literature review on domestic violence in ghana

• Research article
• Open access
• Published: 02 May 2016

Determinants of domestic violence against women in Ghana

• Ebenezer S. Owusu Adjah 1 , 3 &
• Isaac Agbemafle 2  

BMC Public Health volume  16 , Article number:  368 ( 2016 ) Cite this article

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The prevalence of domestic violence remains unacceptably high with numerous consequences ranging from psychological to maternal and neonatal mortality and morbidity outcomes in pregnant women. The aim of this study was to identify factors that increased the likelihood of an event of domestic violence as reported by ever married Ghanaian women.

Data from the 2008 Ghana Demographic and Health Survey (GDHS) was analysed using a multivariate logistic model and risk factors were obtained using the forward selection procedure.

Of the 1524 ever married women in this study, 33.6 % had ever experienced domestic violence. The risk of ever experiencing domestic violence was 35 % for women who reside in urban areas. Risk of domestic violence was 41 % higher for women whose husbands ever experienced their father beating their mother. Women whose mother ever beat their father were three times more likely to experience domestic violence as compared to women whose mother did not beat their father. The risk of ever experiencing domestic violence was 48 % less likely for women whose husbands had higher than secondary education as compared to women whose husbands never had any formal education. Women whose husbands drink alcohol were 2.5 times more likely to experience domestic violence as compared to women whose husbands do not drink alcohol.

Place of residence, alcohol use by husband and family history of violence do increase a woman’s risk of ever experiencing domestic violence. Higher than secondary education acted as a protective buffer against domestic violence. Domestic violence against women is still persistent and greater efforts should be channelled into curtailing it by using a multi-stakeholder approach and enforcing stricter punishments to perpetrators.

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Domestic violence is the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury or death [ 1 ]. According to Act 732 of the parliament of the Republic of Ghana, domestic violence within the context of previous or existing relationship means engaging in acts that constitutes a form of harassment, threat or harm to a person or behaviours likely to result in physical, sexual, economic, emotional, verbal or psychological abuse [ 2 ]. Physical abuse is the use of physical force against a person or the deprivation of a person of access to adequate food, water, clothing, shelter, rest, or subjecting a person to inhuman treatment. Sexual abuse refers to the forceful engagement of a person in a sexual contact or a sexual contact by a person aware of having sexually transmitted disease with another person without given the person prior information of the infection. Economic abuse, involves threatened deprivation of financial resources or hindering the use of property in which a person has material interest or is entitled to by law. Emotional, verbal or psychological abuse is any conduct that makes another person feel constantly unhappy, miserable, humiliated, afraid, jittery or worthless.

Domestic violence occurs in all countries but its prevalence varies greatly across the world and even within sub-Saharan Africa [ 3 , 4 ]. Irrespective of social, economic, religious and cultural groupings, men have been identified as the main perpetrators of domestic violence against women [ 5 ]. The prevalence of domestic violence remains unacceptably high with 10–69 % of women worldwide being physically assaulted by an intimate male partner at some point in their lives [ 6 ]. Statistics in Ghana indicate that 33–37 % of women have ever experienced domestic violence in the form of intimate partner violence in their relationship [ 7 ]. Even in schools, research has shown that 14 and 52 % of girls are victims of sexual abuse and gender-based violence respectively [ 8 ]. These estimates may be far less than what actually persists, as violence against women and girls remain a largely hidden problem (sensitive issue) that only few females have the courage to openly confess [ 9 , 10 ].

There are numerous health consequences of domestic violence particularly against women and children. Some are psychological or emotional in nature and may sometimes result in ill-health [ 11 – 14 ]. For women, physical violence during pregnancy is associated with maternal and neonatal mortality and morbidity [ 15 ]. This devastating consequence of violence against women has called for intensified efforts to curtail this ordeal. Existing efforts at the international level include the adoption of the Declaration on the Elimination of Violence Against Women (DEVAW) by the United Nations. Interventions in Ghana include the setting up of Domestic Violence and Victim Support Unit (DOVSU) of the Ghana Police Service, two specialist gender-based violence courts, provision of shelter for survivors of domestic violence and the passage of the Domestic Violence Act 732 on February 21, 2007 [ 8 ]. Several studies have pointed out factors associated with domestic violence including but not limited to individual factors (young age, heavy drinking, depression, personality disorders, low academic achievement, low income, witnessing or experiencing violence as a child), relationship factors (marital conflict, marital instability, male dominance in the family, economic stress, poor family functioning), community factors (weak community sanctions against domestic violence, poverty, low social capital), societal factors (traditional gender norms, social norms supportive of violence) [ 1 , 5 , 16 ]. Much of Ghana’s efforts in the fight against domestic violence have been geared towards social, economic and political systems which could be identified as the basic causes of violence against women. This in part is due to the fact that most studies regarding risk factors for domestic violence come from developed countries that have other systems different from those persistent in Ghana as well as other African countries. There is therefore the need to examine these risk factors in the context of the Ghanaian population. The 2008 Ghana Demographic and Health Survey (GDHS) included a series of questions that focused on specific aspects of domestic violence against women. This study seeks to use the 2008 GDHS to identify the underlying and immediate factors associated with domestic violence against women in Ghana to serve as a basis for programme planning and implementation.

