Gender‐Based Violence and Associated Factors Among Women of Reproductive Age in Awi Zone, Northwest Ethiopia: A Mixed Study

Abstract

Background and Aims: Gender-based violence (GBV) remains a critical global health and human rights issue, with one in three women affected worldwide. Local evidence on its prevalence and determinants is limited in the study area. This study aims to determine the magnitude of GBV, identify and explore associated and aggravating factors among reproductive-age women in the Awi Zone Administration, Amhara Region. Methods: A community-based mixed-method study, combining a cross-sectional survey and an exploratory qualitative design, was conducted in February 2025. Quantitative data were collected using a semi-structured questionnaire, while qualitative data were gathered through key informant interviews. Data was entered into EpiData 4.6 and analyzed in SPSS version 26. Bivariable and multivariable binary logistic regressions were employed to identify factors associated with the outcome variables. Qualitative data were analyzed thematically, and findings from both approaches were triangulated. Results: A total of 735 women participated in the study (95.4% response rate). Overall, 57.0% (95% CI: 53%-61%) reported experiencing at least one form of GBV in the past 12 months. Multivariate analysis showed that lack of education [AOR = 1.52; 95% CI: 1.02-2.28], alcohol use [AOR = 1.66; 95% CI: 1.19-2.32], low wealth index [AOR = 1.76; 95% CI: 1.22-2.52] and being employed [AOR = 0.40; 95% CI: 0.22-0.74] were associated with GBV. Qualitative findings revealed GBV was widely reported and normalized, manifesting as physical, sexual, and emotional abuse. Poverty, low education, substance use, and weak legal systems fueled its occurrence. Conclusion: GBV is widespread and culturally normalized, fueled by low education, poverty, alcohol use, and weak legal enforcement, whereas employment offers some protection. Therefore, women's education and economic empowerment should be strengthened, legal protections enforced, and community-based interventions implemented to shift cultural norms and reduce GBV.