Intimate partner violence in the contemporary Rwanda: Psychological outcomes and intervention

Abstract

Background: Intimate Partner Violence (IPV) is the worst form of domestic violence that involves physical, sexual, psychological/emotional violence, and controlling behaviors from the intimate partner. Handful research findings have evidenced the negative effect from prolonged exposure to IPV, which include poor physical and mental health for both parents and children. Although interesting research efforts are made to understand the magnitude and long-lasting effect of IPV within heterosexual partners, it is considered that most of those efforts are mainly concentrated on women and in developed countries, and very few are seen in the developing Sub-Saharan Africa countries. This thesis overall objective was to analyze the magnitude of IPV in the contemporary Rwanda and assess its impact on mental health in adults/parents and more especially in children/offspring. Also, the other study aim was to assess the effectiveness of a community-based approach in IPV reduction and outcomes improvement. Methods: A quantitative research design was used for data collection and data analysis. Data analysis included descriptive and correlational statistics. Binary logistic and linear regression was chosen to analyze association and effect between variables. Furthermore, mixed ANOVAs were utilized to evaluate the effect of community-based approach (CBA) over IPV occurrence and mental health outcomes (depression, anxiety, PTSD). Results: Results showed that there was an increase in the prevalence of IPV in the last five years (2015 and 2020), from 40 % (2015) of women reporting current IPV experience to 46% in 2020. Our findings also confirm the association between IPV and poor outcome in physical and mental health.

1 Women victims of IPV report less utilization of antenatal care services, i.e., were less likely to receive more than four ANC visits (O.R = 0.61, CI = 0.417–0.908) and were less likely to attend the first ANC visits within the first 3 months (O.R = 0.656, CI = 0.445–0.967). Results yielded higher prevalence rate of common mental disorders in participants exposed to IPV as compared to non-exposed group, 32.4. % and 11.7% respectively, which is a higher prevalence rate compared to the general population (20.49%). Also, the IPV experience negatively affects the parenting style. A significant positive correlation is established between IPV experience and harsh-negative parenting (r=0. 40, p<0.01), an association that is mediated by the parental psychological distress (B=0.254, Z=5.59, p<0.05). Hence, parental psychopathology and associated negative parenting was found to put at higher risk children who scored high to anxiety, depression, and behavioral problems. Assessing the effectiveness of community-based approach, results yielded a significant effect on IPV experience and mental health outcomes in adults. Conclusion: Results for our research confirm the increase in IPV incidence and its association with poor physical and mental health outcomes. The findings underscored also negative parenting resulting from parental IPV to put at risk offspring who are found to be vulnerable to several mental and behavioral problems. Moreover, our findings highlight the substantial efficacy of CBA for victims in reducing IPV, anxiety, and depression symptoms in Rwanda, a post-genocide country. However, the study didn’t yield significant improvement in PTSD symptoms. Findings could not prove whether PTSD symptoms are outcomes of the IPV exposure or preexisting to the IPV experience. Further studies are recommended to explore the impact of pre-existing mental health difficulties on IPV occurrence and persistence.