Data source

This is a secondary data analysis from the household questionnaire of the 2008 GDHS. A detailed description of the GDHS study design and methods is available elsewhere [ 7 ]. Notably, this study was a nationally representative cross-sectional survey that sampled about 12,000 households using a weighted approach. Half of these households were selected for individual interviews and the domestic violence module was administered to women in two-thirds of households selected for the individual interview. Subsequently, only one person was administered the domestic violence module in each selected household. Informed consent was obtained at the beginning of the individual interview and at the beginning of the domestic violence module and additional information was given for domestic violence. Access to demographic and health survey data is managed and provided by MEASURE DHS following an online registration ( http://www.dhsprogram.com ).

Study participants

Of the households selected for individual interview, 2,563 women were eligible for the domestic violence module, 17 women were excluded because of lack of privacy, 23 women refused to be interviewed with the domestic violence module and 81 women were not interviewed for other reasons. A total of 2442 (unweighted) women agreed to be interviewed. We excluded never married women as well as participants with missing data ( n  = 765) on covariates included in the multivariable model such as partner’s education level, respondent’s alcohol use, husband’s alcohol use, history of mother beating father and vice versa. This resulted in a sample size of 1524 women for analysis of risk factors for intimate partner violence against ever married women after sampling weight was applied.

Domestic violence variables

The outcome variable, domestic violence, as defined for this study included violence perpetrated by intimate partners against women and manifested through acts of physical, sexual, and emotional violence. The following seven (7) questions were used to create the variable for physical violence: (Did) your (last) husband/partner ever i. Slapped you? ii. Twisted your arm or pulled your hair? iii. Pushed you, shook you, or threw something at you? iv. Punched you with his fist or with something that could hurt you? v. Kicked you, dragged you or did beat you up? vi. Tried to choke you or burned you on purpose? vii. Threatened or attacked you with a knife, gun, or any other weapon [ 7 ] . A “yes = 1” to any of these questions constituted physical violence. If a woman scores from 1 to 7 then physical violence was coded as “1” to represent an event of “physical violence” and if a woman scores “0” then physical violence was coded as “0” to represent an event of “no physical violence”. Furthermore, sexual violence was measured using the following set of questions for women: (Did) your (last) husband/partner ever i. physically forced you to have sexual intercourse with him even when you did not want to? ii. Forced you to perform any sexual acts you did not want to? [ 7 ] . A “yes = 1” to either questions constituted sexual violence; as such if a woman gets a score of “1” or “2”, then a code of “1” was assigned to represent an event of “sexual violence”. If a woman scores “0”, then a code of “0” was assigned to represent the event of “no sexual violence”. Subsequently, spousal violence was created as per its definition in the GDHS report by combining physical and sexual violence [ 7 ]. Emotional violence was measured in a similar way, using the following set of questions: (Did) your (last) husband ever: i. Said or did something to humiliate you in front of others? ii. Threatened to hurt or harm you or someone close to you? iii. Insulted you or made you feel bad about yourself? [ 7 ] . A “yes = 1” to any of these questions constituted emotional violence. Scoring from 1 to 3 was coded as “1” to represent the event “emotional violence”. Otherwise, a code of “0” was assigned to represent the event of “no emotional violence”. The outcome variable, domestic violence was then created as per the definition of domestic violence for this study by combining spousal violence and emotional violence. The event of “no domestic violence” was coded as “0” for participants who did not experience either spousal or emotional violence. For those who experienced only emotional violence, only spousal violence and both spousal and emotional violence, a code of “1” was assigned to represent the event of “ever experienced domestic violence”. Covariates considered as risk factors were selected on the basis of causal assumption derived from subject matter knowledge. These included age of respondent, place of residence, educational level of respondent and partner, religion, wealth index, marital status, employment status of both responded and partner and alcohol use by both respondent and partner [ 1 , 4 , 14 , 17 ].

Distribution of categorical variables were reported as frequency counts whilst associations were tested using chi-square or fisher’s exact test. Univariate logistic regression analysis was initially performed to evaluate the ability of each covariate to predict the event “ever experienced domestic violence”. Predictors with some degree of association from the univariate analyses ( p  < 0.25) were entered into a preliminary multivariate logistic model [ 18 ] either as continuous variables or categorized as quartiles and those that showed some degree of association ( p  < 0.25) were added one by one until no remaining variable produces a significant F statistic (forward selection). The forward selection model was chosen over simultaneous model as this study was designed to select from a group of independent variables, the one variable at each stage which makes the largest contribution to R 2 . To ensure that the predictor variables included in the model were independent of each other, variance inflation factor was used as a measure colinearity and none of the predictor variables in final model was highly associated with each other. Data were analysed using SAS version 9.2 (SAS Institute) and all statistical tests were two tailed and a p  < 0.05 was considered statistically significant.

