Available via license: CC BY-NC-ND 4.0
Content may be subject to copyright.
Full Terms & Conditions of access and use can be found at
https://www.tandfonline.com/action/journalInformation?journalCode=tchs20
Culture, Health & Sexuality
An International Journal for Research, Intervention and Care
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/tchs20
Coping responses to intimate partner violence:
narratives of women in North-west Tanzania
Annapoorna Dwarumpudi, Gerry Mshana, Diana Aloyce, Esther Peter, Zaina
Mchome, Donati Malibwa, Saidi Kapiga & Heidi Stöckl
To cite this article: Annapoorna Dwarumpudi, Gerry Mshana, Diana Aloyce, Esther Peter, Zaina
Mchome, Donati Malibwa, Saidi Kapiga & Heidi Stöckl (2022): Coping responses to intimate
partner violence: narratives of women in North-west Tanzania, Culture, Health & Sexuality, DOI:
10.1080/13691058.2022.2042738
To link to this article: https://doi.org/10.1080/13691058.2022.2042738
© 2022 The Author(s). Published by Informa
UK Limited, trading as Taylor & Francis
Group
Published online: 04 Mar 2022.
Submit your article to this journal
Article views: 986
View related articles
View Crossmark data
Coping responses to intimate partner violence: narratives
of women in North-west Tanzania
Annapoorna Dwarumpudi
a
, Gerry Mshana
b,c
, Diana Aloyce
b
, Esther
Peter
b
, Zaina Mchome
b,c
, Donati Malibwa
b
, Saidi Kapiga
b,d
and
Heidi St€
ockl
e
a
Gender Violence and Health Centre, Department of Global Health and Development, London
School of Hygiene & Tropical Medicine, London, UK;
b
Mwanza Intervention Trials Unit, Mwanza,
Tanzania;
c
National Institute for Medical Research, Mwanza Centre, Mwanza, Tanzania;
d
Department
of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK;
e
Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-
Universit€
at M€
unchen, Munich, Germany
ABSTRACT
This study sought to explore the variety of coping strategies that
women employ in response to intimate partner violence. Coping
strategies can help women tolerate, minimise and deal with diffi-
cult challenges or conflicts in their relationships, such as learning
to be independent from their husbands and surviving trauma.
Drawing on 18 in-depth interviews conducted in Mwanza,
Tanzania, we examined two different coping strategies –engage-
ment and disengagement coping –with respect to how women
react to economic, emotional, physical and sexual intimate part-
ner violence. While the choice of coping methods remains a com-
plex issue, most women employed engagement strategies as a
response to economic violence and disengagement coping for
sexual violence. We explore the implications of gender and soci-
etal roles for coping decisions and analyse how access to resour-
ces may provide women with the tools to limit future violence.
ARTICLE HISTORY
Received 14 March 2021
Accepted 12 February 2022
KEYWORDS
Intimate partner violence;
coping; Tanzania
Introduction
Intimate partner violence is a pervasive global public health and human rights issue,
with one in four women globally experiencing physical and/or sexual violence by a
partner during their lifetime (World Health Organization 2021). A 2021 study reported
that about 25% of women in sub-Saharan African countries reported intimate partner
violence, with a higher prevalence in rural areas with lower education and lower
access to economic resources (Wado et al. 2021). In Tanzania specifically, the lifetime
prevalence of physical and/or sexual intimate partner violence was reported to be
44% in 2015 (DHS 2016). The consequences of intimate partner violence, regardless of
CONTACT Heidi St€
ockl heidi.stoeckl@ibe.med.uni-muenchen.de
ß2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives
License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in
any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
CULTURE, HEALTH & SEXUALITY
https://doi.org/10.1080/13691058.2022.2042738
whether it is defined solely as physical and/or sexual or also includes economic and
psychological intimate partner violence, drastically affect women’s mental and physical
health, their participation in social and economic activity, and the wellbeing of their
children (World Health Organization 2021).
To design and implement effective interventions, it is important to understand how
women respond to intimate partner violence. Previous literature has distinguished two
main forms of coping with intimate partner violence: engagement and disengagement
coping (Tobin et al. 1989). Women may utilise engagement strategies to change the
abuser’s behaviour as well as shift the balance of power and maintain agency (Iverson
et al. 2013). Engagement strategies include help-seeking, active opposition, leaving,
covert resistance and violence (Tobin et al. 1989). Covert resistance also includes
women setting limits with their perpetrators, for example through discussion, and uti-
lising their support network. Disengagement coping is often described in terms of pas-
sive reaction patterns, palliative reactions and avoidance (Compas et al. 2001).
Disengagement strategies are usually passive attempts to avoid violence such as
remaining quiet or ignoring the situation while engagement strategies actively address
the violence and disrupt relations (Taft et al. 2007). Disengagement coping has been
associated with higher rates of depression and a lower sense of control, while engage-
ment strategies are associated with lower levels of victimisation and better mental
health outcomes (Tobin et al. 1989). Discerning the use of coping strategies is critical
to creating programmes and interventions and mitigating the health consequences of
intimate partner violence (Waldrop and Resick 2004).
