Original Research

SAGE Open
January-March 2023: 1–12
Ó The Author(s) 2023
Knowledge, Attitude, and Practice DOI: 10.1177/21582440231154461
journals.sagepub.com/home/sgo
of Intimate Partner Violence and
Its Determinants Among Female
Nursing Students in Abakaliki,
Southeast Nigeria

Chidebe C. Anikwe1 , Helen I. Anikwe1, Bartholomew C. Okorochukwu2,

Cyril C. Ikeoha1, Arinze C. Ikeotuonye1, Richard L. Ewah1,
and Justus N. Eze1

Abstract
To assess the knowledge, attitude, practice, and determinants of intimate partner violence (IPV) among nursing female stu-
dent in a tertiary hospital in Abakaliki. A cross-sectional descriptive study was done in a tertiary hospital in Abakaliki between
1st March 2018 and 31st August 2018 among 450 nursing female student. They were interviewed using a Composite Abuse
Scale (CAS) version 2013. Analysis was done using IBM SPSS Statistic version 20. The prevalence of any type of IPV among
respondents was 47.8%. The majority (70.9%) were aware of IPV and the commonest mode of information was mass media
(60.0%). Majority of the respondent would resort to prayer following IPV and only 15.5% would report to police. The most
common form of abuse reported was emotional &or harassment abuse (26.6%). Student’s age (OR = 0.42; 95% CI [0.41,
0.92]), social class (OR = 0.60; 95% CI [0.40, 0.90]), level of study (OR = 0.45; 95% CI [0.29, 0.68]), and partner’s level of edu-
cation (OR = 0.60; 95% CI [0.42, 0.88]) were determinant of respondent experiencing IPV. Less than 50% of the respondent
were aware of legislation against IPV. The study shows a high level of IPV among the studied group. Screening for IPV is advo-
cated among the students’ population especially among the young adolescent. Efforts should also be made by the government
to increase awareness about Nigerian law against IPV.

Keywords
violence, intimate partner violence, violence, nursing, female students, combined abuse scale

Introduction the level of ‘‘domestic terrorism’’ that women under go

Intimate partner violence is a global health problem. It
includes physical violence, sexual violence, stalking, and
psychological aggression by a current/former romantic
and/or sexual partner (Breiding et al., 2015). The true
burden of IPV is not known. While men can be recipi-
ents of IPV, women experience IPV at higher rates. IPV
is estimated to affect 35% of women worldwide (World
Health Organization [WHO], 2013). There is a regional
variation on the lifetime prevalence of IPV, the highest
rate is seen in developing world of which African (36.6
95% CI [32.7, 40.5]) region is second to South-East Asia
(37.7 95% CI [32.8, 42.6]) region on cases of physical
and/or sexual intimate partner violence (WHO, 2013).
Various studies in Africa including Nigeria have shown
from their partners. In Nigeria a high prevalence rate of
IPV has been reported (Anzaku et al., 2017; Benebo
et al., 2018; O. I. Fawole et al., 2005; Onanubi et al.,
2017; Umana et al., 2014) among Nigerian women.
These disturbing findings in Nigeria are also seen in
other studies in African countries (Burgos-Soto et al.,
1
Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi
State, Nigeria
2
Federal Medical Centre, Owerri, Imo State, Nigeria
Corresponding Author:
Chidebe C. Anikwe, Alex Ekwueme Federal University Teaching Hospital,
Abakaliki, Ebonyi State, Nigeria.
Email: drchideanikwechristian@gmail.com