Socio-demographic characteristics

Of the 1524 ever married women in this study, 33.6 % had ever experienced domestic violence (some form of sexual, physical or emotional violence) and 87 % were currently married. The most frequently reported violence against women in Ghana was emotional violence, followed by physical and sexual violence in that order (Fig.  1 ). The median age of the women in this study was 33 years and the majority (87 %) were currently married (Table  1 ). Educational level was higher for men (spouse/partner) than women as shown in Table  1 . Seventy-six percent (76 %) of the women were Christians and 89 % also engaged in some form of employment. About 40 % of the women were in the lowest quintile of the wealth index. The proportion of women (19 %) who consumed alcohol was less than the number of men who drank alcohol (37 %; Table  1 ). Fewer women (3.0 %) reported witnessing mother ever beat father as compared to 12.1 % who mentioned that their father ever beat their mother. For about half of the women, the average number of children reported ranged from one to three. The most common duration of marriage as reported by 40 % of the women was 0–9 years (Table  1 ). There were no differences in proportion for place of residence, educational level, and marital duration between the women who had ever experienced domestic violence as compared to those who had never experienced it (Fig.  2 ). However, there were differences in alcohol use and family history of violence; with the proportion skewed towards the women who had ever experienced domestic violence as compared to those who had never experienced it (Fig.  2 ).

Forms of domestic violence against women in Ghana

Distribution of potential risk factors by domestic violence (legend: REL = respondents education level, PEL = Partner education level, MD = marital duration)

• Risk factors

Higher than secondary level of education of partner from the univariate analysis independently lowered a woman’s risk of domestic violence by 45 % whilst women who had higher than secondary education were 55 % less likely to experience domestic violence ( p -value < 0.05; Table  2 ). Alcohol use by women was independently associated with a 71 % (95 % confidence interval (CI) = 1.34–2.17) increased likelihood of experiencing domestic violence of whereas alcohol use by partner or husband increases the same likelihood by about 3 fold (OR = 2.55, 95 % CI = 2.07–3.15; Table  2 ). History of mother ever beating father independently increases risk of domestic violence by 4folds whilst history of father ever beat mother was associated with a 92 % chance of domestic violence ( p -value < 0.0001). Age, employment status and wealth index were not independent risk factors for domestic violence as shown in the univariate analysis in Table  2 .

After adjusting for other potential risk factors (age, total number of children, employment status, religion, wealth index, last intercourse and marital duration), place of residence, educational level (respondent or partner), husband alcohol consumption and father/mother ever beating spouse were significant predictors of domestic violence among women. Women who reside in urban areas were at 35 % increased risk of ever experiencing domestic violence as opposed to women in rural areas. Educational level seems to confer a protective effect against domestic violence. The higher the educational level of partner, the lower a woman’s risk of ever experiencing domestic violence. The risk of ever experiencing domestic violence was 48 % lesser for women whose husbands had higher than secondary education as compared to women whose husband never attended school (Table  3 ). The odds ratio for experiencing domestic violence for women whose husbands consume alcohol was 2.52 as shown in Table  3 . This indicates that women whose husbands drink alcohol were 2.5times more likely to experience domestic violence. This effect of alcohol use remained statistically significant given that educational level, place of settlement and father/mother ever beat partner were included in the multivariate model. The results of this study also revealed that prior family history of domestic violence is a strong predictor for ever experiencing domestic violence in later life. Notably, women whose mother ever beat father were three times more likely to experience domestic violence as compared to women without family history of domestic violence. The odds ratio for women whose father ever beat mother was 1.41 indicating that the risk of ever experiencing domestic violence for those women was 41 % higher compared to women whose father never beat their mother.

Factors associated with domestic violence that have previously been documented were mostly from countries in Asia and Latin America with varying political, economic and cultural differences and very little focus on sub-Saharan Africa [ 5 , 9 , 12 , 19 – 21 ]. These factors reported in other countries may not necessarily lead to an increase in the likelihood of a Ghanaian woman’s risk of domestic violence. The aim of this study was therefore to identify specific factors that increased the likelihood of an event of domestic violence as reported by a representative sample of married Ghanaian women. To the best of our knowledge, this study is one of the first to evaluate risk factors of domestic violence in Ghana. In this study, physical and sexual violence were less reported by the women as compared to emotional violence. In Ghana as compared to Bangladesh [ 14 ], emotional violence was reported as the most common form of domestic violence against women. This difference might be attributable to methodological complexities and sociocultural variations among women in these countries. Although physical and sexual violence were more readily quantifiable than emotional abuse as reported in Bangladesh [ 14 ], results of qualitative research demonstrated that emotionally-abusive acts might be more devastating [ 4 ]. However, the issue of emotional violence is complex, and more data are needed to understand its complexities.

In this study, the women were not only exposed to various forms of abuse but were more likely to experience an event of domestic violence if they lived in the urban areas compared to living in rural areas. This is because, most of the women in urban areas may reside in slums or poor urban areas and/or may have higher wealth index (economic status) which may increase their risk of domestic violence. A previous study in India reported high prevalence of domestic violence among women living in slums [ 22 ]. Also, Counts et al . [ 23 ] reported that in cities where women have a higher economic status, they were seen as having sufficient power to change traditional gender roles; it is at this point that domestic violence is at its highest.