Social Norms Theory, the Theory of Gender and Power and Empowerment Theory
can be useful in understanding the reasons why women choose disengagement or
engagement strategies when dealing with intimate partner violence. Social norms the-
ory explains why social expectations exert a strong influence on how individuals
behave (Perrin et al. 2019). Individuals comply with social norms for group belonging
and outcome expectations, anticipating rewards and punishments when choosing to
obey social rules (McDonald and Crandall 2015; Lilleston et al. 2017). Therefore, social
norms may inform the use of disengagement behaviours to remain compliant with
traditional power structures and prevent further violence.
According to Connell’s theory of gender and power, the internalisation of gender
norms takes place through socialisation (Wingood and DiClemente 2000). Connell’s
theory identified three distinct structures that characterise gendered relationships: (a)
the sexual division of labour (economic inequalities); (b) the sexual division of power
(imbalances in control) and (c) the structure of cathexis (social norms). Together, these
three interlinked structures help understand the gender-based expectations that lead
to intimate partner violence and the constraints women face to opposing their partner
(Maharaj 1995), particularly in a context where gender inequality and intimate partner
violence against women in Tanzania involves male dominance, traditional gender
roles, and access to economic resources (Gashaw et al. 2019).
Empowerment theory emphasises how despite intimate partner violence being a
complex social issue, women will make independent decisions when they are provided
sufficient support and opportunities to do so. Women in Tanzania are gaining higher
levels of education and economic opportunities, moving away from traditional social
2 A. DWARUMPUDI ET AL.
and gender constraints, giving them more social power to navigate inequalities and
strategically oppose violence from their partners (Fox 2016; Larsen and Hollos 2003).
While literature from the USA and Australia has outlined various coping strategies in
relation to intimate partner violence, there are few studies that have directly investigated
differences in coping strategies for the four forms of violence within an Eastern African
context (Tarzia 2021). Previous research on intimate partner violence in Tanzania has
largely focused on understanding the prevalence of violence, manifestations of violence,
and the pathways leading to abuse (Mahenge and St€
ockl 2021). Furthermore, they stress
the importance of help-seeking from official institutions (Palermo, Bleck, and Peterman
2014). These studies, however, do not explain how women navigate different forms of
violence from their partners and the gender inequalities that impact coping decisions.
This study therefore aimed to understand the utilisation of disengagement and engage-
ment strategies across different forms of intimate partner violence.
Methods
Study setting
The study took place in Mwanza, Tanzania’s second largest city. Mwanza is a major
business and commercial trade hub for neighbouring countries and the Lake Victoria
region (DHS 16). In 2015, according to the Demographic and Health Survey (DHS),
30% of women in Mwanza had no formal education, 46% had completed primary and
23% had higher education, and 67% were currently employed (DHS 2016). The main
source of employment for women in Mwanza was in agriculture (52%), followed by
unskilled manual work (23%) (DHS 2016).
Levels of intimate partner violence are high in Mwanza, with about 61% of women
reporting ever experiencing physical and/or sexual intimate partner violence and 34%
reporting economic abuse during the past 12 months (Kapiga et al. 2017). The largest
ethnic group in Mwanza are Sukuma people, yet inhabitants of Mwanza come from
many different ethnic groups across the country due to its strategic location as an
economic hub. As in other parts of Tanzania, patriarchy is common, with clear gender
expectations for men’s and women’s roles. Intimate relationships formed in this con-
text thereby confer more power and authority to men (Wight et al. 2006). Intimate
partner violence is still perceived to be a private issue in Tanzania, with only half of
the women who reported physical and/or sexual intimate partner violence in the DHS
seeking help from anyone, with most of them only seeking assistance from their fami-
lies and only very few involving official services (Mahenge et al. 2020).
The study was conducted between May and July 2019 in Mwanza. The study was
part of the MAISHA longitudinal study –a mixed-method cohort study investigating
predictors and consequences of intimate partner violence in Tanzania building on the
MAISHA trials (Kapiga et al. 2019). As can be seen in Table 1, 18 women aged 27–57
were randomly sampled from 85 women who reported changes in their experiences
of sexual intimate partner violence, defined as being forced to have sex against their
will, between the baseline and endline survey of the MAISHA trial (Kapiga et al. 2019).
The interviewers called the women to seek consent to participate in this additional
qualitative study and scheduled appointments with those who consented. The women
CULTURE, HEALTH & SEXUALITY 3
in this study have been residents of Mwanza for at least two years and were fluent in
Swahili, the language of the interviews.
The study was approved by the Ethics Committee of the London School of Hygiene
and Tropical Medicine in the UK; the Ludwig-Maximilians-University Munich in Germany;
and the National Institute of Medical Research Ethics Committee in Tanzania.
Data collection
Two trained Tanzanian female interviewers conducted the interviews –the preferred
language of participants. Interviewers received training on issues specific to this study
including ethical issues related to qualitative research and intimate partner violence.
The Principal Investigator (HS), with extensive knowledge and expertise on intimate
partner violence research, developed the first draft of the topic guide, informed by dis-
cussion with the study team and preliminary quantitative findings from the MAISHA
endline survey. The topic guide was revised based on expert input and field-tests and
adapted after the first interviews. Data saturation was ascertained by reviewing the
data and fieldwork notes on a daily basis and was reached when the interviews did
not reveal new information.