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2 SAGE Open
2014; Delamou et al., 2015; Malan et al., 2018; Ogum
Alangea et al., 2018).
The patriarchal nature of African societies which
encourages male dominance with the subjugation of
women as a ‘‘tool to a means’’ is an important factor to
IPV (Bowman, 2003). In Nigeria, for example, the gender
equality index is low, Nigeria is estimated to rank 128th
in Global Gender Gap Index with score of 0.635 (World
Economic Forum, 2019) and this might probably be con-
tributing to IPV. Some women justify IPV against other
women which might ultimately encourage further acts of
IPV (Ajah et al., 2014; Esere et al., 2009). The victims’
apparent non-reporting of an assault to appropriate
channels for redress and lack of enabling laws in some
African countries encourages the perpetration of this
bastard act (IPV) to thrive. It is, however, gladding that
with the passage of Nigerian law against IPV, succor
would be given to victims of domestic violence (Violence
Against Persons (Prohibition) Act, 2015).
The male partner is the common perpetrator of female
IPV. Some of the risk factors for this behavior among
men include drug dependence, jealousy, alcoholism, low
educational attainment, having multiple sexual partners,
inability to meet financial needs, childhood abuse, and
family history of domestic violence (Adebayo, 2014;
Esere et al., 2009; Matseke et al., 2012; Ntaganira et al.,
2008; Onoh et al., 2013; Shamu et al., 2011). IPV is asso-
ciated with several negative health problems on the vic-
tims which some of them are: physical injuries,
disabilities, substance use problems, suicidal ideation,
difficulty in establishing a further relationship with men,
sleep disturbances, fear, poor academic performance,
anxiety, and substance abuse (Breiding et al., 2014;
Onanubi et al., 2017; Spencer et al., 2016; Wood et al.,
2018) huge man-hour lost in production, and health-
related cost (National Center for Injury Prevention and
Control, 2003). It could also lead to femicide and Africa
has been reported to have the highest rate of intimate
femicide (UNODC, 2019). IPV has been argued to occur
in three phases which are the tension building phase, cri-
sis phase, and the honeymoon phase (Shelter For Help in
Emergency, 2022). The cycle of abuse tends to increase
without intervention and could result in femicide.
Femicide could occur either in tension or crisis phase.
The mechanism of femicide vary and could result from
physical injury, neglect of the victim, the victim being
under tension and unlikely to seek and receive prompt
medical care when sick as this is likely to be prevented by
the perpetrator.
Unintended pregnancy, adverse pregnancy outcome,
nonuse of condoms, sexually transmitted diseases includ-
ing HIV/AIDS are some of the sexual and reproductive
health problems of IPV (Maman et al., 2000; Bernstein
et al., 2016; Hampanda et al., 2017; Onanubi et al.,
2017). Exposure to IPV can increase women’s risk for
human immunodeficiency virus (HIV) infection
(Hampanda et al., 2017). It also affects partner disclo-
sure of HIV status and a woman’s adherence to therapy
with resultant poor performance on antiretroviral
medication (Maman et al., 2000). Ignoring the increasing
global burden of IPV, therefore, can be a hindrance to
the international community effort in ending the AIDS
epidemic by 2030 (WHO, 2017). This becomes particu-
larly important in sub Saharan countries like Nigeria
where the prevalence of HIV/AIDS disease is assuming
an epidemic proportion. Apart from the above findings,
IPV negatively affects the academics performance of the
victim.
The majority of women undergo trauma in silence
which makes it difficult to intervene and eradicate IPV
(Ibekwe, 2007; WHO, 2012). This ‘‘silence syndrome’’ in
Nigeria constitute an impediment to eradicating the can-
kerworm called IPV (Ibekwe, 2007). According to a
study by Linos et al. less than 40 % of Nigerian women
that are victims of intimate partner abuse reported ever
seeking help to stop the chain of abuse from the perpe-
trator. Help-seeking among the victims were found to be
dependent on the level of Human Development Index of
the states (Linos et al., 2014) which calls for a deliberate
effort to empower women and develop the girl child in
Nigeria as a long term measure in addressing IPV.
Various reasons adduced for women’s tolerance of an
abused partner include ‘‘fear of retaliation, lack of alter-
native means of economic support, concern for their chil-
dren, lack of support from family and friends, stigma or
