Gender-based violence during COVID-19 among adolescent girls and young women in Nairobi, Kenya: a mixed-methods prospective study over 18 months

Michele R Decker; Kristin Bevilacqua; Shannon N Wood; Grace Wamue Ngare; Mary Thiongo; Meagan E Byrne; Anaise Williams; Bianca Devoto; Nancy Glass; Lori Heise; Peter Gichangi

doi:10.1136/bmjgh-2021-007807

Gender-based violence during COVID-19 among adolescent girls and young women in Nairobi, Kenya: a mixed-methods prospective study over 18 months

BMJ Glob Health. 2022 Feb;7(2):e007807. doi: 10.1136/bmjgh-2021-007807.

Authors

Michele R Decker^{1

2}, Kristin Bevilacqua³, Shannon N Wood^{3

2}, Grace Wamue Ngare^{4

5}, Mary Thiongo⁶, Meagan E Byrne^{3

2}, Anaise Williams³, Bianca Devoto³, Nancy Glass⁷, Lori Heise³, Peter Gichangi^{6

8}

Affiliations

¹ Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA mdecker@jhu.edu.
² Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins University, Baltimore, Maryland, USA.
³ Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴ Department of Sociology, Gender and Development Studies, Kenyatta University, Nairobi, Kenya.
⁵ Women's Economic Empowerment Hub, Kenyatta University, Nairobi, Kenya.
⁶ International Centre for Reproductive Health Kenya, Nairobi, Kenya.
⁷ Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
⁸ Department of Public Health and Primary Care, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium.

Abstract

Introduction: Adolescent girls and young women (AGYW) disproportionately experience gender-based violence (GBV), which can increase during emergencies like the COVID-19 pandemic.

Methods: A cohort of youth ages 15-24 in Nairobi, Kenya was surveyed at three time points over an 18-month period prior to and during the COVID-19 pandemic: June-August 2019 (prepandemic), August-October 2020 (12-month follow-up) and May 2021 (18-month follow-up). We characterise (1) prevalence, relative timing and help-seeking for leading forms of GBV, (2) GBV trajectories over 18 months and (3) associations of individual, dyad and COVID-related factors on GBV trajectories among AGYW (n=612) in Nairobi, Kenya. Virtual focus group discussions (n=12) and interviews (n=40) contextualise quantitative results.

Results: Intimate partner violence (IPV) prevalence hovered at 17% across time points (ever at pre-pandemic; past 12 months at 12-month follow-up (2020); past 6 months at 18-month follow-up (2021)); non-partner sexual violence (SV) was 3% at 12-month and 18-month follow-up. Overall, 27.6% of AGYW experienced IPV during the pandemic. IPV during the pandemic was associated with work as the primary pre-COVID activity, low social support and partner age difference >4 years. Among AGYW partnered at all three time points, 66.2% stayed IPV-free (no IPV), 9.2% saw IPV resolve by 18-month follow-up, while 11.1% had IPV start and 13.6% experienced intermittent IPV. Help-seeking for IPV and SV in 2020 (11.1% and 4.6%, respectively) increased to 21.7% and 15.1%, respectively, by 2021. Qualitative results speak to impacts of curfews, and pandemic-related financial stress in prompting conflict and threatening traditional gender roles, and underlying conditions that enable IPV.

Conclusion: The persistence of IPV against AGYW in Nairobi prior to and during the COVID-19 pandemic reflects endemic conditions and pandemic-specific stressors. Youth, including unmarried youth, remain a priority population for GBV prevention and survivor-centred response.

Keywords: COVID-19; child health; public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
COVID-19* / epidemiology
Child, Preschool
Female
Gender-Based Violence*
Humans
Kenya / epidemiology
Pandemics
Prospective Studies
SARS-CoV-2
Young Adult

Grants and funding

T32 HD094687/HD/NICHD NIH HHS/United States