The interview guide itself (see online supplemental file 1) initiated a broad conver-
sation on how women would portray their perfect relationship to discuss behaviours
they like or do not appreciate in their partner. If women did not start conversations
about the different forms of violence themselves, they were introduced by questions
such as: Does your partner want to have sex when you do not? What do you do? In a
later section, participants were also queried what they considered to be economic,
psychological and sexual abuse and asked to relate this to their own experience.
Interviewers also asked specific questions to explore behaviours and actions in
response to intimate partner violence and explored narratives surrounding coping.
Interviews lasted between 60–90 min, were audio-recorded, transcribed verbatim, and
translated into English. They were conducted at a place and time of the participants’
choice such as their homes and at restaurants that was sufficiently private to ensure
Table 1. Socio-demographic profile of women interviewed.
Participant ID Age Marital status #Children 18 Level of education Occupation Religion
Mary 43 Married 4 Form 4 Tailor Christian
Zaina 45 Married 5 Std 7 Farmer Christian
Linda 44 Married 2 Form 4 Farmer Christian
Neema 48 Widow 3 Std 2 Florist Muslim
Eliza 43 Married 1 Form 2 Unemployed Muslim
Christina 32 Divorced 2 Std 7 Unemployed Christian
Sarah 37 Married 3 Std 7 Entrepreneur Christian
Grace 27 Single 1 Diploma Entrepreneur Christian
Tabitha 45 Married 1 Std 7 Entrepreneur Christian
Destiny 37 Divorced 4 Std 2 Unemployed Christian
Esther 45 Married none Std 7 Entrepreneur Christian
Ana 30 Married 2 Std 7 Entrepreneur Christian
Faith 57 Married 1 Std 7 Entrepreneur Christian
Diana 36 Divorce 3 Diploma Hotelier Christian
Melissa 43 Married 2 Std 7 Entrepreneur Christian
Anna 41 Married 2 Std 7 Entrepreneur Muslim
Laura 49 Married 1 Std 7 Unemployed Christian
Agnes 43 Married 2 Std 7 Entrepreneur Muslim
4 A. DWARUMPUDI ET AL.
that others could not overhear the conversations. The interviewer also paused the
audio recording and changed the topic when privacy was a concern and ensured the
comfort and privacy of the woman before continuing the discussion. Full information
about the study was provided to participants verbally, and written consent obtained.
Participants were reimbursed a total of 8,000 T-shillings (about 3.4 USD) after partici-
pating in each interview. After the interviews, all participants were provided with refer-
ral options for intimate partner violence services if needed.
Data analysis
Personal identifiers from the interview transcripts were removed prior to data analysis.
Data analysis was undertaken in multiple stages. First, DM and EP, who also conducted
the interviews, read half of the transcripts line by line to identify key topics and pat-
terns that were discussed and refined together with by GM, ZM, DM, and HS into a
codebook. Second, for the planned analysis of coping with intimate partner violence,
AD read and re-read all translated manuscripts and subsequently developed codes on
women’s coping based on what emerged from the interview data. After immersing
herself in the literature, AD investigated in how far the concepts of the chosen theo-
ries and literature aligned with her initial codes and in how far they went beyond. AD
also cross-checked her codes with those of the codebook and combined them if pos-
sible. Third, AD and the team identified patterns and relationships between the codes
and synthesised the main themes and chose corresponding quotes until consensus
was reached in multiple meetings. Participants were provided with a pseudonym to
protect their identity and quotes were derived from interview responses.
Findings
Women in this study reported multiple accounts of violence in their relationships,
including experiencing the co-occurrence of various forms of violence. While physical
violence was the least often reported, sexual, economic, and emotional forms of vio-
lence were common experiences. All participants reported a variety of coping strat-
egies to intimate partner violence that can be classified as either engagement or
disengagement strategies, with disengagement strategies, help-seeking and active
opposition being the most commonly chosen ones (Figure 1).
Coping strategies in response to economic intimate partner violence
Active opposition and help-seeking were the two forms of engagement strategies
most used for economic intimate partner violence. The women in this study displayed
active opposition to economic violence by verbally standing up to their partners and
communicating their frustration to actively address the violence. Reported help seek-
ing behaviours included out to family members or close friends for advice, resources
or interventions. For example, one participant, Zaina (45, farmer) described how she
relied on family members to address economic abuse from her partner who would
steal money meant for their children’s needs to buy alcohol.
CULTURE, HEALTH & SEXUALITY 5
I used to share with my elders when the abuse got too much. For example, I used to tell
my mom, but before, I would tell the woman who owns the house that I had rented. I
would tell her that I did not like my husband’s behaviour around money. She would try
to call him and talk to him about his behaviour. He would accept but then he repeats
after a few days. –Zaina, 45, farmer
Active opposition and help-seeking were not only used in response to economic vio-
lence when the partner stole their money, but also when he did not support the children
or pay loans. In this sample, women who commonly opposed their husbands usually
also had their own business, had finished primary education, and had children to sup-
port, alluding to the crucial impact of economic empowerment, education and maternal
responsibility on women’s responses to intimate partner violence. Women also reported
a reduction in economic intimate partner violence because of active opposition.
I told him, “I do not want to borrow other people’s money for you anymore. You do not
help with payments. Don’t you see that you are abusing me economically …To the
extent that I am stressed all the time”Now, he doesn’t ask me to take loans under my
name for him. - Neema, 48, Florist
Figure 1. Outline of coping patterns across four types of violence.
