Determinants of physical intimate partner violence among refugee women in Uganda’s Bidibidi Refugee Settlement: a mixed-methods study

Abstract

Physical intimate partner violence (IPV) remains a major public health concern among refugee women living in humanitarian settings characterised by displacement, poverty, and weakened protection systems. This study examined the extent and determinants of reported physical IPV among married and cohabiting refugee women in Bidibidi Refugee Settlement, Uganda. A cross-sectional mixed-methods study was conducted among 382 refugee women selected through stratified random sampling. Quantitative data were collected using interviewer-administered questionnaires adapted from the World Health Organization Violence Against Women instrument and analysed using logistic regression. Composite index variables underwent reliability assessment before inferential analysis. Qualitative data from nine key informants were analysed thematically to contextualise the quantitative findings. The findings indicate a high prevalence of physical intimate partner violence (IPV), with 67.3% reporting high levels of physical IPV in the past 12 months. At the bivariate level, family structure was associated with physical IPV, with women in polygamous unions reporting higher levels of physical IPV, alongside education level, controlling partner attitudes, and partner substance abuse. However, in the multivariable analysis, only education level, controlling partner attitudes, and partner substance abuse remained significant independent correlates of physical IPV. Women with secondary education and above were less likely to experience physical IPV (AOR = 0.52, 95% CI: 0.29–0.91), while those reporting high controlling partner attitudes had higher odds of experiencing physical IPV (AOR = 2.57, 95% CI: 1.55–4.26). Partner substance abuse was the strongest correlate of physical IPV (AOR = 3.42, 95% CI: 2.08–5.62). Qualitative findings further identified economic stress, coercive control, alcohol and drug use, and shifting gender norms as key contextual drivers of IPV within refugee households. The study found a high prevalence of physical intimate partner violence among refugee women in Bidibidi Settlement. Education was protective, while controlling partner attitudes and partner substance abuse were the strongest correlates of physical IPV. Overall, physical IPV is mainly driven by unequal power relations and harmful partner behaviours, highlighting the need for integrated prevention interventions.