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Empirical research confirms the economic costs of intimate partner violence (IPV) for women. Yet, scholarship on this topic is lacking in Ghana, where IPV against women is commonplace. We used in-depth interviews with 15 female survivors of IPV in the Eastern Region to examine the economic costs of IPV for women. Findings showed that the economic costs were both direct and indirect. Direct costs included out-of-pocket payments for medical and nonmedical services, while indirect costs included diminished work abilities, increased absenteeism from work, and lowered work productivity. Ghanaian policymakers must enforce and strengthen policies to prevent violence against women., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Economic abuse is a significant gender-based problem in Ghana and sub-Saharan Africa, but few studies explore the consequences of this type of abuse on women's lives and their coping strategies. This study examined the narratives of 16 Ghanaian women in intimate relationships who experienced economic abuse in the Greater Accra, Ashanti, and Upper East regions of Ghana. Results indicate economic abuse negatively affected female survivors' jobs, businesses, and food security and led to physical violence and adverse health implications. Some women coped by relying on external family networks, religion, and theft from husbands, while others trivialized their experiences., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study used qualitative data from 30 women in three of Ghana's 16 administrative regions to explore motivations and barriers to help-seeking among victims of intimate partner violence. Results of the thematic analysis showed low reporting to formal support networks, such as the Domestic Violence and Victim Support Unit or the police, with higher preference for informal sources, such as family members and friends. Motivations to seek help included fatigue, severity of abuse, abusive partner's negligence in honoring marital obligations, and trust in family members. Barriers to help-seeking included: fear of divorce, stigmatization, lack of trust in formal support channels, sociocultural norms emphasizing gender role expectations, and family privacy., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Intimate partner violence (IPV) is known to have negative health consequences for victims. For women living with HIV/AIDS, whose health may be compromised, exposure to IPV can be devastating. Yet few (if any) studies have explored the health implications of exposure to IPV among HIV-positive women. We begin to fill this gap by examining the effects of various dimensions of IPV (physical, sexual, psychological/emotional, and economic) on the cardiovascular, psychosocial, and sexual reproductive health outcomes of HIV-positive women in Ghana. Data were collected from a cross-section of 538 HIV-positive women aged 18 years and older in the Lower Manya Krobo District in the Eastern Region. We used logit models to explore relationships between IPV and health. The findings indicate high prevalence of IPV in our sample: physical violence (61%), sexual violence (50.9%), emotional/psychological violence (79.6%), and economic violence (66.8%). Generally, participants with experiences of IPV reported cardiovascular health problems, unwanted pregnancies and pregnancy loss, and poor psychosocial health. Our findings suggest the importance of screening for IPV as part of HIV care in Ghana.

While sexual violence against women has gained attention in sub-Saharan Africa, research examining help-seeking remains limited. Scholarship on barriers to help-seeking among sexually abused married or cohabiting women is particularly lacking. We used the barriers model and held 15 in-depth interviews with sexually abused Ghanaian married or cohabiting women to examine help-seeking behaviors. Participants identified multiple barriers to help-seeking, including financial difficulties, lack of social support, and stigma. The results corroborate the barriers model's formulation of the challenges faced by female survivors in reporting violence. They indicate the need to improve laws to promote help-seeking among women with experiences of sexual violence.

Objectives: To systematically analyze and summarize the literature on intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa (SSA) and to identify their risk factors for IPV., Method: A comprehensive review of the literature using the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) yielded 1,879 articles (PubMed = 1,251, Embase = 491, Web of Science = 132, and identified additional records = 5). Twenty were selected for quantitative and qualitative assessment and synthesis. We employed a random effects model with generic inverse variance method and estimated the odds ratios., Findings: Results indicated a high prevalence of physical, sexual, and emotional violence against women living with HIV/AIDS in SSA. Educational background, alcohol use, marital status, previous experiences with IPV, and employment status were identified as significant risk factors. We also assessed the methodological quality of the articles by examining publication bias and some heterogeneity statistics., Conclusion: There is limited research on IPV against HIV-positive women in SSA. However, the few existing studies agree on the importance of targeting HIV-positive women with specific interventions given their vulnerability to IPV and to address factors exacerbating these risks and vulnerabilities.