6 A. DWARUMPUDI ET AL.
Women commonly used engagement strategies to protect against economic vio-
lence, yet some remained quiet and played a passive reactionary role due to a per-
ceived lack of control or fear of punishment. When her previous partner did not
financially provide for the family, a participant, Destiny decided to seek an independ-
ent income source to pay for her children’s needs instead of confronting her partner.
When I asked where he spent the night, he would tell me that it is none of my business.
I decided to stop asking him for anything and let him decide himself whether to leave us
with money or not …So I was providing for myself. I didn’t depend on a man’s income. I
used to do casual works like laundry for money. –Destiny, 37, Unemployed
Coping strategies in response to emotional intimate partner violence
As seen in economic intimate partner violence, engagement strategies such as active
opposition and help-seeking were also commonly used in response to emotional
intimate partner violence, with women actively confronting their partners verbally or
utilising informal support systems to demand a change in emotional abuse.
Women were keen to have a positive reputation and therefore expressed feelings
of humiliation and anger when arguments with their partner happened in a public set-
ting, revealing abuse to the community. As a result, women were more likely to
actively confront their husband if he emotionally abused them in public.
However, disengagement or avoidance were also prevalent in responses to emo-
tional violence. Women stated that they were afraid that resisting emotional violence
would provoke argument and intensify emotional intimate partner violence or lead to
other forms of intimate partner violence. They claimed that it was not beneficial to
resist their partners. If they remained quiet and not engaged, their partners would
likely realise their abusive actions.
He used to beat me when I asked him where he had spent the night. I got used to the
situation. So, when he was home, I did not say anything because doing so resulted in
fights. Our communication was not like a real one. It was full of fear. –Tabitha, 45,
Entrepreneur
Other women also described how they remained quiet to express their anger and
frustration towards their partners. Another participant, Christina revealed that when
she got angry at her husband, she would stay quiet to provoke a response, thereby
forcing him to acknowledge his actions.
I become furious and quiet. When I become quiet, he will recognize his mistake and from
there we will have to sit together and discuss where he went wrong, and after that he
will end up making an apology. –Christina, 32, Unemployed
Coping strategies in response to physical intimate partner violence
Despite not being mentioned as frequently as economic, emotional and sexual intim-
ate partner violence, women who experienced physical intimate partner violence also
reported actively resisting through their own acts of violence. This did not occur very
often, because women feared that this decision would result in escalated abuse and
CULTURE, HEALTH & SEXUALITY 7
incite more arguments. For example, Ana (30, entrepreneur) reported that she had hit
her husband back after he had poured water on her in public, but in hindsight, she
considered this engagement strategy unsuccessful as it resulted in an increase in phys-
ical violence.
Coping strategies in response to sexual intimate partner violence
Active opposition was not commonly observed in sexual intimate partner violence.
Cases of sexual assault were viewed as shameful, and women usually kept these expe-
riences secret from family and friends to prevent further humiliation. Most of the
women in the sample reported having sex with their husbands when they did not
want to. For example, Sarah also stated that while she did not want to have sex, she
felt like it was her duty as a wife to yield and allow pleasure to her husband.
As a wife, you just give him what he wants just for the sake of it even though you have
already informed him that you are not in the mood. Since he keeps complaining, you just
let him have his way. –Sarah, 37, Entrepreneur
While most women chose to play an inactive role during sexual intimate partner
violence, some reported informal help-seeking in which they solely sought out emo-
tional support from family and friends rather than active ways to cope or stop the sex-
ual violence.
After a long time, I told my friend about the rape. She advised me and told me that this
is the way it is always done. When men have sex with first-time ladies (virgins), they
usually use force. –Christina, 32, Unemployed
When sexual intimate partner violence occurred, women remained silent and did
not actively oppose their partner to keep the peace in the relationship. Even women
who actively opposed their partner when economic or emotional intimate partner vio-
lence occurred tended to play a passive role in their reaction to sexual intimate part-
ner violence. For example, Esther (45, entrepreneur) who actively confronted her
husband when he borrowed her money had a passive reaction to all the experiences
of sexual intimate partner violence she described, sexual intimate partner violence
being regarded as a normal part of marriage.
Barriers to leaving abusive relationships
Leaving the partner was a strategy that three women used to address recurring and
severe forms of violence. Other women chose alternative ways to distance themselves
from their partners, for example by living in separate rooms or houses while being
married instead of seeking a legal separation. Another participant, Neema, who
wanted to get a divorce decided instead to live with her parents for a short period
due to the intimidation and fear she experienced from her partner.
“When I told him I wanted to formally separate, he called me and told me that I was a
fool and that he will slaughter me and leave. I could not live in peace …I stayed with my
parents for a month and came back.”–Neema, 48, Florist
8 A. DWARUMPUDI ET AL.
The women in our sample who chose to leave or informally separate from their
husbands were younger, had higher educational levels, and social and financial sup-
port. Agnes, who experienced emotional intimate partner violence felt able to leave
her husband due to her independent financial means, demonstrating how economic
resources and family support can help in choosing engagement strategies.
