Prevalence, pattern and risk factors for domestic violence against men in Sokoto Metropolis of Sokoto state, Nigeria

INTRODUCTION

Domestic violence or intimate partner abuse is a pattern of behavior which involves the abuse of one partner by the other in an intimate relationship or within the family.¹

The World Health Organization (WHO) defines IPV as any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship, including acts of physical aggression, sexual coercion, psychological abuse, and controlling behaviors.²

Gender‑based violence has been recognized as a global public health and human rights problem with serious deleterious effects including high rates of morbidity, mortality, depression, substance dependence, suicide, and posttraumatic stress disorder.^3,4

Over the years, gender-based violence is believed to be violence directed at only the female folk and it is unthinkable that men could fall victim to such violence perpetrated by women who traditionally are not known aggressors. Nigeria is a male-dominated country and issues around violence against men are shrouded in secrecy with no reportage at all. For a long time, IPV among men has been prevalent but it has not been given the attention it deserves.^5,6 There is no doubt that domestic violence against women is a more serious and bigger problem, however, the problem of domestic violence against men is also presently on the increase in Nigeria and is beginning to receive the necessary attention. Presently in the country, there is a dearth of data on DVAM and IPV generally and the little that is known about violence against women is basically from hospital and police registers. The global prevalence of IPV among men is estimated at 17%.⁷

The prevalence of DVAM was 0.0023% in a study carried out in primary health centers in Nigeria, while in another study from Osun state Nigeria, about a quarter of the respondents alleged they had been victims of DVAM.^8,9 In Uganda, the prevalence of IPV among ever-married men is 44% compared to 56% among ever-married women.¹⁰

According to a 2004 survey in Canada, the percentages of males being physically or sexually victimized by their partners was 6% versus 7% for women.¹¹ Another report by the United States Department of Justice, which surveyed 16,000 Americans showed that 7.4% of men and 22.1% of women reported being physically assaulted by a current or former spouse, cohabiting partner, boyfriend or girlfriend, or date in their lifetime.¹² Coker and colleagues in their study showed that 22% of men had experienced physical, sexual, or psychological intimate partner violence during their lifetime.¹³ Approximately, one in three male victims of IPV sustains serious injuries, lose self-worth, have generally poor health, and resort to alcoholism and drugs.^14-16

The plausible reasons for underreporting female perpetrated IPV include social stigma (fear of losing social respect and position), not being believed, fearing shame, having their masculinity questioned, and being accused of domestic violence.^17,18 Measures often put in place to stem the tide of IPV have always been silent on women perpetrators, for instance, the Nigerian government has taken legal proceedings to prosecute men who abuse women in several states and there is currently a push for federal laws concerning domestic violence.

Much of the research carried out on intimate partner violence centers mainly on women with very little attention to violence against men. Findings from this study will therefore help family and public health physicians identify early, victims in clinical settings with the aim of nipping in the bud the deleterious effects of violence against men. To the knowledge of the authors, no known study about domestic violence against men has been carried out in Sokoto state hence the need for this study. This study therefore, was carried out with the following objectives: to determine the prevalence of domestic violence against men in Sokoto, to identify the nature/type of abuse among men in Sokoto metropolis, to assess the knowledge of intimate partner violence among men in Sokoto metropolis, and to determine the risk factors of domestic violence against men in Sokoto metropolis.

METHODS

Study area

Sokoto State has 23 local government areas (four of which are within the metropolis), with a land mass of 25,972 km2 and an estimated population of 4,802,298 projected for 2021. Farmers form the greater percentage of the population, and they majorly reside in the rural areas, while the rest are civil servants, traders, artisans, and people of other occupations such as tanning and dyeing (and these are mainly concentrated in the metropolis, being the center of commercial activities in the State). This was a descriptive cross‑sectional study carried out between May and November, 2022 in Sokoto Metropolis the capital of Sokoto State, Northwest Nigeria. The study population comprised all adult males who are married, separated or divorced and residing within the metropolis. The sample size for the study was calculated using the formula for cross‑sectional descriptive study using the assumption that the proportion of men that experienced domestic violence (8%) from a previous study.^19,20 The sample size was calculated as follows.

