http://ugspace.ug.edu.gh/ UNIVERSITY OF GHANA COLLEGE OF HUMANITIES DEPARTMENT OF SOCIAL WORK EXPERIENCES OF INTIMATE PARTNER VIOLENCE AMONG MIGRANT FEMALE HEAD PORTERS IN KUMASI BY EMMANUEL ADOMAKO BRENYAH (10244043) THIS THESIS IS SUBMITTED TO THE UNIVERSITY OF GHANA, LEGON IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF MPHIL SOCIAL WORK DEGREE JULY, 2016 1 http://ugspace.ug.edu.gh/ DECLARATION I Emmanuel Adomako Brenyah declare that, this thesis is my own research which was conducted under supervision and it has not been published publicly or submitted by anybody for award in any institution. …………………….. ……./…../……… Emmanuel Adomako Brenyah Date Supervisors …………………….. …..../…../……… Dr. Mavis Dako-Gyeke Date …………………… ……/…../……… Dr. Cynthia A. Sottie Date i http://ugspace.ug.edu.gh/ ABSTRACT Although intimate partner violence has been in existence for decades, it is a social problem because it violates human rights in many countries including Ghana. Hence, this study explored the experiences of intimate partner violence among migrant female head porters in Kumasi. The objectives of the study were to (a) explore the forms of intimate partner violence experienced by migrant female head porters, (b) identify the factors that contribute to intimate partner violence among migrant female head porters, (c) find out the effects of intimate partner violence on migrant female head porters and (d) ascertain the coping strategies adopted by migrant female head porters in abusive relationships. The study adopted a qualitative research design and selected 23 participants comprising 17 migrant female head porters, two group leaders from the head porters, two officials from Marie Stopes International and two officials from Domestic Violence and Victims Support Unit (DOVVSU). Purposive and snowball sampling techniques were employed and individual interviews were used to collect data. The data were analysed thematically and it was found that, migrant female head porters experienced physical, sexual, psychological and financial abuse. In addition, the study revealed that, factors such as alcohol and drug addiction, lack of education, culture of silence, and cultural beliefs contributed to intimate partner violence among migrant female head porters. Furthermore, it was found that, physical injuries, limited use of contraceptives, inability to provide for children’s basic needs, were some effects of partner violence on migrant female head porters. Moreover, evidence showed that, none of the migrant female head porters consulted institutions like DOVVSU for help. The study concludes that, migrant women are vulnerable to intimate partner violence and therefore recommends that, DOVVSU should design programs that would help detect and address intimate partner violence among migrant populations. ii http://ugspace.ug.edu.gh/ ACKNOWLEDGMENTS I will like to thank the Almighty God for the special grace and protection throughout this research. I will also like to offer a profound gratitude to my supervisors Dr. Mavis Dako-Gyeke and Dr. Cynthia A. Sottie for their time and guidelines in this research. The next appreciation goes to Carnegie Next Generation for Academics in Africa Project for supporting this research through their scholarship award. Special thanks to my lovely wife Mrs Philomena Adomako for her love and support. A word of gratitude to Mr. Martin Brenyah, Mrs. Rosina Agyeiwaah, Mrs. Agnes Brenyah, Mrs. Ophelia Brenya, Mr. Emmanuel Agyeman Brenya, Mr. Osei Agyapong Gideon and Mr. Oppong Agyen Seth. To all the Lecturers, Teaching and Graduate Assistants at the Department of Social Work University of Ghana, Legon, I say thank you. To my fellow students who in one way or the other provided me with support, encouragement and friendship, I say thank you and God richly bless you. My next appreciation goes to all the female head porters in Kumasi who participated in the study, thank you for your participation. iii http://ugspace.ug.edu.gh/ DEDICATION To my lovely wife, Mrs. Philomena Adomako, my son Kofi Nyamekye Adomako and my mother Rosina Agyeiwaah. iv http://ugspace.ug.edu.gh/ TABLE OF CONTENTS Declaration………………………………………………………………………………………..i Abstract………………………………………………………………………………………..…ii Acknowledgments…………………………………………………………………………….…iii Dedication……………………………………………………………………………………….iv CHAPTER ONE ............................................................................................................................. 1 INTRODUCTION .......................................................................................................................... 1 1.1 Background of the Study ....................................................................................................... 1 1.2 Statement of the Problem ...................................................................................................... 3 1.2 Objectives of the Study ......................................................................................................... 5 1.3 Research Questions ............................................................................................................... 5 1.4 Significance of the Study ................................................................................................................ 6 1.5 Study Area ............................................................................................................................. 6 1.6 Definition of Terms ............................................................................................................... 8 1.7 Organization of the Study ............................................................................................................... 9 CHAPTER TWO .......................................................................................................................... 10 LITERATURE REVIEW ............................................................................................................. 10 2.1 Introduction ......................................................................................................................... 10 2.2 Forms of Intimate Partner Violence Experienced by Migrant Women .................................. 10 2.3 Factors that Contribute to Intimate Partner Violence among Migrant Women .................... 15 2.4 Effects of Intimate Partner Violence on Women ....................................................................... 20 2.5 Coping Strategies Adopted by Migrant Female Head Porters in Violent Relationships ..... 25 2.6 Theoretical Perspectives ............................................................................................................... 29 2.6.1 Ecological Framework (Bonnie E. Carlson, 1984) ................................................................ 29 2.6.1.1 The Individual Level ............................................................................................................... 29 2.6.1.2 The Family / Relational Level ............................................................................................... 30 2.6.1.3 Social-Structural Level ........................................................................................................... 31 2.6.1.4 Sociocultural Level ....................................................................................................... 31 2.6.1.5 Application of the Ecological Framework to the Study ..................................................... 32 2.6.2 Stress, Appraisal and Coping Theory (Richard S. Lazarus and Susan Folkman, 1984) ... 32 2.6.2.1 Confronting ................................................................................................................... 33 v http://ugspace.ug.edu.gh/ 2.6.2.2 Distancing...................................................................................................................... 33 2.6.2.3 Self-Control ................................................................................................................... 34 2.6.2.4 Seeking Social Support ........................................................................................................... 34 2.6.2.5 Accepting Responsibility ....................................................................................................... 34 2.6.2.6 Escape-Avoidance ......................................................................................................... 35 2.6.2.7 Planful Problem Solving ........................................................................................................ 35 2.6.2.8 Positive Reappraisal ................................................................................................................ 35 2.6.2.9 Application of the Stress, Appraisal and Coping Theory to the Study ............................ 36 CHAPTER THREE ...................................................................................................................... 37 RESEARCH METHODOLOGY.................................................................................................. 37 3.1 Introduction ......................................................................................................................... 37 3.2 Research Design .................................................................................................................. 37 3.3 Target Population ................................................................................................................ 37 3.4 Study Population ................................................................................................................. 38 3.5 Sampling Technique ............................................................................................................ 38 3.6 Sample Size ......................................................................................................................... 39 3.7 Sources of Data ................................................................................................................... 39 3.8 Methods of Data Collection.......................................................................................................... 39 3.9 Data Handling and Analysis ......................................................................................................... 40 3.10 Ethical Considerations....................................................................................................... 41 3.10.1 Informed Consent ........................................................................................................... 41 3.10.2 Confidentiality ................................................................................................................ 41 3.10.3 Pseudonyms and Anonymity .................................................................................................. 41 3.10.4 Plagiarism ....................................................................................................................... 42 3.11 Trustworthiness and Credibility ................................................................................................ 42 3.12 Limitations of the Study……………………………………………………………..…..43 CHAPTER FOUR ......................................................................................................................... 44 PRESENTATION OF FINDINGS AND DISCUSSION ............................................................. 44 4.1 Introduction ......................................................................................................................... 44 4.2 Demographic Characteristics of Participants ............................................................................. 44 4.3 Forms of Intimate Partner Violence Experienced by the Migrant Female Head Porters ..... 45 vi http://ugspace.ug.edu.gh/ 4.3.1 Physical Abuse ................................................................................................................. 45 4.3.2 Sexual Abuse .................................................................................................................... 50 4.3.3 Psychological / Emotional Abuse ............................................................................................. 52 4.3.4 Financial Abuse ................................................................................................................ 54 4.4 Factors that Contribute to Intimate Partner Violence among the Female Head Porters ...... 55 4.4.1 Individual Factors ............................................................................................................. 56 4.4.2 Family/Relational Factors ......................................................................................................... 61 4.4.3 Social Structure ................................................................................................................ 62 4.4.4 Socio-Cultural Factors ............................................................................................................... 67 4.5 Effects of Intimate Partner Violence on Migrant Female Head Porters ................................. 71 4.5.1 Physical Injuries ............................................................................................................... 71 4.5.2 Reproductive Health Issues ....................................................................................................... 72 4.5.3 Psychological Problems ............................................................................................................. 74 4.5.4 Social Isolation ................................................................................................................. 76 4.5.5 Effects on Children........................................................................................................... 77 4.5.6 Effects on Employment…………………………………………………………………………..79 4.6 Coping Strategies Adopted by Migrant Female Head Porters in Violent Relationships ..... 80 4.6.1 Seeking Social Support .............................................................................................................. 80 4.6.2 Self-Control ...................................................................................................................... 81 4.6.3 Distancing......................................................................................................................... 82 4.6.4Confronting…………………………………………………………………………………….….83 4.6.5 Accepting Responsibility ........................................................................................................... 83 4.6.5 Positive Reappraisal ......................................................................................................... 84 4.6.7 Escape Avoidance………………………………………………………………………………..85 4.6.6 Plan Problem Solving ....................................................................................................... 85 4.7 Discussion of the Findings ........................................................................................................... 86 CHAPTER FIVE .......................................................................................................................... 93 SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS ....................... 93 5.0 Introduction ......................................................................................................................... 93 5.1 Summary of the Findings .................................................................................................... 93 5.2 Conclusions ......................................................................................................................... 95 5.3 Recommendations ............................................................................................................... 97 vii http://ugspace.ug.edu.gh/ 5.4 Implications for Social Work……………………………………………………………..98 REFERENCES…………………………………………………………………………………100 APPENDICES...………………………………………………………………………...……..113 Appendix I……………………………………………………………………………...……114 Appendix II…………………………………………………………………………………..118 viii http://ugspace.ug.edu.gh/ CHAPTER ONE INTRODUCTION 1.1 Background of the Study Intimate partner violence has been in existence for decades. It is a social problem because it violates human rights in many countries including Ghana. Intimate partner violence also known as domestic violence refers to the physical, sexual, psychological, economic and financial violence perpetrated by an intimate partner against the other (United Nations (UN), 2014). These forms of violence committed by an intimate partner may include but not limited to kicking, slapping, punching, stabbing, death threats, insults, false accusation, shouting, and forced sexual intercourse (Gender Studies and Human Right Documentation Centre (GSHRDC), 2015). Intimate partner violence is an extreme indicator of gender inequality in society (World Health Organisation (WHO), 2014), and an act that strips victims of safety in their homes and communities (Pillai, 2001). It is the most common form of violence against women which usually leads to death, physical injury, functional impairment, reproductive and mental health problems (WHO, 2014). Reports on intimate partner violence show that it occurs in all countries, cultures and cuts across societies irrespective of classes, races, religion and ethnicities (WHO, 2002). It is estimated that one in three women in the course of her lifetime, experiences intimate partner violence although some population are at greater risk than others (Population Action International, 2013). Domestic violence against women by an intimate partner is not simply a physical assault on her but rather an attack on her entire person, her dignity, her self-worth and her very right to humanity (International Rescue Committee (IRC), 2012). 1 http://ugspace.ug.edu.gh/ Intimate partner violence is a major international, social and public health problem in both developed and developing countries (Agnihotri, Agnihotri, Jeebun, & Purwar, 2006). Globally, an estimated 35% of women have experienced some form of intimate partner violence, 70% of women have experienced physical or sexual violence in their life time and almost half of all women who died in 2012 were killed by their intimate partners (United Nations, 2014). In the United States for example, on average, nearly 20 women per minute are physically abused by an intimate partner which equates to more than 10 million in a year (National Coalition Against Domestic Violence, 2015). Reports from China also show that, about 34% of women have experienced partner violence in the course of their life (Parish, Wang, Laumann, Pan, & Luo, 2004). In South–Western part of Nigeria, it is estimated that the incidence rate of women that experience intimate partner violence is recorded around 89.2% (Silver, Irabor, Olowookere, Owoaja & Adebusoye, 2015). Numerous factors contribute to men’s attitudes towards intimate partner violence in countries like Ghana and some of these factors are ethnicity, socio-cultural beliefs, patriarchy, religion, and financial status (Takyi & Mann, 2006). For example, women believe that the home, including the extended family system forces them to do things just to satisfy society by sometimes marrying the family’s choice and staying in abusive relationships (Amoakohene, 2004). This notion is affirmed by some women in Ghana who presuppose that, tradition has defined certain roles which perpetuate their abuse in relationships with men (Amoakohene, 2004). As a result, intimate partner violence against women in societies like Ghana is significantly underreported by survivors due to stigma, shame and fear mostly associated with it (IRC, 2012). The fact that it occurs in private spheres, many women find it difficult speaking about their experiences (Usta, Farver & Pashayan, 2007). In addition, women who experience 2 http://ugspace.ug.edu.gh/ intimate partner violence are perceived as not performing their roles well as mothers or wives leading to their abuse in some African countries and often resulting in isolation by friends and family members (IRC, 2012). It is against this backdrop that the study sought to explore the experiences of intimate partner violence among migrant female head porters in Kumasi. 1.2 Statement of the Problem In Ghana, it is estimated that one out of three women has experienced physical violence at the hands of a current or previous partner (GSHRDC, 2015). In addition, two out of ten women experienced their first sexual intercourse with an intimate partner through forced means, and three out of ten women are forced by their male partners to have sex sometime in their life (GSHRDC, 2015). This shows that majority of women in Ghana may have experienced intimate partner violence in one form or the other, in the course of their life time. Intimate partner violence, particularly physical abuse has become a daily occurrence in Ghana as reported by the media (Amoakohene, 2004). Additionally, about five percent of women in Ghana have experienced intimate partner violence during pregnancy (Pool, Otupiri, Owusu-Dabo, Jong, & Agyemang, 2014). At least 2,795 cases of wife battery and assault were reported to the Domestic Violence and Victim Support Unit of the Ghana Police Service in the year 2013, and this number increased to 5,212 cases in 2014 (Abbey, 2015). Although women could be perpetrators of violence in relationships with men, majority of the abuses are inflicted on women by men, and the consequences of the violence are more for women as compared to men (Moore, 2008; WHO, 2012). Even though many population- based studies on intimate partner violence have been conducted in Ghana (e.g., Amoakohene, 2004; Dery & Diedong, 2014; Pool et al, 2014; Takyi & Mann, 2006), those that focus on women always concentrate on the larger population by often ignoring certain key populations of women 3 http://ugspace.ug.edu.gh/ with much vulnerability to violence (Muldoon, Deering, Feng, Shoveller, & Shannon, 2015). Nonetheless, there may be unseen and minority groups who are more vulnerable to intimate partner violence among women. For instance, migrant women may be at risk of domestic violence, due to their immigration status. They may face a more difficult time escaping abuse (Stavroula, Beverly, & Tonya, 2012). Migrant women who are in intimate relationships experience higher levels of physical and sexual abuse than single migrant women with 59.5% compared to 49.8% respectively (Dutton, Leslye, & Giselle, 2000). Migrant women often feel trapped in abusive relationships because of various factors, such as language barriers, social isolation and lack of financial resources (Stavroula et al., 2012). Often, migrant women face discrimination both due to their status as migrants and as women (Susan, 2003). Migrant women become more vulnerable and are exposed to countless abuses especially when their residence is dependent upon a relationship with a man (Susan, 2003). Consequently, they find it difficult to leave the abusive relationship regardless of how severe the abuse is because they rely on their partners as their sole means of support (Erez & Ammar, 2003). If a woman migrates from her home of origin to another place, she faces subordination not only as a woman, but also as a minority on a foreign land regardless of the class to which she belongs in her place of origin (Adams & Campbell, 2012). Moreover, socioeconomic and security reasons could lure migrant women into relationships which predispose them to partner violence. Migrant women victimised by intimate partner violence, hardly seek support from professionals because they fear the actions of these professionals will lead to their husbands neglecting them and their children (Erez & Ammar, 2003). Migrant women stand the risk of losing their children to abusive husbands in times of divorce and in cases where the women move back to their home of origin (Erez & Ammar, 4 http://ugspace.ug.edu.gh/ 2003). This and many other factors could trap migrant women in abusive relationships. While studies have been conducted by some scholars on migrant female head porters in Ghana (e.g., Boakye-Yiadom, 2008; Hashim, 2005; Kwankye, 2012), not much is known about their experiences with regard to intimate partner violence. This study seeks to contribute to filling this research gap. 1.2 Objectives of the Study The following were the objectives of the study: 1. To explore the forms of intimate partner violence experienced by migrant female head porters in Kumasi. 