (23.9%) (See Table 1). In addition, most of the young women were single (91.2%) and majority of respondents, (59.3%), reported their monthly allowance was above 10,000 Naira, with (76.8%) respondents reporting that their source of allowance is from their parents/guardian. (20.2%) reported their age of first intercourse was between 16-20 years, and (13.2%) reported their age of first intercourse was between 21-24 years; only (0.9%) respondent reported having her first intercourse below 16 years. (65.8%) respondents did not have their first intercourse within any of the highlighted age categories. (8.5%) respondents reported their first intercourse was non-consensual (See Table 1).
Table 1. Socio-demographic characteristics of participants (n=114)
Characteristics
|
Frequency n (%)
|
Age
|
33 (28.9%)
|
18-20
|
21-24
|
81 (71.1%)
|
What part of Nigeria is your state of residence (n=113)
|
31 (27.4%)
|
North-Central Nigeria
|
South-Western Nigeria
|
32 (28.3%)
|
South-Eastern Nigeria
|
27 (23.9%)
|
North-Eastern Nigeria
|
4 (3.5%)
|
North-Western Nigeria
|
1 (0.9%)
|
South-South Nigeria
|
18 (15.9%)
|
Marital Status
|
104 (91.2%)
|
Single
|
Married
|
0
|
Cohabiting
|
0
|
Have a partner but not cohabiting
|
10 (8.8%)
|
Parents/Guardian level of education
|
0
|
(Father) (n=112)
|
No formal education
|
Primary education
|
9 (8.0%)
|
Secondary education
|
16 (14.3%)
|
Higher education
|
82 (73.2%)
|
I don’t know
|
3 (2.7%)
|
Not applicable
|
2 (1.8%)
|
(Mother) (n=113)
|
1 (0.9%)
|
No formal education
|
Primary education
|
3 (2.7%)
|
Secondary education
|
22 (19.5%)
|
Higher education
|
85 (75.2%)
|
I don’t know
|
1 (0.9%)
|
Not applicable
|
1 (0.9%)
|
(Guardian) (n=84)
|
0
|
No formal education
|
Primary education
|
1 (1.2%)
|
Secondary education
|
7 (8.3%)
|
Higher education
|
57 (67.9%)
|
I don’t know
|
1 (1.2%)
|
Not applicable
|
18 (21.4%)
|
Monthly allowance (n=113)
|
8 (7.1%)
|
Below N5,000
|
N5,000-N10,000
|
24 (21.2%)
|
Above N10,000
|
67 (59.3%)
|
None
|
14 (12.4%)
|
Source of monthly allowance (n=112)
|
86 (76.8%)
|
Parents/guardian
|
Other family member
|
4 (3.6%)
|
Intimate partner
|
1 (0.9%)
|
Part -time job
|
11 (9.8%)
|
Other
|
10 (8.9%)
|
Age of first intercourse
|
1 (0.9%)
|
Less than 16 years
|
16-20 years
|
23 (20.2%)
|
21-24 years
|
15 (13.2%)
|
None of the above
|
75 (65.8%)
|
Nature of 1st intercourse (n=106)
|
28 (26.4%)
|
Consensual
|
Not consensual
|
9 (8.5%)
|
Not applicable
|
69 (65.1%)
|
3.2 Research Question 1: What are young women’s level of Knowledge and Awareness of GBV and Post-SBV health services in Nigeria?
3.2.1 Participants’ knowledge of the forms of GBV
Eighty-nine (89%) of the respondents identified physical and sexual violence as an experience of GBV by an intimate partner. (78%) identified emotional violence as an experience of GBV, but only (39.4%) identified economic violence as a form of GBV. Multiple-answer questions and ‘n’ do not add up to the total as participants ticked multiple forms of GBV.
3.2.2 Knowledge/awareness of SBV and its health impacts.
When asked whether preventing SBV helps to prevent exposure to HIV, (72.6%) respondents answered ‘Yes’, and (11.5%) answered ‘No’. (15.9%) respondents reported they were ‘Not sure’. When asked whether SBV can lead to unintended pregnancies, (94.7%) respondents said ‘Yes’, and (2.6%) respondents reported ‘No’ and ‘Not Sure’, respectively.
