Determinants of Gender-based Violence Among Girls and Young Women Aged 11-24 Years Seeking Care at a Rural Hospital in Zimbabwe: A Case-Control Study

Abstract Background: Physical and sexual violence against women and girls has become a widespread public health challenge associated with negative physical and psychological consequences not only to the victim but to society at large. Gender-based violence (GBV) can result in unwanted pregnancies, unsafe abortions, anxiety, stress, depression, and sexually transmitted infections. The problem is more prevalent in low-income settings like Zimbabwe and this study aimed to investigate the determinants of GBV among young women and girls aged between 11- 24 years, seeking healthcare services at a rural hospital in Zimbabwe.Methods: A 1:1 unmatched case-control study was conducted at a rural hospital in Buhera District, Zimbabwe. A total of 104 cases and 104 controls were recruited using purposive and systematic random sampling methods, respectively. The data was collected using a pretested interviewer-administered questionnaire and data were analyzed using Epi Info statistical package. Bivariate analysis and multivariate logistic regression at 95% confidence interval and statistical significance were set at p-value<0.05.Results: The pooled mean age of participants was 17.6±3.8 years and 89.4% of the cases had no familial relations with perpetrators. Bivariate analysis revealed that young age (<19 years), apostolic religion, having no formal education, not married, living in a polygamous family, and having >3 siblings were associated with GBV. Cases were more likely to report to a health center and were less likely to confide in someone. The most prevalent causes of GBV were religious and cultural beliefs, forced marriages, and alcohol abuse within a family. After multivariate analysis, young age [Adjusted odds ratio (AOR): 4.8; 95% Confidence interval (CI):1.3-17.2], polygamy [AOR: 13.8(3.6-53.1)], alcohol abuse in the family [AOR: 4.1(1.3-13.3)] were associated with GBV, while confiding in someone was protective [AOR: 0.05 (0.01-0.2)].Conclusion: Community religious and cultural beliefs and family structure are major areas to consider when intervening against violence against women. To eradicate GBV, there is a need for collaborative multi-sectoral interventions aimed at sensitizing the community on gender equality and the use of peaceful conflict resolution methods. Education on GBV should integrate children of school-going age, faith-based organizations, and community members in crafting sustainable interventions.