Influence of community social norms on spousal violence: A population-based multilevel study of nigerian women

Violence against women (VAW) is a pervasive human rights and public health problem associated with poor physical and mental health. Studies have examined a range of individual-level predictors of VAW, especially in intimate-partner relationships, however less attention has been devoted to understanding contextual predictors and social determinants of VAW. Using data from the 2008 Nigeria Demographic and Health Survey, we examined whether social norms toward spousal violence in Nigeria, at the state level, are associated with a woman's exposure to physical and sexual violence perpetrated by her husband. Specifically, we fit four 3-level random intercepts models to examine contextual factors associated with spousal violence while accounting for individual-level predictors. Our results indicate that of the 18798 ever-married Nigerian women in our sample, 18.7% reported exposure to spousal sexual or physical violence, with prevalence geographically patterned by state and ranging from 3% to 50%. Permissive state-level social norms toward spousal violence were positively associated with a woman's report of physical and sexual violence perpetrated by her husband (odds ratio [OR] = 1.80; 95% confidence interval [CI] = 1.17, 2.77), after adjusting for individual-level characteristics. A further analysis of female survivors of sexual and physical violence in Nigeria, suggests that only one third of survivors sought help to stop the perpetrator from hurting them again, with community-level variables significantly associated with such help-seeking behavior. Our results suggest that efforts to end violence against women and provide support to survivors, should consider broader social and contextual determinants of violence, including social norms.