Sexual violence and associated factors among housemaid´s living in Debre Tabor town, Northwest Ethiopia

¹Department of Nursing, Debre Tabor Health Science College, Debre Tabor, Ethiopia, ²Department of Reproductive and Child Health, College of Medicine and Health Sciences, University of Gondar, Gondor, Ethiopia, ³Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

^&Corresponding author
Kefyalew Amogne Azanaw, Department of Nursing, Debre Tabor Health Science College, Debre Tabor, Ethiopia

Introduction    

Sexual violence can be defined as “any sexual act, attempt to obtain a sexual act, or other act directed against a person´s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work. Sexual violence can include the following threat of rape attempted rape, rape, sexual harassment and sexual contact with force [1]. Violence against women is a public health problem as well as a basic violation of women´s human rights [2]. The impact of violence is beyond physical injuries it also accounts for disability, depression, physical and reproductive problems, and risky sexual behavior [3]. Gender-based violence is insidious human right issue of public consequence [4]. The prevalence of gender-based violence is difficult to collect data because of estimates fluctuate depending on how the researcher define violence [1]. In the world 10, up to 50% of women suffered from sexual violence by their intimate partners [5]. In sub-Saharan Africa, the experience of women with physical and/or sexual violence by their intimate partner ranges from 27-59% [4]. In Ethiopia, 59% of women were exposed to sexual violence [5].

Generally, in the countries where the statuses of women are low, younger women are more likely to suffer from domestic violence. Ethiopia has one of the highest prevalence of both physical and sexual violence by their intimate partner [6]. Most studies conducted on violence against women agreed that lower educational status, abuse of alcohol, khat, smoke and younger women are more likely increase the experience of violence against women [7-9]. Gender-based violence affected a significant segment of populations on girls and women across all groups and classes [10]. At worldwide within its informal nature of domestic worker still challenge to regulation and policy implementation lead to limited opportunities of access to social and legal protection [11]. Universally, all types of violence overlap in a relationship and a significant public health problem worldwide but the level and pattern of violence greatly vary between setting, culture, and segment of the population [12]. Even though there are many studies conducted on violence in the globe and also in our country Ethiopia in all segments of girls and/or women, there is a lack of information about the magnitude and associated factors of sexual violence against housemaids. Therefore, this study amide to assess the magnitude of sexual violence and also tried to identify factors associated with sexual violence among housemaid. So, this research finding hopes to alleviate scarce of information on housemaids sexual violence in Debre Tabor town northwest Ethiopia.

Methods     

Study design and period: a community-based cross-sectional study was conducted in Debre Tabor town from 1^st -30^th April 2018. The study was conducted in Debre Tabor town northwest Ethiopia. Debre Tabor is the capital town of South Gondar zone which is located 666 km far from Addis Ababa the capital city of Ethiopia to northwest Ethiopia. As the data obtained from South Gondar zone city administration the town had 92,530 populations (2010 EPY). From this population 44,305 were males and 48,225 were females. The town is divided into 4 kebeles and it had 28,040 households. All housemaids aged 15 years and above who were living in Debre Tabor town considered as the source population. Housemaids who critically ill and those who physiologically unable to communicate at the time of data collection were excluded.

Sample size and sampling procedure: a sample of 541 study participants was determined using single population proportion formula taking 28.6% prevalence of sexual violence against housemaids [13], considering 95% CI, 5% margin of error, 1.5 design effect and 15% non-respondent rate. Finally, 636 participants were included in the study. Cluster sampling was used to select study participants. In the study area, there are four Kebeles; from those kebeles 50% of ketenas were selected by using simple random sampling, and the sample size was proportionally allocated for each kebele and study participants in the households were selected from all selected ketenas.

Data collection procedures: a structured, pre-tested interviewer administered questionnaire adapted from a WHO multi-country study was used. The questionnaire was translated into the local language Amharic and pretested was administered on 5% of the sample at Woreta town. The data was collected by eight health extension workers and supervised by four master public health professionals. Both the data collectors and supervisors were trained for 3 days on how to approach study subjects and collect data. The supervisors and the principal investigator closely followed the daily completeness and appropriateness of the data collection. Data was reviewed and checked for its completeness before entering for analysis. Sexual violence was taken as the dependent variable while employers´ characteristics (age, educational status, marital status, religion and occupation, khat chewing, smoking and drinking alcohols) and housemaids´ characteristics (age, previous resident, marital status, educational status, religion, family live situation and salary) were considered as independent variables. Housemaid violence was measured as if a housemaid experience any acts physically forced to have sexual intercourse when she did not want to and/or because she was afraid of what partner might do and/or had unwanted sex position and/or had unwanted warm up for sex was considered as "yes" otherwise "no" [5].

