Shame, Fear, and Stigma: Understanding Psychosocial Barriers to Help Seeking Behavior among Female Survivors of IPV in Nairobi County
Keywords:
Intimate partner violence, Gender based violence, psychosocial support, internal barriers, stigmaAbstract
In Kenya, and particularly in urban contexts like Nairobi, many women continue to experience Intimate Partner Violence (IPV) yet remain silent or reluctant to seek help. However, help seeking rates among female survivors remain low. This paradox points to deep-rooted psychosocial barriers that point to shame, fear, and stigma. This study sought to identify internal barriers to help seeking behavior among women survivors of IPV. Conducted in one of the hospitals in Nairobi County that provides psychosocial support, this study employed the modified survivor theory as developed by developed by Gondolf and Fisher (1988). The study purposively sampled 390 women survivors and 12 key informants who respondent to survey using the 1996 Revised Conflict Tactics Scales-2 (CTS2) and interview guide respectively. A mixed-methods research approach was adopted, integrating both quantitative and qualitative data collection techniques. The positivist philosophy informed the quantitative strand, while the interpretivist philosophy guided the qualitative component. A convergent parallel mixed-methods design was used for data collection and analysis simultaneously. The study findings indicated that internal barriers such as confusion (???? = 2.342, SD = 0.565), shame (???? = 2.286, SD = 0.524) and the fear to be tagged weak (???? = 2.182, SD = 0.324) significantly hindered survivors’ help seeking behavior. The qualitative findings depicting personal barriers and family dynamics complemented the quantitative results. The study recommends strengthening survivor-centered services and increasing community awareness to reduce barriers and promote recovery among women survivors.
References
Ahmadabadi, Z., Najman, J. M., Williams, G. M., Clavarino, A. M., d’Abbs, P., & Tran, N. (2020). Intimate partner violence and subsequent depression and anxiety disorders. Social Psychiatry and Psychiatric Epidemiology, 55(5), 611–620. https://doi.org/10.1007/s00127-019-01828-1
Anderson, G. D., & Overby, R. (2020). Barriers in seeking support: Perspectives of service providers who are survivors of sexual violence. Journal of Community Psychology, 26(1), 1564–1582. https://doi.org/10.1002/jcop.22348
Apatinga, E. M., & Tenkorang, E. Y. (2021). Barriers to help-seeking among women survivors of intimate partner violence in Ghana. Journal of Interpersonal Violence, 36(9–10), 4753–4775. https://doi.org/10.1177/0886260520917369
Chadambuka, C., & Warria, A. (2021). Intimate partner violence: Understanding barriers in seeking formal support services in a rural area in Zimbabwe. Journal of Family Violence, 23(3), 1–12. https://doi.org/10.1007/s10896-021-00275-4
Chilanga, E., Collin-Vézina, D., Khan, M. N., & Riley, L. (2020). Prevalence and determinants of intimate partner violence against mothers of children under-five years in Central Malawi. BMC Public Health, 20(1), Article 1321. https://doi.org/10.1186/s12889-020-09910-z
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Sage.
Cuesta-Garcia, A., & Crespo, M. (2022). Barriers for help-seeking in female immigrant survivors of intimate partner violence: A systematic review. Journal of Victimology, 14(1), 1–28.https://doi.org/10.12827/RVJV.14.01
Dowuona-Hammond, C., Atuguba, R. A., & Tuokuu, F. X. D. (2020). Women’s Survival in Ghana: What Has Law Got to Do With It? SAGE Open, 10(3). doi.org/10.1177/2158244020941472
Heron, R. L., & Browne, K. (2021). Barriers and facilitators of disclosing domestic violence to the UK health service. Journal of Family Violence, 11(6), 1–11.
Hu, R., Xue, J., Lin, K., Sun, I. Y., Wu, Y., & Wang, X. (2020). The patterns and influencing factors of help-seeking decisions among women survivors of intimate partner violence in China. Journal of Family Violence. https://doi.org/10.1007/s10896-020-00145-5
Gibbs, A., Dunkle, K., Jewkes, R., & Willan, S. (2020). Understanding the mechanisms through which exposure to intimate partner violence impacts mental health: A mixed-methods study. Social Science & Medicine, 267, 112364. https://doi.org/10.1016/j.socscimed.2020.112364
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Prentice-Hall.