There was a positive association between past exposures to violence in terms of father abusing mother or vice versa and a woman’s current status of ever experiencing domestic violence. Notably, there were differences in family history of domestic violence exposure risk as reported by women in this study compared to that reported by men in North India [ 16 ]. This may be attributed to bias as men who may be the main aggressors [ 1 ] are more likely to under report events that are defined as physical, sexual or emotional violence whereas women are more likely to over report them. This bias may be of interest to other researchers working on domestic violence or any form of violence. History of family violence has been linked to domestic violence in later life and studies have shown that exposure to violence affects children’s aptitude and perpetuates the intergenerational transmission of violence [ 1 , 16 , 24 – 26 ]. Our study does not provide information about the mechanism through which family history of violence exerts their effect on a child in later life, but it seems reasonable to assume that at least part of the effect is through increased or sustained occurrence of such events such that the attitude of accepting violence in marriage becomes a norm.

The likelihood of domestic violence occurrence was common among women who reported that their partner drinks alcohol. This supports evidence from previous studies [ 16 , 19 , 20 , 22 , 27 ] perhaps making alcohol use the most common risk factor of domestic violence against women. Many researchers believe that alcohol operates as a situational factor, increasing the likelihood of violence by reducing inhibitions, clouding judgement and impairing an individual’s ability to interpret cues [ 27 , 28 ].

Regular alcohol consumption by other partner, exposure to harsh physical discipline during childhood and witnessing father beating the mother during childhood have emerged as risk factors of domestic violence, all of which put women at an increased risk of depression, suicide attempts, psychosomatic disorders and physical injury [ 1 , 12 ]. The consequences and costs of domestic violence may have impact at the individual, family, community and national level. Costs due to domestic violence may include healthcare (mental and physical) costs to the survivor and her family, employment and financial difficulties and the effects on children. Children who witness domestic violence are more likely to have emotional and behavioural problems, perform poorly in school and be at risk of perpetrating or experiencing domestic violence in later life [ 17 ]. Violence against women may have undermined efforts to realize the Millennium Development Goals (MDGs) as it hinders poverty reduction efforts and has inter-generational consequences. It also undermines women’s ability to exercise their reproductive rights with grave consequences for maternal and child health.

In keeping with previous findings, partner education particularly higher than secondary education of husband or partner offers a protective effect against domestic violence. This is in agreement with a recent review of data from 17 sub-Saharan countries that reported that intimate partner violence against women was more acceptable amongst the less educated [ 26 ]. The present study revealed that educational level of partners was slightly higher than that of the women. A study in New Zealand demonstrated that low academic achievement was one of the risk factors predicting physical abuse of partners by men [ 29 ]. Interestingly, a study in India reported higher than secondary level of education of both the woman and her partner as a protective buffer, suggesting the importance education could play in reducing violence against women [ 12 , 30 ]. Women and/or partners with higher than secondary education may be less likely to be abused or abuse their partners because they perceive each other as valuable and perhaps more valuable by their extended families [ 30 ]. Although domestic violence reported was quite high, 87 % of the women were currently married, a finding consistent with a study in Tanzania [ 30 ]. According to McCloskey et al. [ 30 ], majority of women in Tanzania with an intimate partner violence history still live with their violent partners although higher wealth index and education may give women more power to leave their abusive partners, emphasising the value women in Africa place on unions.

The cross-sectional nature of the data limits ability to draw casual inferences. Also, all assessments were based on self-reports by respondents, and are likely to be gross underestimates or overestimates which can undermine the true prevalence of domestic violence in Ghana. Despite these limitations, data for this study comes from a large nationally representative survey and variables from individual, relationship, community and societal levels were tested. Also, this study has provided valuable data on risk factors for domestic violence and established domestic violence as one of the major public health problems in Ghana.

Place of residence, alcohol use by husband and family history of violence do increase a woman’s risk of domestic violence. Higher than secondary education acted as a protective buffer against domestic violence. Domestic violence remains unacceptably high in Ghana and should be treated as one of the major public health problems that needs a multi-stakeholder approach based on culturally acceptable and sustainable intervention strategies to deal with it.

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Abbreviations

Declaration on the Elimination of Violence Against Women

Demographic and Health Survey

Domestic Violence Support Unit

Ghana Demographic and Health Survey

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Acknowledgements

We thank ICF Macro (Measure DHS) for granting access to the data used in this study. The findings and conclusions in this report are those of the authors and do not necessarily reflect the official position of ICF macro or the Ghana Statistical Service.

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Ebenezer S. Owusu Adjah

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ESOA and IA were involved in the conception of the study. ESOA carried out data extraction. ESOA and IA did the statistical analysis. ESOA and IA drafted the paper. Both authors read and approved the final manuscript.