2. To identify factors that contribute to intimate partner violence against migrant female head porters in Kumasi. 3. To find out the effects of intimate partner violence on migrant female head porters in Kumasi. 4. To ascertain the coping strategies adopted by migrant female head porters in abusive relationships in Kumasi. 1.3 Research Questions The study sought to answer the following questions: 1. What are the forms of intimate partner violence experienced by migrant female head porters in Kumasi? 2. What factors contribute to intimate partner violence against migrant female head porters in Kumasi? 3. What are the effects of intimate partner violence on migrant female head porters in Kumasi? 5 http://ugspace.ug.edu.gh/ 4. What are the coping strategies adopted by migrant female head porters in abusive relationships in Kumasi? 1.4 Significance of the Study The findings of this study would contribute to research, policy and practice. Findings of the study will add to existing literature on the forms of intimate partner violence and factors that contribute to intimate partner violence among female head porters. It will serve as a source of reference for future researchers. Moreover, findings of the study will provide information to policy makers regarding the vulnerability of migrant female head porters to intimate partner violence. This information will aid in the formulation of requisite policies that could protect migrant female head porters. Findings of the study will also provide information to social workers and other practitioners with regard to the effects of intimate partner violence and the coping strategies migrant female head porters adopt in abusive relationships. This information could be used as an advocacy tool to promote the formulation of policies and programmes that would address intimate partner violence among vulnerable populations like migrant female head porters. Additionally, based on the findings of this study, social work practitioners could embark on awareness creation programs to sensitise the public about the effects of intimate partner violence on the wellbeing of women and society at large. 1.5 Study Area Kumasi is the regional capital of the Ashanti Region of Ghana. It has a total surface area of 254sqkm and located in the center of the Ashanti Region (Kumasi Metropolitan Assembly (KMA), 2015). According to the Ghana Statistical Service (2014), the population census 6 http://ugspace.ug.edu.gh/ conducted in 2010 recorded a total of 1,722,806 people in the Kumasi metropolis but this was estimated to increase to 2.5 million people by the year 2015 as a result of its role as a commercial city. The city’s population is always on the increase since past decade as a result of youth emigration from other regions as well as rural areas within the region (KMA, 2015). The Kumasi metropolis has an advantageous position when it comes to transportation and commercial activities for both domestic and international (KMA, 2015). Kumasi serves as a middle point in terms of transportation between the south and north of Ghana as well as surrounding neighbouring countries (KMA, 2015). The city of Kumasi can boast of business centres like Kejetia lorry terminal, Central Market, Adum and Dr. Mensah Market which attract traders within and outside the region. As a result of the commercial nature of the Kumasi metropolis, there has been an influx of migrants both internal and international with an estimated population of about one-third of the total population in the region (KMA, 2015). The study was conducted in the Kumasi metropolis in the Ashanti region because the city’s status as administrative and commercial centre has led to the influx of many female migrants from the three northern regions in Ghana, to engage in economic activities. Participants were selected from the Kumasi central market and Adum business centre because many female migrants are located in lorry stations and market centres where they help retailers and wholesalers carry their loads in exchange for money. 7 http://ugspace.ug.edu.gh/ 1.6 Definition of Terms Intimate Partner Violence: Any behaviour in an intimate relationship that is likely to cause harm to either the man or the woman in such relationship (WHO, 2012). Female Head Porters: They are women who carry loads on their heads at business centers in exchange for money. Migrants: They are people who have moved from their place of origin to settle either within or outside their home country. Domestic Violence: Violence perpetrated by intimate partners and other family members which is manifested through physical, sexual, psychological and economic abuse (United Nations Children’s Fund, 2000). Intimate Partner: A person with whom one has a close personal relationship that may be characterised by the partners’ emotional connectedness, physical contact and sexual behaviour, and have knowledge about each other’s lives (Breiding, Basile, Smith, Black & Mahendra, 2015). Intimate Partner Include current or former spouses, boyfriends/girlfriends, Relationship: dating partners and ongoing sexual partners (Breiding et al., 2015). 8 http://ugspace.ug.edu.gh/ 1.7 Organisation of the Study The study has been organised in five chapters. The first part is chapter one which comprises of background of the study, statement of the problem, study objectives, research questions, significance of the study, study area, definition of key concepts and organisation of the study. Chapter two is made up of literature review and theoretical perspectives. Chapter three includes research design, target population, study population, sampling techniques, sample size, methods of data collection, sources of data, data handling and analysis, ethical considerations, trustworthiness and limitation of the study. Chapter four focuses on presentation and analysis of the findings of the study. Chapter five comprises of summary of findings, conclusions, recommendations and implications for social work. 9 http://ugspace.ug.edu.gh/ CHAPTER TWO LITERATURE REVIEW AND THEORETICAL PERSPECTIVES 2.1 Introduction This chapter presents the literature review and theoretical perspectives. According to Kiteley and Stogdon (2014), a literature review is a comprehensive summary of ideas, issues, approaches and research findings that have been published on a particular subject area or topic. In this chapter, literature has been reviewed on the following: (a) forms of intimate partner violence experienced by migrant women, (b) factors that contribute to intimate partner violence among migrant women, (c) effects of intimate partner violence on women and (d) coping strategies adopted by migrant women in abusive relationships. The chapter also comprises of the ecological framework and stress, appraisal and coping theory as theoretical perspectives underpinning the study. 2.2 Forms of Intimate Partner Violence Experienced by Migrant Women The occurrence of domestic violence is pervasive. The literature shows that partner abuse can take on a variety of forms, and most often women experience multiple types of violence in intimate partner relationships (IRC, 2012). Hazen and Soriano (2007) conducted a study that focused on the experiences of intimate partner violence among Latina women who were classified as born in the United States of America (USA), immigrant or migrant seasonal workers. The study used individual interviews to collect data from 292 women that received community health care services from San Diego County in California between January and March 2002. The study used the Psychological Aggression, Physical Assault, and Sexual Coercion scale of the Revised Conflict Tactics Scale to measure women’s experiences of intimate partner violence. Findings of the study revealed that, out of the total participants, 33.9% experienced physical assault with 17.8% experiencing severe assault such as being punched, 10 http://ugspace.ug.edu.gh/ kicked and beaten. Twenty-one percent reported experiencing sexual coercion with which 7% reported severe sexual coercion like using physical force or weapon to coerce sexual intercourse. Finally, 82.5% reported experiencing psychological aggression in intimate relationships. In addition, various forms of intimate partner violence have been reported among West African immigrants in the USA in a study conducted by Akinsulure-Smith, Chu, Keatley and Rasmussen (2013). The study adopted individual interviews and focus group discussions to explore intimate partner violence among 32 heterosexual immigrants. The study used the grounded theory approach to analyse the data. Participants in the study reported experiencing more physical violence from their partners. For example, one participant reported an incident which involved her husband hitting her stomach. The study further revealed participants’ experiences of psychological abuse such as partners hiding toothpaste from the women and husbands having sex with participants any time they the husbands wanted. The study recommended an active outreach to both men and women to provide information and education through different types of media and in different languages to address intimate partner violence among West African communities in the USA. Although, the studies by Akinsulure-Smith et al. (2013), Hazen and Soriano (2007) were conducted in the USA among West Africans and Latinos respectively, both reported different forms of abuse in terms of physical and psychological respectively. Colucci, O’Connor, Field, Baroni, Pryor, and Minas (2013) explored the nature of family violence experienced by Indian women living in Australia. The study used focus group sessions, theatre workshops and community theatre performances as methods of data collection. Seventy- two participants were selected for the focus group sessions and 114 participants agreed to take part in the community theatre performances. Fourteen volunteers participated in the theatre workshop. Data for the study were analysed using the principles of interpretative 11 http://ugspace.ug.edu.gh/ phenomenological analysis. It was revealed that women experienced psychological abuse in the form of excessive control, humiliation, verbal abuse, and threats including the threat of deportation and cancellation of visas. In addition, it was found that participants were controlled by their partners in terms of the money they earned and other possessions. Physical abuse such as beating, hitting and punching were also reported by participants in the study. Besides, the women were forced to engage in sex during menstrual periods, pregnancy and when sick. The study concluded that immigrant Indian women living in Australia were vulnerable to different kinds of domestic violence. The Institute on Domestic Violence in the African American Community (IDVAAC) brought together women representing sixteen different countries, service providers and survivors to engage in domestic violence roundtable discussions to explore issues of domestic violence from their cultural perspectives. This was done in order to understand the needs of African immigrants who were victims of partner violence in the USA. In reporting these women’s stories and their experiences of intimate partner violence, Mose and Gillum (2016), revealed that women participants of the roundtable discussions reported sexual abuse as the worst form of abuse they have experienced. The participants reported that their partners sexually abused them because of cultural practices such as the bride price. They revealed that men of African origin were brought up to believe that sex was granted at marriage and wives had no option than to comply with their sexual desires. It was found that many African men believed there was no such thing as ‘marital rape’. African immigrants reported experiencing more sexual violence than any form of violence. In a qualitative study conducted in the USA, Jordan and Bhandari (2016) investigated the lived experiences of South Asian women who experienced domestic violence. The study used a convenience sampling method to select 20 women from five Asian women organisations across 12 http://ugspace.ug.edu.gh/ the USA. Data were collected through in-depth telephone interviews. Participants of the study reported experiencing physical abuse, such as slapping, pulling of hair, throwing of objects, punching and pushing. In addition, it was found that participants experienced psychological violence like intimidation, coercion, threats, and isolation from their partners. Sexual abuse such as forced sexual contact, sexual coercive behaviours and withholding sex with the intention of punishing women were also found. It was obvious that sexual abuse reported by Mose and Gillum (2016), Jordan and Bhandari (2016) were influenced by cultural beliefs of perpetrators that they had power over women in intimate relationships. Moreover, Leung and Cheung (2008) conducted a study on the prevalence of partner abuse in six Asian American ethnic groups in USA. The study adopted a survey research design and included 1577 participants. Out of the total participants, 13.5% reported that their partners had thrown objects at them, 7% reported being pushed by their partner, 5% reported being slapped, 4% reported being hit with an object, 2% reported being threatened with a knife or gun and 2% reported that they had been beaten by their partners. Furthermore, Abraham (1999) researched on immigrant women in the USA from India, Pakistan and Bangladesh who were abused within their marriages. The study engaged 25 participants in face to face interviews and found that, women in Southern Asia experienced more sexual violence because traditionally, men were taught that sex was their masculine right as husbands and as such marital rape was very prevalent. The study found that men and women from Southern Asia were socialized in the context of sexual relations in marriages which emphasised sexual satisfaction for men and the suppression of women’s sexual needs. As a result, more than 60% of immigrant women from Southern Asia in USA were forced to have sex with their husbands against their will. 13 http://ugspace.ug.edu.gh/ Soni, Hari and Yoko (2009) conducted a study in the USA on the experiences of partner abuse among Nepali women. The researchers adopted a mixed methods design for the study. A total number of 45 participants were selected for the study and 51% of the women reported being abused psychologically. Also, 75.6% reported being verbally abused, 60% reported their partners humiliated them in front of others and 11.1% reported feeling threatened by their partners. The study concluded that Nepali women living in the USA experienced more emotional and psychological abuse than physical and sexual abuse. Whilst South Asian women living in the USA experienced sexual abuse as a result of socialisation (Abraham, 1999), Nepali women in USA experienced more psychological abuse (Soni, et al., 2009). In a quantitative study that involved 189 participants, Kim and Sung (2016) studied the experiences of psychological abuse among Chinese immigrant women in New York City. The study used secondary data from the Chinese Community Organisation and adopted descriptive and multiple regression methods to analyse the data. The findings of the study revealed that, 90.5% reported verbal abuse, 76.2% reported threats and 68.8% reported emotional abuse by their partners. Psychological abuse was the most predominant form of violence experienced by Chinese women that lived in New York. Hurwitz, Gupta, Liu, Silverman and Raj (2006) studied the prevalence of physical abuse among South Asian women living in the USA. The study adopted a mixed methods design in a cross- sectional survey. Out of the 208 participants sampled, about 55% reported being abused physically by a previous or current partner. The study concluded that physical abuse was a prevailing form of intimate partner violence among South Asian women living in the USA. In a similar study conducted among Chinese American women, Hicks (2006) adopted a probability sampling survey to investigate the prevalence and nature of intimate partner violence. The study 14 http://ugspace.ug.edu.gh/ found 23 incidents of physical abuse among 181 cases of intimate partner violence. Hurwitz et al. (2006) found more incidents of physical abuse as compared to Hicks (2006) which reported less physical abuse, even though both studies were conducted in the USA among different immigrant population. This was perhaps as a result of the difference in the research designs they adopted. Kim and Sung (2000) examined the rate of intimate partner violence among Korean American families. The study sampled 256 participants and conducted telephone interviews. Findings of the study revealed that 18% of participants had experienced at least one act of physical abuse such as pushing, slapping, throwing object and grabbing. About 6% of participants reported severe physical violence like kicking, biting, threatening with gun and hitting with an object. Rees and Pease (2007) conducted a qualitative study in Australia and adopted purposive sampling to select 78 participants consisting of immigrants from Ethiopia, Sudan, Serbia, Croatia, Bosnia and Iraq. The study examined the experiences of domestic violence among immigrant women in Australia and the types of violence they experienced. The findings showed that financial abuse was a prominent form of domestic violence where men controlled women through dominating financial resources. 2.3 Factors Contributing to Intimate Partner Violence among Migrant Women Zannettino (2012) explored the factors that contributed to domestic violence among the Liberian community in South Australia. The study adopted a qualitative research design and participants were selected from the Liberian Women’s Gathering in Australia. Eight to ten women were involved in five focus group discussion sessions by the study. Consultations were also done with the leaders of the Liberian community. Data for the study were analysed inductively. The 15 http://ugspace.ug.edu.gh/ findings of the study revealed that participants believed seeking help for domestic violence would require leaving their husbands and partners and would cause a broken home. In addition, the study showed that participants believed seeking help would hurt their husbands and bring shame to the family and community. These factors further contributed to domestic violence among Liberian immigrant women in Southern Australia because these beliefs contributed to their silence in abusive relationships. In another study conducted in rural North Carolina, Moracco, Hilton, Hodges and Frasier (2005) adopted a mixed methods research design to find out the knowledge and attitudes about intimate partner violence among immigrant Latinos. One hundred participants were conveniently sampled. The researchers adopted face to face interviews, telephone interviews and surveys as methods of data collection. The study found that, alcohol and drug addictions by intimate partners contributed to the abusive cases among participants. Understanding and communication between couples, jealousy and women’s provoking attitudes were also contributing factors of intimate partner violence. The researchers concluded that alcohol and drug addiction were the main factors that contributed to intimate partner violence among Latino immigrants in North Carolina. Similarly, Zarza, Ponsoda and Carrilo (2009) researched factors that contributed to intimate partner violence among Latina immigrant women in New Jersey. Out of the 73 participants of the study, 40.9% of the partners of participants had more than 25 drinks per week, 15.1% had between six and 25 drinks per week and 15.1% consumed between two and five drinks per week. It was revealed that, a higher rate of alcohol use contributed to intimate partner violence. The studies by Moracco et al. (2005) and Zarza et al. (2009) similarly found alcohol addiction as a contributing factor to partner abuse among Latino immigrants in different locations. 