263725 Predictors of Help-Seeking Behavior Among Women Exposed to Violence in Nigeria: A multilevel analysis to evaluate the impact of individual and contextual factors

Tuesday, October 30, 2012 : 3:10 PM - 3:30 PM

Natalia Linos, MS , Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
Natalie Slopen, MA , Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
Ichiro Kawachi, MD, PhD , Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
Objectives: We examined contextual and individual-level predictors of help-seeking behavior among women exposed to physical and sexual violence in Nigeria. Methods: Using data from the 2008 Demographic and Health Survey, we fit three 3-level random intercepts models to examine contextual factors associated with help-seeking while accounting for individual-level predictors. Results: Of the 5,553 Nigerian women in our sample exposed to physical and sexual violence, 39.7% reported that they sought help to stop the perpetrator from hurting them again. Rates of help-seeking were geographically patterned by state and ranged from 12% to 65%. State-level development, measured by the Human Development Index (HDI), was positively associated with a woman's help-seeking (z-score OR=1.30, 95% CI=1.05,1.61), after adjusting for individual-level characteristics. State-level prevalence of violence was negatively associated with help-seeking (OR=0.98, 95% CI=0.97,0.99). A small number of individual-level variables were significantly associated with victimization, including a woman's marital status, employment status, history witnessing domestic violence, and relationship to perpetrator. Conclusions: Our paper is the first to document area-level determinants of help-seeking behavior among women exposed to violence. Our multi-level analysis goes beyond a victim blaming ideology premised around why some women ‘take control' and seek help and others do not, and simultaneously accounts for some structural factors that may facilitate this decision. We believe the insight provided is relevant for different countries, in both the developed and developing world, and can help guide policies to ensure that the needs of survivors of violence are fully met.

Learning Areas:
Planning of health education strategies, interventions, and programs
Public health or related public policy

Learning Objectives:
1. Describe how help-seeking behaviors in Nigeria are patterned by geographical location. 2. Demonstrate how multilevel methods can contribute to a more comprehensive understanding of why female victims of violence may seek or not seek help to stop further perpetration. 3. Discuss policy implications for violence prevention and support.

Keywords: Women's Health, Violence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting my doctoral dissertation research on this topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.