fear of losing custody of children associated with divorce
and love with the hope that the partner will change’’
(WHO, 2012).
In Nigeria, reduction or possible elimination of part-
ner based violence would involve the education of
women on their reproductive and sexual rights. There is
a need also to address the cultural belief systems that are
not supportive of women’s rights in Nigeria (Ibekwe,
2007). It has been advocated that women should have
zero tolerance of domestic violence and every case
should be reported to appropriate authorities (Ibekwe,
2007; Titilayo et al., 2014). This will enable punishment
of perpetrators and deter perpetrators from further inci-
dents, compensate survivors, and provide them with the
necessary interventions for their rehabilitation. It has
been argued by Ibekwe (2007) that violence against
women should be made a state affair and with the recent
promulgation of law against IPV in Nigeria (Violence
Against Persons (Prohibition) Act, 2015), it is hoped that
affected women in Nigeria will seek redress when their
right is infringed by their partner.
Anikwe et al.
This work is embarked upon to assess the knowledge,
attitude, and practice of IPV among nursing students in
a tertiary hospital in Abakaliki. It will also help to assess
their rate of IPV victimization and its determinants.
Findings from our study will assist the authority in the
hospital to proactively put measures in place to assist
and prevent IPV among the students. It will also help to
improve their curriculum toward prevention and man-
agement of IPV after their nursing education.
Materials and Methods
Study Design
To assess the knowledge, attitude, practice, and determi-
nants of IPV among nursing female student in a tertiary
hospital in Abakaliki.
Methods
Study Setting
The study was carried out in nursing and midwifery
schools of Alex Ekwueme Federal University Teaching
Hospital, Abakaliki.
Study Population
The study population was female nursing students that
met the inclusion criteria. They were consenting females
who were not pregnant and are currently in an intimate
partner relationship for the past 12 months. Study popu-
lation was limited to those who are currently in an inti-
mate partner relationship to help reduce recall bias and
to help us assess the current risk that the students are
undergoing. Those who were excluded were those who
refused to consent, sick, or are not in an intimate partner
relationship for the past 12 months. A simple random
sampling method (ballot method) was used for respon-
dent’s selection. Consented students were asked to pick a
piece of blue paper marked ‘‘Yes’’ and ‘‘No’’ with
replacement from a black polythene bag into which an
equal number of paper ‘‘Yes’’ and ‘‘No’’ paper were
added. Students that picked a paper marked ‘‘Yes’’ were
recruited as the study population. They were interviewed
between January 2018 and May 2018 in a dedicated
office using a pre-tested structured questionnaire
(Cronbach’s alpha = .72) and a Composite Abuse Scale
(CAS) version 2013 (Hegarty et al., 2005). The question-
naire was filled by the participant after thorough expla-
nation and understanding of the study instrument. The
social class of the study population was determined
based on the work of Olusanya et al. (1985) which used
the educational level of the women and the occupation
3
of the husband for determination of a woman’s social
class. The social class of the study participants that were
not married were based on that of their parents. They
were graded into social classes 1 to 5. Social class 1 and
2 were classified as upper social class while social class 3,
4, and 5 were classified as lower social class. ‘‘Intimate
partner violence (IPV) is defined as actual or threatened
physical, sexual, psychological, emotional, or stalking
abuse by an intimate partner while an intimate partner is
defined as a current or former spouse or non-marital
partners, such as a boyfriend or dating partner’’ (Basile
et al., 2007). Knowledge of IPV was assessed using 22
items, correct answer was scored as 1 and incorrect
answer as 0. Overall knowledge scores were calculated
by adding the individual scores (answers); the highest
scores was 22. A score of 10 and above was assessed as
adequate overall knowledge of IPV while a score less
than 10 was assessed as inadequate overall knowledge of
IPV. The 22 items instrument was pretested among 30
nursing students on ward posting in AEFUTHA. The
internal consistency was found to be good (Cronbach’s
alpha of 0.70).
Sample Size
The sample size was gotten using the formula N = Z2
