Femicide, intimate partner femicide, and non-intimate partner femicide in South Africa: An analysis of 3 national surveys, 1999-2017.

BACKGROUND: In most countries, reliable national statistics on femicide, intimate partner femicide (IPF), and non-intimate partner femicide (NIPF) are not available. Surveys are required to collect robust data on this most extreme consequence of intimate partner violence (IPV). We analysed 3 national surveys to compare femicide, IPF, and NIPF from 1999 to 2017 using age-standardised rates (ASRs) and incidence rate ratios (IRRs). METHODS AND FINDINGS: We conducted 3 national mortuary-based retrospective surveys using weighted cluster designs from proportionate random samples of medicolegal laboratories. We included females 14 years and older who were identified as having been murdered in South Africa in 1999 (n = 3,793), 2009 (n = 2,363), and 2017 (n = 2,407). Further information on the murdered cases were collected from crime dockets during interviews with police investigating officers. Our findings show that South Africa had an IPF rate of 4.9/100,000 female population in 2017. All forms of femicide among women 14 years and older declined from 1999 to 2017. For IPF, the ASR was 9.5/100,000 in 1999. Between 1999 and 2009, the decline for NIPF was greater than for IPF (IRR for NIPF 0.47 (95% confidence interval (CI) 0.42 to 0.53) compared to IRR for IPF 0.69 (95% CI 0.63 to 0.77). Rates declined from 2009 to 2017 and did not differ by femicide type. The decline in IPF was initially larger for women aged 14 to 29, and after 2009, it was more pronounced for those aged 30 to 44 years. Study limitations include missing data from the police and having to use imputation to account for missing perpetrator data. CONCLUSIONS: In this study, we observed a reduction in femicide overall and different patterns of change in IPF compared to NIPF. The explanation for the reductions may be due to social and policy interventions aimed at reducing IPV overall, coupled with increased social and economic stability. Our study shows that gender-based violence is preventable even in high-prevalence settings, and evidence-based prevention efforts must be intensified globally. We also show the value of dedicated surveys in the absence of functional information systems.

Understanding and addressing femicide in Africa: a systematic review of empirical research.

CONTEXT: Against the backdrop of a high prevalence rate of femicide across Africa, it is crucial to gain methodological insights into the existing research on femicide. OBJECTIVE: To develop evidence-based strategies to address the complex and multifaceted nature of femicide in Africa, ultimately contributing to its prevention and reduction. DATA SOURCES: Empirical research was searched for using four electronic research databases (ProQuest, Web of Science, EBSCO and PubMed). ELIGIBILITY CRITERIA: Full-text empirical articles (ie, observational or retrospective studies) published in English between the period of 1 January 1992 and 30 July 2021, which sampled femicide victims and/or perpetrators in Africa, were included in the review. DATA EXTRACTION: Data were extracted using predefined data fields, including study quality indicators. DATA SYNTHESIS: Thomas and Harden's (2008) thematic synthesis method was used to analyse 22 empirical articles that met the inclusion criteria in this study. RESULTS: This review highlights the significant focus on femicide research in South Africa. Most studies of femicides have used cross-sectional research designs. This review also demonstrates that crime dockets have benefited significantly from forensic contributions and police investigations. Furthermore, research efforts have uncovered various contextual factors that contribute to femicide, such as the high prevalence of early childhood trauma and the loss of primary caregivers among femicide offenders. CONCLUSION: This systematic review offers a thorough synthesis of the current understanding of femicide in an African context, focusing on South Africa. Despite acknowledging the strengths and limitations of the existing knowledge, this review emphasises the urgency of addressing femicide and calls for international attention and action to effectively combat this pressing issue.

Who is killing South African men? A retrospective descriptive study of forensic and police investigations into male homicide.

Not much is known about the perpetrators of male homicide in South Africa, which has rates seven times the global average. For the country's first ever male homicide study we describe the epidemiology of perpetrators, their relationship with victims and victim profiles of men killed by male versus female perpetrators. We conducted a retrospective descriptive study of routine data collected through forensic and police investigations, calculating victim and perpetrator homicide rates by age, sex, race, external cause, employment status and setting, stratified by victim-perpetrator relationships. For perpetrators, we reported suspected drug and alcohol use, prior convictions, gang-involvement and homicide by multiple perpetrators. Perpetrators were acquaintances in 63% of 5594 cases in which a main perpetrator was identified. Sharp objects followed by guns were the main external causes of death. The highest rates were recorded in urban informal areas among unemployed men across all victim-perpetrator relationship types. Recreational settings including bars featured prominently. Homicides clustered around festive periods and weekends, both of which are associated with heavy episodic drinking. Perpetrator alcohol use was reported in 41% of homicides by family members and 50% by acquaintances. Other drug use was less common (9% overall). Of 379 men killed by female perpetrators, 60% were killed by intimate partners. Perpetrator alcohol use was reported in approximately half of female-on-male murders. Female firearm use was exclusively against intimate partners. No men were killed by male intimate partners. Violence prevention, which in South Africa has mainly focused on women and children, needs to be integrated into an inclusive approach. Profiling victims and perpetrators of male homicide is an important and necessary first step to challenge prevailing masculine social constructs that men are neither vulnerable to, nor the victims of, trauma and to identify groups at risk of victimisation that could benefit from specific interventions and policies.