When I found out that he was using that same money to get other women and have
affairs, it really hurt me so much, and I was very angry. I then decided to leave him and
left. I told him that this is my money and property from my sweat and God blessed my
efforts. I was also given capital from my father. –Agnes, 43, Entrepreneur
Earlier in the relationship, this same participant also faced economic and emotional
violence from the same partner and chose to stay in the relationship at that time
point due to discouragement from the family and concern for her children. Agnes’s
initial reluctance to leave her partner suggests that repeated accounts of violence can
have a compounding effect and that women may encounter have a critical threshold
or turning point at which they shift towards choosing engagement strategies.
A considerable number of women had considered leaving their partners but were
discouraged to do so because of the negative effect this would have on their children,
economic dependence, and concerns about their partner’s reaction. Women worried
that if they get divorced, they might not find another partner due to social censure.
The moment you get divorced and get married to another man, people tell that you are
a whore. You are regarded as an immoral person. –Woman, 43, Unemployed
Women who did not leave their partner relied on disengagement strategies,
reported lower self-esteem, and chose more harmful coping mechanisms. Due to the
abuse they experienced some reported looking for love elsewhere by engaging in
extramarital affairs or partaking in alcohol use.
That (violence) is what made me get into another relationship. It was like a way to find
comfort, which is how I found myself into that (extra-marital relationship) –Tabitha, 45,
Entrepreneur
In contrast, Grace (27, Entrepreneur), the youngest woman in the study with one
child, had left her husband, and was seeking an educational diploma. She also had
the support of her family and was able to move in with her parents. Her networks
and background were crucial in her decision to leave her marriage.
Barriers to help-seeking and disclosure
Help-seeking is a broad form of resistance in which women seek help from either formal
or informal networks to help reduce or address intimate partner violence. Help-seeking
was a strategy that women in this study used across the different forms of violence.
However, participants rarely described reaching out to law enforcement and health-
care professionals. Most depended on informal channels such as family members,
friends, religious figures, and street leaders to speak to their partner, obtain advice
and receive emotional support. Women stated that family and friends they asked for
advice would tell them to be patient with their husbands, suggesting the limited effi-
cacy of informal help-seeking.
CULTURE, HEALTH & SEXUALITY 9
I used to tell them, the women mostly, if his behaviour becomes excessive, I tell them, he
does this and this and I don’t like it. They just advise me to be patient, they tell me to be
patient. –Lisa, 37, Unemployed
While many women were willing to seek help from informal networks, a minority
remained unwilling to share their violent experiences with anyone, including close rel-
atives and friends. These women shared the perception that matters of abuse should
stay within the private and confidential sphere of the relationship. They believed that
disclosure or help-seeking was not constructive and that conflict within the marriage
should be resolved with the partner privately instead.
Whether we have gone out or whether we have argued we act as if nothing has
happened when somebody visits. You can resume your brawl when she leaves because if
you share your experience with her, she may in turn share that with her loved one. You
will be humiliated further if you share with someone that …you have been beaten …or
you have had your clothes torn from you. –Melissa, 43, Entrepreneur
Women who declined help-seeking services also showed an underlying fear that
rumour would spread in the community, damaging their social reputation. Women
reported fear of punishment from their partners if they revealed abuse to outsiders.
The perceived shame, social backlash, and the wish to retain privacy were reasons
why women behaved in this way.
Some conversations signal violence. For example, my partner may talk harshly to me
alone or in the presence of our children. That is humiliation or violence directed to me.
The next day, my child may ask me, “why did dad say …one …two …three to you?”It’s
one of the things I hate in my life. Why can’t he wait until we are alone …just the two of
us instead of arguing over a phone while other people are listening on. That’s abusing or
violating your partner. Abuse has many faces …See? –Faith, 57, Entrepreneur
Additionally, in this study community, discussing sex is perceived to be taboo.
Thus, women reported discomfort in discussing sexually violent behaviours.
These experiences …(sounding sad). When you sit with most women experiencing sexual
violence you will find that it is hard to disclose about what someone is going through.
Only confident women will discuss this matter with you. That’s why a person who has
confided in you will tell you that you are one of her closest people. –Mary, 43, Tailor
Discussion
This study found that women use a variety of coping strategies to deal with physical,
sexual, emotional and economic intimate partner violence. While women utilised a
mix of engagement and disengagement strategies for emotional and physical intimate
partner violence, women primarily relied on engagement strategies for economic
intimate partner violence and primarily resorted to disengagement strategies to cope
with sexual intimate partner violence.
Women in this study were generally reluctant to disclose intimate partner violence
or to actively seek help, in particular those who experienced sexual violence, an atti-
tude that continues to be commonplace throughout sub-Saharan Africa. In a study in
Nigeria, over 50% of women reported that they would not disclose violence, and
10 A. DWARUMPUDI ET AL.
among the women who were willing to do so, about 70% would choose to report
only to close relatives not formal institutions (Okenwa, Lawoko and Jansson 2009).
Figure 2 outlines how the different theories used in our analysis help explain wom-
en’s choice of coping strategies. Women’s tolerance of intimate partner violence and
conformity to dominant understandings of gender roles and relationships are likely to
be an expression of their experiences and expectations as well as a reflection of pre-
vailing social norms (McCleary-Sills et al. 2016). At the individual level, our study, as
well as existing evidence suggests that a woman’s willingness to disclose abuse or
seek help is influenced by her level of adherence to gender roles, decision-making
autonomy, social empowerment, and perceptions of available social services
(Sardaryan 2017). As suggested by social norms theory, community values that pro-
mote violence, financial dependence and social discrimination impede women’s deci-
sion to disclose violence (Liang et al. 2005). An in-depth qualitative study in Mwanza,
Tanzania showed that women may agree to have sex with their husbands even
though they are not in the mood, given that sex in marriage is framed as a man’s
right (Mchome et al 2020). These barriers to help-seeking illustrate how female agency
is restricted by social norms and systems that are not responsive to their needs. In
Tanzania, for example, there is a pressing shortage of primary care physicians who can
identify victims of intimate partner violence and offer culturally sensitive and appropri-
ate services for coping (Dienye, Gbeneol, and Itimi 2014).
