Use of and access to victims’ support services and institutions

The final research question addressed by this study asks how men and women affected by domestic violence use and access support services and institutions. Levels of domestic violence are typically under-reported across the world. García-Moreno et al. (2005) asked about the use of formal services across several countries (health services, legal advice and shelters), and whether victims of domestic violence asked for support from the police, women’s NGOs, local leaders or religious leaders. The majority of physically abused women reported that they had never approached any formal organisation or service. When asked about the reasons for (not) seeking help, most respondents mentioned a general acceptance of these behaviours as normal. Others feared consequences such as further violence, losing their children or bringing shame to their family. Seeking help – a limited occurrence in the sample – was usually associated with the severity of the violence, the

14 This study interviewed 1,588 women aged over 19 years and 481 girls aged 13–18 years. Nearly a third reported having experienced physical violence, a quarter had experienced psychological violence, and one fifth had experienced sexual violence at least once in their lives.

potential negative impact on children and encouragement from friends and family. Only victims of very severe acts of violence left their husbands.

Similarly, Amoakohene (2004) found that victims of domestic violence in Ghana generally did not report abuse. Support was not always forthcoming when the victims approached relatives, the village chief or the police. The main explanation for these findings was the widespread view that domestic violence was normal. Other barriers that have prevented victims of domestic violence in Ghana from seeking help from outside the family included concern for the children’s economic and emotional well-being, lack of family support, lack of information or economic means to pursue legal rights and the belief that women have to obey their husbands (Coker-Appiah and Cusack, 1999; Ofei-Aboagye, 1994).

Several institutions have been set up to respond to domestic violence in Ghana but are constrained by capacity and other logistical challenges (Mitchell, 2011). Challenges include the lack of initial and continuing training of staff, the slow pace of the courts and the lack of specific support services, such as counselling, emergency shelters, legal advice and medical services. Adu-Gyamfi (2014) analysed the process of prosecuting cases of domestic violence after the implementation of the 2007 Domestic Violence Act in the Mampong municipality of Ghana. The study found that the number of abuse reports increased significantly after the implementation of the Act but was not accompanied by increases in the number of prosecutions or convictions. According to the DOVVSU 2011 annual report, 12,706 cases of domestic violence were filed in 2010. Among these, only 954 cases were sent to court, resulting in only 118 convictions.

One of the objectives of this study was to analyse how resources and services were used in Ghana to support victims of domestic violence, and how and when victims accessed them.

There appears to be a consensus among service users about a lack of resources and poor implementation of relevant policies. The perceptions and experiences of authorities who work at these specialised services are less clear. This study designed a series of structured observations of these services (discussed in more detail in Section 3), to better understand the opportunities and barriers for domestic violence survivors to seek and receive support.

To operationalise this framework, the study interviewed several individuals at different levels, including opinion leaders, activists, legal experts, community leaders (religious and political leaders, including traditional authorities), legal practitioners and journalists.

The evidence above also suggests that under-reporting of domestic violence may be due to social normative pressures. This evidence connects to a growing body of feminist criminology literature that challenges the focus on the criminal justice system as the main avenue for punishing perpetrators of domestic violence (Buzawa and Buzawa, 2003; Rowe, 2015). These studies show that the apprehension and punishment of perpetrators through penal and criminal systems might offer short-term protection for women but does not effectively challenge patterns of violence at a societal or systemic level (Belknap, 2014;

Hoyle, 1998; Sherman et al., 1992). Recent studies show, too, that victims of domestic violence, especially intimate partner violence, might forgo accessing the criminal justice

system altogether because their adjudication wishes (such as anonymity) are not met (Artz, 2014; Cerulli et al., 2015). Further, stigmatisation of those who report violence has also been found to discourage victims of domestic violence from accessing resources available through the criminal justice system (Sulak et al., 2014).

The study will explore these factors, alongside other potential explanations such as people preferring other forms of intervention and mediation due to differing perceptions and trust about the justice system and other government-appointed support structures (lawyers, nurses, social workers and teachers, for instance), community leaders and the police. This approach connects to a current debate in the development literature on whether or not there is value in using ‘organic’ or ‘existing’ informal mechanisms to mediate individual-, household- and community-level conflict (Lugo, 2015; Rowe, 2015). Research in Rwanda and Uganda, for instance, has suggested that ‘organic’ responses foster greater levels of reconciliation among perpetrators and victims than imposed criminal justice routes (Doughty, 2014; Burgess and Campbell, 2015). This study will explore how men and women perceive government institutions and actors (such as police officers and health care providers). It will also explore how the police and other service providers view the help-seeking behaviour of citizens. This analysis will make use of a number of questions included in the formal survey about access to formal and informal services and support structures, use of these structures and perceptions about their usefulness and effectiveness.

3. Methodology

Ghana is a culturally diverse country, and the incidence, causes and consequences of domestic violence are likely to vary across regions, broader kinship and socio-economic relations and individual characteristics. The study, therefore, adopted a mixed-methods approach to collect information about the incidence, nature, determinants and consequences of domestic violence. This approach involved the collection of primary quantitative data through a representative household-level survey and qualitative in-depth data on key mechanisms that may explain trends, patterns and the distribution of domestic violence in Ghana. The qualitative and quantitative instruments were designed to capture information related to the dimensions of the social ecological model – personal histories; individual and household circumstances and relations within; individual and community perceptions and realities of violence; access to, use of and quality of local resources and services at local and regional levels; and experiences of violence perpetrated by a range of possible actors.

From the outset, the aim of the research was to ensure complementarity between the qualitative and quantitative research methods. The quantitative data enabled the production of statistics that are regionally and nationally representative at the household level. The qualitative data explored the perceptions, attitudes and beliefs of women and men within their everyday lives, to understand how they are related to experiences of domestic violence as survivors and victims and to observe how individual experiences of domestic violence are integrated within family, community and wider social and political structures and relations. The following sections describe the design of the quantitative survey (subsection 3.1) and the qualitative instruments (subsection 3.2); sampling procedures for the quantitative survey (subsection 3.3) and qualitative fieldwork (subsection 3.4); the training of enumerators and pre-testing processes (subsection 3.5); the implementation of fieldwork across all sites in Ghana (subsection 3.6); response rates (subsection 3.7); the methods used in the analysis of the qualitative and quantitative data (subsection 3.8); and the strict ethical procedures followed in the study (subsection 3.9).