Child abuse and neglect-related murders in South Africa: a comparison of two national surveys in 2009 and 2017.

BACKGROUND: Population-based statistics on deaths from child abuse and neglect are only routinely available in countries that have reliable national statistics on child murder. For low-income and middle-income countries, relatively little is known about prevalence trends of child murder. South Africa is an exception, having conducted dedicated national studies on child murders for 2009 and 2017 to provide data on child murders overall and on child abuse and neglect-related murders. We aimed to compare child abuse and neglect-related murders in South Africa across two surveys to determine any change between 2009 and 2017. METHODS: We conducted two retrospective national mortuary-based surveys on murder of children aged 0-17 years for 2009 and 2017 from a proportionate random sample of medico-legal laboratories in South Africa. A sampling frame of medico-legal laboratories for each study year was prepared with stratification by medico-legal laboratory size. A minimum of 2 years after the crime was allowed before data collection to enable progression of the investigation process. Child abuse and neglect-related murders were identified using both medico-legal laboratory post-mortem autopsy reports and police data. To identify a child abuse and neglect-related murder, we primarily used the framework of abuse happening within the context of responsibility of care arrangements but broadened this to include all perpetrators and abuse identified from the data. We stratified age into 0-4, 5-9, 10-14, and 15-17 years and further stratified children younger than 5 years into early neonates (newborns killed within 6 days of birth), 7 days to 11 months, and 1-4 years. We calculated incidence rate ratios (IRR) with 95% CIs to compare rates between 2009 and 2017. FINDINGS: An estimated 458 (95% CI 377-539) children in 2009 and 213 (179-247) children in 2017 were murdered in circumstances of child abuse and neglect. The percentage of all child murders that were child abuse and neglect-related declined from 2009 to 2017 (458 [45·0%] of 1018 in 2009 vs 213 [25·0%] of 851 in 2017), with the overall age-standardised rate decreasing from 2·6 to 1·1 per 100 000 children aged 0-17 years (IRR 0·43 [95% CI 0·35-0·54]). Girls represented 276 (60·3%) of 458 murders in 2009, which declined to 96 (45·1%) of 213 murders in 2017, and boys represented 178 (38·9%) of 458 murders in 2009 and 109 (51·4%) of 213 murders in 2017. The decrease was statistically significant for girls in the 0-4 year (IRR 0·33 [0·22-0·49]) and 5-9 year (0·33 [0·15-0·73]) age groups and for boys in the 0-4 year age group (0·49 [0·33-0·71]). Among early neonates (within 6 days of birth), the decrease in child abuse and neglect-related murders was more pronounced among girls than among boys (IRR 0·33 [95% CI 0·19-0·56] vs 0·46 [0·28-0·77]). INTERPRETATION: Child abuse and neglect-related murders are common in South Africa but our study shows that they can be reduced. The high rate of these murders points to the need to continue research and monitoring to inform priority targeted interventions and to better understand the impact of child support policies. FUNDING: Ford Foundation and South African Medical Research Council.

'I'm not the mother I wanted to be': Understanding the increased responsibility, decreased control, and double level of intentionality, experienced by abused mothers.