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Owusu Adjah, E.S., Agbemafle, I. Determinants of domestic violence against women in Ghana. BMC Public Health 16 , 368 (2016). https://doi.org/10.1186/s12889-016-3041-x

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Women’s approval of domestic physical violence against wives: analysis of the Ghana demographic and health survey

David teye doku, kwaku oppong asante.

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Received 2015 Jul 26; Accepted 2015 Dec 2; Collection date 2015.

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.

Intimate partner violence (IPV) has serious consequences for the physical, psychological, and reproductive and sexual health of women. However, the factors that make women to justify domestic violence against wives in many sub-Saharan African countries have not been explored. This study investigates factors that influence women approval of domestic physical violence among Ghanaian women aged 15–49.

A nationally representative sampled data ( N  = 10,607) collected in the 2003 and 2008 Ghana Demographic and Health Survey were used. Multivariate logistic regression was used to study the associations between women’s economic and socio-demographic characteristics and their approval of domestic physical violence against wives.

Women aged 25–34 and 15–24 were 1.5 and 1.3 times, respectively, more likely to approve domestic physical violence against wives compared to those aged 35 years and above. Furthermore, women with no education (OR = 3.1, CI = 2.4–3.9), primary education (OR = 2.6, CI = 2.1–3.3) and junior secondary education (OR = 1.8, CI = 1.4–2.2) had higher probability of approving domestic physical violence compared to a woman who had secondary education or higher. Compared to women with Christian belief, Moslems (OR = 1.5, CI = 1.3–1.8) and Traditional believer (OR = 1.7, CI = 1.2–2.4) were more likely to approve domestic physical violence of wives. Women who were in the richest, rich and middle wealth index categories were less likely to approve domestic physical violence of wives compared to the poorest.

These findings fill a gap in understanding economic and socio-demographic factors associated with approval of domestic physical violence of wives. Interventions and policies should be geared at contextualizing intimate partner violence in terms of the justification of this behaviour, as this can play an important role in perpetration and victimization.

Keywords: Justification of physical domestic violence, Socio-demographic factors, Women’s health, Intimate partner violence

Intimate partner violence (IPV), defined as actual or threatened physical, sexual, psychological and emotional abuse by current or former partners, is currently a public health concern globally. According to World Health Organization, the global prevalence of physical and/or sexual intimate partner violence women was 30 % [ 1 ] and the prevalence is very high in countries from sub-Saharan Africa and South-East Asia [ 2 ]. Intimate partner violence is known to be associated with both short and long term psychological and mental health problems including depression, anxiety, tendencies towards addiction and suicidal ideation [ 3 – 5 ]. In Ghana, the prevalence of IPV has been reported to be low-fewer than 4 % of women report ever experiencing any victimization [ 6 ]. Reasons attributed to the low reported cases of such violence was that such cases of IPV may be considered less appropriate, not worthy of people’s attention and sometimes dependent on the nature of physical violence their husbands use.

Gender equity is an important step in women empowerment. In many societies, norms and cultural practices justify that men have the right to use force against women [ 7 , 8 ]. These practices have serious consequences for the physical, psychological, and reproductive and sexual health of women [ 9 , 10 ]. Approval of partner violence and its psychosocial effects have been documented [ 11 , 12 ]. Most of these studies showed that the rate of justification and approval of domestic physical violence against wives in many countries are quite high and can vary by the reason for abuse (e.g. infidelity, neglect of child). Furthermore, these studies found that women tended to approve of IPV (including physical violence) at a greater rate than men, and factors reflecting lower socio-economic status is associated with typically higher acceptance of IPV [ 8 ].

One of the reasons for the acceptance of violence against women, especially in sub-Saharan Africa and South-East Asia countries has been attributed to patriarchy [ 13 , 14 ]. Patriarchy reflects social attitudes and norms around the role of women in relation to men as a source of partner violence [ 14 ]. The power of male superiority as reflected in studies showed that large percentages of both men and women believe that male violence against women are acceptable under different circumstances [ 7 , 8 , 15 ]. This ideology thus plays an important role acceptance and or approval of IPV towards women, where the behaviours of women are construed to be the triggers of violence by the partners [ 13 ], and women generally accepts this power exertion on them [ 16 ].

There is evidence of the existence of patriarchy in Ghana [ 17 , 18 ], as men are considered wise, strong and placed in positions of authority compared to women. Male dominance has also resulted in low literacy rate of 63.5 % compared to the male rate of 78.3 % [ 19 ]. A study among university students from Ghana showed that the frequency of use of controlling behaviours and victimization/perpetration amongst men and women (e.g. control the other’s money) were similar, and controlling behaviours were seen to be associated with IPV [ 20 ]. A recent study conducted in Ghana has suggested that women who reported physical, psychological and sexual violence were more likely to have suicidal thoughts, sleep deprivation and fear of partners or husbands [ 21 ].