Data processing and analysis: the data was entered into Epi- info version 7.2.2.6 and exported into and analyzed with SPSS version 20.0. It was also cleaned, coded, and analyzed with SPSS. Descriptive analysis was done to describe the different characteristics of the employers and housemaids. Binary logistic regression analysis was done to identify the association between independent and dependent variables. To identify factors significantly associated with the outcome variable adjusted odds ratio (AOR) with 95% confidence interval (CI) was used. Variable having a p-value less than 0.05 was considered as significant predictors. Hosmer and Lemeshow goodness of fit test was used to check the model fitness and that it has a P-value of 0.15. Multicollinearity is also made to check the multicollinearity among independent variables.

Ethical approval and consent to participate: ethical approval was obtained from the University of Gondar, institute of public health ethical review committee. An Official letter was obtained from Debre Tabor town administration, mayor office. From each participant, whose age 18 years and above verbal informed consent was obtained. For participants who less than 17 years of age verbal assent were obtained from their employers after clearly describing the purpose, benefit, and risk of the study and their right on the decision to participate in the study. Their name was omitted for assurance of confidentiality and privacy. The interview was performed at suitable and secure place to respondents. Finally, the questionnaire was cleaned, stored, and analyzed at a secure place.

Results     

Socio-demographic characteristics of housemaids: six hundred thirty six of study participants were participated in the study with 100% response rate. Among the participants, 386 (60.7%) were in the age group of 15-19 years, with the mean age of 19.76 (±4.63 SD) years. About 319 (50.2%) of study participants had no formal education. Of the study participants, 525 (82.5%) previously resided in the rural area. About 593 (93.2%) of housemaids were orthodox Christian. Of all participants 570 (89.6%) housemaids were single. Regarding housemaid´s family situation, about 255 (40.1%) of them had both father and mother. Of those, both father and mother alive 177 (69.4%) of their family were live together. From all study participants, 302 (47.5%) were paid from 301-500 ETB. Concerning work experience 448 (70.4%) of housemaid had 1-4 years of work experience. At about the age of being housemaids, 414 (65.1%) were starting work at the age of 15 years and above (Table 1).

Socio-demographic characteristics of employers: about 405 (70.6%) of the female employer were in the age group of 30-49 years with the mean age of 33.64 years (±13.85 SD). Regarding male employers age 432 (67.9%) were in the age group of 30-49 years, their mean age was 43.37 years (±10.67 SD). The majority, 495 (86.2%), of female employers, and 552 (86.8%) of male employers were orthodox Christians. About the educational status of employers, almost half 295 (51.4%) of female employers and three-fourth 467 (73.4%) of male employers had a certificate and above. The majority, 536 (84.3%), of employers were married. About 451 (70.9%) of employers had 0-3 number of children. Regarding the family size, 412 (64.8%) of employers had 4-6 family size. Five hundred four (79.2%) of employers had no extended family and only 28 (4.4%) of employers had another housemaid. Regarding occupational status, 269 (46.9%) of female employers and 387 (60.7%) of male employers were government employees (Table 2).

Behavioral characteristics of employers: from all participant´s employers 30 (4.7%) of employer had smoking cigarette and 70 (11%) of employers had chewing khat. Ninety (15.7%) of female employers and 158 (24.8%) of male employers had consumed alcohol (Table 3).

Prevalence of housemaid sexual violence: from all study participants, 177 (27.8%) (95% CI: 24.2%-31.4%) have been experienced at least one type of sexual violence in their life time and 69 (10.8%) (95%CI: 8%-13.2%) experienced in the past 12 months.

Factors associated with housemaid sexual violence: in bi-variable logistic regression analysis educational status, previous resident, family live situation, employer alcohol consumption, marital status of housemaid, marital status of employers, age of female employer and extended family living with employers were significantly associated with housemaid sexual violence. In the final model, educational status, previous resident, family live situation, age of female employer, extended family living with employers and male employer alcohol consumption were remaining significantly associated with lifetime housemaid sexual violence at a 5% level of significance. The result of the study revealed that housemaids who had no formal education were 2 times (AOR=2.06 95%CI: 1.13, 3.76) more likely to experience sexual violence as compared to those who had secondary education and above

About residents of housemaids, housemaids who previously lived in rural areas were 3 times (AOR=2.73, 95% CI: 1.31, 5.69) more likely to experience sexual violence than those who resided in urban. Housemaid whose both parents dead were 3 times (AOR=2.6, 95% CI: 1.47, 4.61), more likely to experienced sexual violence as compared to those who had both father and mother alive. Housemaids whose employer has extended family living with them were 3 times (AOR=2.9, 95%CI: 1.77, 4.75) more likely experienced sexual violence. Participants whose female employer age ≥50 years old were 4 times (AOR=4.29, 95%CI: 1.95, 9.48) more likely experienced than those ≤29 years old. Concerning alcohol consumption, housemaid whose male employer drank alcohol were 3 times (AOR=2.56, 95% CI: 1.61, 4.1) more likely to experience sexual violence as compared to those who not drank alcohol (Table 4).

