Community perceptions of causes of violence against young women in Botswana: fuzzy cognitive mapping

ABSTRACTViolence against young women is a problem worldwide. Understanding its causes in a particular setting can inform context-specific interventions. We used Fuzzy cognitive mapping (FCM), a visual method for collating local knowledge about causes of health outcomes, to explore community views of factors that cause or prevent violence against young women in rural communities in southeast Botswana. In three communities, groups of young men, young women, older men, and older women built maps (68 participants and 12 maps in total) of factors they believed increased or decreased the risk of violence against young women. Trained local facilitators guided group sessions, drawing the reported factors as nodes linked by weighted arrows indicating the direction and strength of causal relationships among factors. Fuzzy transitive closure calculated the influence of each factor on others, considering direct and indirect connections. We combined maps by groups of stakeholders and condensed individual factors into categories which emerged from an inductive thematic analysis. The categories labelled conflict in relationships and parenting and family issues had the strongest influences on increasing violence across all maps. These categories were also common intermediaries between other causal categories and violence. The categories labelled women being disrespectful or uncooperative and transactional and intergenerational sex were the third and fourth strongest risk categories overall. Prominent protective concepts included a stronger legal framework and strengthening the role of local traditional leadership, with greater prominence on the maps of older participants. The most influential risk and protective categories were consistent across young men, young women, older men, and older women. FCM was feasible and acceptable with different stakeholders in Botswana. Fuzzy cognitive maps can inform community discussions, for example, of conflictive gender norms, family dynamics or healthier relationships, and are useful to build theories on how to act on the causes of violence against young women.KEYWORDS: Intimate partner violenceviolencegenderparticipatory researchinterpersonal violence AcknowledgmentsWe thank the men and women who contributed their time and knowledge in the FCM sessions. Khalid Omer collaborated in the initial discussion of categories. Sandra Cano checked the digitised maps.Disclosure statementThe authors do not have competing interests to declare.Data availability statementThe data supporting this study’s findings are available with the publication.Ethics reviewThis study is part of a Grand Challenges Canada project (Grant number R-ST-POC-1909–28463), which received ethical approval from the Botswana Ministry of Health under the Health Research and Development Division IRB (Reference HPDME 13/18/1).Additional informationFundingGrand Challenges Canada funded this work under Grant number R-ST-POC-1909-28463.Notes on contributorsIván SarmientoIván Sarmiento is an independent researcher at CIET, a member of the Groups of Studies in Traditional Health Systems, and the program administrator of Participatory Research @ McGill (PRAM). He has over two decades of experience collaborating with local and Indigenous groups in Colombia. His main interest is in promoting intercultural dialogue between Indigenous traditional medicine and Western medicine, particularly for primary health care. He has contributed to developing procedures for participatory modelling of health issues using fuzzy cognitive mapping, applying these methods in over 20 projects across eight countries.Michaela FieldMichaela Field is an independent researcher with a Master of Science in Psychiatry from McGill University. Her expertise spans the fields of psychology, psychiatry, and participatory research. She is particularly interested in the intersection of mental health and sociocultural influences. Her thesis work examined the barriers to access that Black families face when accessing psychosocial services from first episode psychosis clinics in Montréal, Canada. Her previous research experience includes evaluating a mental health promotion program developed and led by Indigenous communities across the settler colonial state of Canada and partnering with UNICEF to develop a toolkit on fostering and evaluating dignity in humanitarian settings. She is currently supporting an initiative exploring the impact of societal discrimination on the wellbeing of Montréal’s Muslim community.Leagajang KgakoleLeagajang Kgakole, is an experienced fieldwork coordinator working with CIET in Botswana since 2007. He has a profound knowledge of local communities and their cultural ways, which has been pivotal for their engagement in participatory research.Puna MolatlhwaPuna Molatlhwa has worked with CIET in Botswana since 2010. She has coordinated CIET training in evidence-based planning for researchers and planners in 14 countries in the Southern Africa Development Community (SADC). As a seasoned fieldworker, she has trained and supervised fieldworkers for both quantitative and qualitative data collection in Botswana communities. She has a particular interest in the prevention of violence against young women.Indu GirishIndu Girish brings over 25 years of experience as a training and project management specialist in the education and NGO sectors. Her work in Botswana and India has centred on community development, education for women and children in remote areas, health communication, and economic empowerment.Neil AnderssonNeil Andersson is a Professor of Family Medicine, director of the amalgamated CIET and Participatory Research at McGill (PRAM) and co-director of the McGill Institute of Human Development and Well-being. His main focus is on method development for large scale participatory approaches that address different health issues. He is particularly concerned about reproducible and culturally safe techniques to build stakeholder voices into systematic reviews, research conceptualization and co-design, intervention development, implementation and analysis. Dr. Andersson’s current interest is in community-led randomized trials of older adult participation in dementia prevention.Anne CockcroftAnne Cockcroft is a professor of family medicine in CIET-Participatory Research at McGill (PRAM) with a background in respiratory and occupational medicine. Over the last 25 years, she has undertaken large scale community-based participatory research projects in some 20 countries. She works with vulnerable populations to document their access to and experience of health and other services, and with service providers and policy makers to use evidence to develop equitable and effective services. In the last decade, her work has focussed on co-designing interventions, implementing them, and measuring the impact. Her current work includes participatory research to improve adolescent sexual and reproductive health and community responses to the impacts of COVID-19 pandemic in Bauchi State, Nigeria, and a study of community-based interventions to reduce youth personal and interpersonal violence in Botswana.