Approximately, 87% of the sample of adolescents had experienced at least one form of violence, 57.2% occurred at home, 44.2% were by relatives and 49.2% were recent within the last 6 months. This qualified most of the violence acts against adolescents to be domestic violence. Domestic violence is the intentional and persistent abusive treatment of any family member by another in the home in a way that leads to pain, distress and injury.[15] The WHO definition of domestic violence as the range of abuse used against women by male intimate partners, has taken focus from adolescent male and female who are also disproportionally affected. Most previous evaluations of domestic violence have focused on partner-related physical assaults and rape on women [16, 17] There is gross under reporting and non-documentation of domestic violence against adolescents. Failure to recognize the impact of domestic violence against adolescents means that required public enlightenment to remedy the situation through counselling will not be effectively implemented. Thus most adolescents may become socialized in violent behavior and consider violence as normal. An abused adolescent, may grow up with rusting issue, engage in relationships with an aggressive mode or often may become withdrawn, reluctant to go into intimate relationship.
Furthermore, the proportion of adolescent that have been sexually abused were 10.2%. This is higher than the reported 4–6% adolescent girls in southwestern Nigeria that have experienced rape [18, 19] and lower than the 18.1% police report. [20] There may be explanations for difference in the findings. Stigmatization associated with rape can be a potential reason for under-reporting.
According to study in Kenya, training on self-defense skills especially for girls in Kenya has reduced the incidence of rape significantly.[21] Furthermore, the studies considered only rape cases which involves proof of penile penetration of vagina without consent [22] excluding other forms of sexual harassment like fumbling and touching of genitals and breasts.
Sexual abuse occurs in homes, in schools religious institutions. The vast majority of perpetrators come from the child’s immediate environment. [23] The reported high incidence of violence at home, and by relatives highlight the hostility most of these adolescent live in, being constantly surrounded by victims and abusers. This has both immediate and future complications, Adolescents who are victims of violence are more likely to perform the role of an abuser in future, may not even realize the magnitude of distress and pain they will be causing their victims. This study reported violence to be associated with very high distress, similar to other report. [24] Unfortunately, most of these victims’ reactions to these stressful act are not adequate. This study, revealed that the actions these victims of violence took, varied significantly from the action they considered appropriate. Could this be due to acceptance of violence as event to keep from outsiders? [25, 26, 27, 28] This sense of acceptance is linked to perpetration of violence among adolescent. [26, 27] In this study most of the violence were at home and majority reported the case to their parents without involving the social welfare or police. The reason(s) to this finding requires further evaluation. The identity of the abusers beyond being relatives, friends, or stranger, were not explored in this study, however we found that majority reported to their parents, and there was higher incidence of violence among adolescents not living with their parents. Furthermore, there is no significant difference in the incident of violence on adolescent with regards to their position in the family, downplaying elder siblings as a major factor in violence. There is need for closers monitoring when co-habiting with other extended family members as well as in the school.
Mental health illnesses was high among adolescents that had experienced violence, and this was very significant from the psychiatric perspective. The mental health illnesses has been documented as a risk factor for and consequence of adolescent violence perpetration. [29] A source of serious concern due to its likelihood of becoming a persistent health challenge if the act of violence is sustained and the victim not counselled and rehabilitated early. Violence/abuse correlates with both functional and structural cerebral alterations in the future [30–32] The injuries are not only physical but emotional. The anger and stress experienced by victims may lead to depression and other emotional disorders sometimes leading to suicide [33] Victims may also exhibit harmful health behavior like excessive smoking, alcohol abuse, use of drugs and engaging in risky sexual activity. This was reported also in this study, mental health challenges, abuse of drug, and or alcohol were more of side effect, rather than a factor in creating violence. Though removal of these vices will not stop violence, but an important consideration in the design of violence control interventions.
The prevalence of violence was significantly high among the female (p = 0.042), adolescent not living with parents (p = 0.015) and adolescent from poor socioeconomic status (p = 0.0001). Studies have shown being dependent and economically vulnerable as major factors to violence. Poverty, is a multidimensional state of deprivation involving lack of basic requirements, political and social exclusion and lack of education. [34] It also entails state of having insufficient income or resources and can extends to lack of basic human needs, like adequate and nutritious food, clothing, housing, clean water, and health services. Poverty even in its modest levels can deprive people from maximizing their potentials. The resultant frustration can manifest in a form of violence. [35]
There is need to design and implement proven strategies effective in preventing abuse of children such as [36] counseling for parents at every opportunity, planned home visits, sexual abuse prevention programs, and systemic interventions.[23] Efforts should be channeled towards supporting adolescents to develop healthy, respectful, and violent-free relationships and interactions. In addition, more focus needs to be put on the development of programs increasing the ability of adolescents and young adults to improve their negotiation and interpersonal skills and to engage in non-controlling relationships. These skills should be taught in schools and other youth programs. It is important that youth starts early to learn the skills needed to create and maintain healthy relationships especially how to manage feelings and healthy communicate skills. This is very important considering that verbal abuse was among the highest abusive incident.
The study has limitations, among which is not evaluating the cost implication of violence among adolescent. Any intervention aimed at reducing violence will come at its cost, knowledge on the cost of violence will be driven towards allocating resource to such programs. Another limitation is not evaluating the predisposing factor to violence from the adolescent perspective. Such information will help in the design of an effective intervention that can reduce violence amongst adolescent.