Drought and intimate partner violence towards women in 19 countries in sub-Saharan Africa during 2011-2018: A population-based study

Abstract

Background

Drought has many known deleterious impacts on human health, but little is known about the relationship between drought and intimate partner violence (IPV). We aimed to evaluate this relationship and to assess effect heterogeneity between population subgroups among women in 19 sub-Saharan African countries.

Methods and findings

We used data from 19 Demographic and Health Surveys from 2011 to 2018 including 83,990 partnered women aged 15–49 years. Deviations in rainfall in the year before the survey date were measured relative to the 29 previous years using Climate Hazards Group InfraRed Precipitation with Station data, with recent drought classified as ordinal categorical variable (severe: ≤10th percentile; mild/moderate: >10th percentile to ≤30th percentile; none: >30th percentile). We considered 4 IPV-related outcomes: reporting a controlling partner (a risk factor for IPV) and experiencing emotional violence, physical violence, or sexual violence in the 12 months prior to survey. Logistic regression was used to estimate marginal risk differences (RDs). We evaluated the presence of effect heterogeneity by age group and employment status. Of the 83,990 women included in the analytic sample, 10.7% (9,019) experienced severe drought and 23.4% (19,639) experienced mild/moderate drought in the year prior to the survey, with substantial heterogeneity across countries. The mean age of respondents was 30.8 years (standard deviation 8.2). The majority of women lived in rural areas (66.3%) and were married (73.3%), while less than half (42.6%) were literate. Women living in severe drought had higher risk of reporting a controlling partner (marginal RD in percentage points = 3.0, 95% CI 1.3, 4.6; p < 0.001), experiencing physical violence (marginal RD = 0.8, 95% CI 0.1, 1.5; p = 0.019), and experiencing sexual violence (marginal RD = 1.2, 95% CI 0.4, 2.0; p = 0.001) compared with women not experiencing drought. Women living in mild/moderate drought had higher risk of reporting physical (marginal RD = 0.7, 95% CI 0.2, 1.1; p = 0.003) and sexual violence (marginal RD = 0.7, 95% CI 0.3, 1.2; p = 0.001) compared with those not living in drought. We did not find evidence for an association between drought and emotional violence. In analyses stratified by country, we found 3 settings where drought was protective for at least 1 measure of IPV: Namibia, Tanzania, and Uganda. We found evidence for effect heterogeneity (additive interaction) for the association between drought and younger age and between drought and employment status, with stronger associations between drought and IPV among adolescent girls and unemployed women. This study is limited by its lack of measured hypothesized mediating variables linking drought and IPV, prohibiting a formal mediation analysis. Additional limitations include the potential for bias due to residual confounding and potential non-differential misclassification of the outcome measures leading to an attenuation of observed associations.

Conclusions

Our findings indicate that drought was associated with measures of IPV towards women, with larger positive associations among adolescent girls and unemployed women. There was heterogeneity in these associations across countries. Weather shocks may exacerbate vulnerabilities among women in sub-Saharan Africa. Future work should further evaluate potential mechanisms driving these relationships.

Abstract

Adrienne Epstein and colleagues study associations between drought and intimate partner violence in sub-Saharan Africa.

Author summary

Why was this study done?

• Extreme weather events (including droughts) are associated with many poor health consequences, yet the link between drought and intimate partner violence has not been studied.

• Previous work has shown that drought is a predictor of many risk factors for intimate partner violence towards women, including food insecurity, migration, and poverty.

What did the researchers do and find?

• We combined survey data from 19 countries in sub-Saharan Africa with publicly available historical rainfall data to estimate exposure to drought among 83,990 married or partnered women aged 15–49 years, and estimated the association between drought and 4 outcomes related to intimate partner violence.

• Drought was associated with reporting a controlling partner and experiencing physical and sexual violence, with stronger associations among adolescent girls and unemployed women. Drought was not associated with reported emotional violence.

• There was heterogeneity in findings across countries; drought was protective for at least 1 type of violence in Uganda, Namibia, and Tanzania.

What do these findings mean?

• Intimate partner violence towards women is yet another potential downstream consequence of the growing intensity and duration of droughts across sub-Saharan Africa.

• Future work should evaluate the pathways linking drought and intimate partner violence in order to best tailor interventions aimed at mitigating drought’s impacts.