Discussion     

This study tried to find the prevalence and factors associated with housemaid sexual violence in Debre Tabor town. The prevalence of sexual violence during their life time was (27.8%) (95% CI=24.2, 31.4) which is in line with the finding from Addis Ababa, Ethiopia (28.6%), Bair Dar, northwest Ethiopia (24.3%) and Nekemte town, western Ethiopia (26.1%) [13-15]. The finding was higher as compared to a study conducted in eastern Sudan [16]. This discrepancy could partly be due to socio-demographic differences, the other study conducted on government employees. Women who had better employment status could have access of information about violence and they can easily protect themselves and lower than the finding from Tanzania (35%) [17]. This could be due to different socio-demographic characteristics of the respondents, former study participated all women aged 10-30 years but this finding restricted on housemaids. Housemaids who have no formal education were 2 times more likely to experience sexual violence. A comparable finding was obtained from a study conducted in Eastern Sudan, showed that women less than secondary education were more likely to experience domestic violence [16]. It consistent from a study done in Shimelba refugee camp, northern Ethiopia, showed women who had primary and secondary education were 78% less likely to experience physical violence [8]. This study also in line with a study conducted in Eastern India showed women who had low educational status were to increase the experience of domestic violence [18]. This is because the low educational status of women had no power to protect the violence.

The housemaid who resided in rural areas was 3 times more likely to experience sexual violence as compared to who resided urban area. This finding was consistent with a study conducted in Gondar town northwest Ethiopia, which showed that rural residency was 5 times more likely to experience domestic violence [19]. This result was also similar to the finding of a study conducted from Eastern India showed that women who resided in the rural area increased the experience of domestic violence [18] and a study conducted around Gondar northwest Ethiopia showed that rap is 2 times more likely occur in rural women [20]. Housemaids who came from rural had no information about violence and they couldn´t complain to legal bodies. But this finding contradicted a study from Ghana, showed that women who resided in urban areas were 35% more likely to increase the risk of domestic violence [21] this could be due to socio-demographic and socio-cultural difference of the study participants. The housemaids who had no both parents were 3 times more likely to experience lifetime sexual violence when compared to those who had both father and mother alive respondents. Family support could increase the confidence of housemaid this helps to protect them from any violence.

Participants whose employer had extended family living with them were 3 times more likely to experience sexual violence. An extended family could increase the exposure of sexual violence due to crowded family size and poor follow-up. Housemaids whose female employer aged ≥50 years old were 4 times more likely exposed to sexual violence when compared to female employer aged ≤29 years old. This is because the increasing age of the wife could decrease the sexual interest of the husband with hers and shifting sexual relation to the housemaid. Participants whose male employer drank alcohol were 3 times more likely to experience lifetime housemaid sexual violence when compared to participants whose employer did not take alcohol. This finding consistent with a study conducted in Mekele town, northern Ethiopia and Addis Ababa showed that housemaid whose employers drink alcohol were more likely to experience housemaid violence than those whose employer did not drink alcohol [9,13]. This result is also similar to a study conducted in Debre Tabor town northwest Ethiopia showed women whose husbands take excess alcohol were 3.5 times more likely experienced with gender based violence than compared to whose husband not take alcohol [22]. This is because alcohol has a depressive mental impairment and which encourages human beings to undertake violence against their housemaids.

Limitation of the study: the limitation of this study was the data collectors interviewed the only housemaid as proxy respondents for their employer that depend on housemaid report only, this lead to bias when they come to reporting employer characteristics. And have been encountered with social desirability bias due to the sensitivity of the information and also exposed to recall bias due to the nature of the cross-sectional design.

Conclusion     

In this study, a high prevalence of housemaid sexual violence has been reported. Being a rural resident, no formal education, both parent dead, extended family living with employers, age of female employer and alcohol consumption of male employers were important predictors of housemaid sexual violence. Local government officials like the labor and social affair office and the women and children office need to provide special support and protection to the housemaids. Labor and social affair office need to interfere with the contract of housemaid and employers with regular follow-up. Women and children's affair office need to expand information education communication and behavioral change on housemaid to empower and report violence as a crime and also need to improve community awareness about housemaid violence. Finally, further research needs to address the economical violence of housemaid is very important.

Competing interests     

The authors declare no competing interests.

Authors' contributions     

KAA designed the study, developed the proposal, participated in the data collection, performed analysis and interpretation of data and drafted the paper. AAG and AML assisted in the design of the study, proposal writing, data analysis, and interpretation of the study. KAA carried out the manuscript preparation. All authors reviewed and approved the final manuscript.

Acknowledgments     

We are highly grateful to thank the study participants, data collectors and supervisors.

Tables     

Table 1: socio-demographic characteristics of the housemaid, Debre Tabor town, 2018

Table 2: socio-demographic characteristics of employers, Debre Tabor town, 2018

Table 3: the behavior of employer, Debre Tabor town, 2018

Table 4: binary logistic regression analysis of factors associated with a lifetime experience of at least one type of housemaid violence, Debre Tabor town, northwest Ethiopia, 2018

References