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The funding organizations played no role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, or in the presentation, review, or approval of the manuscript.
KJ designed the research study and survey instruments, oversaw the interviewer training, supervised data collection and data analysis, and wrote the initial draft of the manuscript. JS contributed to study design, survey development, interviewer training, data collection, data interpretation, and the initial draft of the manuscript. TS assisted in the initial grant proposal, supervised interviewers in the field, contributed to data interpretation, and drafting the initial manuscript. DN helped to inform the study design, contributed to interviewer training, and applied his expertise in the interpretation of data for the final manuscript. MK assisted with study design, conducted the data analysis, and was critical in the process of data interpretation. SR and SB supervised interviewers in the field and contributed to data interpretation and the initial manuscript. VM and AM assisted with interviewer training, pilot testing of the survey instrument, and data interpretation. DR assisted with data analysis and data interpretation. LL oversaw the study design and development of survey instruments, informed data collection, and supervised the data analysis and interpretation. All authors contributed to the writing of the manuscript. All authors read and approved the final manuscript.
Following the contested national elections in 2007, violence occurred throughout Kenya. The objective of this study was to assess the prevalence, characteristics, and health consequences of the 2007–2008 election-related violence.
A cross-sectional, national, population-based cluster survey of 956 Kenyan adults aged ≥ 18 years was conducted in Kenya in September 2011 utilizing a two-stage 90 x 10 cluster sample design and structured interviews and questionnaires. Prevalence of all forms of violence surrounding the 2007 election period, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), and morbidity related to sexual and physical violence were assessed.
Of 956 households surveyed, 916 households participated (response rate 95.8%). Compared to pre-election, election-related sexual violence incidents/1000 persons/year increased over 60-fold (39.1-2370.1; p < .001) with a concurrent 37-fold increase in opportunistic sexual violence (5.2-183.1; p < .001). Physical and other human rights violations increased 80-fold (25.0-1987.1; p < .001) compared to pre-election. Overall, 50% of households reported at least one physical or sexual violation. Households reporting violence were more likely to report violence among female household members (66.6% vs. 58.1%; p = .04) or among the Luhya ethnic group (17.0% vs. 13.8%; p = 0.03). The most common perpetrators of election-related sexual violence were reported to be affiliated with government or political groups (1670.5 incidents/1000 persons per year); the Kalenjin ethnic group for physical violations (54.6%). Over thirty percent of respondents met MDD and PTSD symptom criteria; however, symptoms of MDD (females, 63.3%; males, 36.7%; p = .01) and suicidal ideation (females, 68.5%; males, 31.5%; p = .04) were more common among females. Substance abuse was more common among males (males, 71.2%; females, 28.8%; p < .001).
On a national level in Kenya, politically-motivated and opportunistic sexual and physical violations were commonly reported among sampled adults with associated health and mental health outcomes.