16 http://ugspace.ug.edu.gh/ Tonsing (2014), in a qualitative study, used the snowball and purposive sampling methods to select 14 immigrants from Pakistan, India and Nepal for in-depth interviews during the months of November 2011 and May 2012 in Hong Kong. The focus of the study was to explore the perceptions and experiences of intimate partner violence among South Asian women immigrants in Hong Kong. The study found cultural factors such as women’s perception of making the marriage work, stigma attached to women for leaving abusive relationships, strong emphasis on maintaining the family privacy by not exposing partner abuse considered as a private family matter, and concerns for children, as contributing to partner violence. These factors kept South Asian immigrants in abusive relationships and instigated more abuses. Also, Colucci et al. (2013) researched on the factors that predisposed Indian immigrant women to domestic violence in Australia. The scholars found that, culturally, Indian community accepted inequality and violence against women, as women were expected to maintain silence in violent relationships. Once married, Indian women were expected to accept violence and did not receive social support from their friends and family members. Indian women who were victims of domestic violence were stigmatised, seen as irresponsible by community members and were the ones to blame. These attitudes towards violence generated fear among Indian immigrants for a possible disclosure of partner violence in Australia. The study reported that, over dependency of Indian immigrants on their partners, lack of knowledge about laws and rights, and lack of knowledge about services were some factors that contributed to domestic violence among Indian immigrants. The International Centre for Migration, Health and Development (2013) noted that certain factors contribute to domestic violence against migrant women. One factor was the lack of social support since migrant women left their entire social support systems behind in their country of 17 http://ugspace.ug.edu.gh/ origin. This made them dependent on their partners for emotional, social, and financial support. Most often, perpetrators exploited this dependency and increased women’s insecurity by socially isolating them. This increased the victims’ likelihood of staying in abusive relationships. Other factors were cultural differences (where women had different views on issues they believed to be acceptable for their spouses to abuse them), language barriers, lack of knowledge of available services, economic challenges and fear of deportation. Reina, Lohman, and Maldonado (2013) conducted a study that focused on the factors influencing domestic violence among Latina immigrants from Mexico and Central/South America residing in the USA. The study used individual interviews and focus group discussions to identify the challenges of 10 Latina immigrants who had experienced partner violence and receiving services from anti-violence organisations in the USA. The study revealed that seven out of ten participants indicated that immigration status was one of the major reasons that kept them in their abusive relationships. Participants of the study reported that their partners took advantage of their unstable immigration status as a form of blackmail and abuse. The study further revealed that participants were threatened of deportation by their partners so they were unable to report the abuse to anyone. A quantitative study was conducted by Zarza et al. (2009) on 73 Latina immigrant women in New Jersey. The study focused on finding out the predictors of partner violence among Latina immigrants. The study employed demographic frequency analysis, univariate and bivariate descriptive analysis and multiple regression analysis to analyse data from participants. According to the findings of the study, most participants (93%) reported that, their partners had witnessed or experienced family violence in their childhood. It was found that the participants’ partners had witnessed abuse of many kinds such as insults, beatings, from their fathers (87.5%) towards their 18 http://ugspace.ug.edu.gh/ mothers and on the part of their mothers towards their fathers (75%). In addition, participants themselves reported having witnessed abuse of their own during childhood on the part of their fathers towards their mothers (64.3%) and on the part of their mothers towards their fathers (21.2%). In a similar study, Fuchsel (2013) examined the linkage between childhood sexual violence and adult abuse among immigrant Mexican women in Southwestern USA. The study adopted an exploratory qualitative research design and used in-depth interviews to collect data from nine purposively sampled participants. The findings of the study indicated that seven out of the nine participants who had experienced adult abuse in their relationships were victims of childhood sexual abuse. Many of participant’s experiences of childhood sexual abuse included incest, date rape, and exhibitionism with some experiencing it for as long as five years. The study concluded that immigrant women who experienced childhood sexual abuse were at a greater risk of experiencing domestic abuse in their relationships later in life. Abrahams, Jewkes, Hoffman and Laubsher (2004) conducted a population based cross-sectional study in Cape Town between June 1998 and February 1999. The purpose of the study was to find out the prevalence and risk factors for the perpetration of sexual violence by men against female intimate partners. The study selected 1,368 men working in the Cape Town municipalities. The study found that, all the participants reported having multiple partners in the past with 215 reporting having between 1 and 4 current partners. Having multiple partners was reported as a major contributing factor of abuses against partners. Furthermore, the roles of some extended family members have been recorded by abused women as a contributing factor to intimate partner violence. Jordan and Bhandari (2016) found family 19 http://ugspace.ug.edu.gh/ involvement as a cause of intimate partner violence among 20 South Asian immigrants in the USA. It was revealed that, abuses that were experienced by participants comprised of verbal abuse, physical violence and maltreatment from the woman’s in-laws. Participants reported experiencing emotional abuse from their partner's’ mother in the form of shaming their ability to be acceptable wives and mothers. In a population based study conducted in Jordan; Clark, Silverman, Shahrouri, Everson-Rose and Groce (2010) adopted a mixed methods design that involved 17 focus group discussions for a total of 105 participants and a survey of 418 participants. The study found that, women who lived in the same home with their husbands’ family and/or in the same buildings with their husbands family members were at increased risk of experiencing intimate partner violence. It was revealed in 15 focus group discussions that in-laws interfered in the family affairs of women who had experienced intimate partner violence as these interferences contributed to their husband’s perpetration of the abuse. Also, 45% of the total surveyed participants reported interferences in their relationships from their husband’s extended family which contributed to their abuse by their partners. 2.4 Effects of Intimate Partner Violence on Women Victims of intimate partner violence experience both short and long term effects. Although death can be a result of abuse, physical injuries, emotional and psychological problems are more common results (DeJonghe, Bogat, Levendosky & von Eve, 2008). A qualitative study was conducted in the USA to find out the experiences of domestic violence among Russian speaking women (Crandall, Senturia, Sullivan & Shiu-Thornton, 2005). The researchers used a participatory action research style which means that they partnered with domestic violence service providers, advocates and victims of domestic violence. The study conducted individual 20 http://ugspace.ug.edu.gh/ semi-structured interviews and focus group discussions to collect data from 24 Russian speaking survivors of domestic violence. The findings of the study indicated that Russian speaking women reported having suicidal and homicidal thoughts and feeling stressed and nervous as a result of domestic violence. In addition, the women talked about feeling humiliated and weakened as the abuse destroyed their self-esteem. The study recommended that immigrant women be provided with information about support groups, laws and service agencies. Erez, Adelman and Gregory (2009) in a mixed methods study examined experiences of domestic violence cases among 139 immigrant women from 35 countries in the USA. The study was guided by the feminist theory of intersectionality. According to the findings of the study, the abuse resulted in severe mental and physical harm including physical injuries, anxiety, depression, withdrawal, and numbness. The study showed that about 34% of the victims of domestic violence required hospitalization because of the adverse effects of the abuse. Thurston et al. (2013) conducted a study among immigrant women in three Canadian cities between February 2005 and January 2006. The objectives of the study were to explore the individual causes of homelessness of immigrant women experiencing domestic violence and the pathways into and out of homelessness. The study adopted a qualitative research design and interviewed 37 immigrants in Calgary, Winnipeg and Halifax. The findings of the study revealed that many of the immigrant women interviewed became homeless as a result of domestic violence. The study indicated that the women left their family homes taking their children with them when the violence escalated and concern of their physical safety increased. It was revealed that factors such as low income, low education, unemployment, low English literacy and social isolation predisposed the immigrant women to homelessness when they left their family homes as a result of the abuses by their partners. 21 http://ugspace.ug.edu.gh/ Similarly, Mayock, Sheridan, and Parker (2012) conducted a study on the role of intimate partner violence as the cause of homelessness among migrant women living in Ireland. The study used a qualitative design and purposively selected 60 women for interviews. The study found that, 17 of the homeless women interviewed were immigrants of which 13 had experienced violence in an intimate partner relationship. The study reported that intimate partner violence was a prominent contributor to homelessness among the migrant women and an experience that had led to economic, social and personal consequences. Stockl, Filippi, Watts and Mbwambo (2012) examined induced abortion, pregnancy loss and intimate partner violence in Tanzania. The writers analysed data from the Tanzanian section of the multi-country cross-sectional survey conducted by the WHO (2005). The study found that out of the 3,270 women, 2,492 (91.89%) had been pregnant whiles in a relationship. Among the ever pregnant, ever partnered, 1,233 (49%) reported either physical or sexual abuse. About 568 (22.79%) of the ever pregnant, ever partnered reported having had a pregnancy loss and 169 (6.78%) reported an induced abortion. The study concluded that intimate partner violence was a contributing factor for induced abortion and pregnancy loss in Tanzania. Furthermore, intimate partner violence has a strong impact on the mental health of women. Pico- Alfonso, Garcia-Linares, Celda-Navarro, Blacos-Ros, Echeburua, and Martinez (2006) examined the impact of intimate partner violence on the mental health of women in Spain between the years 2000 and 2002. The study included 182 participants of which 130 reported being abused by their male partners. The study adopted a face to face interview style as their method of data collection. The study reported that intimate partner violence had a negative effect on the women’s mental health, increasing the incidence of depression, Posttraumatic Stress Disorder (PTSD), anxiety as well as suicide thoughts and attempts. In a similar study that adopted a cross- 22 http://ugspace.ug.edu.gh/ sectional survey in Tanzania; Mahenge, Likindikoki, Stockl and Mbwambo (2013) found that out of the 1180 women who were interviewed, 13% experienced symptoms of PTSD, 63% reported high level of anxiety and 73% reported symptoms of depression. The study found intimate partner violence as a significant cause of poor mental health among women as found by Pico-Alfonso et al. (2006). Hanan, Azizeth, Shaher, Ann, Hasan and Ahmad (2012) investigated the psychological problems experienced by Jordanian working women as a result of intimate partner violence. The study selected working engaged and married women in administrative and academic positions aged 18 years and above. One hundred and one participants were conveniently selected for the study. Descriptive statistics including frequency, mean, standard deviation and independence sample t- test were used by the writers to analyse data. The findings of the study indicated that as a result of the women’s experiences of intimate partner violence, 22.2% reported being late for work or leaving work early and 17.2% reported missing work. The findings of the study concluded that, the psychological effects of intimate partner violence on working women altered women’s efficiency levels at work and jeopardized their job security in the long run. Alio, Daley, Nana, Duan and Salihu (2009) examined the correlation between intimate partner violence and contraceptive use among women victims of domestic violence in Sub-Saharan African countries such as Cameroon, Kenya, Malawi, Rwanda, Uganda and Zimbabwe. The researchers used data from the national demographic and health survey conducted in each country between the years 2003 and 2006. In total, 24,311 women provided an account of their experience of intimate partner violence and contraceptive use. The findings of the study showed that African women who had ever been exposed to intimate partner violence were more likely to use contraceptives (65.9%) compared to those with no experiences of intimate partner violence 23 http://ugspace.ug.edu.gh/ (59%). The study found that women who experienced intimate partner violence used contraceptives to avert pregnancy in unfavourable settings and protected themselves against HIV/AIDS and other sexually transmitted diseases. In contrast, a qualitative study conducted by Wilson-Williams, Stephenson, Juvekar and Andes (2008) in rural Indian village of Gangadhar revealed that women experienced physical, sexual and emotional abuse in their quest to use contraceptives which prevented them from using it. The findings concluded that women in India were unable to negotiate for contraceptive use because of intimate partner violence. All the 64 participants revealed in a focus group discussion that their partners’ behaviour of abuse restricted their decision making in contraceptive use. Miller, Decker, McCauley, Tancredi, Levenson, Waldman, and Silverman (2010) researched on pregnancy coercion and birth control restraints among young women that experienced intimate partner violence in North California. The researchers selected 1,319 participants for the study and adopted cross-sectional surveys. The study used a quantitative research design and found that 53.4% participants reported having experienced physical or sexual abuse from an intimate partner. Out of the total number of participants with experiences of intimate partner violence, one in five (19.1%) was associated with pregnancy coercion by means of being hurt physically because they did not agree to get pregnant. Also, about one in seven (15.0%) of participants with experiences of intimate partner violence reported birth control restraints in which participants were abused for exploring methods of family planning. In addition, the study found that as a result of such behaviours, more than two in five (40.9%) of participants experienced unintended pregnancy. Hurwitz et al. (2006) reported sleep disruption, diminished functional health, emotional health concerns, chronic physical health concerns and suicidal thoughts as well as suicidal attempts 24 http://ugspace.ug.edu.gh/ among South Asian women in the USA who were victims of intimate partner violence. According to the researchers, women described how they were affected physically and emotionally as a result of intimate partner violence. In a population based study conducted in Spain; Diez, Escutia, Pacheco, Martinez, Caracena and Contreras (2009) adopted a cross- sectional survey to sample 333 participants from rural and urban areas. The study revealed that health consequences associated with intimate partner abuse were fainting, headaches, lack of appetite, hypertension, abdominal pain and migraines. These studies similarly found intimate partner violence leading to poor physical health consequences on victims. 2.5 Coping Strategies Adopted by Migrant Women in Abusive Relationships Laura (2010) explored the coping behaviours of 15 immigrant African survivors of intimate partner violence in the USA. The study adopted in-depth interviews as a means of data collection. The study revealed that, the immigrants used numerous strategies in order to survive in an abusive relationship. The study found that participants often resorted to hoping for the better and thinking the relationship would get better. It was revealed that participants of the study sought for God’s help and comfort through prayers and received affirmative and emotional support from family members back in Africa. The findings showed that some women endured the abuse and voiced the acceptance of their fate as women in male-dominated patriarchal culture with the certainty that men have the power to control them and it was better not to fight them. Hoan (2003) conducted a qualitative study to explore the help seeking behaviour among 34 abused Vietnamese American women. The study found that, many of the participants resulted to personal networks by asking for emotional support and help before reaching out to the criminal justice system. Twenty-one participants talked with relatives, friends and religious leaders about their experiences with intimate partner violence. However, shame and fear of the abuser 25 http://ugspace.ug.edu.gh/ prevented some from disclosing their abusive experiences to other people. The study revealed that about half of the participants asked for and received assistance from different victim service agencies like women’s shelters, victim advocates, health care, and refugee service agencies in addition to personal networks Mahapatra and DiNitto (2013) used survey methodology and logistic regression analysis to examine sociocultural factors associated with informal and formal seeking of help among 57 female South Asian domestic violence victims residing in the USA. Out of the 57 participants, 34 (60%) women sought informal help (from relatives and friends), and 15 (26%) woman sought formal help (from police, court, counsellors and doctors). The study revealed that participants found informal help (family members and friends) more helpful and effective in coping with an abusive partner. Participants in the study cited socio-cultural factors like isolation, patriarchy and acculturation as a reason for seeking or not seeking support. According to Bhuyan, Mell, Sullivan and Shui-Thornton (2005), sociocultural differences and beliefs among immigrant populations influences the way victims or survivors of domestic violence interpret their situations and what strategies they prefer to adopt in responding to intimate partner violence. In an interview with 39 Cambodian immigrant women living in the USA who were victims of intimate partner violence, the researchers found out that for Cambodians, domestic violence was considered a normal issue within a family. Cambodians believed that domestic violence was supposed to be kept within the family. Participants said that women were told to be patient and endure abuse from their husbands. There was a strong value on keeping the family together and divorce was thought to be detrimental to the children. The study revealed that many immigrant Cambodian women stayed in abusive relationships to work 26 http://ugspace.ug.edu.gh/ things out because they did not want others to hear about their family problems for the sake of their children and respect for their tradition. Furthermore, Farah, Natasha, Mary and Donna (2009) explored the views of immigrant women from India, Pakistan and Bangladesh residing in Toronto in the USA with experiences of partner abuse about the meaning of help-seeking and reasons for and against help-seeking. The study adopted focus group discussions to collect information from 22 women. Thematic analysis was adopted by the researchers to analyse the data. The study revealed reasons such as social stigma, women’s gender roles (silence, marriage obligations, subordinations), children’s well-being, lack of social support and knowledge gaps as contributing factors for delay in help-seeking. The findings of the study showed that participants tried personal strategies to cope with the abuse and did not disclose the extent of the abuse to friends and relatives. They tried to endure, sacrifice themselves and pray to God for an intervention. After privately coping with partner abuse for several years, the study revealed that participants later resorted to the service of physicians for help. Akinsulure-Smith et al. (2013) found some coping strategies adopted by West African immigrants in the USA. The study reported that women victims of intimate partner violence sought help from their family members and that of their partners but to no avail and were rather pressured to remain in the abusive relationships. The study revealed that when families offered no solutions, participants sought direction from elders or religious leaders within the community. Outside resources such as the police or support groups were often a last resort. In a qualitative study conducted among immigrant Sinhalese women in Toronto, Canada; Guruge (2014) worked on the perceptions about and responses to intimate partner violence. The study 27 http://ugspace.ug.edu.gh/ employed snowball sampling technique to select nine participants. Findings of the study revealed multi-level factors that influenced how Sinhalese immigrant women perceived and responded to partner abuse. Participants in the study perceived intimate partner violence as a private and shameful topic and as a result tended to hide their experiences. At the micro level, the study found children’s wellbeing, women’s financial dependency on the husband and family welfare as a key determinant of women’s responses to abusive relationship. A factor identified at the meso- level in the study was social apathy towards violence which reinforced the belief that intimate partner violence was a private matter. The macro-level factors participants revealed in the study included limitations in health as well as social and settlement services. These factors informed participants’ decision to endure the abuse and it kept them in the relationships without seeking any formal support or assistance. Moreover, Haj-Yahia (2000) examined wife abuse and battering in the sociocultural context of the Arab community. Concentrating on women’s strategies for coping with abuse and battering, the study surveyed 2,102 married Arab women in Israel using a systematic random sampling technique. Majority of the women indicated that in an attempt to cope with violence in relationships, it was always important to maintain the values of the Arab community. The women believed that strategies in coping with abusive relationship should be done within the context of the nuclear and extended family to maintain the family privacy. Participants reported that women in Arab societies were obligated to preserve the reputation of their family, respect their husband and seek the interest of their children’s wellbeing. They believed that these took precedence over the couple’s wellbeing. 28 http://ugspace.ug.edu.gh/ 2.6 Theoretical Perspectives This section provides a description of the theories that guided the study. The study adopted the Ecological Framework by Carlson (1984) and the Stress, Appraisal and Coping theory by Lazarus and Folkman (1984). 2.6.1 Ecological Framework (Bonnie E. Carlson, 1984) In 1984, Carlson developed the ecological framework to explain the factors that cause and maintain partner violence in society. The comprehensive conceptual framework is a modified version of Bronfenbrenner’s ecological theory of human development propounded in the 1970s. The ecological framework has been adopted by researchers to explain the issue of violence that occur in intimate relationships (e.g., Ali & Naylor, 2013; Heise, 1998; WHO, 2002). For example, the WHO (2002) used this model to explain the contributing factors to partner violence at the individual level, relationship level, community level and societal level; and has recommended the ecological framework as best suited in explaining the contributing factors to domestic violence. The ecological framework analyses violence within the family at different levels, which operate simultaneously, either independently or interactively. The ecological framework explains partner violence under four different and interrelated levels. These levels are the individual, family/relational, social structural and socio-cultural. 2.6.1.1 Individual Level The individual level focuses on what each partner brings with him or her to the relationship. Carlson (1984) identified self-esteem, attitudes, values, age, beliefs learned in one’s family, abilities, subjective perceptions and personal weaknesses. Carlson argued that the resources partners bring to the relationship play a critical role in violence perpetration or victimisation. The personal resources include occupational status and income, education, and talents. Family 29 http://ugspace.ug.edu.gh/ history is also a contributing factor at this level, thus being a victim of child abuse and/or neglect and witnessing one parent abusing the other as a child may predispose a person to perpetrate violence or become a victim. Relating the individual level to this study, personal attitudes of migrant female head porters like disrespecting their partners could predispose them to abuse. In addition, low level of education and unemployment of migrant female head porters could also contribute to abuse. Moreover, personal behaviours of intimate partners such as alcohol and drug addiction could contribute to partner abuse among migrant female head porters. Partners of female head porters with historical background such as witnessing their fathers abusing their mothers and being victims of childhood abuse may expose them to abusive behaviours which they could transfer into their future relationships. 