In line with the Theory of Gender and Power, women in this study described how
inequitable societal gender role prescriptions and socialisation contributed to the
acceptance of intimate partner violence in communities that made it difficult for them
to gain support against intimate partner violence (Nyamhanga and Frumence 2014). In
a study in Dar es Salaam, Tanzania, young women described their role as one of serv-
ing their partner’s sexual needs and identified the ideal woman as home-bound, set-
tled, submissive and forgiving (Lary et al. 2004). This cultural norm and associated
Figure 2. Developing theoretical framework to understanding women’s decision pathways to cope
with intimate partner violence.
CULTURE, HEALTH & SEXUALITY 11
power differential limits women’s ability to negotiate the terms of their sexual relation-
ships and constructively react to sexual violence specifically (Krishnan et al. 2012).
In this study, empowerment theory was useful in explaining why some women in
the study were able to choose engagement strategies –typically, the individuals con-
cerned had more economic and social resources at their disposal, an important factor
in influencing women’s decision to speak up or leave their abusive partner (De Serpa
Pimentel et al. 2021).
There were various turning points such as extramarital affairs, financial struggles
and recurring abuse, which caused women in this study to choose engagement strat-
egies or oppose their husbands. Previous research has documented how shifts in
beliefs and perceptions of themselves, their partners and their situation can motivate
women to consider active change (Chang et al. 2006). Rapid and profound social
changes are affecting families in Tanzania, as elsewhere in sub-Saharan Africa. Women
are gaining higher levels of education and increasingly contributing materially to the
household (George 2020; Okkolin, Lehtom€
aki, and Bhalalusesa 2010). As empowerment
theory suggests, access to financial resources allows women to make strategic choices
concerning their lives, improving their status in the household and community (Idris
2018). With increased decision-making capacity and higher self-esteem, women may
be more likely to resist economic violence since this action threatens their newly
earned status, income and self-perception (Huis et al. 2017).
Studies have also shown that education enlightens women about their options and
empowers them to challenge gendered norms that normalise violence as it has been
found in our study. Women with more education, and hence more career options, may
be less likely to be abused because they are perceived as more valuable by their hus-
bands; they also may have more power to leave a relationship should their husband
become abusive. A study in Mwanza, Tanzania has highlighted how the prevalence of
violence decreased with increasing level of education for women (Kapiga et al. 2017). As
women’s participation in the domestic economy in East Africa increases, investments in
women’s education and the inclusion of men in intimate partner violence programmes
and interventions could interrupt the cycle of violence in Tanzania.
Limitations
This study has certain limitations. Firstly, women in the study were recruited from a
longitudinal qualitative study, yet we only interviewed them twice, basing this analysis
on the first interviews where how women coped with intimate partner violence was
one of the aims of the study. In addition, interviews were conducted only with mar-
ried women in a heterosexual relationship. It is possible that perspectives may have
differed if unmarried women in a relationship had been included. Secondly, even
though our sample relied on an ethnically diverse group and reports of intimate part-
ner violence aligned with other studies conducted in Tanzania (DHS 2016), we would
have liked to sample a more diverse group including young women and women
growing up outside Mwanza. Thirdly, the research assistants conducting the interviews
for this study were younger than participants, which may have influenced what the
older women said. Fourthly, due to stigma and normative expectations, women may
12 A. DWARUMPUDI ET AL.
also have been reluctant to disclose experiences of intimate partner violence, espe-
cially sexual violence, and their responses to it.
Conclusion
Previous studies investigated intimate partner violence coping mechanisms do not
generally differentiate between different forms of intimate partner violence or consider
the socio-cultural context that may be applicable to women in North-west Tanzania
(Mahenge and St€
ockl 2021; Palermo et al. 2014) This study identified that capturing
the varied experiences of women and differentiating between multiple forms of vio-
lence women experience is necessary to understand how women cope with intimate
partner violence and develop appropriate policies, programmes and interventions. The
notable lack of formal help-seeking in our study suggests that services are either not
widely available, or women do not trust formal systems. Community street leaders
and members should be supported to act as allies for women, addressing the social
norms that normalise violence and perpetuate negative ideas about masculinity.
Ultimately, study findings signal the need for interventions that address the individual,
interpersonal, and community level determinants of intimate partner violence, includ-
ing socio-cultural attitudes concerning gender inequity and economic empowerment.
Acknowledgements
We are grateful to the study participants and local community leaders in Tanzania who contrib-
uted to the research. We thank the study team for their support with data collection
and management.
Disclosure statement
The authors have no conflicts of interest to declare.
Funding
The research was funded by the ERC Starting Grant IPV_Tanzania (716458).