PQ/D2. Where N = required sample size. Z = 1.96 at
confidence level at 95%; P = estimated population of
44.6% (Esere et al., 2009) D; margin of error at 5% and
Q = 1 2 P. The sample size for the study is 460 after the
addition of a 20% attrition rate.
Ethical Consideration
Ethical approval for this study was obtained from the
ethical committee of the hospital. The ethical approval
number is REC APPROVAL NUMBER 14/11/2017-19/
12/2017. Approval for the use of CAS was obtained
from Kelsey Hegarty of the University of Melbourne.
Informed and written consent was obtained from the
participant before inclusion into the study.
Composite Abuse Scale (CAS)
‘‘CAS is an easily administered self-report measure that
provides standardized subscale scores on four dimensions
of intimate partner abuse consisting of 30 items presented
in a six-point format requiring respondents to answer
‘‘never,’’ ‘‘only once,’’ ‘‘several times,’’ ‘‘monthly,
weekly,’’ or ‘‘daily’’ in twelve months. It assess the follow-
ing: Severe Combined Abuse Factor, Emotional Abuse
factor, Physical Abuse factor, and the Harassment factor.
The CAS is made up of four subscales: Severe Combined
4 SAGE Open
Abuse (SCA; 8 items; possible score 0–40), Physical Abuse
(7 items; possible score 0–35), Emotional Abuse (11 items;
possible score 0–55), and Harassment (4 items; possible
score 0–20)’’ (Anikwe et al., 2021; Hegarty et al., 2005).
The Severe Combined Abuse Factor Represent Severe
Physical Abuse Items, All Sexual Abuse Items, and
Physical Isolation Aspects of Emotional Abuse
‘‘Raped me; Used a knife or gun or other weapons;
Took my wallet and left me stranded; Tried to rape me;
Kept me from medical care; Locked me in the bedroom;
Refused to let me work outside the home; Put foreign
objects in my vagina’’ (Anikwe et al., 2021; Hegarty
et al., 2005)
The Emotional Abuse Factor Include Verbal,
Psychological, Dominance, and Social Isolation Abuse
Items
‘‘Told me that I was not good enough; Told me that I
was stupid; Did not want me to socialize with my female
friends; Told me that I was crazy; Became upset if din-
ner/housework was not done when they thought it
should be; Blamed me for causing their violent behavior;
Tried to turn my family, friends and children against me;
Told me that no one else would ever want me; Told me
that I was ugly; Tried to keep me from seeing or talking
to my family; Tried to convince my family, friends and
children that I was crazy’’ (Anikwe et al., 2021; Hegarty
et al., 2005).
The Physical Abuse Factor Has 7 of the Less Severe
Physical Abuse Items
‘‘Pushed, grabbed or shoved me; Hit or tried to hit me
with something; Shook me; Slapped me; Threw me;
Kicked me, bit me or hit with a fist; Beat me up’’
(Anikwe et al., 2021; Hegarty et al., 2005).
The Harassment Factor Represents Actual
Harassment
‘‘Harassed me over the telephone; followed me; Hung
around outside my house; Harassed me at work’’
(Anikwe et al., 2021; Hegarty et al., 2005).
‘‘The subscale score was calculated and was com-
pared with a predetermined cut-off score for each sub-
scale (Hegarty et al., 2005) as shown below to
determine whether they have suffered that abuse’’
(Anikwe et al., 2021). A subscale score greater than the
set score would determine that the respondent had such
abuse. Example if a woman has a SCA score of 10,
Emotional abuse score of 15, Physical abuse score of
30, and Harassment abuse score of 20 the total score is
75; each score above is greater than the predetermined
cut-off score and the woman will be adjudged to have
suffered each of the above abuses. Categorization will
determine the category of composite abuse. An overall
score of 7 and above determines an individual that has
suffered an abuse.
CAS Cut-Off Score
Scale Cut-off score
Severe combined abuse 1
Physical abuse 1
Emotional abuse 3
Harassment 2
Total 7
Abuse Categorizations
‘‘The type of abuse experienced by each respondent
was categorized as shown below. SCA took precedence
over the other forms of abuse so that any participant
who had experienced SCA fell into the SCA category
(Category 1). The second category includes all partici-
pants who had experienced Physical Abuse in combina-
tion with Emotional Abuse and/or Harassment.
Participants who have experienced at least one episode
of Physical Abuse, but no other forms of abuse, fell
into the third category, Physical Abuse Alone. The
final category contains all participants who had experi-
enced Emotional Abuse and/or Harassment, but not
any other form of abuse’’ (Anikwe et al., 2021; Hegarty
et al., 2005).
Anikwe et al. 5

