Sexual abuse and violence are serious problems that transcend racial, economic, social and regional lines. Violence is frequently directed toward females and youth, who lack the economic and social status to resist or avoid it. Adolescents and young women, in particular, may experience abuses in the form of domestic violence, rape and sexual assault, sexual exploitation, and/or female genital mutilation. Accurately estimating the prevalence of sexual abuse and violence in the developing world is difficult due to the limited amount of research done on the subject. Cultural mores against reporting abuse make it difficult to assess accurately, and few adolescent health programs in sub-Saharan African address these critical issues.
Domestic Violence Is Widespread in Sub-Saharan Africa.
- Violence against women is a widespread problem in sub-Saharan Africa. Surveys conducted in sub-Saharan Africa reveal that 46 percent of Ugandan women, 60 percent of Tanzanian women, 42 percent of Kenyan women, and 40 percent of Zambian women report regular physical abuse.(1) In a Nigerian survey, 81 percent of married women report being verbally or physically abused by their husbands. Forty-six percent report being abused in the presence of their children.2
- Violence has a significant impact on the health and life expectancy of women. The World Bank estimates that rape and domestic abuse account for 5 percent of healthy years of life lost to women of reproductive age in developing countries.3
- Domestic violence can have long-term psychological effects. Studies have shown that one out of every four suicide attempts by women is preceded by abuse.4
- Children in abusive households also suffer from the effects of violence, whether or not they are physically abused. Studies have shown that children who witness violence may experience many of the same emotional and behavioral problems that physically abused children experience, such as depression, aggression, disobedience, nightmares, physical health complaints and poor school performance.3
Young People Are Vulnerable to Rape and Sexual Assault.
- Worldwide, 40-47 percent of sexual assaults are perpetrated against girls age 15 or younger.4
- In a study in a South African hospital of children under age 15 in whom a diagnosis of child abuse was considered, 45 percent of the children reported having been the target of sexual abuse. Thirty-one percent reported being physically abused, and sexual abuse was suspected but not confirmed in another 14 percent of the children.5 A study in Uganda revealed that 49 percent of sexually active primary school girls say they had been forced to have sexual intercourse.6
- Abuse takes place in both urban and rural environments. A study in a rural population of South Africa found that 51 percent of children between six months and 15 years of age receiving medical treatment for sexual abuse have been abused by a neighbor, an acquaintance, a lodger or a stranger.7 Studies conducted in a city in Zimbabwe found that half of reported rape cases involve girls less than 15 years of age and that girls are most vulnerable to sexual abuse by male relatives, neighbors and school teachers.8
- Both boys and girls can be targets for sexual abuse. In a District in Uganda, 31 percent of school girls and 15 percent of boys report having been sexually abused, many by teachers.9
- The threat of social stigma prevents young women from speaking out about rape and abuse. In Zimbabwe, rape cases are sometimes settled out of court when the perpetrator either pays compensation to the girl's father or pays a bride price and marries the girl to avoid bringing public attention and shame to the girl and her family.8
- All Anglophone countries have enacted laws which directly address sexual offenses against minors. The age at which young people are protected by statutory rape laws varies in these countries, from under 13 years in Nigeria to under 16 years in Zimbabwe. Only Kenya specifically criminalizes both physical and verbal sexual harassment.10
Young People Are Targets of Sexual Coercion and Exploitation.
- Young girls frequently report that their early sexual experiences were coerced. In a study in South Africa, 30 percent of girls report that their first sexual intercourse was forced.1 In rural Malawi, 55 percent of adolescent girls surveyed report that they were often forced to have sex.8
- Sexual exploitation of young people is frequently facilitated by their lack of economic power and job opportunities. In Addis-Ababa, Ethiopia, an estimated 30 percent (about 30,000) of prostitutes are women ranging from 12-26 years of age. The number of adolescent females engaged in informal prostitution may be far greater.11
- Young women are vulnerable to coercion into sexual relationships with older men. "Sugar daddies" take advantage of girls' lack of economic resources by promising to help with their expenses in exchange for sex.12,13 A study of female adolescents in Kenya revealed that 50 percent of the girls admit receiving gifts in the form of money, ornaments and clothes from their partners when they engaged in sex for the first time.14 In Uganda, twenty-two percent of primary school girls anticipate receiving gifts or money in exchange for sex.6
- In a hospital study on abortion in Tanzania, nearly one third of adolescents receiving abortion were impregnated by men 45 years or older.15
- In villages in Ghana, 70 percent of mothers interviewed said they had encouraged young girls into premarital sexual relationships. Many older women felt that receiving gifts in exchange for sex was not regarded as prostitution but evidence of a man's love.16
- Forced marriage of young girls to older males leaves girls with little or no economic or social power. In rural Northern Ethiopia, the mean age for first marriage is 13.5 years for girls and 19.5 years for boys.17 While the average age at marriage is rising, twelve of sixteen countries included in the Demographic Health Survey have an average age at first marriage of between 16 and 21.18
Female Genital Cutting Threatens the Health of Young Women.
