|Year : 2012 | Volume
| Issue : 2 | Page : 190-193
Sexual assault against women at Osogbo southwestern Nigeria
NA Adeleke1, AS Olowookere2, MB Hassan1, JO Komolafe3, EO Asekun-Olarinmoye4
1 Department of Obstetrics and Gynaecology, Osun State University Osogbo, Nigeria
2 Comm. Medicine O.A.U.Ileife, Nigeria
3 Department of Ophtalmology, Osun State University Osogbo; O and G Lautech University, Nigeria
4 Department of Community Medicine. Osun State University Osogbo, Nigeria
|Date of Acceptance||22-Sep-2011|
|Date of Web Publication||16-Jun-2012|
N A Adeleke
Department of O and G Osun State University Osogbo, P.O. Box 2103 Osogbo
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Sexual assault against women is common all over the world. However, reliable data on the subject in developing countries including Nigeria is not available.
Objective: To review the patterns of sexual violence against women treated at the hospital over a 7-year period.
Materials and Methods: Review of hospital records of victims of sexual assault who presented at the hospital from 1 January 2003 to 31 December 2009. Data obtained were analyzed using descriptive statistics and Chi squire test.
Results: Sexual assault cases constituted 2.1% of female consultation outside pregnancy during the period under study while proportion of cases increased over the years under review. Mean age of the victims was 15.8 (SD 8.1) years ranging from 5 to 48 years. Most (73.7%) were less than 18 years while 93.2% were single (never married). About 81% of the victims less than 18 years were sexually abused in the day time. Majority (79.6%) knew their assailant. About 40% of the victims presented within 24 h of sexual abuse but none had postexposure prophylaxis.
Conclusion: Sexual assault among women is an important health problem in this environment. There is need for hospital based management protocol.
Keywords: Forensic, gender, sexual, survivor, violence
|How to cite this article:|
Adeleke N A, Olowookere A S, Hassan M B, Komolafe J O, Asekun-Olarinmoye E O. Sexual assault against women at Osogbo southwestern Nigeria. Niger J Clin Pract 2012;15:190-3
|How to cite this URL:|
Adeleke N A, Olowookere A S, Hassan M B, Komolafe J O, Asekun-Olarinmoye E O. Sexual assault against women at Osogbo southwestern Nigeria. Niger J Clin Pract [serial online] 2012 [cited 2018 Aug 16];15:190-3. Available from: http://www.njcponline.com/text.asp?2012/15/2/190/97316
| Introduction|| |
The United Nation defines violence against women as any act of sexual assault that results in or is likely to result in physical, sexual, or mental harm or suffering to women including threats of such acts, coercion, or arbitrary deprivation of liberty whether occurring in public or private life. , Following the adoption of the definition above, different agencies of United Nation at different conferences had resolved and recommended many actions to the nations on addressing various aspects of violence (including sexual and physical violence) and human rights violations against women. ,,
The World Health Organization (WHO) multicountry study on women health and domestic violence against women clearly demonstrates that, violence against women is wide-spread and deeply ingrained, and has serious impacts on women's health and well being and its continued existence is morally indefensible. , Using operational definitions of types of violence against women in multi-Country World Health Organization Study, Violence against women when committed by an intimate partner such as husband or/and other family members is referred to as Domestic Violence, while that perpetrated by people outside this group is called nonpartner Violence. ,, Both types of violence affect the physical, psychological, and social status of the female gender and therefore constitute threat to the health of women. ,,
The situation of violence against women in Nigeria may not be different from reports from other countries. ,, However, there is dearth of National data on the subject. The available local reports indicate that violence against women, both partner and nonpartner, are common. , Sexual violence against women gained more relevance because of its capability to promote the spread of HIV/AIDS. ,,
This study reviewed the sexual assault cases managed at State hospital, Osogbo, Osun State, Nigeria over a period of 7 years. The findings may further bring the issue to public attention with the overall goal of reducing the problem of sexual assault against women in this region.
| Materials and Methods|| |
This is a retrospective review of hospital records of victims of sexual assault cases seen at State hospital, Asubiaro, Osogbo. The hospital records of all patients who presented to the Outpatient Department of the hospital with complaints of sexual assault from 1 January 2003 to 31 December 2009 were retrieved and reviewed.
The information extracted from the hospital records of these patients included their sociodemographic characteristics, the place and time of the incident, the relationship of the victims to the perpetrators and the methods employed by the assailants. Others were records of the forensic findings and treatment offered by the hospital as well as attendance at follow up.
The data collected were critically checked and cleaned by the researchers for internal consistency and accuracy. Subsequent analysis was performed using SPSS version 15 software. Descriptive statistics and chi squire test were used for the analysis.