2.6.1.2 Family / Relational Level At the family level, the relationships among the couples, between the partners and their friends and family members can contribute to the perpetrator of intimate partner violence. According to Carlson (1984), the nature of family role structures and interactions play a dynamic role in causing family violence. Carlson noted some causes such as changing of roles, family conflict over children and social network. By social network, he means the relationships between the couple and family members, friends and people within the community that contribute to partner violence. With regards to this study, influence from friends and relatives on partners could contribute to abuse of migrant female head porters. Issues relating to the care of children, financial support for migrant female head porters and hostile relationship between migrant female head porters and their partners may also contribute to intimate partner violence against migrant female head porters. 30 http://ugspace.ug.edu.gh/ 2.6.1.3 Social-Structural Level The social-structural level explains the context of the community in which social relationships occur. Carlson (1984) described the social structural level as major institutions in society such as the school, the workplace and law enforcement agencies that cause and maintain partner violence. The social-structural level factors include but are not limited to weak legal sanctions to offenders, institutional malfunctioning and poverty. This level focuses on the role of the community where the person lives, develops relationship and interacts with friends, school mates and work colleagues (Ali & Naylor, 2013). In this study, migrant female head porters may become over dependent on their partners for financial support due to poverty. This could predispose them to more abuse in their relationships since the partners become their sole support in their new place. Lack of institutional support, weak sanctions for perpetrators of partner abuse, and lack of programs and policies to deal with partner abuse can contribute to intimate partner violence among migrant female head porters. 2.6.1.4 Sociocultural Level The sociocultural level refers to societal norms, cultural values and belief systems that exist in the context of the broader society (Carlson, 1984). Carlson noted such factors like sexism and sex-role stereotyping. Heise (1998) identified factors such as rigid gender roles, cultural definition of manhood that are linked with dominance, toughness and honour, sense of male entitlement over women, and cultural beliefs that condone violence in relationships as some of the factors that perpetrate violence in relationships. In prospect of this study, societal attitudes, cultural values and belief system such as patriarchy, silence and multiple partner relationship could contribute to intimate partner violence against migrant female head porters. 31 http://ugspace.ug.edu.gh/ 2.6.1.5 Application of the Ecological Framework to the Study The ecological framework is applicable to the study because it helped to explain the individual instances of partner violence against migrant female head porters, as well as domestic violence as a social problem. The ecological framework helped the researcher to understand the multiple factors that contribute to partner violence at different levels and the interaction between different factors within and across levels. Also, the ecological model enabled the researcher to differentiate between factors that initially caused violence and those that may later serve to perpetrate it (Carlson, 1984). It is also useful because it helped to explain the cyclical nature of family violence within families and across families (Carlson, 1984). 2.6.2 Stress, Appraisal and Coping Theory (Richard S. Lazarus and Susan Folkman, 1984) The stress, appraisal and coping theory was used to complement Carlson (1984) ecological framework. The ecological framework by Carlson (1984) was useful in explaining the contributing factors of intimate partner violence, without addressing the coping strategies adopted by victims to intimate partner violence. As a result, the stress, appraisal and coping theory by Lazarus and Folkman (1984) was used to explain how migrant female head porters coped with intimate partner violence. According to the theory, stress, appraisal and coping are functionally interrelated. The manner in which individuals appraise an encounter has direct implications for their emotional reactions as well as how they will cope with the situation (Carlson, 1997). Lazarus and Folkman (1984) contend that stress is a condition or feeling in which a person in an environment perceives something as challenging or exceeding his or her resources and endangering his or her wellbeing. With cognitive appraisal, the person assesses the potential harm of the stress to his or her wellbeing (primary appraisal). Afterwards, the individual 32 http://ugspace.ug.edu.gh/ evaluates if something can be done to overcome or prevent the harm, threat or loss created by the stress by assessing the coping resources and constraints (secondary appraisal). This theory contends that a person’s ability to cope with a stressful situation depends on his or her cognitive appraisal about the threatening or harmful nature of the situation. Besides, coping is a process by which a person constantly changes his or her cognitive and behavioural efforts to manage specific internal or external demands that are appraised as challenging or exceeding his or her resources (Folkman, Lazarus, Dunkel-Schetter, DeLongis & Gruen, 1986). Folkman and colleagues further argued that, coping focuses on what the person thinks and does in a specific problem encounter. It always involves multiple thoughts and acts, some of them oriented towards regulating emotional distress and others towards problem solving (Folkman et al., 1986). Lazarus and Folkman (1984) pointed out eight forms of coping with a stressful encounter: (a) confronting (b) distancing (c) self-control (d) seeking social support (e) accepting responsibility (f) escape avoidance (g) planful problem solving (h) positive reappraisal 2.6.2.1 Confronting This describes aggressive efforts by the person experiencing the stressful encounter to alter the situation. With this, persons affected adopt behaviours like fighting back, expressing anger to the perpetrator or doing something risky to the stressor. In relation to the study, migrant female head porters may insult, fight back, throw objects and even withdraw sex as a strategy to express their anger towards abuse. 2.6.2.2 Distancing This describes efforts by the victim to detach himself/herself from the stressful situation in order to create a positive outlook. Such acts include refusing to think about the issue too much by 33 http://ugspace.ug.edu.gh/ trying to forget about it, refusing to get too serious about it, and trying to look on the bright side of it. Migrant female head porters can endure abuse by their partners without taking any action against them. This could be due to factors like over dependency on their partners and in order to maintain their relationship. 2.6.2.3 Self-control Self- control describes efforts to regulate one’s own feeling and actions. For example, keeping others from knowing how bad things are and trying not to act too hastily. Migrant female head porters could prevent their friends, relatives and community members from knowing about their abusive relationships. This could be to prevent any actions against their intimate partners and fear of neglect by their partners. 2.6.2.4 Seeking social support This is the effort made by the individual to seek informational and emotional support from social networks, such as friends, family members, institutions and organisations. With regards to this study, migrant female head porters may inform their friends about the abuse for support since they are the people close to them in their new place. Migrant female head porters can also inform their families back home, relatives of their partners and community members for support. 2.6.2.5 Accepting responsibility This implies that the person experiencing the stressful encounter acknowledges his or her role in the problem and tries to put things right. For example, by realising that he or she caused the problem and apologising. In this study, personal behaviours of migrant female head porters can predispose them to abuse and may apologise when they realise they are at fault. 34 http://ugspace.ug.edu.gh/ 2.6.2.6 Escape-avoidance This mechanism describes wishful thinking and behavioural efforts to escape or avoid the problem. This includes acts like drinking, smoking, using drugs, isolation, and sleeping more than usual. In order to forget about the abuse, migrant female head porters could resort to behaviours like sleeping and isolation. As a mechanism to escape the abuse, migrant female head porters may choose to run from their partners in times of noticing anger. 2.6.2.7 Planful problem solving This is where the person deliberately focuses on the analytical problem solving approach to put an end to the situation. This is by making plans and coming up with alternate solutions. In relation to this study, migrant female head porters can assess the harmful nature of partner abuse and devise plans to limit it occurrence. Such decisions may be to end the relationships with their partners, report to the police or persons in the community such as chiefs, religious leaders and family heads. 2.6.2.8 Positive reappraisal This form of coping describes efforts to create positive meaning by focusing on personal growth. Examples include praying, changing or growing as a person, and coming out of the experience better than before. Relating the positive reappraisal to the study, migrant female head porters may pray to God to change their partners’ abusive behaviours. 35 http://ugspace.ug.edu.gh/ 2.6.2.9 Application of the stress, appraisal and coping theory to the study The stress, appraisal and coping theory is applicable to the study because intimate partner violence is harmful to the health and social functioning of women. As such, the occurrences of the incidence could be a stressful experience for the victim. This theory helped the researcher to understand how migrant female head porters appraised or assessed abuse in intimate relationships and how this appraisal or assessment informed their decisions. The theory also helped the researcher to understand the forms of coping mechanisms migrant female head porters adopted in abusive relationships. 36 http://ugspace.ug.edu.gh/ CHAPTER THREE RESEARCH METHODOLOGY 3.1 Introduction This chapter comprises the methods and procedures that were used in undertaking the study. Research methodology is a systematic way by which a researcher undertakes a study and it provides a work plan for the research (Rajasekar, Philominathqan & Chinnathambi, 2013). This chapter includes the research design, target population, study population, sampling technique, sample size, sources of data, methods of data collection, data handling and analysis, ethical considerations, trustworthiness and limitation of the study. 3.2 Research Design A qualitative research design was used for the study. According to Creswell (2009) qualitative research method focuses on discovering and understanding the experiences and perspectives of participants. Qualitative research is a situated activity that locates the researcher in the world; a set of informative and physical practices that make the world visible (Denzin & Lincoln, 2005). The researcher used a qualitative approach because it provided an avenue to ask open ended questions that helped obtain in-depth, rich and descriptive information (Laura, 2010). In addition, the verbal narratives of the participants provided a reflection of their individual and personal experiences using their own voices (Laura, 2010). The qualitative research approach enabled the researcher to explore and obtain in-depth information about the experiences of intimate partner violence among migrant female head porters in Kumasi. 3.3 Target Population The study targeted all migrant female head porters working in the Kumasi business centre (Adum and central market). Since these migrant female head porters operate in groups and have 37 http://ugspace.ug.edu.gh/ leaders (Kwankye, 2012), the leaders were also targeted. Officials from the Domestic Violence and Victims Support Unit (DOVVSU) of the Ghana Police Service and Marie Stopes International Ghana (MSIG) were also targeted. 3.4 Study Population The study population consisted of migrant female head porters who were 18 years and above, had lived in Kumasi for at least two years, were currently or previously engaged in an intimate relationship and had experienced partner abuse in a current or previous intimate relationship. The researcher selected women who had migrated from the Upper East, Upper West and Northern Regions of Ghana. The study population also involved key informants (head porters’ group leaders, officials from MSIG, and DOVVSU). 3.5 Sampling Techniques Purposive and snowball sampling techniques were used to select participants for the study. Purposive sampling as defined by Tongco (2007) is the deliberate choice of an informant due to the qualities the informant possesses. Purposive sampling was used to select key informants. The group leaders served as gate keepers who protect the individual interest of the migrant female head porters and therefore were deemed to have useful information. Officials from MSIG were selected because of their project on ‘Kayayei’ which focuses on providing free family planning services to migrant female head porters. Officials from DOVVSU were selected because they work and receive reports on domestic violence cases. Snowball sampling was used to recruit migrant female head porters. According to Noy (2008) snowball sampling is the process by which the researcher accesses participants through contact information provided by other participants. This participant refers the researcher to other 38 http://ugspace.ug.edu.gh/ participants who are contacted by the researcher and they refer him or her to get other participants (Noy, 2008). The researcher’s first point of contact was MSIG and was introduced to the head porters’ group leaders to seek for their permission to talk to the migrant female head porters. With the help of the group leaders, the researcher was able to get access to the migrant female head porters. Due to the sensitive nature of the study, I familiarized myself with the female head porters and made friends with them. I then moved to another group and the same procedure was used. Based on the criteria for inclusion potential participants were contacted for the study. 3.6 Sample Size The sample size was 23 and this included migrant female head porters (seventeen), group leaders of the head porters (two), officials from MSIG (two) and officials from DOVVSU in Kumasi (two). The purpose of phenomenological qualitative research is to acquire information that is useful for understanding the complexity, depth, variation or context surrounding a phenomenon (Gentles, Charles, Ploeg, & Mckibbon, 2015). For this study, the sample size was appropriate because saturation was attained. Beyond this number, no new or relevant information emerged. 3.7 Sources of Data The data were derived from a primary source. The primary data comprised of information obtained from migrant female head porters, group leaders among the head porters and officials from MSIG and DOVVSU through in-depth interviews. 3.8 Methods of Data Collection Data for the study were collected through individual interviews and key informant interviews. The interviews were conducted using open ended questions based on the objectives of the study. 39 http://ugspace.ug.edu.gh/ Interview guide was developed by the researcher based on the research questions to ensure the interviews were relevant to the study (Hancock, Windridge, & Ockleford, 2009) and it was used to collect the interviews. The interview guide was written in English and translated into Twi (a Ghanaian Language) by the Linguistics Department at the University of Ghana, Legon. This was done in order to conduct the interviews based on the language preferred by the participants. Interviews conducted with the migrant female head porters and their group leaders were done in Twi and the key informant interviews with officials from MSIG and DOVVSU were conducted in English. The interviews were done in places convenient for participants. With permission from participants, the interviews were audio recorded. Each interview lasted between 45 minutes and an hour. 3.9 Data Handling and Analysis Data analysis is a process that involves making sense out of the data gathered from the field, preparing it for analysis, understanding the data, representing the data and making an interpretation of the larger meaning of the data (Creswell, 2009). Primary data were stored on a computer, password protected and copies were stored on external drive to prevent data lost. The data were analysed using the six-step thematic analysis proposed by Creswell (2009). The researcher organized and prepared the data for analysis. With this, all the interviews with participants that were conducted in Twi were transcribed into English. After this, the researcher read through all the transcribed data for several times in order to familiarize myself and obtain a general sense of the information. The researcher continued by coding which involved taking transcribed data, segmenting participants’ views that were similar in meanings into categories and labelling those categories with a term. Using the coding process, the researcher generated themes out of the descriptions of participants for analysis. The 40 http://ugspace.ug.edu.gh/ researcher used the themes as the major findings that appeared as headings during the analyses. The researcher then described the data to clarify and make full meanings from the experiences of participants. Interpretations were made by analysing and presenting the data. 3.10 Ethical Considerations Ethical considerations needed in dealing with human subjects were given prior consideration throughout the study. The researcher made sure the following ethics were guaranteed in the study: (a) informed consent (b) confidentiality (c) pseudonym and anonymity (d) plagiarism. 3.10.1 Informed Consent Participation in the study was voluntary. The purpose of the study was explained to participants and their consent sought before they were included in the study. Also, participants were made aware about their free entry and exit from the study at any point in time they wished. 3.10.2 Confidentiality Confidentiality was considered an important issue in this research. Information given by participants was kept in secret and no other person apart from the researcher had access to it. In addition, interviews were conducted in places convenient for participants in order to prevent people from hearing their experiences apart from the researcher. Audio taped information was locked with password and this helped much to avoid second person access. 3.10.3 Pseudonyms and Anonymity Identities of participants were not needed for the study. As such, the researcher did not include the names and pictures of participants in the data analysis. Assumed names have been used to represent the participants to protect their identities in order to ensure more confidentiality. 41 http://ugspace.ug.edu.gh/ 3.10.4 Plagiarism Plagiarism is defined as the verbatim copying, near-verbatim coping, or paraphrasing portions of another person’s published document without proper acknowledgement (Boisvert & Irwin, 2006). All relevant journal articles and books of which secondary information were drawn from have been cited and credited. With this, the researcher has acknowledged all borrowed information from authors by use of in-text citations and references in the study to avoid any form of plagiarism. 3.11 Trustworthiness and Credibility The researcher adopted thick description by Creswell and Miller (2000) to demonstrate the quality of the findings. Thick description according to Creswell and Miller (2000) is achieved through the lens of people external to the study such as readers, supervisors and examiners. It is a procedure for establishing credibility and reliability in a study by describing the setting, the participants and the themes in rich details (Creswell and Miller, 2000). As such, readers of this study will be able to establish the credibility of it nature through the narrative experiences of intimate partner violence by participants. The voices by participants are good experiences to show that readers can also experience the same abuses migrant female head porters have experienced. Such events being described by participants can happen to readers should they find themselves in the same situation in a different or same environment. In addition, the discussion and analyses section of the findings can help provide readers the understanding. This is because the findings were related when compared to other findings. In other words, the findings of the study are applicable to other findings in other settings or similar context. This study therefore represents constructive perspectives (Creswell and Miller, 2000) of migrant female head porters experiencing intimate partner violence in a Kumasi. 42 http://ugspace.ug.edu.gh/ 3.12 Limitations of the Study Interviews with migrant female head porters and group leaders were conducted in Twi and translated into English. It is therefore likely that the back and forth translation may result in data lost. However, the researcher employed a second translator to read the transcripts and listen to the voices in order to check for inconsistencies in the data. 43 http://ugspace.ug.edu.gh/ CHAPTER FOUR PRESENTATION OF FINDINGS AND DISCUSSION 4.1 Introduction This chapter covers the findings of the study as well as a discussion of the findings. The findings are presented in terms of the demographic characteristics of migrant female head porters, the forms of violence experienced by migrant female head porters and the factors that contributed to intimate partner violence among migrant female head porters. In addition, the effects of partner abuse on migrant female head porters as well as strategies adopted in coping with such abusive acts are also presented. The findings of this research are further discussed in relation to other studies, the ecological framework and the stress, appraisal and coping theory. 4.2 Demographic Characteristics of Participants The study selected 23 participants which comprised 17 female head porters and six key informants. Two (one female and one male) of the key informants were from the Ashanti regional Domestic Violence and Victim Support Unit (DOVVSU) office. Other key informants were two males from Marie Stopes International Ghana (MSIG). One of them was the Ashanti regional manager and the other was the supervisor for the ‘kayayei’ project. Two group leaders (one female and one male) of the migrant female head porters also participated in the study as key informants. Regarding their place of origin, eleven of the migrant female head porters had migrated from the Northern region and were Dagombas, five from the Upper West region (Waala tribe) and one from the Dagaati tribe of the Upper East region. All the migrant female head porters had stayed in Kumasi for at least two years, with one who had stayed for as long as 15 years. The ages of migrant female head porters ranged from 18 to 45 44 http://ugspace.ug.edu.gh/ years. Seven of them had no knowledge of their date of birth, but their ages were estimated to be more than 20 years. Nine of the migrant female head porters experienced abuse in their current relationships whilst eight in their previous relationships. In terms of education, 15 had no formal education and only two had completed junior high school. 4.3 Forms of Intimate Partner Violence Experienced by the Migrant Female Head Porters Migrant female head porters shared their experiences regarding the different forms of abuse in previous or current relationships. Key informants also shared their views with regard to the forms of abuse experienced by the female head porters. The forms of abusive acts experienced by migrant female head porters were physical, sexual, psychological and financial abuse. 