Background
Gender-based violence (GBV) is an important global public health challenge, which is deeply rooted in gender disparity and violation of human rights in all communities [
1]. GBV affects fundamental human rights, thereby threatening the well-being of women and girls, worldwide [
2]. While the concept of GBV does not imply that violence is always unidirectional, literature shows that women and girls are the most common victims of this type of violence [
3‐
5]. GBV and violence against women and girls (VAWG) are terms that are often used interchangeably, with both frequently pointing at men as prime offenders and women and girls, as the victims [
6]. Intimate partner violence (IPV) is the most common form of GBV, which includes physical or sexual abuse by an intimate partner or spouse [
7]. However, the use of the term ‘gender-based’ has noteworthy implications, as it shows that various types of the VAWG are rooted in patriarchal gender norms and inequitable gender power [
8].
The World Health Organisation (WHO), in collaboration with the London School of Hygiene and Tropical Medicine (LSHTM) and the South African Medical Research Council (SAMRC), analysed the secondary data from more than 80 countries, the results of which showed that 1 in 3 women, globally, have suffered physical or sexual violence by an intimate partner or non-partner sexual violence [
9]. Evidence from the various regions has shown that a number of women who experience GBV varies widely, with 37% being in Eastern Mediterranean, 37.7% in South-East Asia, 29.8% in America, 36.6% in Africa, 44% in sub-Saharan Africa (SSA) and 53% in South Africa (SA) [
10,
11].
Despite the worrying statistics of GBV, globally, the United Nations’ (UN) goal 5 of the 2030 Sustainable Development Goals (SDGs) sets an ambitious target of eradicating all forms of detrimental practices and VAWG by 2030 [
12]. Approximately, 11.4 million women and girls are trafficked, globally, with more than 30% of women having experienced either physical violence, sexual violence or both [
13]. According to Kusuma & Babu [
14], at least 38.6% of all homicides recorded, globally, are likely to be perpetuated by intimate partners. In 2012, approximately 437 000 intentional homicide deaths were recorded, worldwide, with 95% of individuals convicted for the homicide being males [
15]. Globally, at least 38% of women experience violence perpetrated by intimate partners [
16].
In 2011, a dedicated population study on GBV directed to women was conducted in Gauteng province, South Africa, the results of which showed that 37.7% of women ever experienced physical or sexual intimate partner violence, 18.8% testified on sexual (IPV) and 46.2% experienced economic or emotional abuse from the sexual partner [
17]. South Africa has a policy aimed at combating GBV, however evidence on its utility to address GBV, is scanty. According to the South Africa’s National Strategic Plan (NSP) on GBV and femicide, results from non-population-based studies are not generalisable to the country’s population [
17]. Nevertheless, it is still of major concern that prevalence rates reported in other studies are constantly higher than 50%, with men invariably being leading perpetrators [
17].
The 2017 Gauteng study revealed that only 1 in 23 women experiencing sexual abuse report to the police, and this is reflective of gross underreporting of sexual offences [
18]. There is a reason to believe that the true reflection of sexual assaults is substantially higher than what is being reported to the police [
19]. Of concern, is the fact that almost half (46%) of the victims of sexual assaults were children, suggesting that GBV is mainly perpetrated by those who are expected to provide protection [
18]. The Report by an Independent Police Investigative Directorate (IPID) illustrated an increase in rape cases by police officers and a whopping 230% increase in sexual abuse cases perpetrated by teachers in the last 5 years [
18]. In fact, the implication of police in sexual offences may be one of the contributors to gross underreporting of sexual crimes, as victims may not be convinced that police will act in their best interest.
Some factors that favour a great occurrence of gender-based violence are already mapped by other studies from a legal, socio-cultural, and socio-economic perspective. These factors include the payment of lobola, use of alcohol and drugs.