3.2.3 Awareness of strategies/services offered by a Post-SBV health Service
About ninety-five (95.5%) of the respondents reported they are aware of contraceptives, (2.7%) respondents reported they are not aware, and (1.8%) respondents reported they are not sure if they are aware of contraceptives. (66.7%) respondents reported they are aware of emergency contraception, (29.5%) respondents reported they are not aware, and (3.8%) respondents reported they are not sure if they are aware of emergency contraception. (98.2%) respondents reported they were aware of condoms, and (1.8%) respondents reported they were not aware of condoms. (43.5%) respondents are aware of post-exposure prophylaxis (PEP) for HIV, (42.6%) reported they are not aware, and (13.9%) respondents reported that they are not sure.
(24.3%) respondents reported having used contraceptives, while (74.8%) reported having never used contraceptives. (21.9%) had used emergency contraception, and (77.1%) had never used It. (30.8%) respondents used condoms, and (69.2%) have never used it. (94.1%) respondents had never used PEP to prevent HIV. About twenty-seven (27.5%) of the respondents reported they had been worried or concerned about their health during or after having sex with a partner. One in seven (14.7%) reported having sought support or spoken to someone about it, and (87%) of respondents did not seek support from a SBV health service facility. (See table 2)
Table 2: Knowledge and Awareness of SBV and Post-SBV health services among the study participants (n=114)
Survey questions
|
Knowledge and Awareness
|
|
Yes
|
No
|
Not Sure
|
N/A
|
Preventing SBV prevents HIV exposure
(n=113)
|
82 (72.6%)
|
13 (11.5%)
|
18 (15.9%)
|
-
|
SBV can lead to unintended pregnancies?
|
108 (94.7%)
|
3 (2.6%)
|
3 (2.6%)
|
-
|
Indicate if you are aware of the following
|
|
|
|
|
Contraceptives (n=105)
|
105 (95.5%)
|
3 (2.7%)
|
2 (1.8%)
|
-
|
Emergency contraception (n=105)
|
70 (66.7%)
|
31 (27%)
|
4 (3.8%)
|
-
|
Condoms (n=109)
|
107 (98.2%)
|
2 (1.8%)
|
0
|
-
|
Post-exposure prophylaxis (PEP) for HIV (n=108)
|
47 (43.5%)
|
46 (42.6%)
|
15 (13.9%)
|
-
|
Indicate if you have used any of the following
|
|
|
|
|
Contraceptives (n=107)
|
26 (24.3%)
|
80 (74.8%)
|
1 (0.9%)
|
-
|
Emergency contraception (n=105)
|
23 (21.9%)
|
81 (77.1%)
|
1 (1%)
|
-
|
Condom (n=107)
|
33 (30.8%)
|
74 (69.2%)
|
0
|
-
|
PEP for HIV (n=102)
|
2 (2.0%)
|
96 (94.1%)
|
4 (3.9%)
|
-
|
Indicate if you have ever been concerned or worried about your health and well-being while or after having sex with a partner (n=109)
|
30 (27.5)
|
21 (19.3%)
|
1 (0.9%)
|
57 (52.3%)
|
Indicate if you spoke to anyone about it (n=95)
|
14 (14.7%)
|
74 (77.9%)
|
7 (7.4%)
|
-
|
Indicate if you got support from a SBV-health service facility (n=77)
|
6 (7.8%)
|
67 (87%)
|
4 (5.2%)
|
-
|
N/A means Not Applicable, HIV means Human Immunodeficiency Virus.
3.3 Research Question 2: What are young women’s perceptions of Post-SBV health services in Nigeria?
About a half (50.9%) and (20.5%) of respondents, respectively, strongly agreed and agreed that a Post-SBV health service should be the first place to go following rape. When asked whether healthcare workers (HCWs) can prevent SBV from re-occurring, (23.2%) respondents strongly agreed. (33.9%) and 35 (31.3%) respondents respectively agreed and were neutral about the statement, Also, less than half of the respondents (39.6%) strongly agreed, and (38.7%) agreed, that HCWs are available to offer PEP to prevent HIV following rape. . In addition, although not up to half of the respondents, most respondents strongly agreed (42.9%) and agreed (42.9%) that Post-SBV health services are effective in offering services to prevent pregnancy following rape. A very small percentage (0.9% for both) strongly disagreed and disagreed with the statement.