Permission to conduct the study was granted by the State hospital Ethical Committee.
| Results|| |
The total number of female patients seen at the Outpatient department during the study period was 14, 970 with 318 cases presenting with sexual assault. Three hundred and nine case notes were available for analysis (retrieval rate 97%). The yearly case presentation showed steady increase from 0.72% in 2003 to 3.61% in 2009 [Table 1].
|Table 1: Yearly trend of sexual assault against women at State hospital, Osogbo|
Click here to view
The mean age of the patients was 15.8 (SD 8.1) years ranging from 5 to 48 years. [Table 2] reported that patients less than 18 years constituted 73.7% including the age group 13-18 that accounted for 42.7%.
|Table 2: Socio-demographic characteristics of sexual assault at State hospital, Osogbo|
Click here to view
Most (93.2%) victims reviewed were single while only 1.9% victims were married [Table 2].
[Table 3] reported the relationship between victim characteristics and time of occurrence of the violence. About 81% of victims less than 18 years were attacked during the day while 79.6% of the victims knew their assailant (P=0.001). The attack on the married, widow, and divorce all took place at night.
|Table 3: Victims characteristics and time of occurrence of sexual assault at state hospital, Osogbo|
Click here to view
[Table 4] reported time interval between assault and presentation at the hospital. About 40% presented on the day of occurrence.
|Table 4: Time Intervals before presentation of sexual assault victims at the State hospital, Osogbo|
Click here to view
[Table 5] showed the methods used by the assailants. In all cases force was employed. However, in some instances this was combined with a luring attitude described in this study as "Bait".
|Table 5: Victims characteristics and method used by assailants in sexual assault cases at State hospital, Osogbo|
Click here to view
[Table 6] showed the medical management of the victims. It reported that screening for Sexually Transmitted Infections including HIV/AIDS were not done except for few victims in the last 2 years under review and none had postexposure prophylaxis. Also pregnancy prevention, and follow up visits were not done except in some victims. Forensic evidence materials were not obtained in the earlier years of the period under review. However, all identified injuries were treated but very few victims returned for follow up.
|Table 6: Medical Management of cases of sexual assault at State hospital, Osogbo|
Click here to view
| Discussion|| |
Sexual assault is a public health issue in this environment as it constituted 2.1% of female consultation outside obstetrics. This finding is in agreement with other reports from sub-Saharan Africa. ,, This study showed that percentage of sexual assault reported cases decreased from 2003 to 2005 and from then increased till 2009. This finding is similar to a study in South Africa that reported a yearly increase in prevalence of sexual assault cases from 2001 to 200.  This study reported that children and young adults less than 18-year-old constituted almost three quarters of all the review cases. This finding is similar to the reports from Zimbabwe and Benin. , The implications of this finding are that the adolescent and young adults are the most at risk group of sexual violence in this region. The vulnerability of this group may be related to low socioeconomic status and inexperience in matters of sexuality as reported in many previous studies. ,, This age-group should be focused upon by any intervention to reduce sexual violence against women in this environment.
Although single women are particularly affected due to the number of adolescent involved, no woman of reproductive age is immune from sexual violence as married, divorced, and widowed were victims as well. This is similar to the findings in other places. ,,
As documented in earlier studies, the profiles of the perpetrators of sexual assault on women in this study included blood relations, neighbors, acquaintances, authority figure, and strangers. ,, Women have been known to suffer violence, physical, and/or sexual from intimate partners and strangers. ,, Assault occurred both during the day and at night. In this study, the blood relations, neighbors, and acquaintances were involved mostly during the day while the strangers attacked the victims during the night and this was statistically significant.
All the victims after assault were reported to the police before coming to the hospital. These findings could result from believes that such cases should be reported to the law enforcement agents first before presenting at the hospital.
About two-fifth of the cases presented at the Hospital on the day of occurrence, others presented over the next 1 or 2 weeks. This finding differs from the Jos study.  The relevance of time interval before medical examination lies on its effect on forensic evidence materials that can be obtained. The longer the time interval, the lower the quantity and quality of such evidences. 
The standard clinical Management of Sexual violence involves documentation and treatment of injury, getting forensic materials, detecting prior pregnancy, screening for sexually transmitted infections including HIV and provision of appropriate post exposure prophylaxis.  In our case series, treatment offered included documentation of injuries and the care received throughout the period of review however, the forensic materials availability, detection of an existing pregnancy, screening for sexually transmitted infections including HIV/AIDS and postexposure prophylaxis were done mostly in the last 3 years.