Goodson, A., & Hayes, B. E. (2018). Help-Seeking Behaviours of Intimate Partner Violence Victims : A Cross-National Analysis in Developing Nations. Journal of Interpersonal Violence, 36(9), 1–23. https://doi.org/10.1177/0886260518794508
Haj-Yahia, M. M., & Tishby, O. (2021). Patriarchal culture and the experience of intimate partner violence: The role of shame and stigma. Journal of Interpersonal Violence, 36(19-20), 9181–9205. https://doi.org/10.1177/0886260520965967
Handebo, S., Kassie, A., & Nigusie, A. (2021). Help-seeking behaviour and associated factors among women who experienced physical and sexual violence in Ethiopia: Evidence from the 2016 Ethiopia Demographic and Health Survey. BMC Women’s Health, 21(427), 1–8. https://doi.org/10.1186/s12905-021-01574-0
Hellmuth, J. C., Jaquier, V., Swan, S. C., & Sullivan, T. P. (2014). Elucidating posttraumatic stress symptom profiles and their correlates among women experiencing bidirectional intimate partner violence. Journal of Clinical Psychology, 70(10), 1008–1021.
Hu, R., Xue, J., Lin, K., Sun, I. Y., Wu, Y., & Wang, X. (2020). The patterns and influencing factors of help-seeking decisions among women survivors of intimate partner violence in China. Journal of Family Violence. https://doi.org/10.1007/s10896-020-00145-5
Hulley, E., Dworkin, S. L., Kruger, S., & Coetzee, J. (2022). Barriers to help-seeking for intimate partner violence among women in low-income communities of Cape Town, South Africa. Violence Against Women, 28(5), 1285–1308. https://doi.org/10.1177/10778012211049308
Issahaku, P. A. (2017). Correlates of intimate partner violence in Ghana. SAGE Open, 7(2), 1–12. https://doi.org/10.1177/2158244017709861
Jetha, E., Keygnaert, I., Martins, E., Sidat, M., & Roelens, K. (2020). Domestic violence in Mozambique: From policy to practice. Research Square, 1(13).https://doi.org/10.21203/rs.3.rs-18370/v1
Kenya Demographic and Health Survey (KDHS). (2014). Kenya Demographic and Health Survey 2014. Kenya National Bureau of Statistics (KNBS). https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf
Kenya National Bureau of Statistics (KNBS). (2014). Kenya Demographic and Health Survey 2014. KNBS and ICF Macro. https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf
Kothari, C. R. & Garg, G. (2023) Research Methodology: Methods and Techniques. New Age International Limited, Publishers.
Lacey, K. K., Jiwatram-Negron, T., & Sears, K. P. (2020). Help-seeking behaviors and barriers among Black women exposed to severe intimate partner violence: Findings from a nationally representative sample. Violence Against Women, 24(3), 1–21.
https://doi.org/10.1177/1077801220917464
Leonardsson, M., & Sebastian, M. S. (2017). Prevalence and predictors of help-seeking for women exposed to spousal violence in India: A cross-sectional study. BMC Women’s Health, 17(99), 1–16. https://doi.org/10.1186/s12905-017-0453-4
Lokot, M., & Bhatia, A. (2020). Anticipated stigma and internalized shame as barriers to help-seeking among women experiencing intimate partner violence in Africa and South Asia: A systematic review. Trauma, Violence, & Abuse, 21(3), 456–470.
https://doi.org/10.1177/1524838019860816
Malihi, Z., Fanslow, J. L., Hashemi, L., Gulliver, P., & Mcintosh, T. (2021). Factors influencing help-seeking by those who have experienced intimate partner violence : Results from a New Zealand population- based study. PLoS ONE, 16(12), 1–18.
McLindon, E. V. (2020). "It happens to clinicians too": The prevalence, impact, and implications of domestic and family violence against health professional women. Journal of Interpersonal Violence, 0(0), 1–1.
Muluneh, M. D., Alemu, Y. W., & Meazaw, M. W. (2021). Geographic variation and determinants of help-seeking behavior among married women subjected to intimate partner violence: Evidence from a national population survey. International Journal for Equity in Health, 20(13), 1–14.
Noelle, S., Bushra, S., Nwokolo, V., Kamila, A. A. (2016). A Qualitative Study of Survival Strategies Used by Low-Income Black Women Who Experience Intimate Partner Violence. Social Work 62(1). DOI:10.1093/sw/sww080
McLindon, E. V. (2020). "It happens to clinicians too": The prevalence, impact, and implications of domestic and family violence against health professional women. Journal of Interpersonal Violence, 0(0), 1–1.
