Psychological Violence and Associated Factors Among Housemaid’s in Northwest Ethiopia.

doi:10.21203/rs.3.rs-52769/v1

Background: psychological violence often called emotional violence is a form of violence that may result in psychological trauma. Psychological violence can destroy intimate relationships, friendships and even our relationship with us. The majority of human beings may have been a victim of some form of psychological violence at some point of their life. Therefore this study expected to assess the magnitude of Psychological violence and its associated factors among housemaids.

Methods: A community based cross-sectional study was conducted from April 1-30/ 2018. About 688 study participants were selected using cluster sampling. Data were entered into Epi info version 7.2.2.6 and analyzed with SPSS version 20 then, mainly analyzed using descriptive statistic and Binary logistic regression.

Result: A community based cross-sectional study was conducted from April 1-30/ 2018 among 688 randomly selected housemaids. From 688 participated in the study, about 387(56.3%) (95%CI: 52.6 - 60.2) housemaids had experienced at least one form of psychological violence in their life time. From those who had experienced violence, 175(25.4%) (95%CI: 22.1%-28.6%) had experienced in the last 12 months. No formal education (AOR=3.13, 95%CI: 1.76, 5.57), primary education (AOR=2.09, 95%CI: 1.12, 3.90), being rural (AOR=2.04, 95%CI: 1.13, 3.71), and family live situation and alcohol consumption of employers had significant association with housemaid psychological violence.

Conclusion: n this study,high prevalence of housemaid psychological violence has been reported. To resolve the problem, it is important to expand information education communication and behavioral change to empower housemaid.

Health Policy

housemaid psychological violence

prevalence

Debre Tabor

Ethiopia

Psychological violence which includes behavior that is anticipated to intimidate and Persecute, and takes the form of threats of abandonment or abuse, confinement to the home, surveillance, threats to take away custody of the children, destruction of objects, isolation, verbal aggression and constant humiliation[1]

Violence against women has reached epidemic proportions in many societies and suggests that no racial, ethnic, or socio-economic group is protected [2]. Violence against women is a public health problem as well as a basic violation of women’s human rights [3]. The impact of violence is beyond physical injuries it also accounts disability, depression, physical and reproductive problem, and risky sexual behavior [4]. Gender based violence is insidious human right issues of public consequence [5].

In the world (24 -38%) of children experienced with psychological violence[6]. in sub- Saharan Africa the experience of women with psychological sexual violence by their intimate partner ranges from 12.1% Rwanda-48.6% Uganda[5]. In Ethiopia 24% of women were exposed to psychological violence [7].

Generally: in the countries where the status of women were low younger women more likely to suffer from domestic violence. Ethiopia has one of the highest prevalence of both physical and sexual violence by their intimate partner[8]. Most study conducted on violence against women agreed that lower educational status, abuse of (alcohol, kchat, and smoke) and younger women are more likely increase experience of violence against women [9-11].

Gender based violence affected the significant segment of populations on girls and women across all group and classes [12]. At worldwide with in its informal nature of domestic worker still challenge to regulation and policy implementation lead to limited opportunities of access to social and legal protection[13]

Universally all type of violence overlap in relationship and a significant public health problem worldwide but the level and pattern of violence greatly varies between setting, culture and segment of the population [14]

However there are many study conducted on violence in the globe and also in our country Ethiopia there is lack of information about magnitude and associated factors of violence against housemaids.

Therefore this study will assess the magnitude of violence against housemaids and also try to identify factors associated with housemaid violence. So this research finding hope to alleviate scarce of information on housemaids violence in South Gondar zone.

Study design and period

Community based cross- sectional study design was conducted from April, 1-30/ 2018.The study was conducted in Debre Tabor town Northwest Ethiopia. Debre Tabor is the capital town of South Gondar zone which is located 666 km far from Addis Ababa the capital city of Ethiopia; to northwest Ethiopia. As the data obtained from South Gondar zone city administration the town had 92,530 populations (2010 EPY).

