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. 2025 Jun 5;25(1):2103.
doi: 10.1186/s12889-025-23349-0.

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

Girmatsion Fisseha Abreha  1 , Hadgay Hagos Adhanu  2 , Abera Berhe Aregawi  3 , Alem Desta Wuneh  3 , Freweni Tesfay  4 , Gebretsadik Kiros Lema  3 , Balem Demstu  2 , Hale Teka  4 , Awol Yemane  4 , Hagos Gidey  4 , Kibrom Berhanu Gebreselassie  5 , Tigist Hagos  3 , Helen Bitew Tareke  6 , Tensay Kahsay W/Gebriel  5 , Yemane Berhane Tesfau  7 , Brhane Ayele  8 , Ataklti Hailu Atsbaha  8 , Teame Zegeye  9 , Yaynshet Gebreyohannes Redda  9 , Abrahim Hassen  9 , Hagos Godefay  9 , Afework Mulugeta  3
Affiliations

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

Girmatsion Fisseha Abreha et al. BMC Public Health. .

Abstract

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.

Keywords: Conflict; Ethiopia; Gender-based violence; Health consequences.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical clearance was obtained from the Institutional Review Board of the College of Health Sciences, Mekelle University (Reference No: MU-IRB1905/2011). Permission letters were obtained from the Tigray Health Bureau and district health offices. Written informed consent was taken from adult women. Moreover, informed consent (assent) was obtained from a parent or legal guardian to interview underage women. Participants were informed about the purpose and use of the study and gave their consent without any pressure to speak or participate. Information confidentiality was maintained throughout. All methods were performed in accordance with the relevant guidelines and regulations. Additionally, a referral pathway was established for all survivors who were not receiving health services at the end of the interview. A primary objective was to guide them in connecting to these referral services and inform them about accessing health care. We set up a telephone service to facilitate their communication with health facilities through the One-stop Center, a separate project aimed at assisting survivors in the Tigray region. Moreover, a psychological support, including adequate time and reassurance was provided when survivors became emotional during the interviews. The study adhered to the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Schematic representation of sampling procedure used to select survivors of sexual violence in Tigray war, 2021
Fig. 2
Fig. 2
Age of survivors by the type of sexual violence during the wartime in Tigray, 2021
See this image and copyright information in PMC

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