The minimum sample size was determined using the formula, where: n=minimal sample desired, Z=standard normal deviate at 95% confidence interval=1.96, p=prevalence of domestic violence against men from a previous study=8%=0.08, q=complimentary probability of p=1-p, and d=tolerable alpha error or level of precision=5%=0.05.

Allowing for 80% response rate, the optimum sample size (ns) was given as: ns=n/0.8=113/0.8=141

Sampling technique

A multistage sampling technique was used to select the study participants.

Stage 1: Selection of LGAs

One LGA (Sokoto North) was selected from the 5 that make up the metropolis through simple random sampling by balloting.

Stage 2: Selection of wards

Three wards were selected from Sokoto north LGA through simple random sampling by balloting.

Stage 3: Selection of settlements

From each ward 1 settlement was selected through simple random sampling by balloting.

Stage 4: Selection of household

A comprehensive list of the total number of households in all the settlements in the selected LGA was obtained and a line list of the households and numbering was done in the selected settlements. Proportionate to size allocation was done for each settlement and systematic sampling was used to enroll households to obtain the study subjects. In a household without an eligible study subject, the next household was chosen and this was continued until the desired sample size was obtained for the settlement

Instrument and method of data collection

An interviewer-administered standardized questionnaire was used to obtain relevant information from the respondents. The questionnaire comprised of three sections: sections A and B-socio-demographic characteristics of respondents and their partners, section C: Knowledge of domestic violence against men, section D: prevalence and patterns of domestic violence, and section E- risk factors for domestic violence.

Six resident doctors from the department of community medicine, Usmanu Danfodiyo University Teaching Hospital Sokoto were recruited and trained as research assistants on the objectives of the study and the general administration of the study instruments. The filled questionnaire was checked for completeness and entered into and analyzed using IBM statistical package for the social sciences (SPSS)® version 25 (NY, USA). The data were summarized using frequencies and percentages and were presented as tables. Bivariate and multivariate analyses were carried out to determine the level of associations and predictors of domestic violence against men.

Each correct answer to the knowledge questions was awarded a mark, with no marks awarded for wrong answers. Knowledge was graded with scores ≥65 and <65 adjudged good and poor knowledge, respectively. Similarly, every correct answer to the attitude question was awarded one mark, with no marks for wrong answers. The level of statistical significance was set at P < 0.05 at 95% confidence interval. Approval for the study was sought from the research ethics committee of the Sokoto State Ministry of Health. While verbal informed consent was obtained from each study subject after a detailed explanation of the study.

RESULTS

More than half, 68 (56.7%) of the respondents were above 40 years of age. A majority, 105 (87.5%), were Hausa tribe, and 113 (94.2%) were Muslims. Almost 113 (94.2%) were married, while 36 (30%) were married to more than one wife; most attained tertiary education 88 (73.3) and had children with partners, 106 (88.3%) (Table 1).

Almost all, 115 (95.8%) of the respondents’ partners were below 40 years of age, only 45 (37.5%) and 36 (30%) of the respondents attained tertiary education and were civil servants, respectively (Table 2).

Among the respondents, only 59 (49%) were aware of domestic violence against men. About three-quarters of the respondents, 91 (75.8%), knew that being shoved, slapped or kicked was a form of violence against a man. Similarly, 89 (74.2%) of the respondents knew that being insulted or use of abusive language on men was a form of violence. Slightly above two-thirds, 80 (66.7%) knew that getting jealous or suspicious of a man as unfaithful when he relates with other women is violence (Table 3). Overall, most of the respondents, 88 (73.3%) had good knowledge of violence against men (Figure 1).

A majority of the respondents, 93 (77.5%), had experienced their wives called them awkward names, while only 28 (23.3%) have experienced their wives criticizing their beliefs. Overall, 99 (82.5%) of the respondents have experienced at least one form of verbal violence from their wife/ partner. Only 8 (6.7%) reported that their wives/partners often ignored their feelings and 56 (56.7%) said that their wives/partners monitored their calls with others. Overall, 109 (90.8%) of the respondents experienced at least one type of psychological violence (Table 4).

Eleven (9.2%) of the men admitted ever been slapped or had something thrown at them; while 17 (14.2%) were pushed, shoved or had their hair pulled by their wife/partner. Overall, 24 (20%) of the respondents’ d experienced at least one form of physical violence. About half, 63 (52.5%) of respondents had been forced to have sex with their wife/partner against their will. Overall, 109 (90.8%) had experienced at least one form of sexual violence (Table 5).