- Estimates suggest that between 85 and 114 million girls have been subjected to female genital cutting, also known as female genital mutilation (FGM) or female circumcision. The practice varies from cutting the external genital area to closing the genital area leaving a small opening for passage of urine and menstrual flow. As populations grow, the number of girls undergoing the procedure is increasing by about 2 million per year.19
- Female genital cutting has severe and lifelong health consequences for girls. In Sudan, doctors estimate that 10 to 30 percent of young girls die from it, especially in areas where antibiotics are not available.4 Medical complications of FGM include pain, prolonged bleeding, hemorrhaging, urinary retention, infections, obstetric complications, and psychological trauma.20
- Few laws protect young women from FGM. In Anglophone African nations where genital cutting is prevalent, only Ghana has passed specific laws opposing its practice.10
- Wood K, Jewkes R. Violence, rape, and sexual coercion: everyday love in a South African township. Gender & Development.1997; 5(2):41-46.
- Odunjinrin O. Wife battering in Nigeria. Int J Gynaecol Obstet 1993; 41:159-164.
- Heise LL, Pitanguy J, Germain A. Violence Against Women: the Hidden Health Burden. [World Bank Discussion Papers, no.255] Washington, DC: World Bank, 1994.
- Heise L. Violence against women: the missing agenda. In: Koblinsky M, Timyan J, Gay J, ed.. The Health of Women: A Global Perspective. Boulder, CO: Westview Press, 1993.
- Argent AC, Bass DH, Lachman PI. Child abuse services at a children's hospital in Cape Town, South Africa. Child Abuse & Neglect 1995; 19:1313-1321.
- Noble J, Cover J, Yanagishita M. The World's Youth, 1996. Washington, DC: Population Reference Bureau, 1996.
- Larsen IV, Chapman JA, Armstrong A. Child sexual abuse in a rural population letter: S Afr Med J 1996; 86:1432-1433.
- Njovana E, Watts C. Gender violence in Zimbabwe: a need for collaborative action. Reprod Health Matters, 1996; (7):46-52.
- Sebunya C. Child abusers face mob justice: AIDS Analysis Africa 1996; 6(3):15.
- The Center for Reproductive Law and Policy [and] International Federation of Women Lawyers, Kenya Chapter. Women of the World: Laws and Policies Affecting Their Reproductive Lives: Anglophone Africa. New York: The Center, 1997.
- Bohmer L. Adolescent Reproductive Health in Ethiopia: an Investigation of Needs, Current Policies and Programs. Los Angeles, CA: Pacific Institute of Women's Health, 1995.
- Sellix T. An Investigation into the Relationship between Older Males and Adolescents Females in Africa: Deconstructing the "Sugar Daddy." Submitted in partial fulfillment of the requirements for Master of Arts in International Development. Washington, DC: American University, 1996.
- Moore K, Rogow D. Family planning and sexuality. In: Moore K, Rogow D, ed. Family Planning and Reproductive Health: Briefing Sheets for Gender Analysis. New York, NY: Population Council, 1994.
- Wjau W, Radeny S. Sexuality among Adolescents in Kenya. Nairobi: Kenya Association for the Promotion of Adolescent Health, 1995.
- Sharif H. AIDS education efforts begin to address plight of Tanzania youth. AIDS Captions 1993; 1(1):20-21.
- Ankomah A. Premarital relationships and livelihoods in Ghana. Focus Gender 1996;4(3): 39-47.
- Dagne HG. Early marriage in Northern Ethiopia. Reprod Health Matters 1994; (4):35-38.
- Alan Guttmacher Institute. Sexual Relationship and Marriage Worldwide [Women, Families, and the Future]. New York, NY: The Institute, 1994.
- Toubia N. Female genital mutilation and the responsibility of reproductive health professionals. Int J Gynaecol Obstet 1994; 46:127-135.
- Kiragu K. Female genital mutilation: a reproductive health concern. Popul Rep J 1995; 23(33, Suppl):1- 4.
Compiled by Lola Delano
February 1998 © Advocates for Youth