4.3.1 Physical Abuse Migrant female head porters expressed their experiences of physical abuse from their partners in the form of beating, slapping, pushing, hitting, kicking, and throwing of objects. The female head porters gave accounts on how they were physically attacked by their partners: I moved out of my husband’s house into a kiosk because he married a second wife and the three of us were sharing a single room. One fateful morning, I went to my husband to collect money for my child’s upkeep and my husband together with his second wife beat me up. The second wife hit me with a bowl on my head and said, she could not see me disgrace her husband every morning because of money. My husband held my throat and threatened to kill me (Head Porter, 1). 45 http://ugspace.ug.edu.gh/ Another migrant female head porter with a child living with a disability also shared her experience of physical abuse by her partner and her rival: I lived with my visually impaired child together with my rival in the same compound…there was a time when my step children made mockery of my son whilst playing, so I beat them… they reported me to my husband and it resulted in a fight. My husband ganged up with his second wife to beat me severely (Head Porter, 4). A migrant female head porter revealed that, her partner abused her on several occasions when she fought with her rival: …We divorced because my husband inflicted a lot of abuse on me and that caused my moving out of his house. The abuse especially physical, became worse when I delivered my child. Anytime I had a disagreement and fight with my rival, my husband took her side and they gang up to beat me. He always did that because he felt that I should not fight his lovely queen (Head Porter, 2). The attacks also came when migrant female head porters complained about their partner's’ affairs with other women. One participant expressed her experience in this manner: I usually complained about my boyfriend’s infidelity…he liked chasing women a lot. Any time I did, he beat me mercilessly by slapping, kicking and hitting (Head Porter, 6). 46 http://ugspace.ug.edu.gh/ Some migrant female head porters experienced myriad physical abuse by their intimate partners during pregnancy. Some of the female head porters were forced to engage in tedious activities and were abused upon their refusal. This was revealed in the voice below: My previous husband made me work for hours whilst I was pregnant because he engaged in corn flour business. He would bring about 100 to 300 sacks of the flour to the house for me to wash...I could wash 100 sacks a day…. The nurses were concerned about my health and even advised me to desist from engaging in hard work, when I told him; he did not listen and continuously made me to work. One day, he told me to move out of his room, when I probed further, he just went out without uttering a word. As soon as he returned, he started beating me. He would have killed me, if not for the intervention of neighbours. His behaviour changed as soon as I got pregnant because that is when the beatings started (Head Porter, 3). In addition, some migrant female head porters experienced physical abuses when they complained about their partner's’ refusal to take care of them. Their partners did not provide enough support in terms of basic needs. A migrant female head porter shared her experience: I used to fight with my boyfriend a lot and it was all because of money. Any time I asked him of money he refused, and he would beat me for complaining...in order to provide for myself, I had to rather go and carry load in the market (Head Porter, 11). One participant revealed that, her partner gave her corn instead when she asked him for money and was beaten when she complained; One day, I asked my husband for money to prepare food; instead, he gave me corn and said that it was all he could provide. He did not care how I was going to mill the corn- 47 http://ugspace.ug.edu.gh/ and make food out of it. I made up my mind that he would not leave the house until he gave me money. He became furious and started pushing and beating me for disrespecting him. I suffered that day because I received a lot of his beatings (Head Porter, 5). It was found that, some participants who were divorced encountered abuse when they went to their ex-partners for money to cater for their children: I went to my son’s father to collect money for his upkeep; before I knew it, he stood up and gave me a dirty slap. He beat me mercilessly without giving me the money so I ran to my house to seek refuge (Head Porter, 10). Furthermore, some perpetrators of intimate partner violence attacked the female head porters physically with weapons such as cutlasses, gun and sticks. One participant expressed her concern on how her partner attacked her with a physical weapon: I have lived in Kumasi for the past fifteen years. I came with my husband purposely to engage in the head porter business to improve our financial condition. I have been through countless abuse since our arrival here. He beat me physically and anytime we fought he would enter the room and come with a cutlass threatening to kill me (Head Porter, 8). To add to this, another female head porter revealed that, her husband beat her and threatened her with a gun when she refused him sex: Oh, for my husband he used to beat me a lot and even threatened to kill me with a gun. One night, upon his late arrival home around 2:00am, he wanted to have sex with me- 48 http://ugspace.ug.edu.gh/ but I refused. We fought and he beat me very well...he pulled a gun, threatened to kill me and himself if I did not allow him to have sex with me (Head Porter, 9). Moreover, an officer from DOVVSU shared his view on some cases the department had received from the female head porters in terms of physical abuses. This was what he said: DOVVSU as an institution receives reports on cases of intimate partner violence such as physical, psychological, and sexual but the most dominant cases of abuse we receive are physical abuse and assaults. We have not conducted any well-structured research to ascertain why the physical abuse occurs, but day in day out people come and report. All our figures are based on individual reports (DOVVSU Male Official). One of the group leaders of the head porters shared an eyewitness account on how a female head porter was mercilessly beaten by her partner: Men beat the head porters everyday right in front of me... they have no regard for them (head porters). They beat the head porters as if they are their younger siblings...last time a head porter was severely beaten and left with a black eye...at times some of us have to intervene to calm the situation (Male Group Leader). Besides, some migrant female head porters received physical abuse when they took decisions independently. Their partners physically abused them when they sought contraceptives for family planning without informing them. An official from MSIG also attested to this: We went for a public talk on family planning at Bantama (a suburb in Kumasi) market with the female head porters; some came to access our family planning services. About one o’clock in the night, a female head porter called and told me her husband had- 49 http://ugspace.ug.edu.gh/ beaten and thrown her and the child outside for practicing family planning. It was late and there was nothing I could do but to advise her to find a secure place to sleep. We attended to her early in the morning to see if she was ok. We went to see the husband and explained things to him before he accepted the head porter back in the house (MSIG Official 1) 4.3.2 Sexual Abuse Migrant female head porters described behaviours perpetrated by former or current partners such as forced sexual intercourse or sexual harassment. One female head porter revealed that, her current partner had sex with her anytime he was drunk: My boyfriend is the kind of person who wants to have sex with me whenever he comes home drunk…he forces me to have sex with him anytime he wishes, as a matter of fact there is nothing I can do to stop him when he is in such mood but to comply with his wish otherwise I will receive a beating if I refuse (Head Porter, 11). It was found that, some female head porters feared unwanted pregnancy so they tried to deny their partners sex but to no avail. This was what one participant said: My boyfriend has beaten me on countless occasions which I cannot even remember and tell you. Every evening he wants to have sex with me and I also do not want to because I know I would get pregnant again… he beats me and forces to have sex with me anytime I refuse (Head Porter, 12). 50 http://ugspace.ug.edu.gh/ Besides, some female head porters were forced by their partners into multiple sexual encounters. One DOVVSU official gave an account of a female head porter who was kept in a room by the boyfriend and was abused sexually: Marie Stopes International Ghana organised a talk on reproductive health for female head porters in Kumasi, so DOVVSU took advantage of the programme to talk to them (head porters) about domestic violence. As a DOVVSU coordinator in the Ashanti region, I gave my telephone number out and asked them to call me whenever they needed our services. One day, a head porter called me on phone, crying that she had been kidnapped by her boyfriend who had locked her in a room. Apparently, the man had sex enhancement drugs which resulted in him having sex with her throughout the night till the following morning and did not want to release her...she was in so much pain...and was pleading with the man but he would not listen…whilst talking to me, I heard somebody hit her and she shouted. The man took the phone from her and asked who I was. I told him I was her auntie and he said, ‘look you are her auntie ehh...she has been taking money from me but she is refusing to marry me, I am not ready to release her unless you pay all my money’ (DOVVSU Female Official). A group leader among the migrant female head porters revealed that, one migrant female head porter had confided in her about her husband's bid to engage her in sexual intercourse daily: One of the female head porters came to me some time ago, and asked if I could lead her to go and do family planning. I asked her what the problem was, and she complained bitterly about how her boyfriend sleeps with her every day; she did not want to get pregnant. My brother, I am not saying this to disgrace or disregard northerners, I am a- 51 http://ugspace.ug.edu.gh/ northerner, I cannot do that, but this is exactly what has been happening to the head porters (Male Group Leader). 4.3.3 Psychological Abuse Migrant female head porters reported that their partner’s behaviours affected their psychological health. Some migrant female head porters were subjected to derogatory remarks such as insults and other verbal abuse. One female head porter shared this: You know, if a man and a woman stay together for a long time definitely there will be disagreements between them which sometimes lead to fights. My partner has not beaten me before but rather rain insults on me whenever he is angry. When I delay in doing something for him or refuse to do it, he insults me as if I am a fool (Head Porter, 15). Additionally, some female head porters reported that not only did their partners deny them food, but their children were also denied food, clothing and money. Such treatment tremendously affected their psyche: My partner was not providing for my child’s needs. Whatever the child needed to eat came from me. There was a time when my child was sick; all the burden of hospital bills and medication was on me. Since I left his (partner) house, I am the one who provides for his (son) clothing because the father has simply refused to support me financially (Head Porter, 2). 52 http://ugspace.ug.edu.gh/ Also, migrant female head porters revealed that their partners stopped providing for their needs when they got pregnant and they remained unsupported financially after delivery: My husband refused to give me money and my only option was to go to nearby shops to borrow foodstuffs in order to cook for myself and our two children. He was not taking proper care of me since he was not buying me clothes or food. In the end I got pregnant for another man in Kumasi here and he has also not been taking care of me. I decided to abort the pregnancy in its early stage, but he told me not to. He refused to assist me financially during the pregnancy so I suffered a lot... I had to engage in small scale mining to make ends meet during my pregnancy (Head Porter, 8). A female head porter reported that her partner never gave her money for antenatal care when she got pregnant and he refused to pay the hospital bills after delivery: When I was pregnant my boyfriend refused to support me financially…he never gave me money for antenatal care... at times I would dress up and go to him just to show that I really wanted to go for antenatal, but he would not speak to me… He used to sell fried rice and I remember when I was pregnant, I would go to him for some rice to eat but he would refuse…When I was in labour people went to call him and he took me to the hospital. He left the hospital few hours after and never returned to see what happened to me that day...I only saw him again when I returned to the house. He never bothered about how I survived at the hospital and how I was able to settle for the hospital bills (Head Porter, 10). 53 http://ugspace.ug.edu.gh/ One participant stated that her husband intentionally blacklisted her on his phone in order to avoid the responsibilities of providing for her needs: When I was pregnant with my second child, my boyfriend was not taking care of me… he blacklisted my telephone number, so I was not able to reach him on phone. The abuse became worse when I gave birth to the second child….he was not taking care of me and the child, when I complained he insulted and told me all sort of unpleasant words (Head Porter, 14). As a tactic to emotionally hurt their partners, some perpetrators of intimate partner violence compared their previous relationships to their current relationship with migrant female head porters whenever misunderstandings arose between them: …I suffered verbal abuse from my partner and it affected my emotions. He made references to his previous relationship which hurt me. He was still seeing that lady and at times when we had misunderstanding he would tell me what happened when he visited the other woman, with the intention of causing me pain. I am a woman and I expected him to keep to himself whatever he did with other women outside our relationship (Head Porter, 7). 4.3.4 Financial Abuse Migrant female head porters expressed their views on how their partners controlled their finances and at times denied them money they rightfully earned. One head porter had this to say: At the beginning life was difficult for us, so we moved to Nkawkaw where he had somebody’s cocoa farm as a sharecropping. Anytime we harvested the cocoa and went- 54 http://ugspace.ug.edu.gh/ to the market to sell, he would not talk to me that day and would fight with me...It was a strategy he developed to keep me away from the money we got from the cocoa harvest, meanwhile I worked with him on the same farm every day (Head Porter, 8). Likewise, one group leader shared that some female head porters in intimate relationships with kiosk owners, gave their money to be kept and were abused when it came time to collect it back: If I tell you how some of the leaders who are kiosk owners take advantage of the head porters due to their intimate relationship with them, you will be surprised. Some of the head porters, after the day’s work, give their money to the kiosk owners to save for them because of the trust they have with them. Sometimes the head porters receive beatings in an attempt to claim their money back and in the long run end up losing their hard earned money (Male Group Leader). 4.4 Factors that Contributed to Intimate Partner Violence among the Migrant Female Head Porters There were many factors that contributed to the perpetration of intimate partner violence among the migrant female head porters. These factors contributed to the abuse of female head porters in Kumasi and are presented under themes comprising individual level, family/relational level, social structural level and the socio-cultural level. These themes were guided by the ecological framework and are analysed based on the various levels proposed by the theory. 55 http://ugspace.ug.edu.gh/ 4.4.1 Individual Factors Some head porters talked about the fact that their partners’ addiction to alcohol and drugs facilitated their abuse. The abuse usually occurred when the perpetrators were under the influence of alcohol and drugs such as Indian hemp. One participant talked about her partner’s alcoholic behaviour: My husband started drinking alcohol and got addicted to it. For me I believe this sexual harassment is as a result of his alcoholism. Whenever he is drunk, he wants to have sexual intercourse with me. Sometimes when I am in my menstrual period he would still want to have sex with me by force (Head Porter, 11). In addition, some migrant female head porters mentioned their partners’ drug addiction as a contributing factor to their abuse: My boyfriend smokes Indian hemp (weed) and whenever he is high, he abuses me. Because I endure so much pain, I advised him to stop but it is difficult for him to do so outright. He smokes it secretly without my knowledge and when I find some in his pocket I throw it away (Head Porter, 7). Another migrant head porter revealed that her partner abused her physically and chased her with a cutlass any time he smoked. This was her comment: My partner smokes Indian hemp. He smokes a lot and always beats me whenever he is under the influence of the Indian hemp and cigarette. After he smokes for the day and I ask him for money it turns into a fight. He beats and threatens to kill me with a cutlass (Head Porter, 8). 56 http://ugspace.ug.edu.gh/ Moreover, the low educational level of migrant female head porters also emerged as a contributing factor to their abuse. A female DOVVSU officer revealed that the lack of respect some uneducated women show their partners lead them to fight unnecessarily and therefore experience abuse in the process: Have you not heard people say that educated women cannot marry? The issue is, I am empowered, educated, I have my job and I am also aware that my dignity matters, so if I see that your actions will not grant me freedom, I will call it quit. That is the secret, but I tell you educated women do understand marriage well and so would not allow someone to maltreat them. Also, educated women have self-respect as such would not insult their husbands in public to warrant any abuse…but for the uneducated women, most often they insult their husbands on the street without any shame using phrases such as foolish man… your big head which results in the abuse. This is the case with female head porters (DOVVSU Female Official). A male DOVVSU officer shared that women with minimal or no education are not empowered enough in terms of resources and also do not know that the abuse they experience infringes their rights. He revealed that this put them in a disadvantageous position to endure the abuse: The fact of the matter is that, when people’s educational level is low, they become ignorant about the law. The victims do not know that their rights are being abused and even the perpetrators, when you arrest them, they are still adamant and think that what they did was right. I have also realised that the women lack educational empowerment. Most of them are not as educated as the men, as such if they find themselves in a relationship with educated men, they (women) are easily abused. The women tend to- 57 http://ugspace.ug.edu.gh/ endure the abuse because they solely depend on the men for survival…the same thing happens to the female head porters (DOVVSU Male Official). One group leader had a similar view he shared on the low educational level of participants: Because the female head porters’ educational level is very low, they are easily deceived and taken for granted by the men (Male Group Leader). Moreover, it emerged that some perpetrators were quick tempered which on many occasions led to the abuse of the female head porters: My husband as a person gets angry with me so easily, he insults and abuses me verbally in the process. He has a very bad temper as an individual (Head Porter, 16). In support of this, one female head porter mentioned that because her partner was a stammerer by nature, he got angry with her easily: My boyfriend easily gets angry with me when I speak to him; he stammers and you know by nature such people are easily annoyed (Head Porter, 3). Moreover, some female head porters talked about the fact that they exhibited certain personal attitudes such as stubbornness and disrespectfulness that pushed their partners to abuse them: I think it is my behaviour that makes my husband insults me. He always complains that when he tells me to do something, I do not do it and whenever he talks to me in a bad way, I also talk back to him in a similar manner. I think I am too outspoken (Head Porter, 13). 58 http://ugspace.ug.edu.gh/ One head porter reinforced that, she insulted her partner whenever he discussed his affairs with other women with her and he would abuse her in the process: For me, my insults have caused my situation. When he tells me anything that goes on between him and other women, I insult him and in the process he also beats me up (Head Porter, 7). In support, one participant said that her personal attitude of keeping her ex-boyfriend’s phone number led to her abuse by her current partner: On my part, I think he was angry with me because he realised I was still keeping my ex- boyfriend’s number on my phone and he did not like it….he thought I was still seeing him. I remember he saw me speaking with my ex-boyfriend and really got angry. I think this was part of the reasons why he abused me (Head Porter, 14). Childhood exposure to violence of some female head porters contributed to the perpetuation of abuse. One head porter talked about her exposure to abuse during childhood when her father constantly abused her mother: I stayed with my mother and my step-father. I remember well that my step-father used to abuse my mother verbally because she always complained about his inability to provide for the children’s needs. I also remember one day when my stepfather beat my mother because she asked him money for her business. They always fought on issues relating to money so I think it is the same in every relationship (Head Porter, 14). 59 http://ugspace.ug.edu.gh/ On the other hand, one perpetrator’s attitude was a demonstration of his father’s attitude. This was revealed by a migrant female head porter: My husband’s behaviour runs in their family. He behaves the same way as his father and brothers as well. Other family members behave the same way so I will say he took such behaviour from the family. None of his family members treat their wives well (Head Porter, 9). Additionally, some personal beliefs of some perpetrators served as a contributing factor to partner abuse among the head porters. One group leader revealed that the men thought their abusive acts would deter the female head porters from engaging in certain acts that would make them promiscuous: Head porters are also abused by their partners when they go for family planning and other programs without informing them. Last time one head porter was beaten by the boyfriend because she went to register for health insurance without informing him. The men think that once the head porters do the family planning, it will provide an avenue for them to engage in multiple sexual relationships and cheat on them (Male Group Leader). One key informant also revealed that the men had personal beliefs that family planning would give their partners the edge to sleep with other men: The men think that if the head porters come in for the family planning, they will become promiscuous and will sleep around with other men. When you visit their places of residence, there are a lot of guys around competing for the ladies so the men believe that once they do the family planning, it will give the head porter an avenue to flirt around. Their partners become so domineering that once they find out the head porter had gone- 60 http://ugspace.ug.edu.gh/ in for family planning they (men) abuse them (head porters). One other reason why the men abuse them for practicing family planning is their desire to have children (MSIG Official, 1). 