ORCID
Annapoorna Dwarumpudi http://orcid.org/0000-0003-0713-2762
Gerry Mshana http://orcid.org/0000-0001-8753-7561
Diana Aloyce http://orcid.org/0000-0002-0648-3184
Zaina Mchome http://orcid.org/0000-0002-4016-3571
Donati Malibwa http://orcid.org/0000-0003-4586-1472
Saidi Kapiga http://orcid.org/0000-0003-1753-4060
Heidi St€
ockl http://orcid.org/0000-0002-0907-8483
CULTURE, HEALTH & SEXUALITY 13
References
Chang, J. C., D. Dado, S. Ashton, L. Hawker, P. A. Cluss, R. Buranosky, and S. H. Scholle. 2006.
“Understanding Behavior Change for Women Experiencing Intimate Partner Violence:
Mapping the Ups and Downs Using the Stages of Change.”Patient Education and Counseling
62 (3): 330–339.
Compas, B. E., J. K. Connor-Smith, H. Saltzman, A. H. Thomsen, and M. E. Wadsworth. 2001.
“Coping with Stress During Childhood and Adolescence: Problems, Progress, and Potential in
Theory and Research.”Psychological Bulletin 127 (1): 87–127.
De Serpa Pimentel, A., G. Mshana, A. Dwarumpudi, D. Aloyce, E. Peter, Z. Mchome, D. Malibwa,
S. Kapiga, and H. St€
ockl. 2021.“Women’s understanding of economic abuse in North-Western
Tanzania .”Women’s Health 17 (1): doi:10.1177/17455065211042180
DHS. 2016.“Tanzania Demographic and Health Survey.”Bureau of Statistics, Planning
Commission, Dar es Salaam, Tanzania and Macro International Inc, Columbia, MD, USA.
Dienye, P., P. Gbeneol, and K. Itimi. 2014.“Intimate Partner Violence and Associated Coping
Strategies among Women in a Primary Care Clinic in Port Harcourt, Nigeria.”Journal of Family
Medicine and Primary Care 3 (3): 193.
Fox, L. 2016. "Gender, Economic Transformation and Women’s Economic Empowerment in
Tanzania." ODI.https://www.odi.org/publications/10571-gender-economic-transformation-and-
womens-economic-empowerment-tanzania.
Gashaw, B., J. Magnus, B. Schei, and K. Solbraekke. 2019.“Community Stakeholders’Perspectives
on Intimate Partner Violence during Pregnancy—A Qualitative Study from Ethiopia.”
International Journal of Environmental Research and Public Health 16 (23): 4694–4707.
George, F. M. 2020.“Gendered Patterns of Labour-Force Participation and Productivity in
Tourism and Hotel Sectors in Arusha and Moshi Urban Areas, Tanzania.”Journal of African
Studies and Development 12 (1): 1–16.
Huis, M. A., N. Hansen, S. Otten, and R. Lensink. 2017.“A Three-Dimensional Model of Women’s
Empowerment: Implications in the Field of Microfinance and Future Directions.”Frontiers in
Psychology 8:1678. doi:10.3389/fpsyg.2017.01678
Idris, I. “Mapping Women’s Economic Exclusion in Tanzania –GSDRC.”K4D Helpdesk Report.
May 2018. University of Birmingham. https://gsdrc.org/wp-content/uploads/2018/06/Mapping_
Womens_Economic_Exclusion_in_Tanzania.pdf
Iverson, K. M., S. D. Litwack, S. L. Pineles, M. K. Suvak, R. A. Vaughn, and P. A. Resick. 2013.
“Predictors of Intimate Partner Violence Revictimization: The Relative Impact of Distinct PTSD
Symptoms, Dissociation, and Coping strategies.”Journal of Traumatic Stress 26 (1): 102–110.
Kapiga, S., S. Harvey, G. Mshana, C. H. Hansen, G. J. Mtolela, F. Madaha, R. Hashim, I. Kapinga, N.
Mosha, T. Abramsky, et al. 2019.“A Social Empowerment Intervention to Prevent Intimate
Partner Violence against Women in a Microfinance Scheme in Tanzania: Findings from the
MAISHA Cluster Randomised Controlled Trial.”The Lancet Global Health 7 (10): e1423–e1434.
Kapiga, S., S. Harvey, A. K. Muhammad, H. St€
ockl, G. Mshana, R. Hashim, C. Hansen, S. Lees, and
C. Watts. 2017.“Prevalence of Intimate Partner Violence and Abuse and Associated Factors
among Women Enrolled into a Cluster Randomised Trial in Northwestern Tanzania.”BMC
Public Health 17 (1): 190–201. doi:10.1186/s12889-017-4119-9
Krishnan, S., D. Vohra, D. de Walque, C. Medlin, R. Nathan, and W. H. Dow. 2012.“Tanzanian
Couples’Perspectives on Gender Equity, Relationship Power, and Intimate Partner Violence:
Findings from the RESPECT Study.”AIDS Research and Treatment 2012:187890–187899. doi:10.
1155/2012/187890
Larsen, U., and M. Hollos. 2003.“Women’s Empowerment and Fertility Decline among the Pare
of Kilimanjaro Region, Northern Tanzania.”Social Science & Medicine (1982) 57 (6): 1099–1115.
Lary, H., S. Maman, M. Katebalila, A. McCauley, and J. Mbwambo. 2004.“Exploring the
Association between HIV And Violence: Young People’s Experiences with Infidelity, Violence
and Forced Sex in Dar Es Salaam, Tanzania.”International Family Planning Perspectives 30 (4):
200–206.
