Exploring physical, sexual and mental health consequences of gender-based violence among women and girls during conflict in Tigray, Ethiopia.

Background: Gender-based violence is becoming an increasing during conflict, with negative short and long-term consequences for the victims, their families, and communities. Since the eruption of war in November 2020 in Tigray, many women reported sexual violence. Thus, this study aimed to explore the physical, sexual and mental health consequences of gender-based violence among female survivors in severely war-affected areas of the Tigray region of Ethiopia.

Methods: This study employed mixed methods including quantitative and qualitative studies during the war in Tigray, Ethiopia. A total of 528 sexually abused women and girls were included in the quantitative study from a community-based survey conducted in August 2021. Moreover, six in-depth interviews with rape survivors were conducted to share their experiences. A standardized interviewer-administered questionnaire was used for the community survey and a semi-structured checklist recorded by audio was used for qualitative study. Descriptive statistics and the Pearson chi-square test were used to assess the relationship between health consequences, different socio-demographics, and types of sexual violence. Thematic analysis was performed after the recorded audios were transcribed.

Results: Of the survivors, 435 (82.4%) had been raped and 404 (76.5%) had experienced a triple trauma burden of sexual, physical, and psychological violence. Most survivors had experienced consequences ranging from mild (34.5%) to severe injuries (42.1%), mental health and behavioral problems (75.6%) like posttraumatic stress disorder (12.1%), stress (63.5%), anxiety (38.6%), depression (27.5%), sleeping disturbance (35.2%), nightmare (29.0), flashbacks and social isolation. More than one-fifth (21.8%) of rape survivors experienced sexual and reproductive health problems such as exposure to STIs, unwanted pregnancy, abortion, and HIV. Survivors encountered the worst rape scenarios such as gang rape by troops and combatants.

Conclusions: Survivors experienced severe forms of physical injuries, posttraumatic stress disorder, and sexual and reproductive health problems. Humanitarian agencies and civic organizations need to provide immediate medical and psychological support to victims to reduce further health consequences and harm.