Domestic violence and its determinants among reproductive-age women in Sub-saharan Africa: a multilevel analysis of 2019–2024 demographic and health survey data

Abstract

BACKGROUND: Domestic violence is a global health issue that impacts health policies and initiatives, as well as women's health, reproductive outcomes, and family well-being. It violates human rights, hinders gender equality, and requires a multifaceted approach. Studies in sub-Saharan Africa (SSA) reveal significant disparities across nations. This study utilizes data from the 2019-2024 Demographic and Health Survey (DHS) to determine the prevalence of domestic violence among reproductive-age women in Sub-Saharan African countries and its associated factors. METHODS: A cross-sectional study design was used through multilevel logistic regression analysis. A total of 67,764 women aged 15-49 were included in the study. To ensure representativeness, weighted estimates were applied in the analysis using STATA version 17. Statistically significant variables were identified using adjusted odds ratios (AOR) with a 95% confidence interval (CI). RESULTS: The overall prevalence of domestic violence among reproductive-age women in sub-Saharan African countries was found to be 38.14% (95% CI: 37.78-38.51). The highest and the lowest prevalence of domestic violence were observed in Sierra Leone and Mauritania, 60.72% and 18.70%, respectively. Across regions, the highest prevalence of domestic violence was observed in Central Africa (45.7%), while the lowest prevalence was observed in West Africa (35.34%). Factors associated with domestic violence included justifying wife beating, witnessing mother beaten by father, education status, current working status, smoking tobacco, marital status, being afraid of their partner, and having a partner who exhibited jealousy when the respondent talked with other men. In contrast, age (15-29 years old) is protective against domestic violence. Residence, media exposure, and regions were also community-level factors associated with domestic violence. CONCLUSION: The prevalence of domestic violence among reproductive-age women in sub-Saharan African countries is high. Individual and community-related factors contribute significantly to violence. Strengthening legal protections, economic and social empowerment of women, and implementing community-based education programs for partners are recommended to reduce domestic violence in sub-Saharan African countries.