Knowledge, Experience and Perception of Gender-Based Violence Health Services: A Mixed Methods Study on Adolescent Girls and Young Women in Tanzania.

Caroline Mtaita,Rose Mpembeni,Maureen Mcgowan,Albrecht Jahn,Elvis Safary,Samuel Likindikoki

doi:10.3390/ijerph18168575

Abstract

Many adolescent girls and young women (AGYW) experience gender-based violence (GBV) in Tanzania and only few seek GBV health services following violence. The objectives of our study are (1) to evaluate knowledge of gender-based violence among AGYW, (2) to explore their perceptions of and experiences with GBV health service quality and (3) to evaluate access to comprehensive GBV services. This study employed an explanatory, sequential mixed methods design in two districts of Dar es Salaam, Tanzania (Kinondoni and Temeke). A quantitative cross-sectional survey among AGYW (n = 403) between 15–24 years old was performed to assess their knowledge of GBV as well as perceptions of and experiences with GBV health services. The quantitative data was complemented by 20 semi-structured in-depth interviews with participants. Out of 403 study participants, more than three quarters (77.9%) had moderate to good knowledge of how GBV is defined and what constitutes gender-based violence. However, few participants (30.7%, n = 124) demonstrated knowledge of GBV health services offered at local health facilities. For example, only 10.7% (n = 43) of participants reported knowledge of forensic evidence collection. Additionally, of 374 participants (93% of total participants) who reported to have received GBV education sessions, only 66% accessed GBV health services (n = 247) and about half of these (52.7%, n = 130) were satisfied with these services. The study indicated that—despite good knowledge about what constituted GBV—knowledge about the roles and availability of GBV health services was limited and utilization of GBV health services remained low. Coordinated actions need to be strengthened to reach AGYW who remain unaware of GBV health services offered at health facilities by improving GBV service quality, bettering interventions aimed at reducing GBV among AGYW in Tanzania, and scaling-up integrated service models, such as GBV one-stop centers.

Highlights

The risk of being subjected to gender-based violence (GBV) is prominent among women and girls, those belonging to ethnic minorities, those of low socioeconomic status and those who are poorly educated resulting in severe social, economic, Int
We present our results according to three topic areas: (1) knowledge of gender-based violence among AGYW, (2) perceptions of and experiences with GBV health services among
Knowledge of GBV among AGYW was similar to findings from another study conducted in three regions of Tanzania (Mbeya, Dar-es-Salaam and Iringa) where participants maintained relatively high awareness (78.4%) of what constitutes GBV and were able to identify a range of violent behaviors including physical aggression, insults, beatings, being threatening with an object and the intended destruction of property [36]

Summary

Introduction

Violence against women is a major impediment to the fulfillment of women’s rights and to the achievement of the sustainable development goals (SDGs) [1]. Organization (WHO) defines violence as the intentional use of physical force or power (threatened or actual) against oneself, another person or a group/community that results in, or has a high likelihood of resulting in injuries, death, psychological harm or deprivation [2,3]. The risk of being subjected to gender-based violence (GBV) is prominent among women and girls, those belonging to ethnic minorities, those of low socioeconomic status and those who are poorly educated resulting in severe social, economic, Int. J.

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