Furthermore, (48.2%) respondents strongly agreed, and (42.0%) respondents agreed that HCWs can offer or provide linkages for psychosocial and counseling services to SBV survivors. (44.2%) strongly agreed, and (49.6%) agreed that HCWs could provide linkages for legal aid services following SBV. Also, (46%) and (46.9%) respondents, respectively, strongly agreed and agreed that HCWs could be helpful in the collection of evidence for forensic medical services, including semen, blood samples, and hair. Finally, less than half of the respondents, (44.2%) and (40.7%) respondents, respectively, strongly agreed or agreed that SBV survivors should visit Post-SBV health services to treat physical injuries following a SBV incident. (See Table 3 and Figure 1).
Table 3: Perceptions of Post-SBV health services among the study participants
S/N
|
Statement
|
Strongly agree
|
Agree
|
Neutral
|
Disagree
|
Strongly disagree
|
1.
|
A Post-SBV health service should be the first place to go following rape (n=112)
|
57 (50.9%)
|
33 (29.5%)
|
17 (15.2%)
|
4 (3.6%)
|
1 (0.9%)
|
2.
|
HCWs are able to prevent SBV from re-occurring (n=112)
|
26 (23.2)
|
38 (33.9%)
|
35 (31.3%)
|
11 (9.8%)
|
2 (1.8%)
|
3.
|
HCW are available to offer PEP for the prevention of HIV following rape (n=111)
|
44 (39.6%)
|
43 (38.7%
|
18 (16.2%)
|
5 (4.5%)
|
1 (0.9%)
|
4.
|
Post-SBV health services are effective in offering services to prevent pregnancy following rape (n=112)
|
48 (42.9%)
|
48 (42.9%)
|
14 (12.5%)
|
1 (0.9%)
|
1 (0.9%)
|
5.
|
HCWs can offer or provide linkages for psychological and counseling services to SBV survivors (n=112)
|
54 (48.2%)
|
47 (42%)
|
10 (8.9%)
|
1 (0.9%)
|
0
|
6.
|
HCWs can link SBV survivors to legal AID services (n=113)
|
50 (44.2%)
|
56 (49.6%)
|
5 (4.4%)
|
2 (1.8%)
|
0
|
7.
|
HCWs can be helpful in the collection of evidence for forensic medical services (n=113)
|
52 (46%)
|
53 (46.9%)
|
7 (6.2%)
|
1 (0.9%)
|
0
|
8.
|
SBV survivors should visit Post-SBV health services to treat physical injuries (n=113)
|
50 (44.2%)
|
46 (40.7%)
|
14 (12.4%)
|
2 (1.8%)
|
1 (0.9%)
|
SBV-Sexual-based violence; HIV-Human immunodeficiency virus; HCW-Health care workers; PEP-Post-exposure prophylaxis.
3.4 Research Question 3: What are the Barriers and Facilitators to accessing Post-SBV health services in Nigeria
3.4.1 Barriers
A scale of 1-5 (1 being ‘not at all’ and 5 being ‘very much’) was used to rate how much the following barriers (as derived from literature) affect young women in accessing Post-SBV-health services. The following are the results of the barriers to accessing Post-SBV health services as reported by the survey respondents. (Future studies will describe numbers 2, 3 and 4 on the scale, but participants for this study were asked to rate the barriers from number 1 (not at all) to number 5 (very much) on the scale).
3.4.1.1 Stigma/Shame
Over half, (58.1%) of 105 respondents to this question rated stigma and shame as number 5 (very important) on the scale. The next majority, (15.2%), rated it as number 4 on the scale. (13.3%) respondents rated it as number (3.8%) and (9.5%) rated this barrier as number 1 and 2 on the scale, respectively.
3.4.1.2 Lack of support systems in the home, school, and community to facilitate visits to Post-SBV-health services
About fifty-four (54.1%) of 111 respondents rated this barrier as number 5 on the scale. (10.8%) rated it as number 4, and 15 (13.5%) rated it as number 3. (12.6%) and 10 (9.0%) rated this barrier as 1 and 2 on the scale, respectively.
3.4.1.3 Lack of awareness of existing Post-SBV-health services
Over half of the respondents, (53.2%) of 111 respondents, rated lack of awareness of existing Post-SBV health services as number 5 on the scale. (11.7%) rated it as number 4, and (15.3%) respondents rated it as number 3 on the scale. (9.0%) rated it as number 2 on the scale, and (10.8%) rated it as number 1.
3.4.1.4 Financial Barrier (Cost of accessing services)
Out of 111 respondents to this question, (41.4%) respondents, which formed the majority of the respondents, rated financial barrier as number 5 on the scale. The next majority of respondents rated this barrier as number 4 and 3 on the scale (19.8%) respondents each.