4.4.2 Family/Relational Factors It was revealed that many migrant female head porters stayed in the same house with their in- laws and the nature of activities of the in-laws played a role in the perpetration of intimate partner violence: My husband had the support of his family members so nothing could stop him from abusing me…. all of a sudden some of his relatives that I was in good relationship with started hating me for no reason…the family influenced him a lot because they loved the second wife more than me (Head Porter, 2). In addition to this, one participant said that her in-laws blamed her for not satisfying her husband sexually and advised the man to go in for a second wife: People see him beating me, even his own parents...his parents always shift the blame on me accusing me for refusing to have sex with my husband. We were staying in the same compound so they saw whatever went on….his parents’ attitude gave him the urge to abuse me more because they advised him to get another woman if I was not able to satisfy him sexually which he eventually did (Head Porter, 11). 61 http://ugspace.ug.edu.gh/ Furthermore, it was found that some migrant female head porters were sometimes forced by their partners to forgo their businesses in order to perform household duties. The head porters encountered abuse when they refused the demands of their partners: What actually brings about the verbal abuse is he sometimes tells me to stop going to work or delay going to work and cook for him so he can enjoy the meal when he returns from work. If I wait and cook for him I will lose customers and if I do not go to work at all I will not get money for the day … so I do not honour his demands but go to work. When he comes back and there is no food he will insult me verbally. When I deny cooking for him early in the morning before he goes to work, it leads to a fight (Head Porter, 15). It also emerged that the time to engage in sexual intercourse with their partners brought about abuses. Some partners had the habit of having sex with the head porters any time they wished to. The head porters had no say in negotiating when to have sex with their partners: At times, he may want to have sex with me but if I am not in the mood, I refuse and he easily gets angry and would stop talking to me for days… if I talk to him he won’t mind me… I will go and carry this heavy loads during the day; come back home very tired and still he wants to have sex with me every day (Head Porter, 17). 4.4.3 Social Structure The study found that as a result of poverty, some partners were not able to take proper care of the migrant female head porters. The discussion of money always led to a fight. Some of the men did not have good jobs to cater for the head porters and their children: My husband never gave me money, all he did was to give me some of the maize he sells in the market…I had to suffer because as a woman you need to go and carry loads in order- 62 http://ugspace.ug.edu.gh/ to prepare something from the maize. As soon as I asked him for money it resulted in a fight. All the fights we had were due to money… if you give your wife money all these fights will not happen (Head Porter, 5). To buttress the issue of poverty as one major cause of intimate partner violence, one officer from DOVVSU gave account of a domestic violence case she handled: …the scenario I told you, all arrangements were made to pay the money to the man and as a result we were able to arrest him. We held him in custody until he was granted bail and eventually we processed him for court. The perpetrator and his family members gave the female head porter (victim) two thousand Ghana cedis to forget about the case and run to the north. You know, this is somebody who had come all the way from the north in search of money and so because of poverty she took the money and they made sure she moved to the north. She forgot about the fact that her right and dignity were violated; I had no witness for the case because the victim was nowhere to be found. As I’m talking to you the case could not continue (DOVVSU Female Officer). Societal attitudes and perceptions on domestic violence contributed to the act. Some community members had the perception that intimate partner violence needed to be dealt with in the home and as such cases were not to be taken to or handled by institutions: If there is such an abuse, the family members of the perpetrator will go and see some chiefs and dignitaries within the community to come and plead on the perpetrator’s behalf. The victim will then mount pressure on you to drop the case so that it is settled in the house because it is a domestic issue…if you say no, she will not come to you at all- 63 http://ugspace.ug.edu.gh/ and as an officer you will not have anyone to prosecute because you have no witness (DOVVSU Female Officer). One group leader talked about the fact that he had become an enemy within the community because he reported abuse cases: When there are cases of abuse, I take the victim to the hospital and then to the police station….I know the DOVVSU coordinator so when such issues crop up, I make a complaint and the perpetrator will be arrested. But when the person is arrested, the Zongo (community) people and their relatives would come to plead and he will be released…..they make it a family matter and all my efforts become useless. Sometimes I become an enemy to some of the guys in the Zongo due to such actions I take against abusers (Male Group Leader) Moreover, institutional failure was found as a major factor that contributed to intimate partner violence. The DOVVSU coordinator revealed that they lack specific programs to deal with domestic violence cases among vulnerable populations like migrant female head porters: Anytime MSIG organises the female head porters to educate them on reproductive health, they invite us to give a talk on domestic violence. We take the opportunity to educate them on safety precautions and effects of domestic violence and how they can reach us in times of help. Aside this, there is no other peculiar programme singled out for female head porters to help them deal with intimate partner violence. All other programs are for the general public of which they are included (DOVVSU Male Official). 64 http://ugspace.ug.edu.gh/ Another DOVVSU official revealed that the institution has a radio sensitisation program for the general public; however, in her view it was not effective on the part of the migrant female head porters: From a general point of view DOVVSU sometimes do sensitisation. We go out and we talk to schools and churches….for the female head porters it is difficult to get due to the nature of their work. All they are interested in is to trade and get money. We also do radio talks but then it is when the person tunes to that station that she will get the information.... The question then is, will the news get to the female head porter who is busily carrying loads or has she even tuned in to the radio station you are talking? So for me I am not in favour of the radio because populations like the female head porters do not benefit from it (DOVVSU Female Officer). It was revealed that DOVVSU as an institution had limited resources to carry out their duties: DOVVSU does not have enough resources to execute its duties and responsibilities especially in issue related to intimate partner violence. We use our own resources; for example, our private cars in the sensitisation programmes that we do, which limits our impact (DOVVSU Female Officer). The power relations between men and women in society also facilitated intimate partner violence. It was found that the patriarchal system gave men the privilege to abuse their partners. One key informant had this to say: I think that our culture does not also help…our culture grants men privileges as heads of families which gives them power over women in terms of responsibilities and leadership roles. As a result of patriarchal arrangements, some men believe that they have the- 65 http://ugspace.ug.edu.gh/ power and the right to assault their partners. Some of the partners believe that they have the right to abuse the migrant female head porters (DOVVSU Male Official). Also, the study found that, issues of intimate partner violence were underreported because of the culture of silence. One key informant gave credence to this: A woman will be staying in a compound house receiving a lot of abuse in full glare of the people in the house and no one will care to report. The victims themselves feel reluctant to report, how much more eyewitnesses. The whole situation is like, you have a sore on your leg and you cover it with your trousers, if it is opened someone will see it and help you with some treatment….but because people cover the abuse and it continues until it reaches a dimension which becomes difficult for institutions to notice and deal with (DOVVSU Male Official). More so, perpetrators were sometimes influenced by their friends in the community they lived. These friends played an active role in the abuse of migrant female head porters. One participant shed light on this: I think my husband got influenced by a couple of friends he had...Sometimes his friends bragged about how their wives could not refuse to cook for them. Such words from his friends pushed him to insult me when I refuse to cook for him (Head Porter, 14). 66 http://ugspace.ug.edu.gh/ 4.4.4 Socio-Cultural Factors One socio-cultural practice that permits men to marry more than one woman was discovered as a contributing factor of intimate partner violence. One head porter revealed that her partner had intimate relationships with four other women aside her: Apart from my son, my husband has four other children all with different women. He claims he is a ‘maalam’ (spiritual healer) and he has taken advantage of that by sleeping with women in the locality. I have no say because Dagombas can marry four…this has given him the opportunity to maltreat me how he likes (Head Porter, 1). Another participant revealed that her partner had an affair with another woman and that led to her abuse: Some of his friends told me he had another girlfriend but I never cared about his second relationship. Sometimes we will be in the room and the other woman will call him, he just walks out to attend to her. I believe it is as a result of that lady that is why he started beating me and has refused to marry me. As I am speaking to you now, he left when my child was three months old (Head Porter, 3). This participant attested that her husband’s decision to marry a third wife would worsen their situation; she therefore protested and it resulted in her abuse: My husband decided to marry a third wife which I did not support, because he could not even take care of me and my co-wife including our children, so I fought with him over that decision which resulted in him beating me (Head Porter, 4). 67 http://ugspace.ug.edu.gh/ A female head porter revealed that her partner married another woman when she was five months pregnant and his attitude towards her drastically changed: He married another woman when I was about five months pregnant and all of a sudden his attitude towards me changed. The arrival of the second wife led to so many misunderstandings between us (Head Porter, 2). Similarly, a group leader shared his view on multiple relationships as a contributing factor of intimate partner violence among the migrant female head porters: Due to their circumstances, many female head porters do not hesitate to engage in intimate relationships with the kiosk owners. Many of these relationships involve multiple partners because it is common among many tribes in the northern region. Sometimes because of my position as a leader, I ask some of the men why they abuse the female head porters and they (men) would tell me that it is because they (head porters) cheated on them (Male Group Leader). Drawing from personal experience, this female group leader revealed that, her husband had eight wives including her, and she was of the view that men who engage in multiple relationships are liars and abusive: Some of the fights are as a result of the polygamous nature of many relationships, which often bring about rivalry among the female head porters. As I said earlier, any man who has more than one wife is a deceiver…. he is not consistent with his words so it always brings about fight among the wives. My husband for example, got married to seven women and I was the last one so there were always fights between us. Sometimes the- 68 http://ugspace.ug.edu.gh/ other wives would gossip about me to our husband and this always resulted in beatings (Female Group Leader). It also emerged that, the cultural beliefs of female head porters prohibited them from reporting cases of abuse to mandated institutions which then led to more abuse; …because of the abuse I was going through, some people advised me to report my husband, but you see, some of the Dangombas’ customs and beliefs do not permit women to report their husbands to authorities especially when there are children involved. In some cases if you report and it leads to an arrest of the man, he can denounce paternity of the child. As for me I am enduring the abuse because of my child. Sometimes I report him to the elders to intervene (Head Porter, 1). One head porter indicated that according to their custom, reporting her husband would be disgraceful and could lead to her death after his release from the police cell: In our tribe (Waala), one cannot report a man to be arrested once they are both married, your family members would not even take it kindly with you if you take such action...it is not good to report your husband for beating you and it is considered a disgrace according to our custom. Another thing is that, the man can even kill you after returning from the police station because the same anger that caused him to beat you can make him kill you as well (Head Porter, 3). Some participants also believed that reporting their partners to institutions would serve as a bad omen to their sons in the future: Our custom (Dagaati) does not permit us to report our husbands to institutions like the police and social welfare. I have five children now and two of them are boys, if I should- 69 http://ugspace.ug.edu.gh/ report my husband to be arrested because he is abusing me, in the future when my sons get married, the same thing will happen to them. For us, in our custom we do not believe in institutions solving issues related to partner abuse (Head Porter, 12). Furthermore, it was discovered that family members of the head porters relinquished all responsibilities once they got married. Some female head porters called their relatives back home to inform them about the abuse, but received no response: …when my husband came to beg, my parents told me that he paid my bride price so I needed to give him a child. That is what usually happens in the north; my father insisted that I should go back to my marital home because he had already accepted a cow and other items from him (husband). He even cited my mum as an example that because he paid for her bride pride, she gave him a child so I should do the same. My husband told me he cannot accept the bride price back because I have not given him a child (Head Porter, 16). One participant revealed that customarily, women are considered as being properties of their husbands after marriage and it leads their relatives to be removed from their lives irrespective of the circumstance: I called my parents to inform them about the abuse but no help came. In our custom (Waala) when a man pays your bride price you become his wife and your relatives can no longer interfere in your affairs even when you are in need. In cases where you are experiencing physical or verbal abuse, they will not help you. You only have to endure and they will only come in when you are at the point of death (Head Porter, 2) 70 http://ugspace.ug.edu.gh/ 4.5 Effects of Intimate Partner Violence on Migrant Female Head Porters Migrant female head porters with experiences of partner abuse were affected in the form of physical injuries, reproductive health issues, emotional and psychological trauma, homelessness, isolation and practice of prostitution. 4.5.1 Physical Injuries Migrant female head porters were injured physically by their partners’ abusive behaviours. Injuries such as cuts, blood clots and bruises were sustained: See the marks on my ear it was my husband’s second wife that bit me and the ones on my face are as a result of my husband’s beatings (Head Porter, 1). One female head porter revealed that she had blood clots on her eyes which kept her indoors for a couple of days: I had to remain indoors for some days because I had blood clots on my eyes after my husband had beaten me. I suffered injuries on my face with my eyes being the most affected (Head Porter, 9). In support of the physical injuries, one participant reported a cut on the lips as well as a swollen face as a result of her partner’s abuse: My husband beat me to the point that I had a cut on my mouth and was unable to open it to eat. I had cuts and a swollen face with a lot of pain for more than three days. I could not go out or eat due to my physical condition (Head Porter, 6). 71 http://ugspace.ug.edu.gh/ 4.5.2 Reproductive Health Issues Migrant female head porters were prevented by their partners to use contraceptives because of their misconceptions about family planning. Those who went in secretly for the contraceptives were abused by their partners: The partners abuse the female head porters because of the decision to practice family planning. Most of the time the abuse is linked to misconceptions some men have about family planning, he tells the lady that when you do it, especially the IUD, it will pierce the manhood. It becomes a threat issued over the woman, so nothing will convince her to do it because the guy says she should not do it. If she disregards the partner, more abuse will follow (MSIG Official 2). Some female head porters were unable to initiate family planning discussions or insist on condom use from their partners. This is what one female head porter reported: My husband had sexual intercourse with me at least three times a week but I was in no position to tell him to protect himself with a condom and I could not use one either. His abusive behaviour prevented me from using contraceptives and he almost killed me one day when I brought in the idea of using contraceptives (Head porter, 11). Another participant supported this with the view that there was always resistance to the use of contraceptives by the head porters as a result of partner abuse: There is always resistance when it comes to use of contraceptives especially among female head porters in relationships. When the man says he does not like to use a- 72 http://ugspace.ug.edu.gh/ condom or any contraceptive and the woman openly goes for it, there is the tendency for abuse, so many of them turn down free family planning services (MSIG Official 1). Intimate partner violence contributed to induced and unsafe abortion among migrant female head porters. It was revealed that the head porters who became pregnant due to sexual violence aborted them by self means: Safe abortion is not very prevalent among migrant female head porters. They do not go to professionals like MSIG for abortion services because of cost and some of the cultural implications. What really happens then is that, many of them undertake unsafe abortion from quacks and friends, majority of them self-medicate to induce abortion. They intentionally take overdose of certain pills or take concoction just to terminate their unwanted pregnancies (MSIG Official 2). Since many of the head porters were unable to use contraceptives, they were unable to space their children. One head porter revealed that she got pregnant three times in four and half years and experienced pain for all three pregnancies: All my three children with my husband were delivered by caesarean section...Sometimes he starts sleeping with me a month after delivery. Even when I was pregnant he was forcing me because he was always drunk…my first child was four months old when I got pregnant again. As a result I experienced a lot of abdominal pain which resulted in me spending many weeks at the hospital. The nurses advised me not to get pregnant again after the third one because I may lose my life but I could not tell them my story… it is a very big problem I am facing (Head Porter, 11). 73 http://ugspace.ug.edu.gh/ In addition, one head porter voiced that she was subjected to abuse which led her to develop waist pains which made her pregnancy lasted for twelve and half months: …I could feel pain around my waist when washing the sacks, but still needed to wash in order to prevent further abuse from him. My pregnancy lasted for one year two weeks before I delivered (Head Porter, 3). Some head porters did not get the chance to go for antenatal services when they got pregnant. Some were exposed to malaria and other illnesses; hence morbidity among the head porters was very high during pregnancy: …because these are not stable relationships, migrant female head porters tend to have challenges in their finances and antenatal becomes a challenge. Some of them may even not go for the antenatal at all because when they ask for money from their partners they either receive beatings or refusal to give the money. Once they are not going for antenatal, if there is something wrong with the pregnancy for example anaemia, it will not be detected early for treatment. Most often they do not take vitamins necessary in pregnancy like folic acid and other antimalarial drugs. Look, at the areas they sleep they are so prone to malaria and you know malaria in pregnancy is dangerous as it can lead to anaemia (MSIG Official 1). 4.5.3 Psychological Problems The study found that, some female head porters developed mental health problems because of partner violence. This was what one female head porter uttered: I developed psychological problems when I went to the north. My parents even took me to one maalam (spiritual healer) in our village when they noticed my abnormal behaviour.