Extant research, mostly in western countries, confirms the consequences of sexual violence against women, but academic scholarship on this topic remains scant for Ghana. This study built on existing research by exploring the consequences of sexual violence against married women in the Eastern Region of Ghana. Data were obtained from in-depth interviews purposely conducted with 15 survivors of sexual violence. The thematic analysis showed that sexual violence was accompanied by physical and emotional abuse. Following sexual violence and abuse, these women experienced physical injuries, psychological problems, sexual and reproductive health problems, and suicidal ideations. These health difficulties significantly undermined their economic activities and depleted their income. Sexual violence clearly affects women's empowerment; campaigns against gender-based violence should make sexual violence a top priority in Ghana and elsewhere.

Some evidence suggests that in sub-Saharan Africa, sexual violence is commonplace among married women, yet this problem is underresearched. Using qualitative methods and applying Heise's social-ecological model, this study examined the experiences of 15 Ghanaian women suffering sexual violence in their marriages. Results from the thematic analysis indicate several determinants of sexual violence. Whereas some participants identified macro-level and exosystem factors, including poverty, others pointed to micro-level and ontogenic factors, such as husbands' substance abuse. The results corroborate the core idea of Heise's framework, namely, that structural- and individual-level factors make women vulnerable to violence. The study concludes that Ghanaian legal and policy frameworks must be enforced and strengthened to address the etiology of sexual violence and abuse.

This article presents qualitative findings on women's knowledge and perceptions of services available to victims of domestic violence in Ghana. In addition, the challenges to access of service and service delivery are explored. Semistructured interviews were conducted with 10 female residents of Sowutuom, a periurban community in Accra, Ghana. An additional three semistructured interviews were also conducted with local service providers in Accra. Results showed that awareness among respondents of available services was low. The majority of women had heard of the Domestic Violence and Victim Support Unit of the Ghana Police Service, though they had limited knowledge of the kind of support provided by this service provider. In addition, most women expressed doubt in the ability of these services to adequately handle cases of intimate partner violence. This study demonstrates that more educational campaigns need to be carried out to raise awareness among Ghanaians on domestic violence and the formal interventions available in the country.

Few studies have examined the relationships between intimate partner violence (IPV) and the sexual and reproductive health outcomes of women in sub-Saharan countries in general and Ghana specifically. This study began to fill the gap by investigating whether individual- and community-level IPV influenced unwanted pregnancy and pregnancy loss among women in Ghana. Nationally representative cross-sectional data were collected from 2,289 ever-married women, and multilevel modeling was used to estimate individual- and community-level effects. At the individual level, IPV was significantly associated with unwanted pregnancy and pregnancy loss. Women with experience of both physical and sexual violence were more likely to have reported an unwanted pregnancy and a pregnancy loss. However, only those experiencing sexual violence reported unwanted pregnancies. Similarly, community-level IPV was associated with sexual health outcomes. Respondents in communities with higher levels of sexual violence were significantly more likely to have had unwanted pregnancies. The findings corroborate calls for policy makers to consider IPV a reproductive health issue. They also emphasize the need to move beyond individual-level interventions to consider structural and community contexts when addressing the sexual and reproductive health outcomes of women in Ghana.

Although academically underexplored, economic abuse is common in most societies. Using data collected from 2,289 ever-married Ghanaian women, this study employed regression techniques to examine dimensions of economic abuse (employment sabotage, economic exploitation, and economic deprivation) on the cardiovascular, psychosocial, and overall general health of respondents. Results showed respondents with experiences of economic sabotage had poor psychosocial health. Meanwhile, compared with those with no such experiences, respondents with experiences of economic exploitation not only reported poor psychosocial health but were also more likely to live with cardiovascular diseases. Women with experiences of economic deprivation reported poor psychosocial health, were more likely to live with cardiovascular diseases, and more likely to report poor or good than very good health. Our findings suggest the need to screen for economic abuse as a correlate of poor health among women in Ghana.