Abuse Categorizations Sequence

Does the participant meet the cutoff for Severe combined

Severe combined abuse? YES abuse

NO

Does the participant meet the cutoff for Emotional and/or

NO
Physical Abuse? Harassment

Y
E
S

Does the participant meet the

Physical Abuse
cutoff for Emotional and/or NO alone
Harassment?

Y
E
S

Physical, Emotional, and/or

Harassment
6 SAGE Open

Table 1. Socio - Demographic Characteristics of the Women Table 2. Respondent Knowledge About Intimate Partner
(n = 450). Violence.

Characteristics Frequency (n) Percentage (%) Variables Frequency Percentage

Age (years) Knowledge of IPV

<19 61 13.6 Adequate 319 70.9
20–24 258 57.3 Inadequate 131 29.1
ø 25 131 29.1 Source(s) of informationa
Marital status Reading books 81 18.0
Single 344 76.4 Friends 117 26.0
Married 97 21.6 Newspaper 90 20.0
Separated 2 0.5 Radio 63 14.0
Divorced 7 1.5 Television 117 26.0
Residence From school 54 12.0
Rural 145 32.2 Church 27 6.0
Urban 305 67.8 Sibling 27 6.0
Mother’s education Parent 54 12.0
None 84 18.7 Types of IPV knowna
Primary 110 24.4 Sexual violence 180 40.0
Secondary 112 24.9 Physical violence 135 30.0
Tertiary 144 32.0 Emotional violence 171 38.0
Year of study Psychological abuse 144 32.0
Year 1 124 27.6 Stalking 54 12.0
Year 2 162 36.0 Friends with a history of IPV
Year 3 164 36.4 Yes 207 46.0
Partner No 243 54.0
Age
<19 9 2.0 a
Multiple answer allowed.
20–24 70 15.5
25–29 147 32.6
30–34 143 31.8
ø 35 81 18.0 and 5 (lower social class) were reclassified for easy analy-
Occupation sis. The partner’s characteristics were also reclassified
Unemployed 217 48.2 into ł 30 years and .30 years. The odds ratios with their
Employed 233 51.8 95% CI were calculated to determine the strength and
Education
Primary 22 4.9
presence of an association. p-Value of \.05 is adjudged
Secondary 197 43.8 significant. Odds ratio \1 implies decreased likelihood
Tertiary 231 51.3 of being a victim of IPV, while OR . 1 represented
increased probability of suffering from IPV.

Validation of CAS Results

‘‘To test the reliability and internal consistency of the
CAS, we surveyed 36 female nurses in the Department of
Obstetrics and Gynaecology of Alex Ekwueme Federal
University Teaching Hospital, Abakaliki. Respondents
completed the questionnaires twice in 2 weeks and
responses were matched and compared for test-retest
reliability. The internal consistency for the scale was
good (Cronbach’s alpha = 0.72)’’ (Anikwe et al., 2021).
Data Analysis
Data analysis was done using IBM SPSS statistic 20 soft-
ware. Chi-square (x2) and logistic regression analysis
were used for categorical variables where applicable. The
student’s age ( ł 23 or .23 years), marital status (mar-
ried or single), year of education ( ł 3 or .3 years), and
social class 1 and 2 (upper social class); social class 3, 4,
A total of 460 questionnaires were shared, out of which
450 (97.8%) students were in intimate partner relation-
ships and were analyzed. From Table 1, the mean age of
the women was 23.0 (95% CI [22.4, 22.6]) years (not in
the Table). The majority of the study population were
between 20 and 24 years. More than 40 % of the respon-
dent belong to lower socioeconomic class. More than
three-quarters are single. The mean partner’s age was
30.0 (95% CI [29.0, 31.1]) years (not in the Table) with
the majority being employed. The highest level of educa-
tion attended by the male partner was tertiary education.
From Table 2, the majority had adequate knowledge
of IPV which they got majorly from friends and watching
television. Only 12% of women were aware that stalking
is a form of IPV. When asked whether they have a friend
with a history of IPV, 46% (207) was affirmative in their
answers.
Anikwe et al. 7

RADIO

SIBLING

PARENT

VICTIM

CHURCH

SCHOOL

NEWSPAPER

TELEVISION

FRIENDS

READING BOOKS

0 20 40 60 80 100 120

Figure 1. Sources of information about Nigerian Law against IPV.