The legal and socio-cultural system works against the rights of women in that the patriarchal norms deny women the right to make decisions, thereby leaving women vulnerable to GBV [
20]. Cultural practices, such as paying lobola (bride price), place men in a powerful position over women, often leaving women with little power in the marriage [
21]. This assertion is supported by Chiweshe’s earlier study on Christian women’s experiences of IPV in Zimbabwe, which revealed that lobola had become the source of oppression and ultimately led to IPV [
22]. The social norms associated with lobola, such as being submissive to the husband and sex as a conjugal right, has a silencing effect on women, forcing them to accept violence within marriages as they feel, by virtue of lobola payment, it is normal and should not be questioned [
22].
There is a body of evidence suggesting that men feel some entitlement over their female partners once they have paid lobola. For example, a study conducted in Mpumalanga, Eastern Cape and Limpopo showed that 84% women interviewed agreed that as soon as he partakes in lobola payments, it is considered culturally appropriate for a man to physically abuse his wife, if she does something perceived to be immoral [
23]. The practice that men have the right to abuse their women if they neglect household responsibilities or for infidelity, has been observed in other settings [
24‐
26]. Omeje & Chikwedu [
27] went on to say that women are not allowed to discuss their marital experiences with anyone, as these are regarded as family affairs, which should be resolved within their families. Regrettably, this arrangement further creates fertile ground for abuse to take place.
A cross-sectional study conducted among 1 568 male participants in four districts of Sri Lanka revealed that one-fourth of the participants considered sexual teasing harmless and a majority of the respondents were of the view that women deserve to be beaten at times, if they do not perform their supposedly primary responsibilities, such as taking care of the family and household [
28]. The study further revealed men’s stereotyped view that a woman cannot decline sexual intercourse with her husband, and that she should make it her obligation to prevent falling pregnant. Various authors are in agreement in that inequitable power distribution across genders render women vulnerable to violence by men, in the name of discipline or maintenance of order in their home [
29‐
31].
Alcohol and substance abuse also contribute to GBV, in that they directly affect the cognitive and physical function, leaving individuals less capable of negotiating non-violent ways to resolve disputes within relationships [
32]. A study conducted in Cape Town, South Africa, found a strong association between violence and alcohol use, with heavy alcohol use leading to negative styles of resolving issues [
33]. Furthermore, drinking with a girlfriend was found to increase the expectations of her agreeing to sexual activities, thereby resulting in the use of force in non-consensual circumstances [
34]. These findings are consistent with Ngonga’s study linking alcohol consumption and IPV, with men often using alcohol as their excuse for perpetrating violence [
32].
From Hidayat’s perspective in an Indonesian study, most men were concerned about the women’s attitudes, behaviours and responses, implying that they provoke men into committing GBV [
32]. This perspective is supported by the results of a study conducted in South Africa, whereby one of the respondents believed that women wearing short skirts is a contributing factor to GBV [
33]. Various participants linked men’s perpetration of GBV to women’s behaviours and clothing, regrettably sending a message that women should take the responsibility for the GBV and not men [
33,
34]. Societal expectations of masculinities to men’s perpetration of violence are a phenomenon of research importance; hence this study explored men’s conceptualisation of GBV. Given that fingers often point to men as perpetrators of GBV, it is important to explore how they conceptualize GBV, so that appropriate interventional strategies can be proposed.
GBV endangers the well-being of women, globally, adding to the burden of disease [
35] and imposing strain on women’s physical and emotional well-being. GBV has negative outcomes for girls and women, including sexually transmitted diseases, unwanted pregnancies, induced miscarriages and forced abortions [
35‐
37]. A survey conducted in South Africa, showed that women in abusive relationships were 48% more likely to be infected with HIV than their non-abused female counterparts [
37]. The Tanzanian study revealed that abrasion and bleeding caused by forced sexual intercourse exacerbated HIV transmission [
37]. Gender inequality, male manipulative behaviour and intimate partner violence threats limit women’s ability to negotiate for consistent condom use, refuse unwanted sex and the ultimate risks of HIV infection [
38]. Women who experience GBV do not only engage in HIV risky behaviours, including unprotected sex [
39], but are also hindered from engaging in women’s HIV care [
40,
41]. A systematic review and meta-analysis conducted by Hatcher and colleagues exploring the effects of IPV on antiretroviral (ART) use, showed that IPV was associated with lower ART uptake, lower adherence and lower chances of viral suppression [
40], and these results are consistent with that of Leddy et al. [
39] on the linkages between GBV, HIV and their effects on HIV care continuum.