Within this context, it is further relevant to understand the role of socio-demographics such as age, place of residence, marital status, education, occupational status and wealth in the dynamics of domestic physical violence against wives across the globe [ 7 ]. We focus on Ghana because some previous studies have reported that less than 5 % of all women have reported being abused in one form or another [ 22 ]. Despite this observation, there is a paucity of scholarly research on women’s approval of domestic physical violence against women by their husbands and or partners especially using data at the national level. The aim of this study is to investigate factors that influence women approval of domestic physical violence against women in Ghana using data from the 2003 to 2008 Ghana Demographic and Health Survey.

Theoretical framework

The resource theory and the subculture-of-violence theory were used to explain intimate partner violence (IPV) and its approval [ 23 – 25 ]. Resource theory indicates that the availability of resources to both men and women, determines the nature and magnitude of violence among partners. Some researchers [ 23 , 24 ] have argued that the imbalance in IPV among income groups occurs as a result of the fact that individuals with lower socio-economic status (i.e. income and social status) may have fewer legitimate resources to utilize to attain power. Some proponents of the resource theory have suggested that the availability of resources for women in particular, may to some extent alter the dependency relationship between men and women, and possibly lower men’s dominance over women in the domestic space. Applying the resource theory to women’s approval of domestic physical violence against women, we can argue that women’s financial independence and autonomy provides some form of protection against physical violence. The lack of such resources may not only make women vulnerable to IPV, but also to the approval of such violence act. Thus, lower levels of SES (i.e. income, education and occupation) may predispose women to accepting violence against women.

The subculture-of-violence theory developed by Wolfgang and Ferracuti [ 25 ] posits that the occurrence of violence is not evenly distributed among groups in the social structure; it is concentrated in poor urban areas. According to these theorists, since violence is known to occur frequently among a specific subset of the larger community, it is believed that, there is a value system at work in that subculture that makes violence more likely. According to Wolfgang and Ferracuti [ 25 ], “there is a potent theme of violence present in the cluster of values that make up the life-style, the socialization process, the interpersonal relationships of individuals living in similar conditions”(p. 140). This suggests that individuals found in that sub-culture learn the values and norms of violence through socialization and social control in their environment. In other words, violence is learned socially and passed on by group members, thus sustaining the subculture of violence. In applying the subculture-of-violence theory to this study, we hypothesized that certain subcultures of society, measured by the socio-demographic characteristics relate to justification of intimate partner violence, particularly physical domestic violence against wives.

We utilized a national representative data ( N  = 10,607) from the Ghana Demographic and Health Surveys (GDHS) conducted in 2003 and 2008. The Ghana Demographic Health Survey is a nationwide survey with a representative sample of women and men aged 15–49 and 15–59, respectively. The present study used the women questionnaire in 2003 ( N  = 5691) and 2008 ( N  = 4916). All the surveys used a two stage sample based on the Ghana Population and Housing Census to produce separate estimates for key indicators for each of the ten regions in Ghana. The first stage involved selecting sample points or clusters from an updated master sampling frame constructed from the Ghana Population and Housing Census. The second stage of selection involved systematic sampling of 30 of the households listed in each cluster. This was done to ensure adequate numbers of completed individual interviews to provide estimates for key indicators with acceptable precision and to provide a sample large enough to identify adequate numbers of under-five deaths to provide data on causes of death. The clusters were selected using systematic sampling with probability proportional to size. Each household selected for the GDHS was eligible for interview with the household questionnaire. In half of the households selected for the survey, all eligible women aged 15–49-year-old were interviewed with the women’s questionnaire. In 2008, data was not administered in one cluster due to security concerns. The data collection took place over a three-month period, from early September to late November. The response rates were generally very high for example, 93.8 and 95.8 % in  2003 and 2008, respectively. The main reason for non-response was the failure to find individuals at home despite repeated visits to their household. Ethical approval for the study protocol was given by the Ghana Health Service Ethical Review Committee in Accra, Ghana.

Dependent variable

Respondents were asked whether a husband is justified in beating his wife under a series of circumstances, that is if: wife burns the food; wife argues with him, wife goes out without telling him, wife neglects the children, and wife refuses to have sex with him. The response format to these questions were yes = 1 and no = 0.

Independent variables

A number of independent variables were used based on previous studies [ 1 – 5 , 7 ]. The independent variables used in this study included place of residence (urban and rural) and age categorized as 15–19, 20–24, 25–29, 30–34, 35–39, 40–44 and 45–49 years. To increase enough power for the study age was re-categorized as 15–24, 25–34 and 35–49 years for the logistic regression analysis. The rest of the independent variables were marital status (never married, currently married and formerly married), religion (Christian, Traditional, Moslem and Others) and household wealth, represented by wealth index (in five categories from poorest to richest). The wealth index was constructed using data on a household’s ownership of selected assets, such as televisions and bicycles; materials used for housing construction and types of water access and sanitation facilities. This constructing of wealth index using these items have previously been used in Ghana [ 26 , 27 ]. The index places individual households on a continuous scale of relative wealth. It was then categorized into five (poorest, poorer, middle, richer, and richest). In addition, education (coded as; no education, primary, secondary and higher) was used.