All the respondents reported experiencing at least one form of violence; nine (7.5%) have experienced only one type of violence, while 61 (50.8%) reported experience of three forms of violence (Figure 2).

Seven (5.8%) of the respondents’ d reported experience of injury due to violence from their partners, with 3 (42.9%) of them eventually seeing a doctor after a fight (Table 6).

A total 92 (76.7%) of the respondents have had the experience of watching violence between couples while growing up. Only 5 (4.2%) and 4 (3.3%) consumed alcoholic drinks and illicit drugs respectively; almost two-thirds, 72 (60%) of the respondents kept late at night with only one (0.8%) of the men who considered his life at risk with his partner (Table 7).

Those who were older than 40 years were more likely to have good knowledge of violence [aOR:2.49; 95% CI=(1.09-6.63)] while those whose wives/partners felt family members or friends influenced their husbands were more likely to have good knowledge of violence [aOR: 5.08; 95% CI (1.83-14.19)] (Table 8). None of the men in this study reported their experiences of violence by their partners to anyone mainly due to shame.

*Multiple responses allowed.

cOR=Crude odds ratio, aOR=adjusted odds ratio.

DISCUSSION

This present study was an attempt to determine the prevalence, forms, and risk factors for domestic violence against men in a Muslim dominated state of Nigeria.

In this study, most of the respondents were between ages 20 and 30 years and this is in contrast to some other studies where most of their study subjects were more than 30 years.^8,21,22 This is an indication of the youthful composition of our study population when compared to the previous studies.

Findings from our study showed that about half, (49%) of the study participants were aware of domestic violence against men. This near-average level of awareness amongst our study subjects may not be unrelated to the fact that most people believe it is unthinkable to hear a man undergo violence in the hands of an intimate partner, hence the under reporting and low awareness of violence against men. Very low level of awareness (7.6%) was recorded in the study carried out in Osun State, Nigeria.⁷ However, in contrast to this, very high level of awareness was observed in a separate study in South west Nigeria.⁹ The near average level of awareness of DVAM in this study may not be unrelated to the socio-cultural milieu of the study area when compared to the high levels recorded in south west Nigeria. A majority, (73.3%) of the respondents had good knowledge of DVAM which could be attributed to the level of awareness amongst almost half of the respondents.

All the respondents in this study had experienced at least one form of domestic violence in their relationship. In a predominantly patriarchal society such as the study location where women are supposed to be submissive, it is unexpected that all the men would have experienced domestic violence of this magnitude. This finding may be attributable to the high knowledge of DVAM among the study subjects who hitherto did not appreciate what they went through to mean domestic violence. In a study involving 8 African countries, prevalence figures of 7% (Malawi), 7% (Mozambique), and 27% (Zambia) were reported.²² On the other hand, findings from the Ugandan demographic and health survey showed that almost half, (44%) of ever married men had experienced some form of domestic violence, while another study from India showed a higher prevalence rate of 52.4%.^21,24 A high prevalence of domestic violence was also observed in other studies.^25,26 The low prevalence rates recorded in these African countries could be as a result of low reporting since most of them lack accurate data on domestic violence.

Concerning the pattern of violence against the men, a greater majority, 82.5% of them experienced verbal abuse. Anecdotal evidence has shown how women often used derogatory words on their partners including not being able to satisfy them sexually, not being the breadwinner in the home and inability to carry out the role of the head of the home to name but a few. In some instances, it is the verbal abuses when responded to by the men that will lead to physical and other forms of abuses. The high prevalence of verbal abuse in this study is in tandem with what was obtained (82%) in a similar study carried out in Osun State, Nigeria.⁹

Overall, about 20% of the respondents had experienced at least one form of physical violence by their partners. In Africa cases of DVAM have been on the increase; for instance, it was reported that DVAM had assumed an alarming proportion in Kenya where almost five hundred thousand men were beaten by their wives.²⁷ In self-reported cases from Canada, 15% of men were beaten, choked or threatened with a gun or knife by female partners.²⁸ Similar findings of physical violence against men were observed in other studies elsewhere.^9,29,30

