Periodic Reporting for period 4 - IPV_Tanzania (Investigating the predictors of intimate partner violence: A mixed method longitudinal study in Tanzania)
Reporting period: 2021-08-01 to 2023-05-31
This study investigates the change in prevalence, risk and protective factors of intimate partner violence, a prominent public health and human rights issue.
Worldwide, it is estimated that one in three women experience physical and/or sexual violence by a partner in their lifetime, with even higher rates reported in sub-Saharan Africa. Estimates also show that at least one in three murdered women have been murdered by their partners (WHO 2022). Cross-sectional surveys have documented the adverse health impacts of intimate partner violence and the factors that increase the risk of female experience and male perpetration. Nonetheless, theoretical and programmatic development has stalled due to a lack of clarity on the temporality of identified associations: do documented associations represent risk factors for intimate partner violence, or do they reflect the consequences of abuse? This deficit of understanding is especially pressing in low- and middle-income countries, where few longitudinal cohort studies with intimate partner violenceas an outcome have been conducted.
This study seeks to address this gap by following forward in time a cohort of 1200 Tanzanian women, using state of the art methods to measure their experiences of intimate partner violence, encourage disclosure and ensure participant safety. Both quantitative and qualitative data were collected at 4 discrete time points over 5 years, making this the largest longitudinal study of intimate partner violence ever undertaken in a low- and middle-income country. In addition, a cross-sectional survey of young men was conducted to explore their experiences of violence and associated risk and protective factors with intimate partner violence. This study is informed by 30 qualitative in-depth interviews and 16 photovoice interviews of Tanzanian men.
The goal of the research is to advance our understanding of the predictors and consequences of intimate partner violence to better inform the design of interventions to reduce this phenomenon in low- and middle-income countries, as well as globally.
The main objectives are therefore to: 1) map the dynamics of partner violence over time; 2) advance the theoretical frameworks of intimate partner violence; 3) investigate the temporality of key factors linked to intimate partner violence; 4) and investigate pathways leading to intimate partner violence.
This research is of immediate necessity to address a vital public health challenge of our time and has the strong potential to have a long-lasting impact on shaping the research agenda on intimate partner violence.
Worldwide, it is estimated that one in three women experience physical and/or sexual violence by a partner in their lifetime, with even higher rates reported in sub-Saharan Africa. Estimates also show that at least one in three murdered women have been murdered by their partners (WHO 2022). Cross-sectional surveys have documented the adverse health impacts of intimate partner violence and the factors that increase the risk of female experience and male perpetration. Nonetheless, theoretical and programmatic development has stalled due to a lack of clarity on the temporality of identified associations: do documented associations represent risk factors for intimate partner violence, or do they reflect the consequences of abuse? This deficit of understanding is especially pressing in low- and middle-income countries, where few longitudinal cohort studies with intimate partner violenceas an outcome have been conducted.
This study seeks to address this gap by following forward in time a cohort of 1200 Tanzanian women, using state of the art methods to measure their experiences of intimate partner violence, encourage disclosure and ensure participant safety. Both quantitative and qualitative data were collected at 4 discrete time points over 5 years, making this the largest longitudinal study of intimate partner violence ever undertaken in a low- and middle-income country. In addition, a cross-sectional survey of young men was conducted to explore their experiences of violence and associated risk and protective factors with intimate partner violence. This study is informed by 30 qualitative in-depth interviews and 16 photovoice interviews of Tanzanian men.
The goal of the research is to advance our understanding of the predictors and consequences of intimate partner violence to better inform the design of interventions to reduce this phenomenon in low- and middle-income countries, as well as globally.
The main objectives are therefore to: 1) map the dynamics of partner violence over time; 2) advance the theoretical frameworks of intimate partner violence; 3) investigate the temporality of key factors linked to intimate partner violence; 4) and investigate pathways leading to intimate partner violence.
This research is of immediate necessity to address a vital public health challenge of our time and has the strong potential to have a long-lasting impact on shaping the research agenda on intimate partner violence.
The study set out to achieve knowledge on the dynamics of intimate partner violence over time and its risk and protective factors in Mwanza, Tanzania, through a) a longitudinal quantitative survey of women, b) an in-depth qualitative longitudinal follow up of women, c) a cross-sectional quantitative survey of men, and d) an in-depth qualitative study of men, including a participatory photovoice exercise.
