Objectives: To simultaneously examine contextual and individual-level predictors of help-seeking behaviour among women exposed to physical and sexual violence in Nigeria.
Design: A multi-level cross-sectional study. We fit three 3-level random intercepts models to examine contextual and individual-level characteristics associated with help seeking, simultaneously.
Setting: Nigerian Demographic and Health Survey for 2008.
Participants: 5553 women (15-49 years) who reported physical or sexual violence, drawn from 23 715 women in the Nigerian Demographic and Health Survey that responded to questions on violence exposure.
Main outcome measures: Help seeking to prevent future victimisation was based on self-report.
Results: In our sample of women exposed to physical and sexual violence, 39.7% reported that they sought help to stop the perpetrator from hurting them again. Rates of help seeking were geographically patterned by state (range: 12% to 65%). State-level development, measured by the Human Development Index (z-score), was positively associated with help seeking (OR=1.30, 95% CI 1.05 to 1.61), after adjusting for individual-level characteristics. State-level prevalence of violence against women (z-score) was negatively associated with help-seeking (OR=0.68, 95% CI 0.55 to 0.84), suggesting that service providers who may target their programmes to areas with high prevalence of violence, may need to simultaneously address barriers to help seeking. Few individual-level characteristics were associated with help seeking, including wealth, marital status, employment status, ethnicity, history of witnessing domestic violence and relationship to perpetrator.
Conclusions: Efforts to support female survivors of violence should consider broader social and contextual determinants that are associated with help-seeking behaviours.
Keywords: GENDER; SOCIAL EPIDEMIOLOGY; VIOLENCE.