Sample size and sampling procedure

The sample size was determined using single population proportion formula, taking 62.3% prevalence of psychological violence against married women in a study conducted in Debre-tabor town north west Ethiopia[15],by considering 95% CI, 5% margin of error, 1.5 design effect and 20% non-respondent rate. Finally 688 study participants were included in the study.

Cluster sampling was employed to select study participants. In this study area there are four Kebeles; from those kebeles 50% of ketenas was selected by using simple random sampling and the sample size was proportionally allocated for each Kebeles. Then, study participants in the households were selected from each selected Ketena until achieving the required number of respondents.

Data collection procedures

A structured, pre-tested Interviewer administered questionnaire was used, that was adopted from WHO multi country study and then was translated in to the local language Amharic. Four MPH for supervisors and 8 health extension workers for data collectors were recruited and training was provided for 3 days. The questionnaire was pretested on 5% of the total sample size from wereta town. Data was collected through face to face interviewing from each respondent. Psychological violence was taken as the dependent variable while employers’ characteristics and housemaids’ characteristics were considered as independent variables. Housemaid psychological violence was measured as if a housemaid experience any acts of insulted her or made her feel bad about herself, belittled or humiliated her in front of other people, done things to scare or intimidate her on purpose ,he looked at her, by yelling and smashing things, threatened when asking her friends/family, threatened to hurt her or someone she care about was considered as ‘‘yes’’ otherwise ‘’no’’[16].

Data quality control

Data was collected by well-trained data collectors using pretested questionnaires. Training was given to supervisors and data collectors. Data were reviewed and checked for its completeness before entering for analysis.

Data processing and analysis:

Data were entered into Epi- info version 7.2.2.6 and exported into SPSS version 20.0. the data were also cleaned, coded, and analyzed with SPSS. Descriptive analysis was done to describe the different characteristics of the employers and housemaids. Binary logistic regression analysis was done to identify association between independent and dependent variables. To identify factors significantly associated with the outcome variable adjusted odds ratio (AOR) with 95% confidence interval (CI) was used. Variable having p-value less than 0.05 were considered as significant predictors.

Socio-demographic characteristics of respondents

About 688 were participated in the study, among the participants 419(60.9%) were in the age group of 15-19 years, with the mean age of 19.72 years (±4.55SD). About 348(50.6%) of participants had no formal education. Participants, 564(82%) were previously resided in rural area. About 642(93.3%) of were orthodox Christian. Around 619(90%) of were single. Regarding housemaid’s family situation, about 278(40.4%) them had both father and mother. Participants, 317(46.1%) were paid from 301-500 ETB. Concerning work experience 491(71.4%) of housemaid had 1-4 years of work experience. About 448(65.1%) of were start work at the age of 15 years and above.(table 1)

Table 1 Socio-demographic characteristics of housemaid, Debre Tabor town, 2018(n=688).

Characteristics	Number	Percent (%)
Age in year
15-19	419	60.9
20-24	177	25.7
≥25	92	13.4
Educational status
No formal education	348	50.6
Primary education	189	27.5
Secondary education and above	151	21.9
Previous resident
Urban	124	18
Rural	564	82
Marital status
Married	36	5.2
Single	619	90
Divorced	18	2.6
Widowed	15	2.2
Religion
Orthodox	642	93.3
Protestant	8	1.2
Muslim	38	5.5
Amount of income per month
100-300	311	45.2
301-500	317	46.1
≥501	60	8.7
Work experience
1-4	491	71.4
5-9	142	20.6
≥10	55	8
Age of being housemaid(Mean
5-9	13	1.9
10-14	227	33
≥15	448	65.1
Family live situation
Both father and mother alive	278	40.4
Only father alive	120	17.4
Only mother alive	136	19.8
Both father and mother dead	154	22.4
Family marital status (n=278)
Live together	194	69.8
Divorced	84	30.2