commonest type of IPV experienced was Emotional &/

Table 3. Profile of Intimate Partner Violence Among the Study
or Harassment abuse.
Respondent.
As shown in Table 4, more than 50% of the student
Variables Frequency (n) Percentage (%) would report a case of IPV. A majority (167, 37.1%) of
those that will report said they would report to their par-
Intimate partner violence ent while 24% will report to the partner’s parent. Less
Yes 215 47.8
than one-fifth of the respondent would report to the
No 235 52.2
Afraid of partner criminal justice system for redress on experiencing IPV.
Yes 170 37.8 Those that would not report attributed their major rea-
No 280 62.2 son for not reporting on fear of further attack (26.0%)
Types of IPV and shame (24.0%). The Table also shows that majority
Severe combined abuse 63 14.0
Physical, emotional, and/or 25 5.6
of the respondent would resort to prayer (243, 54.0%)
harassment abuse while 35.1% (158) would keep quiet on being assaulted.
Physical abuse 7 1.6 From Table 5, the age of the respondent and history of
Emotional and/or 120 26.6 IPV had a significant association. There is a 58% chance
harassment abuse of a student who is more than 23 years being assaulted
None 235 52.2
than those that are ł 23 years with true effect size of
35% to 73%. Being in lower socio-economic class is asso-
ciated with increased odds of being a victim. Cohort of
Among our study population, only 47% were aware women who are married were at reduced risk of IPV than
of such legislation against IPV. The commonest source being single (OR = 0.61 95% CI [0.24, 0.48]).
of information was reading the newspaper and watching
television (Figure 1).
Discussion
Table 3 below shows the profile of IPV observed in
the women. The point prevalence of IPV was 47.8%; IPV is an epidemic which needs to be prevented. This
37.8% including those with and without experience have study is embarked upon to assess the knowledge, atti-
a history of being afraid of their partner. The tude, practice, and determinants of intimate partner
8 SAGE Open

Table 4. Respondent Reaction and Attitude Toward Intimate Table 5. The Determinant of Intimate Partner Violence Among
Partner Violence. the Respondent.

Variables Frequency (n) Percentage (%) Intimate partner violence

Reaction to IPVa Variables Yes (n, %) No (n, %) OR 95% CI

Keeping quiet 158 35.1
Crying 97 21.5 Age
Praying 243 54.0 <23 years 41 (19.1) 84 (35.7) 0.42 [0.27–0.65]a
Fight back 88 19.5 .23 years 174 (80.9) 151 (64.3) 1
Involve third party 95 21.1 Social class
Leave house 113 25.1 Lower 138 (64.2) 176 (74.9) 0.60 [0.40–0.90]a
Kill me approach 38 8.4 Upper 77 (35.8) 59 (25.1) 1
Begging 70 15.5 Marital status
Reporting IPV 274 60.8 Married 68 (31.6) 38 (16.2) 2.39 [1.52–3.76]
Whom to reporta Single 147 (68.4) 197 (83.8) 1
Police 70 15.5 Year of study
Parent 167 37.1 \3 years 134 (62.3) 185 (78.7) 0.45 [0.29–0.68]a
Sibling 50 11.1 ø 3 years 81 (37.7) 50 (21.3) 1
Church 63 14.0 Partner
Friends 32 7.1 Age
Health worker 48 10.7 <30 years 134 (62.3) 165 (70.2) 0.70 [0.47–1.04]
Relation of partner 106 23.5 .30 years 81 (37.9) 70 (29.8) 1
Counselor 11 2.4 Occupation
Partner’s parent 36 8.0 Not employed 95 (44.2) 122 (51.9) 0.73 [ 0.51–1.06]
School authority 11 2.4 Employed 120 (55.8) 113 (48.1) 1
Reason for not reportinga Education
Fear of further attack 115 25.5 Below tertiary 91 (42.3) 129 (54.9) 0.60 [0.42–0.88] a
Shame 108 24.0 Tertiary 124 (57.7) 106 (45.1) 1
Against my religion 93 20.6
a
Against my culture 99 22.0 Significant.