Musyimi, C. W., Mutiso, V., Musau, A. M., Matoke, L. K., & Ndetei, D. M. (2020). Barriers to accessing mental health services in Kenya. International Journal of Mental Health Systems, 14(1), 1-10. https://doi.org/10.1186/s13033-020-00366-7
Muuo, S., Muthuri, S. K., Mutua, M. K., McAlpine, A., Bacchus, L. J., Ogego, H., Bangha, M., & Hossain, M. (2020). Barriers and facilitators to care-seeking among survivors of gender-based violence in the Dadaab refugee complex. Sexual and Reproductive Health Matters, 28(1), 1–17. https://doi.org/10.1080/26410397.2020.1722404
Potter, L. C., Morris, R., Hegarty, K., García-Moreno, C., & Feder, G. (2020). Categories and health impacts of intimate partner violence in the World Health Organization multi-country study on women’s health and domestic violence. International Journal of Epidemiology, 1–11. https://doi.org/10.1093/ije/dyaa220
Prosman, G., Lo, S. H., & Lagro-Janssen, A. L. M. (2014). Why abused women do not seek professional help : a qualitative study. Scandinavian Journal of Caring Sciences, 17(2), 1–9. https://doi.org/10.1111/scs.12025
Robinson, A. L., Camacho, E., & Hayes, M. (2020). Barriers to help-seeking for intimate partner violence: A systematic review. Aggression and Violent Behavior, 50, 101311. https://doi.org/10.1016/j.avb.2019.101311
Saint Arnault, D., & Sinko, L. (2022). Understanding IPV disclosure and help-seeking: A global systematic review. Global Public Health, 17(4), 469–482. https://doi.org/10.1080/17441692.2021.1946063
Schrag, R. J. V., Ravi, K., Robinson, S., Schroeder, E., & Padilla-Medina, D. (2020). Experiences with help-seeking among non-service-engaged survivors of IPV: Survivors’ recommendations for service providers. Violence Against Women, 23(2), 1–22.https://doi.org/10.1177/1077801220963861
Semahegn, A., Torpey, K., Manu, A., Assefa, N., Tesfaye, G., & Ankomah, A. (2019). Are interventions focused on gender norms effective in preventing domestic violence against women in low and lower-middle-income countries? A systematic review and meta-analysis. Reproductive Health, 16(1), 1–12. https://doi.org/10.1186/s12978-019-0726-5
Stewart, D. E., & Vigod, S. N. (2017). Mental Health Aspects of Intimate Partner Violence. Psychiatric Clinics of North America, 40(2), 321–334.
Swaine, A. (2018). Understanding and Addressing Conflict-Related Violence Against Women. Briefing Paper 2018, Political Settlements Research Programme (PSRP) UK.
Taherkhani, S., Negarandeh, R., Simbar, M., & Ahmadi, F. (2017). Barriers to seeking help among abused Iranian women. The Journal of Adult Protection, 19(5), 261–273.https://doi.org/10.1108/JAP-03-2017-0007
Thorvaldsdottir, H., & Halldorsdottir, S. (2022). Emotional barriers to help-seeking among IPV survivors: A qualitative exploration. Trauma, Violence, & Abuse, 23(2), 505–517. https://doi.org/10.1177/1524838020933866
Waller, M., Wright, K., & Halldorsdottir, S. (2022). The interplay of stigma, shame, and help-seeking among women survivors of partner violence: A multi-country study. Journal of Interpersonal Violence, 37(21–22), doi.org/10.1177/08862605211060651
Wambui, S., & Wanjala, C. (2019). Protecting family reputation: Internal barriers to reporting intimate partner violence in Kenya. Journal of African Studies, 43(2), 175–192.
Winter, S. C., Obara, L. M., & McMahon, S. (2020). Intimate partner violence: A key correlate of women’s physical and mental health in informal settlements in Nairobi, Kenya. PLOS ONE, 15(4), 1–18. https://doi.org/10.1371/journal.pone.0230894
Zhang, H., Zhao, R., Macy, R. J., Wretman, C. J., & Jiang, Y. (2019). A scoping review of 37 years of intimate partner violence research in China. Trauma, Violence, and Abuse. https://doi.org/10.1177/1524838019881738.
Published
How to Cite
Issue
Section
Copyright (c) 2025 Doreen M Njagi

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.