Table 2: Socio-demographic characteristics of employers, Debre Tabor town, 2018

Characteristics	Number	Percent (%)
Age of female employer
25-29	115	18.4
30-34	161	25.7
35-39	110	17.6
40-44	132	21,1
45-49	32	5.1
≥50	76	12.1
Age of male employer(n=636)
25-29	14	2.2
30-34	87	13.7
35-39	120	18.9
40-44	161	25.3
45-49	64	10.1
≥50	190	29.9
Female employer religion(n=626)
Orthodox	541	86.4
Protestant	21	3.4
Muslim	64	10.2
Male employer religion (n=636)
Orthodox	552	86.8
Protestant	23	3.6
Muslim	61	9.6
Female employer educational status (n=626)
Not read and write	52	8.3
Read and write but no formal education	54	8.6
Grade 1-8	62	9.9
Grade 9-12	137	21.9
Certificate and above	321	51.3
Male employer educational status (n=636)
Not read and write	4	0.6
Read and write but no formal education	40	6.3
Grade 1-8	42	6.6
Grade 9-12	83	13.1
Certificate and above	467	73.4
Marital status of employers (n=688)
Married	549	79.8
Single	46	6.7
Divorced	57	8.3
Widowed	36	5.2
Number of children employer have(n=688)
0-3	496	72.1
4-6	184	26.7
≥7	8	1.2
Employer family size
1-3	201	29.2
4=6	429	62.4
≥7	58	8.4
Extended family living with employer (n=688)
Yes	147	21.4
No	541	78.6
Another housemaid living with employers(n=688)
Yes	28	4.1
No	660	95.9
Female employer occupation
Housewife	150	24
Student	7	1.1
Government employer	294	47
Private employer	66	10.5
Merchant	98	15.7
Pensioned	11	1.8
Male employer occupation (n=636)
Government employer	387	60.7
Private employer	98	15.4
Merchant	122	19.2
Pensioned	29	4.6

Socio-demographic characteristics of employers

The mean ages of female and male employers were 33.2 years and 40.1years respectively. Majority, 541(86.4%), of female employer and 552(86.8%) of male employer were orthodox Christians. About 321(51.3%) of female employers and 467(73.4%) of male employers had certificate and above. Majority, 549(79.8%), of employers were married. About 496(72.1%) of employers had 0-3number of children and 429(62.4%) of employers had 4-6 family size. About 541(78.6%) of employers had no extended family and only 28(4.1%) of employers had another housemaid. About 294(47%) of female employers and 386(60.7%) of male employers were government employee. (Table2)

Behavior of employers

About 30(4.4%) of employer had smoking cigarette and 74(10.8%) of employers had chewing khat and 92(14.7%) of female employers and 158(24.8%) of male employers had consumed alcohol. (Table 3)

Table 3: Behavior of employer, Debre Tabor town, 2018 (n=688)

Characteristics	Number	Percent (%)
Employer smoking status(688)
Yes	30	4.4
No	658	95.6
Frequency of employer smoking (n=30)
Sometimes	24	80
Daily	6	20
Employer khat chewing status(688)
Yes	74	10.8
No	614	89.2
Frequency of chewing khat(n=74)
Sometimes	45	60.8
Daily	29	39.2
Female employer alcohol consumption status(n=626)
Yes	92	14.7
No	534	85.3
Female employer intoxication status(n=92)
Yes	4	4.3
No	88	95.7
Frequency of female intoxication (n=4)
Sometimes	3	75
Daily	1	25
Male employer alcohol consumption status(n=636)
Yes	158	24.8
No	478	75.2
Male employer intoxication status (n=158)
Yes	118	74.7
No	40	25.3
Frequency of male employer intoxication(n=118)
Sometimes	35	29.7
Daily	83	70.3

Prevalence Psychological violence

About 387(56.3%) (95%CI: 52.6%-60.2%) of housemaids have been experienced at least one type of psychological violence in their life time and 175(25.4%) (95%CI: 22.1%-28.6%) experienced in the past 12 months.

Perpetrators of psychological violence

Housemaids who had been experienced with psychological violence were traumatized by around three fourth of 306(73.7%) female employers. (fig1)

Factors associated with housemaid violence

In binary logistic regression analysis educational status, previous resident, family residence, family live situation, employer alcohol consumption, and extended family living with employers were significantly associated with psychological violence. In the final model, educational status, previous resident, family residence, family live situation, family resident and employer alcohol consumption were remaining significantly associated with lifetime psychological violence at 5% level of significance.