Statistical analysis

First, Pearson Chi-square test was used to examine the relationship between socio-demographic factors and the indices of attitudes towards domestic violence against wives by husband. Next, univariate and multivariate logistic regression analyses were conducted to assess the association between women’s socio-demographic characteristics and attitude towards domestic violence against wives by husbands. The results from the logistic regression analyses are presented as odds ratios (OR) with 95 % confidence intervals (CIs). Statistical significance was defined as a two-tailed p value < 0.05 in all analyses. The SPSS statistical package (version 21) was used to conduct data analyses.

Sociodemographic characteristics of participants

The socio-demographic characteristics of the participants are presented in Table  1 . Approximately 39, 30 and 31 % of the women were in the age groups of 15–24, 25–34 and 35–49 years, respectively. The majority (75.7 %) were working and currently married (62.6 %), and Christians (73.5 %). The results as presented in Table  1 further shows that over half (57.2 %) of the participants lived in the rural areas, and about 22.90 and 21.4 % were found in the wealth index of poorest and richest, respectively. The majority (67.1 %) of the participants had primary or junior secondary school as the highest level of educational qualification.

N  = Number; % = Percentage of N

Socio-demographic factors and attitude towards physical domestic violence of wives

The prevalence of the approving at least one form of domestic violence against wives was 39 %. The relationship between socio-demographic factors and attitudes towards domestic violence are presented in Table  2 . Age, level of educational, marital status, place of residence, religion and wealth index were related to all the indices of attitudes towards domestic physical violence. Occupational status was related to only three indices of domestic physical violence namely going out without telling husband, refusal to have sexual intercourse with husband and burning of food. All the background variables in this study, with the exception of occupational and marital status, were related to women agreeing to at least one measure of attitudes towards domestic violence (Table  2 ).

Attitude towards domestic physical violence by background characteristics among Ghanaian women age 15–49 year old 2003-2008

* p  < 0.05; ** p  < 0.01; *** p  < 0.001

A similar pattern was observed in Model II, albeit with reduced magnitude, women with no education were about 3.1 times (OR = 3.1, CI = 2.4–3.9) more likely to approve physical domestic violence of wives. Women with primary education (OR = 2.6, CI = 2.1–3.3) and junior secondary education (OR = 1.8, CI = 1.4–2.2) were 2.6 times and 1.8 times, respectively, more likely to approve physical domestic violence against wife than women with secondary education or higher. The results in Model I, further suggests that currently married women were 1.3 times (OR = 1.3, CI = 1.2–1.45) more likely to approve physical domestic violence of wives than those who were never married. Rural residency (OR = 1.2, CI = 1.0–1.2) increased the probability of a woman approving physical domestic violence of wife compared to urban residency.

The results from Table  3 further indicate that in Model I as compared to Christian women, Moslem (OR = 2.1, CI = 1.9–2.3), traditional believers (OR = 2.9, CI = 2.2–3.5) and women of other faith (OR = 1.9, CI = 1.5–2.4) were more likely to approve physical domestic violence. In Model II these associations remained although they attenuated slightly, and the relationship between approval of physical violence against wives and other faith lost its statistical significance. Furthermore, the result shows that the richer a woman the less likely that she would approve physical violence against wives. Women who were in the poorer (OR = 3.5, CI = 2.7–4.4), poor (OR = 2.3, CI = 1.8–2.9), middle (OR = 1.9, CI = 1.6–2.4) and rich (OR = 1.6, CI = 1.4–2.0) quintiles on the wealth index were more likely to approve physical domestic violence against wives compared to their counterparts who were in the richest category.

Odds ratios (OR) and their 95 % confidence intervals (CI) for factors associated with approval of domestic violence against wives a

a Computed from the 2003 and 2008 Ghana Demographic and Health Survey

b Model I = Univariate model

c Model II = Multivariate model of all independent variable statistically significant at the bivariate level

This study was conducted to examine socio-demographic trends in women’s approval of domestic physical violence among Ghanaians women using data from 2003 to 2008 Ghana Demographic and Health Survey. This study found that several socio-demographic factors were associated with the likelihood of a woman approving domestic physical violence against wives. Age, level of education, place of residence, religion and wealth index were independently associated with approval of physical violence against wives. The younger a woman, the more likely that she would approve domestic violence against wives. No consistent trend was found between marital status and approval of physical domestic violence against wives. The relationship between level of education and women’s approval of domestic physical violence against wives were mainly negative and significant such that women with lower education had higher chances of approving domestic physical violence against wife compared to those with higher education. Furthermore, women of the Moslem and Traditional beliefs were both more likely to approve physical domestic violence against wife than those with Christian beliefs. The findings also showed that women who were in the richest, rich and middle wealth index categories were less likely to approve physical domestic violence against wife compared to those in the lower wealth category.