- 74 http://ugspace.ug.edu.gh/ I withdrew from people and could sit quietly for some time without talking to anyone (Head Porter, 11). One key informant also reported that some head porters experienced sleepless nights due to the abuse they endured: If you walk in town between 8am and 10am in the mornings you will see some head porters sleeping in their pans… do you think someone who has had a sound sleep over the night will be sleeping at that time of the day?...their partners are really abusing them physically and sexually which even affects their rest (Male Group Leader). Moreover, many of the migrant female head porters were dependent on their partners for shelter. Those who were unable to endure the abuse sometimes moved out to seek accommodation on verandas, in front of stores and market tables: Most of the men bring the female head porters from the north and provide accommodation for them, so they are prone to all forms of abuse. Those that protest or resist the abuse, particularly sexual abuse, risk losing their accommodation… so at times you will see them sleeping in front of stores, on market tables and under road interchanges in town (Male Group Leader). Furthermore, one participant reported a case of unconsciousness as a result of beatings by her partner: I do not know what happened when he was beating me, I woke up on a hospital bed. I asked what I was doing there and the nurse told me I fainted when my husband beat me- 75 http://ugspace.ug.edu.gh/ so people in the house together with my husband brought me to the hospital (Head Porter, 13). Additionally, suicidal attempt was one effect recorded among migrant female head porters due to intimate partner violence: Sometimes the women I borrowed from would come and fight me just because I was unable to pay the money I owe. I went through a lot of humiliations and agony so I thought of killing myself one day because it was too much for me to bear (Head Porter, 8). 4.5.4 Social Isolation One problem that emerged from intimate partner violence among migrant female head porters was social isolation. A group leader revealed that the perpetrators prevented the female head porters from making friends. Due to rivalry, some of the porters became enemies: One major problem associated with partner abuse is social isolation. Those that are engaged in relationship with one man are not in good terms with each other and they fight among themselves…at times you will see the man with one head porter beating another head porter who happens to be the third or second wife...the men also prevent their partners from making friends because they think they will talk to their friends about their experiences. For example, what happens is that, the kiosk owner may sometimes end up having sex with all of them in the kiosk which brings about rivalry among the head porters and this is because in the north we do not forbid multiple relationships (Male Group Leader). 76 http://ugspace.ug.edu.gh/ In addition, one head porter revealed that her partner prevented her from visiting friends, relatives and public events: I was prevented from visiting my friends or attending any public event and my husband would beat me if I disregard his instructions...I went for a funeral one day in town, he came to the funeral grounds to beat me for attending it. His claim was that the person who died was not my relative so there was no need attending the funeral...that day he threatened to kill me with a cutlass insulting me as being disrespectful...meanwhile I cooked and left him food in the house before leaving for the funeral (Head Porter, 8). 4.5.5 Effects on Children Intimate partner violence had a negative effect on the children of the migrant female head porters. A female head porter narrated how the violence affected her child's education: I moved out from his house because of the abuse and the fact that he brought in another woman to occupy the same room. I am currently staying in a kiosk with my friends plus my five year old boy...that place is not conducive for him and he easily gets malaria but I have no choice. Sometimes I go to the father for money to take care of him, he gives me one Ghana cedi and at times too two Ghana cedis which is not enough for him (child). My husband and his second wife verbally and physically abused me when I went to their house to take money for my child. I am unable to pay for his school fees which has affected his education as he has to stay home sometimes because of money (Head Porter, 1). 77 http://ugspace.ug.edu.gh/ A key informant revealed that the abuse left some head porters homeless and their children became susceptible to malaria and other diseases: The men abuse and chase the head porters from their houses… they find themselves on the street or perching with their friends….they are easily exposed to malaria and other sicknesses. Their babies are underweight when they give birth and become unhealthy. Morbidity is very high among their children since they are not fed well and are exposed to mosquitoes (MSIG Official 2). Another key informant emphasised how some head porters did not eat nutritious food during pregnancy: Because of the challenges migrant female head porters have when they are pregnant in terms of the abuse, they tend to give birth to babies with low birth weight because even their nutritional status before and during pregnancy is not the best which may lead to stillborn (babies born death) (MSIG Official 1). In addition, it was revealed that, the children born to abused migrant female head porters were born to live in the cycle of poverty: The children may come and live in the poverty cycle of head porters and may have stunted growth because they are not eating well. They may be battling with all kinds of diseases like malaria, pneumonia etc… since their children do not get any education some grow and also become head porters (MSIG Official 1). 78 http://ugspace.ug.edu.gh/ 4.5.6 Effects on Employment As a result of the physical injuries and the emotional trauma instigated by the abusive partners, it affected the work performances of the female head porters. Some remained indoors because of the physical injuries which affected their work: Anytime my boyfriend beats me, the following day I get pain all over my body. This has affected my health so as a result I am unable to go to work (Head Porter, 16). One participant reported that although the abuse did not prevent her from going to work, it affected her income because she needed to return home early to cook for her husband: I think a lot when I quarrel with my husband before going to work… it affects my job performance for the day and sometimes I need to close early like 3pm to go home in order to cook for him so that by the time he returns from work the food will be ready to avoid further insult from him. I do not get enough money for the day, but there is nothing I can do than to go home and cook to save my marriage (Head Porter, 15). In addition, many of the head porters got into practices like prostitution. A group leader revealed that there were prostitution joints in some of the areas the head porters stayed: If you go to Dechemso and Krofrom (suburbs in Kumasi) you would see many Dagombas and Dagaatis who are head porters engaging in prostitution….are you aware that there is a prostitute joint in Dagomba line? I have never heard of a prostitute joint in any Muslim community in the world, but we have some in Ghana here (Male Group Leader). 79 http://ugspace.ug.edu.gh/ 4.6 Coping Strategies Adopted by Migrant Female Head Porters in Abusive Relationships In this research, participants adopted strategies such as seeking social support, self-control, distancing, confronting, accepting responsibility, escape avoidance, positive reappraisal and planful problem solving. 4.6.1 Seeking Social Support The study found that, the only social support participants resorted to were family members of their perpetrators, their own friends and people in their community: I complained to his brother about the issue and he advised me to be patient. I talked about my marriage issues with my friend in Kumasi only because she told me about her abuse too… My parents knew about him because he impregnated me when I was in Junior High School….they were willing to take him to court but I did not permit them because I thought nothing good would come out…. after taking him to court he will not marry me again and no man will marry a lady that takes her husband to court in the future….I could not inform them about the abuse I have been going through in Kumasi (Head Porter, 7). It was found that, some head porters consulted the relatives of their partners but received no support: My husband had some family members in the area but when I informed them about his abusive behaviour they remained adamant to my predicament. The people in town talked to him to stop the abuse, but he did not listen. There was a time I complained to a man in the community and the man talked to him, he returned and told me that he will one day- 80 http://ugspace.ug.edu.gh/ kill me and commit suicide if I report him to any person again. At times I will shout and people will come to my rescue (Head Porter, 9). One participant also revealed that, she reported the abuse to her partners’ friend. This was what she said: I used to complain to his friend and he would advise him (husband) but he (husband) did not listen…even people around the neighbourhood talked to him but he turned deaf ears (Head Porter, 6). 4.6.2 Self-Control Some female head porters adopted a self-control tactic to endure the abuse. One head porter revealed that she lied to her friends when they noticed her injuries: I refused to tell anyone about the abuse I suffered at the hands of my husband... one day I had a black eye and I lied to my friends that I was cutting firewood and one hit my eye...they would have told my parents about it because the condition of my eyes was horrible (Head Porter, 10). In addition, another head porter said she developed a habit of crying anytime her partner abused her so he would apologise to her: I only cried anytime my husband beat or insulted me...he was much older than me so there was nothing I could do than to cry…..he would just apologise to me after realising that I was crying…he would take me to the room, start touching, romancing and eventually we would have sex which closes the case. I always did this and gave in to him- 81 http://ugspace.ug.edu.gh/ just to retain my marriage. I knew being patient like that would keep me in the marriage (Head Porter, 17). It was found that some migrant female head porters controlled themselves in order to cope with the abuse because they did not want to disgrace the family: I chose to stay with my abusive husband because of the children...in our tradition you cannot always complain about your husband’s abusive behaviour to your relatives or parents because such an act is seen as a disgrace to your husband...I do not report to any institution either because we believe it is not good for a wife to report her husband. Such a woman would not enjoy a happy marriage…the only strategy is to forgive him despite all his beatings and bad behaviour towards you (Head Porter, 13). One participant revealed that she endured the abuse for the sake of her child and also because she knew none of her partners’ relatives: I care less about his actions towards me because I believe God is the only provider of man….I do not know any member of his family because he has never told me anything about his relatives so I do not get to speak to them about the issue. In spite of all the abuse, I care less…. he should just provide for the child I have with him (Head Porter, 13). 4.6.3 Distancing Migrant female head porters developed strategies to detach themselves from the abuse. It was discovered that some head porters ignored the abuse in order to remain in their relationships: I was patient other than that I could not have stayed with him to deliver my baby. I did not care about all those things he did, I just kept being patient. I just pretended nothing- 82 http://ugspace.ug.edu.gh/ was happening to me and remained with him. I just forgot about everything after he beat or insult me. I thought if I should think about all his abusive acts, I would die in my pregnancy so I needed to remain strong and patient (Head Porter, 6). 4.6.4 Confronting Furthermore, some participants confronted the abuse by fighting back. It was revealed that, some migrant female head porters verbally abused their partners back. A participant shared her experience: I do not tell my friends or anyone about my experience of partner abuse because I do not think it is necessary to tell people about things happening in my home. I sometimes insult him back when he verbally abuse me…As for me I talk a lot, so I face him verbally and he knows I can do it better than him (Head Porter, 13). 4.6.5 Accepting Responsibility Additionally, some female head porters accepted the responsibility of provoking their partners and recognised their faults and apologised to their partners: …there was nothing I could do because it is like that in our place, men get what they want…sometimes I see it as my fault and I apologise...I give in for sex whenever he demands. The times that I denied him sex, I felt ashamed but what could I have done, I thought my children were too young to give birth again (Head Porter, 11). 83 http://ugspace.ug.edu.gh/ A female head porter said she apologised to her partner through her brother in-law. This was her comment: Mostly when I realised it was my fault that brought about the fight, I quickly apologised to my husband. He had a brother who stayed closer to our house, so when it happens like that, I explain the issue to his brother and ask him to apologise. Sometimes I tell my friend and my sister about what goes on between myself and my husband. When my sister realises I am at fault, she advices me to cook for my husband whenever he demands (Head Porter, 15). 4.6.6 Positive Reappraisal Prayer was used as a coping mechanism. Some migrant female head porters resorted to prayer because they believed that was the only way their situation could be changed: I remained silent and prayed that he would change. I did not bother about the abuse because I did not want to move out, since there was no better place to go. I could not do anything, first because of the child, tradition and what other relatives will say in case I take any action against him (Head Porter, 1). One participant said she resorted to prayer because she could not report the abuse to her parents. Her relationship was not supported by them and therefore, she was isolated. Reporting her partner to an institution was not an option for her because she believed that they would take money from him: I was unable to report the abuse to my parents back in the north, because they were not in support of our relationship. I am not ready to report to any police station either. I- 84 http://ugspace.ug.edu.gh/ have three children with him and if he is arrested, the little money we have saved would be used to pay the fine and other charges. You know these are marital issues, so I do not tell friends as well…. I only pray to God that one day things would change for the better (Head Porter, 11). 4.6.7 Escape Avoidance The study found that, some migrant female head porters developed behavioural efforts to escape the abuse. Some participants took to their heels when they realised their partners were angry and could abuse them: I always walk out of the house whenever he gets angry and starts insulting me because I know that if I talk back, he will beat me. I run from the house and by the time I return, he would have cooled down, so I quickly sneak in and sleep. The next morning, I wake up early and go to work before he wakes up, and at the workplace nothing will show that I fought with my husband because I work happily. I believe that everything happens by the will of God, He makes peace between us whenever we fight, so I just have to rely on Him (Head Porter, 16). 4.6.8 Planful Problem Solving Some female head porters threatened divorce against their partners any time they were abused. The findings show that the partners apologised upon the threat of divorce. I made up my mind to leave the marriage, so I left his house to the north, but he followed me and begged my parents that he wanted to take me back. I did not inform the police about the incident because in our tradition we do not do that (Head Porter, 14). 85 http://ugspace.ug.edu.gh/ In addition, a head porter who was silent whenever her partner abused her shared her experience: Whenever my boyfriend beats me, I do not talk to him for some time. Due to that, he comes and apologises. Sometimes, if I decide not to talk to him, he would come crying and begging me to forgive him... I do not discuss whatever happens between us with any other person. People only get to know about the abuse when he beats me outside, other than that, nobody gets to know what happens between us (Head Porter, 7). 4.7 Discussion of the Findings The findings of this study revealed that, migrant female head porters experienced diverse forms of intimate partner violence. Migrant female head porters experienced different forms of physical abuse from their partners such as beating, slapping, pushing, hitting, and kicking. It was discovered that the head porters had to compete with other women for the attention of their partners and such competition created tension which led to their abuse. The physical abuse of the female head porters by their partners was detrimental to their health and continued even during pregnancy. This is consistent with previous studies (Hazen & Soriano, 2007; Hicks 2006; Hurwitz et al., 2006; Kim & Sung, 2000) which found physical abuse to be more prevalent among immigrant populations. Migrant female head porters experienced physical and verbal abuse from their partners regardless of the environment. Also, some female head porters were denied basic necessities. Perpetrators intentionally prevented some of the victims from visiting friends and attending public events with the suspicion that their abusive behaviour would be disclosed. These findings corroborate other studies by Colucci et al. (2013); Kim and Sung (2016); and Soni et al. (2009) in Australia, New York and United State respectively, which reported occurrences of social isolation and verbal abuse in public among immigrant women in their studies. 86 http://ugspace.ug.edu.gh/ In addition, sexual abuse was found to be very prevalent among migrant female head porters. The perpetrators took advantage of the victims’ vulnerability and abused them sexually. Some perpetrators forced victims to have sexual intercourse with them any time they wanted and any resistance on the part of the victims ended in abuse. Though female head porters indicated that at times they did not want to have sex due to tiredness and fear of getting pregnant, the coercion from their partners limited their power to negotiate for safer sex. This confirms findings by Abraham (1999); Akinsulure-Smith et al. (2013); and Mose and Gillum (2016) that, migrant women are more vulnerable to sexual abuse at the hands of abusive partners. Additionally, incidences of forced sex as found in the current study were also documented by Mose and Gillum (2016) in their study on African immigrants in the United States. Some female head porters worked with their partners which led to their exploitation as their partners often refused to give them their equal share of the earnings. Other times, some migrant female head porters would save their money with their partners and any attempts to get it back led to abuse. This supports a study by Rees and Pease (2007) which found financial abuse among immigrants in Australia. Furthermore, findings of the study support the ecological framework by Carlson (1984) which contends that, there are various interrelating and interdependent factors that contribute to the perpetration of intimate partner violence. The findings indicated that, multiple factors contributed to partner abuse in intimate relationships among migrant female head porters. For example, in this study, the demographic characteristics of head porters showed that only two had primary education while the rest had never been to school. As a result of their minimal education, they had little or no knowledge about their rights or institutional support. This supports the explanation that at the individual level of the ecological framework, low educational 87 http://ugspace.ug.edu.gh/ level of people predisposes them to partner violence. Moreover, the study found that perpetrators who were addicted to alcohol and hard drugs abused the female head porters. The abuse intensified anytime their partners were under the influence of a substance. This supports the assumption by the ecological framework by Carlson (1984) and previous studies conducted among immigrant Latinos by Moracco et al. (2005); and Zarza et al. (2009) which found perpetrators’ addiction to drugs and alcohol as the contributing factor to partner abuse. Some migrant female head porters witnessed their mothers being abused by their fathers during childhood and some perpetrators had the same violent behavioural attitudes as their fathers. This indicates that, family background and childhood exposure to violence by victims and perpetrators are major contributors to intimate partner violence among migrant female head porters. This also verifies studies by Fuchsel (2013); and Zarza et al. (2009) conducted among Mexican immigrants and Latinos in the USA. Evidence also showed that many migrant female head porters stayed in the same house with their in-laws and the nature of relations, behaviours and activities of these in-laws played a role in the perpetration of intimate partner violence. The actions of the in-laws sometimes instigated the perpetrators to abuse female head porters. This is consistent with studies conducted by Clark et al. (2010); and Jordan and Bhandari (2016) which found that women who lived in the same home with their husband’s family and in the same building with their husband and his extended family members were at an increased risk of experiencing intimate partner violence. Having multiple partners emerged as another factor that contributed to intimate partner violence among migrant female head porters. The perpetrators had multiple partners which sometimes brought about jealousy and rivalry among the head porters leading to their abuse. This is in line with Abrahams et al. (2004) study conducted in Cape Town which found perpetrators of partner abuse engaging in multiple relationships. 