3.4.1.5 Fear of reporting the offender
Less than a half (40.9%) of the respondents rated this barrier as number 5 on the scale; this was the majority of the respondents, followed by the next majority, (21.8%) respondents who rated this as number 4 on the scale, and (19.1%) respondents who rated this barrier as number 3 on the scale.
3.4.1.6 Negative and unfriendly attitude, including distrust of health care providers
Thirty-seven (37.8%) of 111 respondents rated this barrier as number 5 on the scale, and the next majority rated it as number 3 ( 24.3%) and 4 (, 19.8%) on the scale respectively. (8.1%) respondents rated it as number 2, and (9.9%) respondents rated it as number 1.
3.4.1.7 Fear of HIV testing
About thirty-three (33.3%) respondents rated this barrier as number 5 on the scale, (19.8%) as number 4, and (27.0%) respondents as number 3. (6.3%) rated it as number 2, and (13.5%) respondents rated this barrier as number 1 on the scale.
3.4.1.8 Difficulty in accessing Post-SBV-health services due to the distance of SBV-health service facility
(32.7%) of 111 respondents rated this barrier as number 5 on the scale, (15.9%) rated it as number 4, and (29.2%) respondents rated it as number 3 on the scale. (11.5%) rated it as number 2, and (10.6%) rated this barrier as number 1 on the scale.
3.4.1.9The belief that violence was normal
About twenty (20.7%) of 111 respondents rated this as number 1 on the scale, (10.8%) rated it as number 2, and (21.6%) respondents rated this barrier as number 3 and 4 on the scale, respectively. Only (25.2%) rated this barrier as number 5 on the scale.
3.4.2 Facilitators
A scale of 1-5 (1 being ‘not important’ and 5 being ‘very important’) was used to rate the facilitators in accessing Post-SBV health services (online and in-person). The following are the results of the facilitators' in accessing Post-SBV-health services, as reported by the survey respondents. (Future studies will describe numbers 2, 3 and 4 on the scale, but participants for this study were asked to rate the barriers from number 1 (not important) to number 5 (very important) on the scale).
3.4.2.1 Assurance of confidentiality after visiting GBV-health services
Most respondents, (61.3%) of 111, rated this facilitator as ‘very important’ on the scale. (10.8%) rated it as number 4, and (13.5%) respondents rated it as number 3. (2.7%) respondents rated the facilitator as number 2, and (11.7%) rated the facilitator as number 1 on the scale.
3.4.2.2 Presence of Post-SBV health service facilities in the community people live in, e.g., Universities
Majority of the respondents, (57.7%) of 111, rated this facilitator as number 5 on the scale. The next majority, (17.1%), rated it as number 3. (14.4%) rated it as number 4. (7.2%) respondents rated it as number 1 on the scale, and (3.6%) respondents rated this facilitator as number 2 on the scale.
3.4.2.3 Free/Affordable GBV-health services
Over half of the respondents, (56.4%) of 110 respondents, rated free/affordable SBV-health services as a very important facilitator (number 5 on the scale), followed by the next majority, (15.5%) respondents who rated this facilitator as number 3, (12.7%) respondents rated it as number 4 on the scale. (4.5%) respondents and (10.9%) respondents rated this facilitator as number 1 and 2 on the scale, respectively.
3.4.2.4 Effective care and support from Post-SBV-health services and health workers
Majority of the respondents (54.1%) of 111 respondents rated this facilitator as number 5 on the scale. The next majority, (17.1%), identified it as number 4 on the scale. (15.3%) respondents rated it as number 3 on the scale, and (1.8%) participants rated it as number 2. (11.7%) participants rated the facilitator as number 1 on the scale.
3.4.2.5 Support systems in homes, schools, and communities to facilitate access to Post-SBV health services
About a half (53.2%) respondents out of 111 respondents rated this as number 5 on the scale. (16.2%) rated it as number 4, and (18%) respondents rated it as number 3 on the scale. (2.7%) respondents rated it as number 2, and (9.9%) respondents rated this facilitator as number 1.
3.4.2.6 Availability of Post-SBV-health services as part of the larger general healthcare services
(52.7%) of 110 respondents rated this facilitator as number 5 on the scale; (20.0%) respondents) rated it as number 4 on the scale; (11.8%) respondents rated it as number 3. (9.1%) and (6.4%) rated the facilitator 1 and 2 on the scale, respectively.