Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: Violence against women remains a major public health concern in African countries. We conducted a matched case-control study to identify risk factors for recurrent violent injuries among African women in The Gambia, a small West African country.

Methods: During the 12-month study period, we recruited study participants from eight emergency departments in the metropolitan areas of the municipality of Kanifing and the West Coast region. We selected women aged ≥15 years who sought medical treatment for an injury due to physical violence at least twice over the study period. Two control groups were used: violence controls (VC), which included those who had experienced a single violence-related injury in the prior 12 months; and nonviolence controls (NVC), which included those who had experienced a nonviolent injury. Control patients were matched based on gender, health facility, injury date, and age (±2 years).

Results: In total, 116 case patients and 232 control patients participated in the study. Results of the conditional logistic regression analyses of the VC and NVC control groups individually showed that women with recurrent violent injuries had a significantly higher likelihood of having a secondary education (odds ratio [OR]_VC 6.47; OR_NVC 4.22), coming from a polygamous family (OR_VC 3.81; OR_NVC 3.53), and had been raised by a single parent (OR_VC 5.25; OR_NVC 5.04). Furthermore, compared with the VC group, women with recurrent violent injuries had a significantly higher likelihood of living in a rented house (OR_VC 4.74), living with in-laws (OR_VC 5.98), and of having experienced childhood abuse (OR_VC 2.48). Compared with the NVC group, women with recurrent violent injuries had a significantly higher likelihood of living in an extended family compound (OR_VC 4.77), having more than two female siblings (OR_VC 4.07), and having been raised by a relative (OR_VC 3.52).

Conclusion: We identified risk factors for recurrent injuries from physical violence among African women in The Gambia. Intervention strategies targeting these risk factors could be effective in preventing recurrent violence against African women.