Gender-based violence can have an intense and long-lasting effects on the survivor’s mental health, such as anxiety, increased peril of post-traumatic stress disorder and depression [
42]. Rees et al. [
43], confirmed that women exposed to GBV experience have high risk of mental disorders and suicidal behaviours. Nonetheless, Tsai [
44] argued that there are ethical and methodological challenges in defining the chronological cycle of GBV and mental disorders. The author also revealed that it is not easy to conduct surveys inquiring on the mental health problems from the survivors or family members, because the abuse usually occurs within the confined family context [
44].
A study conducted amongst students in Ethiopia confirmed that there was an association between GBV and mental health disorder, which often resulted in depression [
45]. GBV is also associated with mood, anxiety and substance abuse [
46]. A study conducted in rural KwaZulu-Natal, South Africa, on the correlation between GBV, psychosocial stress and self-esteem, revealed that the perpetrators also suffered from mental health, such as anxiety and depression, resulting from GBV perpetration [
47]. The study also indicated that 60% of men were involved in psychologically abusing women, which affects the mental health of women [
47].
The above shows that VAWG negatively affects the victims leading to unwanted pregnancies, greater propensity to be infected with HIV, low ART uptake, anxiety, and depression which adds to the burden of diseases.
GBV can be best understood through ecological theory as a methodological framework underpinning the study [
32]. According to Heise’s ecological theory, nested, multilevel structural and normative systems cause multiple forms of violence against women [
24]. Heise [
24], further analysed the ecological theory as a framework made up of four stages of analysis, which are in the form of four interactive concentric circles referred to as systems of interactions, whereby each system is dependent on the environment of a particular person [
33]. The four factors include individual, relationship, community and societal factors. This theory is useful for understanding the intricacies of gender-based violence, since it conceptualizes violence as a multifaceted phenomenon with various factors at play [
34].Therefore, from the ecological perspective, there is no single factor that explains why some people are more violent than others, but the goal is to focus on the various ways through which gender-based violence manifests [
48].
Discussion
Participants shared similar understanding of what constitutes GBV and used phrases like “beating your partner”, smashing of belongings”, “violation and rights” and “killings”. The ecological framework offered useful insights into the understanding of multi-layered and multidimensionaldrivers of GBV, at least from the perspectives of males. The study revealed that men are generally not only aware of the occurrence of GBV as a social-ill engulfing the communities, but are also concerned about its deadly repercussions in families and communities, alike. Socio-economic conditions, evolving cultural dynamics, partner insecurities and infedility, as well as government’s women-centred approach to GBV, were all perceived to be among the key factors aggravating GBV in the community. Socio-economic factors and related social ills, such as poverty, unemployment, alcohol and drug abuse were all identified as important issues necessary for a broader understanding of GBV. Poverty and unemployment were particularly linked with the growing frustration experienced by men, thereby resulting in increased GBV, especially since men find themselves being unable to provide for their families. Participants’ use of the concept poverty was not confined to unemployment, but included those whose incomes could not meet their basic needs.
Socio-economic difficulties have ripple-effect on increasing alcohol and drug abuse, which are also linked to gender based violence. However, results noted alcohol and drug abuse as something pervasive across gender, although intoxicated men were seen as likely to resort to abuse than their female counterparts. Easy access to alcohol and drugs in the study setting jeorpadise efforts to curb GBV. Men participating in this study also got into finger-pointing by alleging that women do provoke them, something that results in physical abuse, a phenomenon that arguably goes unreported to law enforcement authorities until it gets worse. Partner infedility and insecurities were also identified as important factors to GBV. However, the participants did not share how infidelity on the part of a male partner affects GBV. Participants of the study blamed women-centred government policies as contributing factors to ever-increasing GBV, as well as weak protection of male GBV victims by law enforcement agencies.