The study has completed the following activities for each component:
a) Out of the planned 1200 women who participated in the baseline and follow-up interviews in the control group of two randomized control trial (600 women in micro-finance loan groups and 600 women not participating in a micro-finance loan group), 1008 women have been interviewed a third time and 986 women were interviewed for a fourth time, resulting in a dataset of around 1000 women interviewed for four times within five years.
b) Repeated qualitative in-depth interviews were conducted with 18 women about their experiences of changes of intimate partner violence in their relationship. Based on the preliminary analysis of these interviews, the question guide for the next round was developed. We have completed studies on how romantic jealousy and unfaithfulness lead to intimate partner violence, women’s conceptualizations of sexual and economic intimate partner violence and how women cope with different forms of intimate partner violence.
c) We conducted a two-wave nested phone survey of 456 women in the MAISHA longitudinal study to inquire about their experiences of intimate partner violence during COVID-19 and how far this has led to an increase in violence in their relationships.
d) We completed a survey of 1002 young men aged 18 to 24 on their experience and perpetration of intimate partner violence. Men have been interviewed once by specially trained interviewers and have been recruited after being identified randomly through GPS points in their randomly chosen streets.
e) In-depth interviews with 30 men have been completed about their experiences and perpetration of violence from and against other men and their intimate partners. Of the 30 men, 16 have further participated in a participatory photovoice exercise.
f) The systematic review of theories on IPV has been completed, with two articles on economic theories and sociological theories explaining IPV published and three more articles on feminist theories, stress theories and psychological theories currently under review or in the process of submission.
The study has completed the following activities for each component:
a) Out of the planned 1200 women who participated in the baseline and follow-up interviews in the control group of two randomized control trial (600 women in micro-finance loan groups and 600 women not participating in a micro-finance loan group), 1008 women have been interviewed a third time and 986 women were interviewed for a fourth time, resulting in a dataset of around 1000 women interviewed for four times within five years.
b) Repeated qualitative in-depth interviews were conducted with 18 women about their experiences of changes of intimate partner violence in their relationship. Based on the preliminary analysis of these interviews, the question guide for the next round was developed. We have completed studies on how romantic jealousy and unfaithfulness lead to intimate partner violence, women’s conceptualizations of sexual and economic intimate partner violence and how women cope with different forms of intimate partner violence.
c) We conducted a two-wave nested phone survey of 456 women in the MAISHA longitudinal study to inquire about their experiences of intimate partner violence during COVID-19 and how far this has led to an increase in violence in their relationships.
d) We completed a survey of 1002 young men aged 18 to 24 on their experience and perpetration of intimate partner violence. Men have been interviewed once by specially trained interviewers and have been recruited after being identified randomly through GPS points in their randomly chosen streets.
e) In-depth interviews with 30 men have been completed about their experiences and perpetration of violence from and against other men and their intimate partners. Of the 30 men, 16 have further participated in a participatory photovoice exercise.
f) The systematic review of theories on IPV has been completed, with two articles on economic theories and sociological theories explaining IPV published and three more articles on feminist theories, stress theories and psychological theories currently under review or in the process of submission.
This project has completed all envisioned data collection and analysis, with additional analyses still underway and planned for the next two years, given the richness of the collected data.
There are six main achievements and developments to highlight:
• The PI has successfully obtained additional funding to organise an expert meeting to draft ethical recommendations for conducting research on violence against women that will be published by the World Health Organisation.
• Additional research funds were obtained to conduct a nested study of participants during COVID-19, with funding received from NBER.
• Staff at MITU and LSHTM are conducting analyses on the female and male qualitative data beyond the analysis in the Plan of Action and investigate women‘s coping behaviours with intimate partner violence and women‘s and men‘s perceptions of sexual violence, emotional and economic violence and controlling behaviour. This has led to a number of first author publications by junior members of the research team and local partners.
• Two team members have completed their PhD during the project period, three are currently pursuing their PhD and two members of the Tanzanian research team obtained MSc level qualifications.
• The project has developed a highly successful capacity building strategy through informal writing and analysis workshops of local and LSHTM junior staff run by the PI. Furthermore, we have trained junior highly motivated fieldwork staff to successfully conduct, code and analyse qualitative interviews, two of whom pursued their Master degrees within this project.
• The project resulted in 24 peer-reviewed accepted journal articles so far, with seven more under review and at least eight more publications in process to being submitted for publication.
There are six main achievements and developments to highlight:
• The PI has successfully obtained additional funding to organise an expert meeting to draft ethical recommendations for conducting research on violence against women that will be published by the World Health Organisation.
• Additional research funds were obtained to conduct a nested study of participants during COVID-19, with funding received from NBER.
• Staff at MITU and LSHTM are conducting analyses on the female and male qualitative data beyond the analysis in the Plan of Action and investigate women‘s coping behaviours with intimate partner violence and women‘s and men‘s perceptions of sexual violence, emotional and economic violence and controlling behaviour. This has led to a number of first author publications by junior members of the research team and local partners.
• Two team members have completed their PhD during the project period, three are currently pursuing their PhD and two members of the Tanzanian research team obtained MSc level qualifications.
• The project has developed a highly successful capacity building strategy through informal writing and analysis workshops of local and LSHTM junior staff run by the PI. Furthermore, we have trained junior highly motivated fieldwork staff to successfully conduct, code and analyse qualitative interviews, two of whom pursued their Master degrees within this project.
• The project resulted in 24 peer-reviewed accepted journal articles so far, with seven more under review and at least eight more publications in process to being submitted for publication.