a
Multiple answers allowed.
violence among nursing students in, Abakaliki. Our
study shows that the majority of the female nursing stu-
dents have adequate knowledge of IPV and the common
sources of information are mass media (60%), friends
(26%), and reading books (18%). The most common
type of IPV known by the study group was sexual vio-
lence which was followed by emotional and psychological
violence. This might be a reflection of the type of assault
that has been experienced by themselves, their friend and
relation. It is quite discomforting that about 53% of the
students are not aware of a Nigerian law that was
recently promulgated against intimate partner violence.
Apart from its recent promulgation into law by Nigerian
government (Violence Against Persons (Prohibition) Act,
2015) being a factor for lack of knowledge among the
study population, the fact that only 15.5% (70) of the
students are willing to report to the Police might not be
unconnected to the socio-cultural and religious factors
affecting the fight against elimination of violence against
women (Ibekwe, 2007). It, therefore, calls for dissemina-
tion of information about this law to the general popu-
lace by the Nigerian government. This will help the
victim seek redress, punish perpetrator, deter perpetra-
tors from further incidents, compensate survivors and
provide them with the necessary interventions for their
rehabilitation.
In our study, the rate of IPV among the study popula-
tion was unacceptably high as almost 50% of the student
reported being a victim of IPV within 12 months before
the study. This is in keeping with the high rate of IPV in
the study area (Anzaku et al., 2017; Benebo et al., 2018;
Onanubi et al., 2017; Owoaje & OlaOlorun, 2012;
Oyediran & Feyisetan, 2017; Tanko et al., 2016; Umana
et al., 2014) and other African nations (Burgos-Soto
et al., 2014; Ogum Alangea et al., 2018; Spencer et al.,
2016). The two most common forms of IPV observed in
the women were Emotional &/or Harassment abuse
(26.6%) and SCA (14%). Physical, Emotional &/or
Harassment abuse and physical violence were reported
in 5.6% and 1.6% of respondents respectively. The rates
of different forms of IPV seen in our study, however, dif-
fers from a similar study in Kano, Nigeria (Tanko et al.,
2016); difference in the study population might account
for this observation. (National Population Commission
Nigeria, 2014). The occurrence of SCA among the
female nursing students is highly disturbing as SCA rep-
resents the most severe form of abuse a woman can suf-
fer (Hegarty et al., 2005) which can lead to the death of
the victim. IPV increases the odds of negative physical
and mental health conditions of the victim (Breiding
Anikwe et al.
et al., 2014; Spencer et al., 2016) and a significant contri-
butor to poor academic performances of the victim
(Wood et al., 2018). It can therefore adversely affect the
academic performance of our study population thereby
impinging on their future development. This finding
from our study calls for urgent interventions by the
Government and Non-Governmental Organization
(NGO) in Nigeria to help address this ‘‘domestic terror-
ism’’ which these unfortunate women are experiencing.
IPV ‘‘cripples’’ and isolates a woman (Follingstad
et al., 1990; Sassetti, 1993) and it not surprising from our
study that a sizable number of the female nursing stu-
dents are afraid of their male partner which might not be
unconnected to the level of violence that they have
undergone from their partners. It is however encoura-
ging from our study that most of the women studied
would report a case of IPV although it is disappointing
that most would report to their relatives as shown in
Table 4. This finding from our study negates the think-
ing that for the eradication of violence against women,
women should have zero tolerance of it and every case of
violence should be reported to appropriate authorities
for redress (Ibekwe, 2007; Onanubi et al., 2017). It high-
lighted the need for a clarion call on the need to educate
the women folk on their right and to the ‘‘evil’’ nature of
domestic violence to themselves and her children (O. A.
Fawole et al., 2016; National Population Commission
Nigeria, 2014; Spencer et al., 2016; Titilayo et al., 2017).
More than two-fifth of the women interviewed attrib-
uted their reasons of not wanting to report a case of IPV
to culture and religion while fear and shame accounted for
the majority of their reasons which agrees with earlier
reports (WHO, 2012). Cultural and Feminist theories of
IPV in Africa offer a more plausible reason for these
responses among our study population (Bowman, 2003).
The patriarchal nature of traditional African societies with
subordinate positioning of women with its pervasive gen-
der inequality and interacting with traditional mores and
norms supporting wife battering in Africa are plausible
reasons for this attitudinal rationalization seen among our
study population (Bowman, 2003). Benebo et al. (2018) in
a study showed that community belief system that justify
IPV negates the positive influence of women’s status on
IPV reduction (OR = 1.89; 95% CI [1.26, 2.83]). Programs
should, therefore, be put in place to re-orientate commu-
nity members to embrace gender equity, mutual respect,
and amicable resolution of family issues as a panacea to
partner violence (Oyediran & Feyisetan, 2017).
The mean age of the women was 23.0 (95% CI [22.4,