A paucity of research has been conducted within South Africa on abused women's experiences of motherhood, even though abused women tend to be at increased risk of negative physical and mental health difficulties, which can interfere with their ability to take care of themselves and their children. The aim of this qualitative study was to explore women's experiences of mothering in the context of an abusive relationship. Data was collected via individual, telephonic, semi-structured, in-depth interviews with 16 mothers from three South African provinces, and analyzed according to the principles of grounded theory. Our findings highlight the mothers' experiences of: a simultaneous increased sense of responsibility with regards to their children and a loss of control over their mothering; as well as experiencing abuse aimed at either the mother or the child, which is simultaneously meant to affect the other; and lastly, mothers' assessing themselves negatively through normative paradigms of 'good mothering', regardless that they often mother in the best way they know how to, given challenging circumstances. Therefore, this study highlights that the motherhood institution continues to create 'good mothering' benchmarks against which women themselves evaluate their mothering, often leading to feelings of inadequacy. Our findings also emphasize that the environment created by men's abuse is in conflict with the great expectations placed upon mothers in abusive relationships. Thus, mothers may experience huge pressure, which may lead to feelings of failure, self-blame, and guilt. This study has demonstrated that the abuse mothers' encounter adversely impacted on their mothering. We therefore emphasize the need to better understand how mothering is influenced by and responsive to violence. This is important as understanding abused women's experiences can assist us to further develop appropriate support mechanisms needed to ensure minimal impact on both women and their children.

South Africa's male homicide epidemic hiding in plain sight: Exploring sex differences and patterns in homicide risk in a retrospective descriptive study of postmortem investigations.

South Africa has an overall homicide rate six times the global average. Males are predominantly the victims and perpetrators, but little is known about the male victims. For the country's first ever study on male homicide we compared 2017 male and female victim profiles for selected covariates, against global average and previous estimates for 2009. We conducted a retrospective descriptive study of routine data collected through postmortem investigations, calculating age-standardised mortality rates for manner of death by age, sex and province and male-to-female incidence rate ratios with 95% confidence intervals. We then used generalised linear models and linear regression models to assess the association between sex and victim characteristics including age and mechanism of injury (guns, sharp and blunt force) within and between years. 87% of 19,477 homicides in 2017 were males, equating to seven male deaths for every female, with sharp force and firearm discharge being the most common cause of death. Rates were higher among males than females at all ages, and up to eight times higher for the age group 15-44 years. Provincial rates varied overall and by sex, with the highest comparative risk for men vs. women in the Western Cape Province (11.4 males for every 1 female). Male homicides peaked during December and were highest during weekends, underscoring the prominent role of alcohol as a risk factor. There is a massive, disproportionate and enduring homicide risk among South African men which highlights their relative neglect in the country's prevention and policy responses. Only through challenging the normative perception of male invulnerability do we begin to address the enormous burden of violence impacting men. There is an urgent need to address the insidious effect of such societal norms alongside implementing structural interventions to overcome the root causes of poverty, inequality and better control alcohol and firearms.

'I will rather be killed by corona than by him ': Experiences of abused women seeking shelter during South Africa's COVID-19 lockdown.

BACKGROUND: In April 2020, the United Nations predicted that the COVID-19 pandemic will have a 'calamitous' impact on the lives of women. This was based on concerns about an upsurge in Intimate Partner Violence (IPV) arising from increased opportunities for relational conflict due to forced co-existence and therefore additional time spent with abusive partners. AIM: Research has shown an increase in IPV during times of crisis. The COVID-19 pandemic has generated unprecedented circumstances and stress, and opportunities to do research to understand whether the COVID-19 pandemic impacted on IPV experiences were limited. Thus, the present study aimed to understand women's experiences of being in and leaving an abusive relationship during the COVID-19 pandemic. METHODS: Individual, telephonic interviews were conducted with 16 women living in domestic violence shelters within three Provinces during South Africa's lockdown period. RESULTS: Findings reveal that the public health measures implemented by the South African Government to curb the spread of the virus, may have placed vulnerable groups at increased risk of violence. Specifically, lockdown likely magnified the risk for escalation of abuse in families already experiencing IPV prior to COVID-19. The study highlights an IPV and COVID-19 relationship, showing that the gender insensitive pandemic control measures, such as stay at home orders and travel restrictions, likely placed women at risk of increased abuse. Given the recurrency of COVID-19 epidemic waves, attention must be given to gender disparities or many South African women may experience worse outcomes. CONCLUSION: This study reminds us that being ordered to stay at home is not always the safest option for women and thus, in a country with one of the highest levels of GBV, it becomes imperative to ensure that IPV safeguards are integrated into COVID-19 measures. It also becomes evident that COVID-19 requires enhanced ways of responding by paying attention to gender disparities.

Exploring adversities among parents convicted of killing their children.