In this study, women aged 25–34 and 15–24 had higher probability of approving domestic violence against wives compared to those aged 35 years and above. This therefore suggests that the younger a woman, the likelihood of accepting domestic violence against wives. A woman’s age has been shown to affect the perception and attitudes towards physical domestic violence against wives [ 8 , 28 – 30 ]. There is, however, no consistency in the literature. While some studies have found that age decrease the likelihood of approving physical violence against women [ 8 ] other studies indicated otherwise [ 28 , 29 ]. In some other studies, approving of domestic violence of women is dependent on the type of offence committed. For example, Waltermaurer et al. [ 8 ] found out that Georgian woman less than 25 years of age were more likely to justify physical domestic violence against wives when a woman refuses sex compared to women aged 25–34. The same study further indicated that older women were more likely to justify physical domestic violence against wives around issues of infidelity or going out without permission compared to the middle age group [ 8 ]. A recent study in Ghana indicated that the age difference between younger women and their older male partners can create a “father-daughter” relationship, leading to emotional violence [ 31 ]. In the same vein, this relationship could lead to the acceptance or approval of physical domestic violence against wives as found in this study.

We found that the lower a woman’s education, the more likely that she would accept domestic physical violence against women. We found that women with no education, primary education and junior secondary education had higher probability of approving physical domestic violence against wives compared to a woman who had secondary education or higher. Furthermore, a gradient exist in these relationships, implying that the higher a woman’s education, the lower the likelihood of approving physical domestic violence against wife. Similar findings had been reported in a recent study conducted in Malawi [ 32 ], and an extensive literature review on women’s attitudes towards physical domestic violence against wives in 25 countries in Sub-Saharan African countries [ 33 ]. Similarly, Mann and Takyi [ 15 ] reported that Ghanaian women with no education were more likely to support violent ideologies, suggesting that higher education could lead to the reduction in supporting violent ideologies. Education does not only provide important information for decision making but also encourages empowerment and autonomy. These numerous benefits of education is vital in influencing women’s perception about domestic violence. The inverse relationship between education and acceptance of domestic violence of wives among women could be attributed to the fact that educated women perceive domestic violence as a negative phenomenon which could have physical and psychological harm on the victim [ 15 ], while less educated women are less informed about the consequences of such behaviour.

Consistent with previous studies in Kenya [ 34 ], Uganda [ 35 ] and elsewhere [ 36 ], rural residency was found to increase the likelihood of accepting domestic physical violence. Disparities in women empowerment campaigns, especially to those living in rural setting, as well as the lack of exposure to new forms of interpersonal relationship management including domestic violence could account for the rural–urban differences in justification of domestic physical violence.

Traditional faith practitioners had the likelihood to approve physical domestic violence of wife compared to Christians. Also, Moslems were more likely to approve physical domestic violence against wives compared to Christians. A study conducted among Egyptian, Palestine, Israelis and Tunisian women found that religion (Islamic) was associated with acceptance of violence against wives, as selective excerpts from the Koran are erroneously used to justify it [ 37 ]. Religion which exercises a strong regulatory system may have different shared social values among its members. This could therefore confirm the findings in the present study regarding differences among women in approving domestic physical violence of wives among women by religion. It would be important for religious leaders especially those in Africa to educate their members about the physical and psychological effect of domestic violence against women.

Women who were in the richest, rich and middle wealth index categories were less likely to approve physical domestic violence wives compared to those from lower wealth index. A previous study in Ghana has found a similar result where a significant relationship was found between economic dependency and IPV [ 15 ]. The mechanism underlying the relationship between wealth index and approval of physical domestic violence of wives by women could be explained from the resource theory, along with women financial independence, where there is less today reliance on men for their source of living. This finding suggests that improving the standards of living of women could have an effect on women’s perception of domestic violence against wives.

The findings of this study must be interpreted cautiously in the light of some important limitations. This study is limited by its cross-sectional nature and hence causal inferences cannot be made. Furthermore, the study relied on self-report measures, which could be affected by social desirability bias or memory bias. Future research is also needed to ascertain which social as well as cultural factors are influencing women’s justification of domestic violence again wives. Despite these shortcomings, the study has compelling strengths. First, the large sample size gave the study sufficient power. Additionally, the representativeness of the sampling strategy as well as the nationwide nature of the data boosts the study’s generalizability to other settings.

Conclusions

In summary, age, level of education, place of residence, religion and wealth index were found to be associated with Ghanaian women’s approval of domestic physical violence against women. This study contributes to the scanty literature on the influence of socio-demographic factors in relations to women’s attitude towards domestic violence against women in countries in sub-Saharan Africa and Ghana in particular. Interventions and policies should be geared at contextualising intimate partner violence in terms of the approval of this behaviour, as this can play an important role in perpetration and victimization. These interventions must target women with low educational status and less wealth.

Acknowledgment

The authors would like to thank Measure DHS for access to Ghana Demographic Health Survey’s unrestricted survey data files, which it is authorized to distribute, at no cost, for legitimate academic research.

Competing interests

The authors declare that they have no competing interest.

Authors’ contributions

DTD was involved in the conceptualization of the study, and conducted the statistical analysis. DTD and KOA drafted the manuscript. DTD revised the manuscript for quality, consistency and accuracy. Both authors read and approved the final manuscript.

Contributor Information

David Teye Doku, Email: [email protected].

Kwaku Oppong Asante, Email: [email protected].

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