Findings from our study indicated that a greater majority, 90.8% of the respondents experienced at least one form of psychological violence in the hands of their partners and this is in tandem with the findings from other studies.^{9, 24,30-32}

More than half, (52.5%) of the men in this study had experienced sexual violence perpetrated by their female partners with over 90% having experienced one form of sexual violence including being forced to have oral sex, forced to have sex with condoms against the man’s will, denial of sex as a punishment and caused injury to the man’s private parts intentionally. The high prevalence of sexual violence observed in our study is however higher than figures in most other studies.^21,24,30 In contrast to the prevalence rates of sexual violence in these studies, a similar study from Osun State Nigeria observed that 67.8% of the studied men were forced to have sex or engaged in sexual acts against their will.⁹ In other studies, men have been reported being coerced or pressured by their partners to engage in unwanted sexual acts or activities through the use of threats, manipulation and false promises.^33,34

In most instances, violence in any intimate relationship inadvertently does not occur in isolation as there are often a triggering factor that initiates its occurrence. Witnessing or watching violence between couples while growing up was the commonest risk factor observed in this study. It has been observed that men who witnessed their fathers beat their mothers were more likely to experience emotional as well as other forms of intimate partner violence.²¹ Similar findings were observed in other studies elsewhere.^8,35,36 Witnessing parental violence inculcates certain norms whereby people tend to tolerate and accept IPV to be a part of their socio-cultural lives which in most cases is passed from one generation to another. This is believed to explain the concept of intergenerational transmissibility of IPV.³⁷

Although present among a few of our respondents, alcoholism was observed as one of the high risk-factors in the cycle of DVAM. Alcohol consumption has been found to reduce self-control and affects cognitive and physical functioning which reduces the ability of an individual to negotiate conflict resolution. Similarly, alcohol consumption increases the occurrence and severity of domestic violence.³⁸ The intake of alcohol was a prominent risk factor known for DVAM as reported by other previous studies.^9,29 Several other studies from Uganda have reported alcohol to be a precursor to the experience of DVAM.^21,39-41 Other notable risk factors for DVAM identified by the respondents included infidelity and suspected influence of friends and relations on the partner. These are in tandem with the findings from other studies.^8,9

The men in this study did nothing even in the face of brazen abuse at the hands of their partners for fear of retribution, shame, and embarrassment. It is important to note that most violence perpetrated against men goes underreported or unreported altogether, perhaps due to cultural and societal norms where women are viewed as nurturers rather than aggressors.⁴² Although women oftentimes can be aggressive and become perpetrators of IPV, the general public however finds it difficult to believe this which invariable lends credit as to why the male victims do not report such abuses because of the associated shame. A lot of men have endured all the abuses and resigned to their fate hoping that things might get better and also for the fear of losing on the economic side since they need the cooperation and contributions of their partners who may be economically stronger. It has been observed that some victims of women perpetrated violence against men cope with the stress and trauma associated with such violence through externalizing behaviors such as substance abuse, smoking, alcohol use and other anti-social behaviors that have the potential to impact negatively on health.^43,44

Limitations

Some men who were victims of DVAM may be constrained to inadvertently hoard information on their experiences due to shame. Similarly, since perpetrators of intimate partner violence in the past have never been sanctioned, some victims are of the opinion that issues round DVAM should not be related either to the families or law enforcement agencies.

CONCLUSION

Although women can be perpetrators of DVAM, there is generally a tendency for the society to think otherwise especially in a patriarchal society as ours. The prevalence of DVAM in this study was high with all the men having experienced one form or the other. There is the need to urgently create public awareness and channels through which cases of DVAM can be handled discretely. Similarly, necessary amendments should be made to laws concerning violence against women to incorporate the experiences of men in Nigeria. It is hoped that the findings from this study will help policy makers in developing practical frameworks aimed at strengthening and domesticating existing laws that are responsible for nipping in the bud all forms of violence by intimate partners. Furthermore, there is the need for operations research in the area of intimate partner violence as this will help drive the needed policies against the menace of DVAM.

ACKNOWLEDGEMENTS

Authors would like to thank all the final year medical students and resident doctors in the Department of Community Medicine who helped in the data collection.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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