The result of the study revealed that housemaids who had no formal education were 3 times (AOR=3.13, 95%CI: 1.76, 5.57) and maids who had primary education were 2 times (AOR=2.09, 95%CI: 1.12, 3.90) more likely to experienced violence as compared to those who had secondary education and above.

Pertaining to resident of housemaids, who previously resided at rural areas were 2 times (AOR=2.04, 95% CI: 1.13, 3.71) more likely to experience psychological violence than those who resided at urban. Housemaid whose family resided rural areas were 2 times (AOR=1.84, 95% CI: 1.12, 3.01) more likely to experienced psychological violence than those whose families resided in urban.

Housemaid who had only father alive 2 times (AOR=2.34, 95% CI: 1.32, 4.14) and only mother alive 2 times (AOR=2.08, 95% CI: 1.22, 3.55), more likely to experienced psychological violence as compared to those who had both father and mother alive.

With regard to alcohol consumption, housemaid whose female employer drank alcohol were 8 times (AOR=7.98, 95% CI: 3.49, 18.29) and male employer drank alcohol were 3 times (AOR=2.59, 95% CI: 1.49, 4.49) more likely to experience psychological violence as compared to those who not drank alcohol (Table 4).

Table 4: Factors associated with lifetime experience of housemaid Psychological violence, Debre Tabor town, 2018.

Variables	housemaid violence	COR(95%CI)	AOR(95%CI)
	YES (%)	NO (%)
Previous residence
Urban	40(5.8)	84(12.2)	1	1
Rural	347 (50.4)	217(31.5)	3.36(2.22,5.086.24)	2.04(1.13,3.71)*
Educational status
No formal education	218(31.7)	130(18.9)	2.54(1.72,3.76)	3.13(1.76,5.57)**
Primary education	111(16.1)	78(11.3)	2.28(1.47,3.53)	2.09(1.12,3.90) *
Secondary education and above	58(8.4)	93(13.5)	1	1
Family live situation
Both father and mother alive	102(14.8)	169(24.6)	1	1
Only father alive	77(11.2)	43(6.3)	3.09(1.98,4.83)	2.34(1.32,4.14)*
Only mother alive	87(11.2)	49(7.1)	3.06(2.00,4.69)	2.08(1.22,3.55)*
Both father and mother not alive	1154(22.4)	33(4.8)	6.33(4.01,9.98)	.97(.06,16.37)
Family residence
Urban	56(10.5)	105(19.7)	1	1
Rural	211(39.5)	162(30.3)	2.44(1.66,3.58)	1.84(1.12,3.01)*
female employers consumption status	alcohol
Yes	83(13.3)	9(1.4)	9.29(4.58,18.87)	7.99(3.49,18.29)**
No	266(42.5)	268(42.8)	1	1
Male employers consumption status	alcohol
Yes	126(19.8)	32(5)	4.18(2.72,8.06.401)	2.59(1.49,4.49)**
No	252(39.6)	226(35.5)	1	1
Extended family/relative living with employer
Yes	106(15.4)	41(6)	2.39(1.61,3.58)	1.63(.92,2.90)
No	281(40.8)	260(37.8)	1	1

Keys: 1=reference *= significant with p<0.005, **=significant with p<0.001

This study tried to find the prevalence and factors associated with housemaid Psychological violence in Debre Tabor town. The prevalence of at least one form of Psychological violence during their life time was (56.3%) (95% CI=52.6, 60.2).This study finding was in line with a study conducted at rural Vietnam (55.4%)[17] and eastern India (52%)[18]. This finding was higher as compared to a study conducted Ghana, eastern Sudan, Tanzania, and Romania (30%, 30.1%, 39%, and 45.1%) respectively [19-22]. This could partly be due to socio-demographic difference, former studies included government employee. Women who had better employment status could have access of information about violence and they can easily protect themselves.