14 A. DWARUMPUDI ET AL.
Liang, B., L. Goodman, P. Tummala-Narra, and S. Weintraub. 2005.“A Theoretical Framework for
Understanding Help-Seeking Processes Among Survivors of Intimate Partner Violence.”
American Journal of Community Psychology 36 (1–2): 71–84.
Lilleston, P. S., L. Goldmann, R. K. Verma, and J. McCleary-Sills. 2017.“Understanding Social
Norms and Violence in Childhood: Theoretical Underpinnings and Strategies for Intervention.”
Psychology, Health & Medicine 22 (sup1): 122–134.
Maharaj, Z. 1995.“A Social Theory of Gender: Connell’s Gender and Power.”Feminist Review 49
(1): 50–65.
Mahenge, B., and H. St€
ockl. 2021.“Understanding Women’s Help-Seeking with Intimate Partner
Violence in Tanzania.”Violence against Women 27 (6–7): 937–951.
McCleary-Sills, J., S. Namy, J. Nyoni, D. Rweyemamu, A. Salvatory, and E. Steven. 2016.“Stigma,
Shame and Women’s Limited Agency in Help-Seeking for Intimate Partner Violence.”Global
Public Health 11 (1–2): 224–235.
McDonald, R. I., and C. S. Crandall. 2015.“Social Norms and Social Influence.”Current Opinion in
Behavioral Sciences 3: 147–151. doi:10.1016/j.cobeha.2015.04.006
Nyamhanga, T. M., and G. Frumence. 2014.“Gender Context of Sexual Violence and HIV Sexual
Risk Behaviors among Married Women in Iringa Region, Tanzania.”Global Health Action 7 (1):
25346.
Okenwa, L. E. E., S. Lawoko, and B. Jansson. 2009.“Factors Associated with Disclosure of
Intimate Partner Violence among Women in Lagos, Nigeria.”Journal of Injury Violence
Research 1 (1): 37–47.
Okkolin, M.-A., E. Lehtom€
aki, and E. Bhalalusesa. 2010.“The Successful Education Sector
Development in Tanzania –Comment on Gender Balance and Inclusive Education.”Gender
and Education 22 (1): 63–71.
Palermo, T., J. Bleck, and A. Peterman. 2014.“Tip of the Iceberg: Reporting and Gender-Based
Violence in Developing Countries.”American Journal of Epidemiology 179 (5): 602–612.
Perrin, N., M. Marsh, A. Clough, A. Desgroppes, C. Yope Phanuel, A. Abdi, F. Kaburu, S. Heitmann,
M. Yamashina, B. Ross, et al. 2019.“Social Norms and Beliefs about Gender Based Violence
Scale: A Measure for Use with Gender Based Violence Prevention Programs in Low-Resource
and Humanitarian Settings.”Conflict and Health 13 (1): 6–18. doi:10.1186/s13031-019-0189-x
Sardaryan, Y. 2017.“Risk Factors Impeding Help-Seeking Behaviors among Victims of Domestic
Violence.”European Journal of Public Health 27 (suppl_3): 414. doi:10.1093/eurpub/ckx186.037
Taft, C. T., P. A. Resick, J. Panuzio, D. S. Vogt, and M. B. Mechanic. 2007.“Examining the
Correlates of Engagement and Disengagement Coping among Help-Seeking Battered
Women.”Violence and Victims 22 (1): 3–17.
Tarzia, L. 2021.“Toward an Ecological Understanding of Intimate Partner Sexual Violence.”
Journal of Interpersonal Violence 36 (23–24): 11704–11724.
Tobin, D. L., K. A. Holroyd, R. V. Reynolds, and J. K. Wigal. 1989.“The Hierarchical Factor
Structure of the Coping Strategies Inventory.”Cognitive Therapy and Research 13 (4): 343–361.
Wado, Y. D., M. K. Mutua, A. Mohiddin, M. Y. Ijadunola, C. Faye, C. V. Coll, A. J. Barros, and C. W.
Kabiru. 2021.“Intimate Partner Violence against Adolescents and Young Women in Sub-
Saharan Africa: Who Is Most Vulnerable?”Reproductive Health 18 (Suppl 1): 119.
Waldrop, A. E., and P. A. Resick. 2004.“Coping among Adult Female Victims of Domestic
Violence.”Journal of Family Violence 19 (5): 291–302. Jofv.0000042079.91846.68.
Wight, D. M. L., Plummer, G. Mshana, J. Wamoyi, Z. S. Shigongo, and D. A. Ross. 2006.
“Contradictory Sexual Norms and Expectations for Young People in Rural Northern Tanzania.”
Social Science & Medicine 62 (4): 987–997.
Wingood, G. M., and R. J. DiClemente. 2000.“Application of the Theory of Gender And Power to
Examine HIV-Related Exposures, Risk Factors, and Effective Interventions for Women.”Health
Education & Behavior 27 (5): 539–565.
World Health Organization. 2021.“Violence against Women Prevalence Estimates, 2018 –
Executive Summary.”World Health Organization, March 2021. https://www.who.int/publica-
tions-detail-redirect/9789240026681.
CULTURE, HEALTH & SEXUALITY 15