88 http://ugspace.ug.edu.gh/ Furthermore, intimate partner violence had a lot of implications on the lives of migrant female head porters. Evidence showed that, unsafe abortion was critical among them. Female head porters migrated purposely to engage in economic activities and in their attempt to acquire shelter, got into relationships with men who sexually abused them, resulting in unwanted pregnancies. In their quest to be economically active, some terminated their pregnancies through unsafe methods. The perpetrators also persuaded them to abort the pregnancies due to their poor economic status. This is consistent with the findings by Stockl et al. (2012) which indicated intimate partner violence as a contributing factor to induced abortion and pregnancy lost in Tanzania. Findings of this study showed that migrant female head porters were victimised through physical injuries such as broken bones, bruises, scratches, wounds and swollen faces as a result of partner violence. This supports findings by Erez et al. (2009) that, people who experience intimate partner violence are sometimes affected with physical injuries. In addition, migrant female head porters depended on their partners for accommodation. Those who were unable to withstand or tried to resist the perpetrators’ abuse were forced to move out of their homes. As a result of that, some became homeless and were found sleeping on verandas, in front of stores and marketplaces. This finding is similar to that of Mayock (2012) and Thurston et al. (2013) which found intimate partner violence as a contributing factor to homelessness among migrant women who lived in Ireland and Canada. Also, Post-Traumatic Stress Disorder (PTSD), and anxiety symptoms were associated with migrant female head porters who experienced intimate partner violence. This has also been revealed in studies conducted by Mahenge et al. (2013) and Pico-Alfonso et al. (2006). Moreover, intimate partner violence negatively impacted the migrant female head porters in the sense that, some were unable to go to work. This confirms findings by Hanan et al. (2012) which 89 http://ugspace.ug.edu.gh/ showed that intimate partner violence contributed to women’s lateness to work, neglect of work which affected their efficiency and eventually jeopardised their job security in Jordan. Partner consent was a key limiting factor to the use of family planning services by the head porters. Perpetrators threatened migrant female head porters not to engage in family planning services and this affected the capacity and willingness of the head porters to practice family planning. There were instances where many head porters turned down free family planning services from organisations as a result of partner abuse. This is inconsistent with the findings by Alio et al. (2009) which posited that, women exposed to domestic violence are more likely to use contraceptives. On the other hand, the finding by this study is in line with the study by Wilson- Williams (2008) which concluded that women are unable to negotiate for contraceptive use because of intimate partner violence. Migrant female head porters were unable to space their children and were forced to get pregnant repeatedly as a result of their inability to negotiate for safer sex. Their partners engaged them in sexual intercourse without their wish and without the use of contraceptives. Some got pregnant a few months after delivery. This is similar to findings by Miller et al. (2010) in Northern California where victims of intimate partner violence experienced birth control restraints and unintended pregnancies. Because they received no support and were constantly in danger of being abused, some migrant female head porters attempted ending their lives. This is evident in the work of Hurwitz et al. (2006) which found suicidal attempts as an effect of partner violence among U.S. South Asian women. This study also found unconsciousness as a health consequence associated with intimate partner abuse among migrant female head porters. It supports the findings by Diez et al. (2009) and Hurwitz et al. (2006) that women who are victims of intimate partner violence sometimes lose consciousness. Being abused affected the job situations of some 90 http://ugspace.ug.edu.gh/ of the head porters which drew many into prostitution as a means of survival. Prostitution became the only way some female head porters could escape abuse from their partners. The findings of this study support the stress, appraisal and coping theory by Lazarus and Folkman (1984) because participants adopted various coping strategies which were informed by their individual evaluations of the abuse. It was found that some head porters coped with intimate partner violence by adopting a positive reappraisal where they prayed for God’s intervention. This finding is similar to that of Laura (2010) where African immigrants in the USA sought God’s help and comfort through prayer. Some female head porters sought for social support from relatives of perpetrators, friends and community members. This finding support the study by Akinsulure-Smith et al. (2013) which found that, West African immigrants in the USA resulted to family members, elders and religious leaders within their community for help when their partners abused them. In addition, migrant female head porters controlled themselves as if nothing was happening to them and endured the abuse for the sake of their children. This is consistent with Sinhalese women in Canada who perceived intimate partner violence as a private and shameful topic and as a result tended to hide their experiences (Guruge, 2014). It was found that, some female head porter’s coped accepted responsibility of the cause of the abuse and apologised to the perpetrators as a way to cope. Nevertheless, an outstanding finding of this study was that, none of the migrant head female porters reported cases of abuse to institutions like DOVVSU due to cultural beliefs. The migrant female head porters had been socialised to believe that a married woman being abused could not report her partner to any institution. They were made to understand that intimate partner violence is privately handled by the family and not institutions. The reasons cited for underreporting were that; married women ceased to be wives after making institutions know what happened in their 91 http://ugspace.ug.edu.gh/ married life. Migrant female head porters also revealed that it was a disgrace to the husband and the entire family to report abuse cases. In addition, they reported that, it would have a long lasting negative impact on their children and they may not grow to love their mothers when they come of age and get to know their mothers took such actions against their fathers. The study found the culture of silence as a factor that contributed to intimate partner violence among migrant female head porters. Community members did not report to institutions on behaviours that were abusive to the migrant female head porters. Although Ghanaians by nature live a communal life where each is the other’s keeper, intimate partner violence is underreported because it is perceive as a private matter between the two individuals and their families. This is not meant to suggest a cultural justification of intimate partner violence, but it is used to contextualize (Abraham, 1999) the experiences of migrant female head porters at the sociocultural level as proposed by the ecological framework by Carlson (1984). 92 http://ugspace.ug.edu.gh/ CHAPTER FIVE SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS 5.0 Introduction In this chapter, the findings are summarised and conclusions are made based on the findings of this study. The chapter continues with recommendations and implications for social work. 5.1 Summary of the Findings The study found that migrant female head porters experienced different types of partner violence comprising of physical, sexual, psychological and financial abuse. Physical abuse were in the form of beating, the throwing of objects, hitting, and kicking. Migrant female head porters were also sexually abused through coercive sexual intercourse. With the psychological abuse, the head porters were subjected to threats, insults, and humiliation. As a way to maintain power over the migrant female head porters, it was discovered in the study that they were abused financially by their partners. Being financially reliant on the men made it difficult for the head porters to escape their abuser. In addition, different factors contributed to intimate partner violence among migrant female head porters. The first contributing factor was at the individual level. At this level, low education of the head porters, alcohol and drug use of the partners, victim’s witness to domestic violence during childhood, the perpetrator’s family history with respect to abuse, some personal behavioural patterns of the female head porters and their partners contributed to partner violence. The next contributing factor to partner violence was at the family or relational level. Some head porters lived with their partners and their in-laws and as such, some actions and behaviours of the partners’ relatives incited the abuse of the head porters. Also, issues related to when the 93 http://ugspace.ug.edu.gh/ partners want to engage in sexual intercourse as well as the head porters paid work interfering with household duties brought about abuse. The next factor that contributed to partner violence among migrant female head porters was at the social structural level. The study found that poverty made it difficult for some of the partners to take proper care of the head porters and their children. In addition, societal attitudes and perceptions of regarding intimate partner violence as a private issue contributed to partner abuse. Other factors were influences from perpetrators’ friends, institutional failure and patriarchy. The study also found that multiple relationships played a role in intimate partner violence among migrant female head. Their partners were engaged in intimate relationships with other women; therefore female head porters were not valued much and abused for voicing their disapproval. Furthermore, the study found that intimate partner violence had negative impacts on migrant female head porters. Physical injuries in the form of bruises, cuts, swollen faces and swollen eyes were sustained. The study found that there was limited participation in family planning services among migrant female head porters. Induced and unsafe abortions were among the effects of partner violence. Also, this study found that the head porters were unable to access antenatal services due to partner violence. Moreover, findings revealed that some migrant female head porters were homeless because they were unable to withstand the abuse and were sent out of their homes by their partners. As a result, they found shelter in front of stores and market tables. The study found that intimate partner violence affected the children of the head porters. The head porters were unable to provide proper care for their children with regard to food, clothing, shelter, and education. Some head porters resorted to prostitution as an escape and also as a way to earn money. Sleepless nights and mental health illnesses such as anxiety and suicidal ideations 94 http://ugspace.ug.edu.gh/ were found to be among the effects of intimate partner violence among migrant female head porters. Some migrant female head porters were socially isolated from friends, relatives, community members and normal activities because of partner violence. The violence affected the ability of the head porters to undertake their economic activities due to stress and injuries that kept them indoors. Additionally, the study found that the migrant female head porters adopted numerous strategies in dealing with intimate partner violence. Although many prevented others from knowing about the abuse to protect their partners, some resorted to friends, relatives of perpetrators, and community members for help in times of abuse. It was revealed that others detached themselves from the abuse for the sake of their children, and to secure accommodation in their partner’s homes. As a result, some head porters accepted the blame for the abuse and apologised to their partners while others fought back. The study also found that, some head porters adopted a planned behavioural attitude, such as threats of divorce so their partners apologised to them after the abuse. 5.2 Conclusions The findings of this study attest to the fact that intimate partner violence is a social problem. Migrant women experience intimate partner violence and are mostly affected by the problem. Once women migrate to a place, they become foreigners with no social support, no accommodation and no job. According to Moracco et al. (2005), immigrant women are often without family and social networks they had in their home of origin. As a result, they become economically dependent on abusive partners. In the context of this study, the only people migrant female head porters knew in Kumasi were the friends they migrated with to undertake economic 95 http://ugspace.ug.edu.gh/ activities. Those who found themselves in relationships were exposed to physical, sexual, psychological and financial abuse by their partners. Some migrant female head porters were trapped in abusive relationships to secure their accommodation and financial security. Moreover, once the migrant female head porters became involved in relationships with men, different factors combined to contribute to their abuse which confirmed the tenets of the ecological framework by Carlson (1984). They were mostly trapped in the relationships because when they complained or tried to resist the abuse, they were kicked out by their partners and some became homeless. The study therefore concludes that intimate partner violence has adverse impacts on the wellbeing of migrant female head porters. Due to limited resources, intimate partner violence proved to be a stressful and difficult experience for victims. The migrant female head porters did not have access to family support due to geographical distance and many were apprehensive of utilizing institutional support. Additionally, culture and tradition played a major role in underreporting even though some of the migrants had knowledge about the institutional support. Some talked to friends and relatives of the perpetrators as a coping mechanism while others chose to remain silent and live with the abuse. It is very difficult to detect intimate partner violence among migrant female head porters because of their tightly knit community. They hardly interact with outsiders about issues like intimate partner violence. It is important to note that institutions such as DOVVSU that have the mandate to deal with intimate partner violence have many of their programs targeted at the general population. Thus, they fail to consider specific sections of the population like migrant female 96 http://ugspace.ug.edu.gh/ head porters who are vulnerable to intimate partner violence and are afraid to access such services due to repercussion. 5.3 Recommendations Since the study found that DOVVSU does not have programs that specifically deal with intimate partner violence among migrant female head porters, it is recommended that the institution organize programs that will focus on the detection and reduction of intimate partner violence among migrant women. Also, given that institutional failure emanating from inadequate resources was one of the major contributing factors, the study recommends that there should be a budgetary allocation by the government to institutions like DOVVSU to help fund operations on domestic violence cases especially among migrant populations. In view of the fact that intimate partner violence has a myriad of effects on migrant female head porters and some perpetrators are ignorant about the fact that their abuse is an infringement on the rights of their victims, the study recommends that DOVVSU in collaboration with non- governmental organisations like MSIG should organise educational programs in this regard. The educational programmes should focus on behaviour change communication and awareness creation. By targeting perpetrators of intimate partner violence, it is hoped that they will desist from acts that result in abuse. Based on the findings that societal perceptions and culture of silence increase the spread of intimate partner violence among migrant female head porters, the study recommends that there should be a public sensitisation by DOVVSU, National Commission for Civic Education and the Department of Social Welfare about the effects of intimate partner violence and its 97 http://ugspace.ug.edu.gh/ disempowerment of women. Religious bodies and other stakeholders should become involved to reach a wider and more diverse audience. 5.4 Implications for Social Work As a primary service responsibility, social workers could help reduce the incidence of intimate partner violence by educating migrant female head porters about the risk factors of intimate partner violence, its effects on their wellbeing and violation of their fundamental human rights. This should be in the form of peer education and should be offered on Sundays when the head porters are not at work. Leaders among the migrant female head porters could serve as mobilizers because they are in the same community with the migrant female head porters. Given that the female head porters included in this study experienced different forms of intimate partner violence and are vulnerable, social workers could advocate for changes in existing policies and programmes and formulation of new policies that would focus on domestic violence among migrant populations. Moreover, social workers as agents of social change should work with ethnic groups, religious bodies and institutions like schools within communities to help foster behavioural change that could contribute to intimate partner violence against vulnerable groups like migrant women. Cultural practices and traditional beliefs that promote intimate partner violence against women should be modified. In view of the fact that many migrant female head porters did not report cases of abuse to institutions for help, social workers should intensify their broker role as professionals, to help link migrant female head porters who are trapped in abusive relationships to formal institutions in Ghana, like DOVVSU and Social Welfare for help and protection. Furthermore, since many migrant female head porters could experience abuse in intimate relationships for lengthy periods 98 http://ugspace.ug.edu.gh/ of time without reporting, the abuse could depress many thereby disempowering them. Social workers could offer counselling to victims of intimate partner violence to help boost their confidence and take preventive measures to curb negative effects of intimate partner violence, such as suicide. 99 http://ugspace.ug.edu.gh/ References Abbey, E. E (2015, March 20). Domestic violence cases reported to DOVVSU in 2014. th Graphic Online. 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Zarza, M. J., Ponsoda, V., & Carrillo, R. (2009). Predictors of violence and lethality among Latina immigrants: Implications for assessment and treatment. Journal of Aggression, Maltreatment & Trauma, 18, 1-16. doi:10.1080/10926770802616423. 112 http://ugspace.ug.edu.gh/ APPENDICES 113 http://ugspace.ug.edu.gh/ APPENDIX I UNIVERSITY OF GHANA DEPARTMENT OF SOCIAL WORK This is an academic study that seeks to examine the experiences of intimate partner violence among migrant female head porters in Kumasi. It is part of the requirement for the award of Master of Philosophy in Social Work at the Department of Social Work, University of Ghana Legon. All information derived will be used for academic purposes; as such information from participants will be kept confidentially. GUIDE FOR INDIVIDUAL INTERVIEWS - FEMALE HEAD PORTERS Demographic Characteristics  How old are you?  Educational background  Which part of these regions is your place of origin, Upper West, Upper East and Northern?  How long have you stayed in Kumasi?  Are you currently living with an intimate partner or have you ever lived with an intimate partner? Forms of Intimate Partner Violence Migrant Female Head Porters Experienced  Have you ever been hit, slapped, kicked, pushed, insulted, shouted at, threatened, denied visit to love ones, or coerced to have sex by your partner?  Can you share with me your experience? Factors that Contribute to Intimate Partner Violence among Migrant Female Head Porters  Tell me what you know about your husband that you think makes him abuse you. 114 http://ugspace.ug.edu.gh/  Is there anything you do personally that makes your husband angry and abuses you?  Is there anything about you that gives your partner the advantage to abuse you?  What do you think is within the community that influences your partner to abuse you?  Tell me about the customs and beliefs within the society that gives your partner more opportunity to abuse you.  How does the society perceive your partner’s action of abuse and how does your partner identify himself as victim? Effects of Intimate Partner Violence on Migrant Female Head Porters  How does your partner’s violent behaviour towards you affect your physical health?  Tell me how the abuse affects your economic life (e.g. Work, finances)?  In your view how does the abuse affect your reproductive health?  How does the violence affect your self-image and everyday life?  How does the violence affect your children? Coping Strategies adopted by Migrant Female Head Porters  What kind of strategy do you normally adopt to handle your partner’s abusive behaviour? Both positive and negative.  What are the reasons for using such coping strategy?  Is there something that caused you not to tell anyone about your situation?  Is there anything you want to share that hasn’t been asked? 115 http://ugspace.ug.edu.gh/ INTERVIEW GUIDE FOR KEY INFORMANT - DOVVSU OFFICIALS Forms of Intimate Partner Violence Migrant Female Head Porters Experienced  Do migrant female head ports report incidence of partner violence to your institution?  Can you tell me the forms of intimate partner violence normally reported by female head porters?  Why do you think these forms of violence are pervasive among migrant female head porters? Factors that Contribute to Intimate Partner Violence among Migrant Female Head Porters  Tell me more about how your institution handles intimate partner violence among female head porters.  What is your personal perception about intimate partner violence against women?  How does community members perceive intimate partner violence among migrant female head porters.  What is your institution doing to reduce the incidence of violence against women by intimate partners? INTERVIEW GUIDE FOR KEY INFORMANT - MSIG OFFICIALS Effects of Intimate Partner Violence on Migrant Female Head Porter’s Wellbeing  Has there been a case of refusal of contraceptive use by female head porters on the basis of intimate partner abuse?  In your view how does intimate partner violence affect female head porter’s decision making with regard to contraceptive use?  How does partner violence affect female head porters before, during and after pregnancy? Give examples of cases received in your organisation. 116 http://ugspace.ug.edu.gh/  Can you share with me about any instances of partner violence and induce abortion among female head porters? INTERVIEW GUIDE FOR KEY INFORMANT – GROUP LEADERS  In your opinion what are some of the factors that lead to the abuse of migrant female head porters in intimate relationships?  What is your perception about intimate partner violence against women?  What are some of the negative impacts of partner violence on the female head porters? THANK YOU FOR YOUR TIME AND PARTICIPATION 117 http://ugspace.ug.edu.gh/ APPENDIX 11 (GHANAIAN LANGUAGE TWI) ANKORƐANKORƐ NSƐMMISA AKWANKYERƐ – HEAD PORTERS Wei yɛ nhomasua ho nhwehwɛmudwuma bi a ɛfa Kayayefoɔ asetena ho wɔ Kumase. Ɛka nnoɔma a wɔbɛgyina so ama me Master of Philosophy in Social Work abodin wɔ Department of Social Work, University of Ghana, Legon no ho. Nsɛm a ɛbɛfiri saa nkutahodie yi mu aba nyinaa yɛ deɛ yɛde bɛyɔ adesua nko ara; enti deɛ wobɛka biara no, yɛbɛkora no sɛ ahuntasɛm a obi foforɔ biara rente. Wo Ho Nsɛm  Woadi mfeɛ sɛn?  Wokɔɔ sukuu duruu gyinapɛn sɛn?  Saa amantam yi mu deɛ ɛwɔ he na wofiri mu: Upper West, Upper East ne Northern  Mmerɛ tenten sɛn na woatena Kumase?  Wo ne wo hokafoɔ bi na ɛte anaasɛ wo ne wo hokafoɔ bi atena pɛn? Ayayadeɛ Ahodoɔ a Kayayefoɔ Ahokafoɔ De Yɔ Wɔn  So wo hokafoɔ no: abɔ wo, abɔ wo sotorɔ, atu ne nan awɔ wo, asum wo, adidi wo atɛm, ateatea wo, ahunahuna wo, asi wo kwan sɛ nkɔsra w’ adɔfo bi, anaa ahyɛ wo ne wo ada pɛn?  Wobɛtumi aka deɛ ɛtoo wo no akyerɛ me? Nnoɔma a Ɛnam So Ma Wɔyɔ Kayayefoɔ Ayayadeɛ  Kyerɛ me nnoɔma a wogye di sɛ ɛnam so ma wo kunu yɛ wo ayayadeɛ. 118 http://ugspace.ug.edu.gh/  So nnoɔma bi wɔ hɔ a woyɔ a, ɛhyɛ wo kunu no abufuo ma ɔyɛ wo ayayadeɛ?  So biribi wɔ wo ho a, ɛhyɛ wo kunu abufuo ma ɔyɛ wo ayayadeɛ? Nsunsuansoɔ a Ayayadeɛ a Kayayefoɔ Ahokafoɔ De Yɔ Wɔn Nya Wɔ Wɔn So.  Nsunsuansoɔ bɛn na ayayadeɛ a wo hokafoɔ de yɔ wo no nya wɔ w’apomuden so?  Kyerɛ me nsunsuansoɔ a ayayadeɛ no nya wɔ wo sikasɛm so? (Sɛ ebia w’adwumayɛ, wo sika)  Wohwɛ mu a, nsunsuansoɔ bɛn na ayayadeɛ no nya wɔ w’apomuden so wɔ ɔbaa ne ɔbarima nna mu?  Nsunsuansoɔ bɛn na ayayadeɛ no nya wɔ sɛdeɛ nnipa bu wo fa ɛne wo daa daa asetena mu so? Akwan Ahodoɔ a Wonam So Tumi Gyina (Ayayadeɛ No) Ano  Akwan ahodoɔ bɛn na wofa so de gyina wo hokafoɔ no ayayadeyɔ suban no ano?  Adɛn nti na wofa saa akwan yi so?  Biribi wɔ hɔ a ɛsi wo kwan a enti wontumi nka w’amanehunu yi nkyerɛ afoforɔ?  Biribi wɔ hɔ a, yɛmmisaa wo ho asɛm a wopɛ sɛ woka? ANKORƐANKORƐ NSƐMMISA AKWANKYERƐ – GROUP LEADERS Nnoɔma a Ɛnam So Ma Wɔyɔ Kayayefoɔ Ayayadeɛ  Wohwɛ mu a, nnoɔma bɛn na ɛma kayayefoɔ (a wɔwɔ ahokafoɔ no) ahokafoɔ yɔ wɔn ayayadeɛ?  Wo ankasa, adwene bɛn na wowɔ fa ayayadeɛ a mmaa ahokafoɔ yɔ de tia wɔn no ho? 119