This study reported that very few of the patients attended follow up clinic. Studies available to the authors did not address issues of follow up of sexually assaulted clients. It is necessary to explore further why sexually assaulted patients do not come for follow up.
| Conclusions|| |
Sexual assault against women is of public health significance in this environment with the adolescent being the most affected. There is a need to establish a rape management protocol in the hospital in line with the WHO guideline. This work recommends further research on the subject in this environment.
| References|| |
|1.||Declaration on the elimination of violence against women. New York, NY: United Nations. United Nation General Assembly resolution document. RES/48/104; 1993. p. 1-10. [Last accessed on 2010 Oct 20]. |
|2.||Jewkes R, Garcia-Moren C, Sen P. Sexual violence. In: World report on violence and health. Geneva: World Health Organization; 2002. p. 149-81. |
|3.||Caldwell JC. The International Conference on Population and development, Cairo, 1994. Is its plan of action important, desirable and feasible? The nature of the forum. Forum. Health Transit Rev 1996; 6: 71-122. |
|4.||United Nations. Fourth World Conference on Women, Beijing. Platform of Action on Violence against Women. Beijing, China. United Nations publication; 1995. p. 1-6. |
|5.||United Nations General Assembly. United Nations Millennium Declaration. Millenium Development Goals (MDG). New York. United Nations publication; 2000. p. 1-9. |
|6.||Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts C. WHO multi-country study on women's health and domestic violence against women: Initial results on prevalence, health outcomes and women's responses. Geneva: World Health Organization; 2005. p. 1-50. |
|7.||Garcia-Moreno C, Watts C. Violence against women: An urgent public health priority. Bull World Health Organ 2011;89:2. |
|8.||Ilika AL, Okonkwo PI, Adogu P. Intimate partner violence among women of childbearing age in a primary health care centre in Nigeria. Afr J Reprod Health 2002;6:53-5. |
|9.||Amah N, Shittu SO, Abdul MA. Risk scoring for domestic violence in pregnancy. Niger J Clin Pract 2008;11:18-21. |
|10.||Amnesty International. Nigeria Rape the silent weapon. Abuja. Amnesty International publication. 2006. p. 3-42 |
|11.||Fawole OI, Ajuwon AJ and Osungbade KO. Evaluation of interventions to prevent gender-based violence among young female apprentices in Ibadan, Nigeria. Health Education, 2005 105 (3): 186-203 |
|12.||Omorodion FI, Olusanya O. The Social Context of reported rape in Benin City Nigeria. Afr J Reprod Health 1998:11;37-43. |
|13.||Aimakhu CO, Olayemi O, Iwe CA, Oluyemi FA, Ojoko IE, Shoretire KA, et al. Current causes and management of violence against women in Nigeria. J Obstet Gynaecol 2004:24;58-63. |
|14.||Ugbuji C. Violence against Women Impact on Their Reproductive Health. Trop Obstet Gynaecol 2004;21:61-64. |
|15.||Caroline HO, Richter A. Exploring Intersections between Gender Violence; Lessons from Zimbabwe. Afr J Reprod Health 1999;3:51-65. |
|16.||United Nations Development Fund for Women (UNIFEM). Get the facts: Violence against young women and girls. United Nations publication; 2010;1-3. |
|17.||Population council. Sexual and sexual assault in Africa: Literature review. 2008. Population council publication. 2008: 6-61. |
|18.||Olusanya O, Ogbemi S, Unuigbe J, Oronsaye A. The pattern of rape in Benin City, Nigeria. Trop. joun Med 1986;38:215-20. |
|19.||Welsh J, Manson F. Rape and sexual assault. BMJ 2007;334:1154-8. |
|20.||Meel BL. Trends of rape in the Mthatha area, Eastern cape, South Africa. South African Family Practice 2008;50:69. |
|21.||Elegbeleye OS. Is rape in the eye or the mind of the offender? A survey of rape perception among Nigerian University stakeholders. Educ Res Rev 2006; 1:40-51. |
|22.||World health Organization. Clinical Management of rape Survivors; developing Protocols for use with refugees and internally displaced persons Revised edition. Geneva: WHO; 2004. p. 12-77. |
|23.||World health Organization. Guideline for Medico-Legal care for the Victims of sexual violence. Geneva: WHO; 2003. p. 10-154. |
|24.||Ikuomola A D. The Nigerian civil war of 1967 and the stigmatization of children born of rape victims in Edo Nigeria. A paper presented at International conference of rape in war time: A history to be written. 2009. p 1-21. |
|25.||United Nations. Unite to end violence against women. Africaunitefactsheet. United Nations publication. 2010. p. 1-7 |
|26.||Daru PH, Osagie EO, Pam IC, Mutihir JT, Silas OA, Ekwempu CC. Analysis of cases of rape as seen at the Jos Teaching Hospital, Jos, North Central Nigeria. Niger J Clin Pract 2011;14:47-51. |
|27.||Onyejekwe CJ. The dominance of rape. Indian J Med Ethics 2006; 3: 48-63. |
|28.||Lammers K, Martin L, Andrews D, Seedat S. Reported rapes at a hospital rape centre: Demographic and clinical profiles. S Afr Med J 2010;100:362-3. |
|29.||Wilken J, Welch J. Management of people who have been raped. BMJ 2003;326:458-9. |
|30.||Williams A. Managing adult sexual assault. Aust Fam Physician 2004;33:825-8 |
|31.||Pitre A. Caring for survivors of sexual assault. Indian J Med Ethics 2006;3:90-2. |
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]