22.6]) years with the majority belonging to 20 to 24 age
brackets. This age bracket is the late adolescent stage
when young girls might be trying to start an intimate
partner relationship, for possible marriage, with the
opposite sex. This agree with an earlier report of women
9
at risk of intimate partner violence (Breiding et al., 2014;
Onanubi et al., 2017; Stöckl et al., 2014). Our study pop-
ulation are mostly single and in low socioeconomic strata
which leaves them prone to monetary manipulations by
the opposite sex for their selfish gains. The mean age of
female partner’s in our study was 30.0 (95% CI [29.0,
31.1]) years and it is the age bracket when most men
have established a source of livelihood in the study area
and are looking for a life partner.
The female nursing student’s age, social class, year of
study, and partner’s level of education are a significant
determinant of IPV among the women studied (p \ .05).
In our study, students who are 23 years and below and in
low socioeconomic class have an increased odd of been
assaulted by their partner and vice versa. This finding
from our study could be explained from the perspective
of Right and Feminist theories of IPV in Africa
(Bowman, 2003). The Feminist theory of IPV in Africa
attributes women’s subordinate position, passivity, gen-
der inequality, and economic dependence as fundamental
to the development of domestic violence (Bowman,
2003). Our study population being young and in lower
class as an extension of feminist thinking, therefore,
leaves them unacceptably prone to abuse by their male
partner who are much older and economically less
dependent. Apart from this, an explanation of the abuse
could arise from the influence of cultural dictates of
domestic violence in Africa and individual psychology
and psychopathology of the batterer (Bowman, 2003).
The latter argues that the batterer engages in violence
against their partner as a result of personal insecurity
and deep psychological dependence on their victim. In
our study, the male partner being unemployed increases
the risks by 73% of his partner being assaulted by him
(95% CI [0.51, 1.06]); p . .05) and this odd is increased
among male partners with below tertiary education
(OR = 0.60; 95% CI [0.42, 0.88]). Above observations is
in tandem with other works on this subject (Onanubi
et al., 2017). According to the ecological model of vio-
lence, relationship level factors predisposing female
youth to IPV seen in our study include unemployment
and lower levels of education. Other factors include
female partners having multiple partners, partner’s exhi-
biting controlling behavior, use of substance abuse and
those who experienced violence when growing up (Krug,
2002; Uthman et al., 2010).
Limitations of the Study
Our study is a cross-sectional study involving only the
nursing student in our center and the findings of this
study could not be a representative of the population of
the students in Abakaliki. It, however, opens a window
to the possible prevalence of IPV in the state and Nigeria
10
in general. It is also limited by the fact that a causal rela-
tionship could not be ascertained and there might be
recall and social desirability bias. An effort was however
made to reduce recall bias and social desirability bias by
encouraging recall of IPV in the past 1 year and inform-
ing the study population not to write their names, phone
numbers, and that the findings and report would not
have anything to do with them. Privacy was also pro-
vided for them when answering the questionnaire. The
study instrument (CAS) was validated in the study area
before applying it to our respondents to ensure its valid-
ity in assessing partner violence in the study area. The
questionnaire was pretested before being applied. Our
study was also limited by non-inclusion of women that
were not currently in relationships and people who were
sick as these women might have suffered from IPV.
Conclusion
Our study shows a high level of IPV in the studied group
is high. The two most common form of IPV is Emotional
&/OR Harassment abuse and SCA. It is however
encouraging that the majority of the students believed
that IPV should be reported. We recommend appropriate
management of such cases and effort made to inform the
women and the general populace at large of Nigerian leg-
islation against gender-based violence because of poor
awareness seen in our study. Enablement should also be
provided by the Government and NGOs to assist the vic-
tim to seek redress.
Author Contributions
CCA and IHA: study design, data collection/analysis, and
interpretation of findings and drafting of the manuscript. BCO
and ACI: interpretation of findings and drafting of the manu-
script. RLE and JNE, CCI: data analysis and the interpretation
of findings and drafting of the manuscript. All participated in
the review of the final manuscript. All the authors approved
the manuscript.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
Ethical Approval
Ethical approval for the study was obtained from the Health
Research and Ethics Committee of the hospital.
SAGE Open
Informed Consent
Informed written consent was obtained from the study
population.
ORCID iD
Chidebe C. Anikwe https://orcid.org/0000-0002-3730-621X
Availability of Data and Material
All data generated or analyzed during this study are included in
this published article.
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