War-related sexual and gender-based violence in Tigray, Northern Ethiopia: a community-based study

Girmatsion Fisseha; Tesfay Gebregzabher Gebrehiwot; Mengistu Welday Gebremichael; Shishay Wahdey; Gebrekiros Gebremichael Meles; Kebede Embaye Gezae; Awol Yemane Legesse; Akeza Awealom Asgedom; Mache Tsadik; Abraha Woldemichael; Aregawi Gebreyesus; Haftom Temesgen Abebe; Yibrah Alemayehu Haile; Selome Gezahegn; Maru Aregawi; Kiros T Berhane; Hagos Godefay; Afework Mulugeta

doi:10.1136/bmjgh-2022-010270

War-related sexual and gender-based violence in Tigray, Northern Ethiopia: a community-based study

BMJ Glob Health. 2023 Jul;8(7):e010270. doi: 10.1136/bmjgh-2022-010270.

Authors

Girmatsion Fisseha¹, Tesfay Gebregzabher Gebrehiwot², Mengistu Welday Gebremichael³, Shishay Wahdey¹, Gebrekiros Gebremichael Meles¹, Kebede Embaye Gezae¹, Awol Yemane Legesse⁴, Akeza Awealom Asgedom¹, Mache Tsadik¹, Abraha Woldemichael¹, Aregawi Gebreyesus¹, Haftom Temesgen Abebe¹, Yibrah Alemayehu Haile⁵, Selome Gezahegn^{6

7}, Maru Aregawi⁸, Kiros T Berhane⁹, Hagos Godefay⁵, Afework Mulugeta¹

Affiliations

¹ School of Public Health, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia.
² Epidemiology, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia.
³ Department of Midwifery, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia.
⁴ School of Medicine, Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia.
⁵ Tigray Health Bureau, Mekelle, Tigray, Ethiopia.
⁶ Hennepin Healthcare, Minneapolis, Minnesota, USA.
⁷ University of Minnesota Medical School, Minneapolis, Minnesota, USA.
⁸ Global Malaria Program, World Health Organization, Geneve, Switzerland.
⁹ Biostatistics, Columbia University, New York, New York, USA kiros.berhane@columbia.edu.

Abstract

Introduction: Sexual and gender-based violence (SGBV) during armed conflicts has serious ramifications with women and girls disproportionally affected. The impact of the conflict that erupted in November 2020 in Tigray on SGBV is not well documented. This study is aimed at assessing war-related SGBV in war-affected Tigray, Ethiopia.

Methods: A community-based survey was conducted in 52 (out of 84) districts of Tigray, excluding its western zone and some districts bordering Eritrea due to security reasons. Using a two-stage multistage cluster sampling technique, a total of 5171 women of reproductive age (15-49 years) were randomly selected and included in the study. Analysis used weighted descriptive statistics, regression modelling and tests of associations.

Results: Overall, 43.3% (2241/5171) of women experienced at least one type of gender-based violence. The incidents of sexual, physical and psychological violence, and rape among women of reproductive age were found to be 9.7% (500/5171), 28.6% (1480/5171), 40.4% (2090/5171) and 7.9% (411/5171), respectively. Of the sexual violence survivors, rape accounted for 82.2% (411/500) cases, of which 68.4% (247) reported being gang raped. Young women (aged 15-24 years) were the most affected by sexual violence, 29.2% (146/500). Commonly reported SGBV-related issues were physical trauma, 23.8% (533/2241), sexually transmitted infections, 16.5% (68/411), HIV infection, 2.7% (11/411), unwanted pregnancy, 9.5% (39/411) and depression 19.2% (431/2241). Most survivors (89.7%) did not receive any postviolence medical or psychological support.

Conclusions: Systemic war-related SGBV was prevalent in Tigray, with gang-rape as the most common form of sexual violence. Immediate medical and psychological care, and long-term rehabilitation and community support for survivors are urgently needed and recommended.

Keywords: community-based survey; health policy; injury; public health.

MeSH terms

Adolescent
Adult
Ethiopia / epidemiology
Female
Gender-Based Violence*
HIV Infections*
Humans
Middle Aged
Pregnancy
Sexual Behavior
Violence
Young Adult

Grants and funding

001/WHO_/World Health Organization/International