Intimate partner violence: A key correlate of women’s physical and mental health in informal settlements in Nairobi, Kenya

Abstract

Globally, one billion people live in informal settlements, and that number is expected to triple by 2050. Studies suggests that health in informal settlements is a serious and growing concern, yet there is a paucity of research focused on health outcomes and the correlates of health in these settlements. Studies cite individual, environmental and social correlates to health in informal settlements, but they often lack empirical evidence. In particular, research suggests that high rates of violence against women (VAW) in informal settlements may be associated with detrimental effects on women's health, but few studies have investigated this link. The purpose of this study was to fill this gap by empirically exploring associations between women's experiences of intimate partner violence (IPV) and their physical and mental health. Data for this study were collected in August 2018 in Mathare Valley Informal Settlement in Nairobi, Kenya. A total of 550 randomly-selected women participated in surveys; however, analyses for this study were run on a subpopulation of the women (n = 361). Multivariate logistic regressions were used to investigate the link between psychological, sexual, and emotional IPV and women's mental and physical health. Results suggest that while some socioeconomic, demographic, and environmental variables were significantly associated with women's mental and physical health outcomes, all types of IPV emerged key correlates in this context. In particular, women's experiences of IPV were associated with lower odds of normal-high physical health component scores (based on SF-36); higher odds of gynecological and reproductive health issues, psychological distress (based on K-10), depression, suicidality, and substance use. Findings from this study suggest that policies and interventions focused on prevention and response to VAW in informal settlements may make critical contributions to improving health for women in these rapidly growing settlements.

Adapting the myPlan safety app to respond to intimate partner violence for women in low and middle income country settings: app tailoring and randomized controlled trial protocol

“…Our extensive formative phase revealed high feasibility and acceptability of community-partnered technologybased safety planning intervention within Nairobi's informal settlements, where the high prevalence and health impact of IPV has garnered calls for prevention and response [13]. Moreover it generated necessary refinements to ensure successful implementation that builds on the strengths of this community.…”

“…In Kenya, national data from 2014 indicates that 39% percent of ever-married women age 15-49 have ever experienced spousal physical or sexual violence, relative to 9% of ever-married men in the same age group [12]. The prevalence of IPV is even higher in Nairobi's informal settlements, and confers profound consequences to physical, sexual and mental health [13]. Social norms create a culture of IPV tolerance that challenges women's ability to seek help or identify their experiences as abuse [14,15].…”

The prevalence and correlates of depression before and after the COVID-19 pandemic declaration among urban refugee adolescents and youth in informal settlements in Kampala, Uganda: A longitudinal cohort study

“…Similar to a cross-sectional study with urban refugee youth in Kampala's informal settlements, that used different scoring methods and found two-thirds reported any depression symptoms, we found that violence exposure, food insecurity, and lower social support were associated with depression [20] . Violence exposure is a stressor associated with a sequalae of poor health outcomes, including mental health disorders, in internally displaced communities in Northern Uganda [41] , rural refugee settlements in Uganda and Rwanda [42] , with adolescents in Kampala [40] , and in urban informal settlements in Kenya [43] and South Africa [ 44 , 45 ].…”

The effects of COVID-19 on the health and socio-economic security of sex workers in Nairobi, Kenya: Emerging intersections with HIV

“…Although IPV is not a new phenomenon for sex workers (see, e.g. for Pack et al, 2014;Winter et al, 2020), and Kenya possesses well-established networks of NGOs that specifically respond to gender-based violence, including IPV (Ondicho, 2018), the state has closed many of the faith-based rescue centres, leading excess case-management burden to fall on sex worker-led organisations. Such organisations do not possess the specialized training and resources to effectively respond to the increased urgency of members around IPV.…”