The results of this study identified men’s frustration emanating from lack of employment as a contributory factor to GBV and this is congruent with a study conducted in the European asylum reception facilities, which also made similar findings [
54]. The ripple-effect of unemployment on men’s ability to meet the basic needs for their families perpetuated GBV [
55], as was the case in the study by Mosavel et al. [
56] conducted in South Africa. Shiva et al. [
57] have linked alcohol, drug abuse and GBV, especially since communication mannerism gets lost when people are intoxicated, a phenomenon that is supported by our findings. Despite the association between alcohol and GBV being established, the pathway for this association requires further research [
57].
Gender-based violence has many contributing factors in SA that can be traced back to cultural and traditional practices, gender inequalities and discrimination in all forms, such as economic, social, religious or political aspects [
19]. These factors are rooted in unequal power relations between women and men, low status of women in communities and beliefs that men are superior and entitled to certain things, including toxic masculinity [
30]. Culture as a key factor on GBV was supported by the findings of Le Mat et al. [
55] study, which indicated that cultural factors are usually used as an excuse for violent behaviours and this is consistent with our findings. The study participants in our study asserted that, as the head of the house, they expected respect from their female partners. A study conducted in KwaZulu-Natal revealed that some men belonging to the Zulu nation used culture to justify their patriarchal practices [
58] and culture has generally been used to justify power imbalances often resulting in GBV [
59], a phenomenon that is continuosly reinforced by the patriarchal value system. This system identifies women as inferior to men, with illiteracy, poverty and low status of women being prevalent in the communities [
41]. Economic liberation enables women to escape abusive relationships better than economically dependent women [
52]. When women are capable of providing for themselves, own assets and have control to their resources, they tend to have more economic power and they can use it to escape abusive relationships [
53]. Participants shared that women should also learn to be independent, so that they do not rely on men who may manipulate their dependancy to abuse them. Sadly, violence is not only confined to home settings, as some women escape violence from home, only to encounter it in other locations, such as work, markets and public spaces, owing to social and gender inequalities and societal norms [
53,
54]. Participants from our own study also demanded that they should be respected on account of being heads of the households. The patriarchal attitudes frequently favour men over women and there is an acknowledgement that GBV is largely caused by the interplay between individual, societal and cultural factors interacting at different levels of communities [
42]. There is documented evidence linking infedility to GBV, 37% of the participants indicated that infidelity contributes to GBV [
60], this is caused when a partner is suspected of being unfaithful and misplaced anger [
61]. Respondents from this study also drew a link between infedility, jealousy and GBV, which is often a result of a partner checking each other’s cellphone. However, participants in our study were silent on infidelity committed by men, unsurprisingly so, as they were all males. The study setting also have a culture of not intervening on GBV issues, as community members view GBV as an internal affair that can only be handled by the couple or family concerned.
Applying the ecological framework to the understanding of our findings places the role played by societal, community, relationship and individual factors to perpetuating GBV in context. The different factors influence the occurance of GBV, for example the study showed that societal factors like cultural norms in a community with a high unemployment rate influence alcoholism, which, in turn exacerbate GBV. This illustrates the intedepencance of these factors to perpetuating GBV in communities.
Strengths
The study explored how men in Alexandra conceptualize GBV from their own perspective. The study participants were recruited from the community, thereby making our observations and other data more dynamic than those generated from captive environments. This study makes an important contribution to the body of evidence in South Africa on GBV from a men’s perspectives, since most studies are female-focused.
Limitations
The researcher’s limited familiarity with the setting did not place her in good standing for recruiting information-rich participants that would help us deepen our understanding of the phenomenon. The fact that the researcher was a young female who interviewed males may have rendered the study prone to social desirability bias. However, this was mitigated through detailed explanation of the purpose of the study and the value of truthfulness. While efforts were made to properly document the study processes, transferability of findings may have been affected by the weaknesses pervasive in sampling and recruitment strategy.
Contribution of evidence-based research
There is paucity of data in South Africa on how men conceptualize GBV. The study findings can be used to guide the government and stakeholders on the design strategies aimed at reducing GBV.