The relationship between housing and HIV infection is complex. On one hand, poor housing arrangements may affect the health of persons living with HIV/AIDS (PLWHAs). On the other hand, PLWHAs may be more likely to live in substandard homes because of their health. We used qualitative in-depth individual interviews of 38 PLWHAs attending voluntary counseling services at two government hospitals in the Lower Manya Krobo District (LMKD) in the Eastern region of Ghana to examine their housing and health outcomes. Results show that the majority of PLWHAs lived in homes that lacked basic amenities, were overcrowded, had structural deficiencies, and were noisy and dirty. They suffered from poor housing conditions mainly because of their HIV serostatus, as this affected their ability to finance adequate homes, while HIV-related stigmatization led to eviction from either family homes or rented facilities.

In African societies, kinship ties determine how women are socialized, their access to power and wealth, as well as custody of children, often considered important factors in married women's experience of intimate partner violence (IPV). Yet studies that examine how kinship norms influence IPV are scant. Using in-depth interviews collected from women identifying with both matrilineal and patrilineal descent systems, we explored differences in Ghanaian women's experiences of IPV in both kin groups. Results show that while IPV occurs across matrilineal and patrilineal societies, all women in patrilineal societies narrated continuous pattern of emotional, physical, and sexual assault, and their retaliation to any type of violence almost always culminated in more experience of violent attacks and abandonment. In matrilineal societies, however, more than half of the women recounted frequent experiences of emotional violence, and physical violence occurred as isolated events resulting from common couple disagreements. Sexual violence against matrilineal women occurred as consented but unwanted sexual acts, but patrilineal women narrated experiencing violent emotional and physical attack with aggressive unconsented sexual intercourse. Contextualizing these findings within existing literature on IPV against women suggests that policies aimed at addressing widespread IPV in Ghanaian communities should appreciate the dynamics of kinship norms.

There is evidence that between half and two thirds of Nigerian women have experienced domestic violence, and that this is higher in some ethnic groups than others. Yet, studies that examine the ethnic dimensions of domestic and marital violence are conspicuously missing in the literature. We fill this void using data from the Nigeria Demographic and Health Survey. Results indicate significant ethnic differences with Igbo women more likely to have experienced sexual and emotional violence compared with Yoruba women. Hausa women were however significantly less likely to experience physical and sexual violence but not emotional violence, compared with Yoruba women. Women with domineering husbands were significantly more likely to experience physical, sexual, and emotional violence. Similarly, those who thought wife-beating was justified were more likely to experience all three types of violence. The independent effects of ethnicity on domestic violence suggests that specific interventions may be needed for women belonging to different ethnic groups if the problem of domestic violence is to be dealt with effectively in Nigeria.

The theory of social gradient in health posits that individuals with lower socioeconomic status (SES) have poorer health outcomes, compared with those in higher socioeconomic brackets. Applied to noncommunicable diseases (NCDs), this theory has largely been corroborated by studies from the West. However, evidence from sub-Saharan Africa are mixed, with those from Ghana conspicuously missing in the literature. Using data from the Study on Global Ageing and Adult Health, and applying random-effects C log-log models, this study examined the relationship between SES and the risks of living with NCDs in Ghana. Results confirmed a negative social gradient, as Ghanaians with higher SES were more likely to live with NCDs compared with those with low SES. The addition of lifestyle factors attenuated the risks of living with NCDs among Ghanaian men and women with higher SES. This study underscores the need for policies targeted at specific socioeconomic and demographic groups, such as the emerging middle and upper class Ghanaians. It is similarly important for interventions to move beyond biomedical solutions that put more emphasis on epidemiological risk factors to strategies that embrace psychosocial factors as important correlates of cardiovascular health., (© 2015 Society for Public Health Education.)