Educational status of respondents was significantly associated with housemaid psychological violence. Where, housemaids who have no formal education were 3 times more likely to experience violence. Comparable finding was obtained from a study conducted in western Ethiopia ,northwest Ethiopia, Eastern Sudan, rural Vietnam and WHO multicounty study showed that women who had low educational status were more likely experience domestic violence[9, 10, 17, 18, 20, 23, 24]. This is due to the fact that low educational status of women had no power to protect the violence.

Rural residence of respondents and their families were significantly associated with experience of housemaid violence. Housemaid who resided in rural areas and whose family resided in rural area were 2 times more likely to experienced violence as compared to who resided urban area. This finding was consistent with a study conducted in western Ethiopia, eastern India, around Gondar, and Gondar town northwest Ethiopia, showed that rural residency were more likely experience domestic violence[9, 18, 23, 25]. Housemaids who previously resided at country side had no information about violence and they couldn’t complain to legal bodies. But this finding contradicted with a study from Ghana, showed that women who resided urban areas were 35% more likely increase risk of domestic violence[19] this could be due to socio- demographic and socio-cultural difference of the study participants.

Housemaid who had only father alive were 2 times more likely experience lifetime psychological violence, respondents who had only mother alive were 2 times more likely

experience housemaid psychological violence when compared to those who had both father and mother alive respondents. This finding in line with other study[11]. Family support could increase the confidence of housemaid this help to protect them from any violence.

Alcohol consumption of employers was significantly associated with housemaid violence. Participants whose female employers drank alcohol were 8 times and male employer drank alcohol were 3 times more likely experience life time housemaid psychological violence when compared to participants whose employer not take alcohol. This finding consistent with a study conducted in Mekele town, northern Ethiopia and Debre Tabor town northwest Ethiopia showed that employers and husbands drink alcohol were more likely increase experience of violence than those whose employers and husbands not drink alcohol respectively[11, 15, 26]. This is due to the fact that alcohol has depressive mental impairment and which encourages human beings to undertake violence against their house maids.

In this study, high prevalence of psychological violence has been reported. Being rural resident, no formal education, only father alive, only mother alive and alcohol consumption of employers were important predictors of housemaid violence. Women and children affair office need to expand of information education communication and behavioral change on housemaid to empower and report violence as a crime and also need to improve community awareness about housemaid violence.

Finally, further research need to address the economical violence of housemaid is very important.

The limitation of this study was that the data collectors interviewed only housemaid as a proxy respondents for their employer that depend on housemaid report only, this lead to bias when they come to reporting employer characteristics. And had been encountered with social desirability bias due to sensitivity of the information and also exposed with recall bias due to the nature of cross-sectional design.

AOR: Adjusted Odds Ratio, CI: Confidence Interval, COR: Crude Odds Ratio,

ETB: Ethiopian Birr, OR: Odds Ratio, SD: Standard Deviation, SPSS: Statistical Package for Social Sciences, WHO: World Health Organization.

Ethical approval and consent to participate:

Ethical approval was obtained from university of Gondar, institute of public health ethical review committee. Official letter was obtained from Debre Tabor town administration, mayor office. From each participant, who aged 18 years and above written informed consent was obtained. Participants who less than 18 years age written assent was obtained from their employers after clear describing purpose, benefit, and risk of the study and their right on decision of participation in the study.

Consent to publish

Not applicable

Availability of Data and Materials

The datasets analyzed during this study are available from the authors on reasonable request.

Competing interest

The authors declare that they have no competing interest.

Funding

There was no external funding source for this study.

Authors’ contributions

KAA designed the study, developed the proposal, participated in the data collection, performed analysis and interpretation of data and drafted the paper. AAG and AML assisted in the design of the study, proposal writing, data analysis, and interpretation of the study. KAA carried out the manuscript preparation. All authors reviewed and approved the final manuscript.

Acknowledgements

We are highly grateful to thank the study participants, data collectors and supervisors

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Psychological Violence and Associated Factors Among Housemaid’s in Northwest Ethiopia.

Status:

Version 1

Abstract

Figures

Introduction

Materials And Methods