Experiencing adversities has been associated with the use of violence but this has not been explored with filicide offenders in South Africa. Individual, semi-structured interviews were conducted with 22 parents/stepparents/caregivers convicted of child homicide in South Africa, resulting in 49 in-depth interviews. Data were analyzed by means of grounded theory. Using an ecological framework, this study alludes to the widespread and cumulative nature of violence and trauma experiences within multiple domains of the participants' lives. The study highlighted the absence of support in the aftermath of experiencing trauma, possibly resulting in these parents lacking resources to mitigate the sequelae of adverse experiences. This study calls for trauma related, mental health components to be integrated into violence interventions and for these to address the impact of trauma at the individual, family, and societal levels, to prevent the transition from victim to offender.

Exploring the Intersection Between Violence Against Women and Children from the Perspective of Parents Convicted of Child Homicide.

Violence against women and violence against children are distinct research fields. Quantitative studies have demonstrated their intersection, but qualitative data provides an opportunity for a comprehensive understanding of this interface. Interviews with 22 parents/caregivers convicted of child homicide provided an opportunity to explore the context of violent experiences in their lives including their use of violence and their experiences of it in their intimate and parenting relationships. Using a feminist framework, we found that patriarchal family structures, gender and power dynamics contribute to the use of violence. Revenge child homicide was common with distinct gendered differences. This study calls for closer collaboration between the two fields to assist in developing prevention interventions to address and eradicate both forms of violence.

Women's recovery, negotiation of appearance, and social reintegration following a burn.

The gendered nature of postburn coping has received scant research attention in South Africa, a country that has a high rate of burns with significant concentrations among women. In this study, narratives that emerged from in-depth interviews with seven women were examined. The narratives emphasized essential needs of these burn survivors for personal support, the complexities of negotiating intimate relationships, struggles with the humiliation from family and friends, in some instances strained relationships with children, the support found through religious beliefs and institutions, and often frustratingly slow psychological acceptance of scars. These difficulties faced by women survivors of burns have highlighted the need to include religion/spirituality, intimate male partners, and women's children into the psychological recovery process, in an attempt to assist women's journey to psychological and emotional healing after burn.

Exploring adverse parent-child relationships from the perspective of convicted child murderers: A South African qualitative study.

Child homicide is the most extreme form of violence against children. Within South Africa, children face the highest risk of homicide by parents/caregivers. It is suggested that prolonged exposure to adverse relationships with one's own parents may be linked to committing child homicide as it may lead to psychological damage and disturb neurological functioning. This paper explores the adverse parent-child relationships of 22 men and women incarcerated for the murder of either a biological child, a stepchild or a child in their care and draws on 49 in-depth interviews with these participants. We illustrate that traumatic parent-child experiences in the form of absent parents, neglect and abuse have a profound impact on establishing unhealthy attachment styles and emphasize the importance of early adverse parent-child bonds in setting the tone for future bonds as adults. The pathway to adopting an adverse attachment with one's own child is argued to be influenced by these early traumatic emotional experiences within the home. This study highlights the need to acknowledge the impact that adverse parent-child experiences have on the formation of violent forms of parental behavior. It is imperative to reduce children's emotional vulnerabilities by implementing strategies to strengthen current parenting practices, to promote the development of less violent parent-child relationships and to work towards resolving parents' experiences of trauma in reducing child homicide.

Child homicide perpetrators worldwide: a systematic review.

OBJECTIVE: This study aims to describe child homicide perpetrators and estimate their global and regional proportion to inform prevention strategies to reduce child homicide mortality worldwide. DESIGN: A systematic review of 9431 studies derived from 18 databases led to the inclusion of 126 studies after double screening. All included studies reported a number or proportion of child homicides perpetrators. 169 countries and homicide experts were surveyed in addition. The median proportion for each perpetrator category was calculated by region and overall and by age groups and sex. RESULTS: Data were obtained for 44 countries. Overall, parents committed 56.5% (IQR 23.7-69.6) of child homicides, 58.4% (0.0-66.7) of female and 46.8% (14.1-63.8) of male child homicides. Acquaintances committed 12.6% (5.9-31.3) of child homicides. Almost a tenth (9.2% (IQR 0.0-21.9) of child homicides had missing information on the perpetrator. The largest proportion of parental homicides of children was found in high-income countries (64.2%; 44.7-71.8) and East Asia and Pacific Region (61.7%; 46.7-78.6). Parents committed the majority (77.8% (61.5-100.0)) of homicides of children under the age of 1 year. For adolescents, acquaintances were the main group of homicide perpetrators (36.9%, 6.6-51.8). There is a notable lack of studies from low-income and middle-income countries and children above the age of 1 year. CONCLUSION: Children face the highest risk of homicide by parents and someone they know. Increased investment into the compilation of routine data on child homicide, and the perpetrators of this homicide is imperative for understanding and ultimately reducing child homicide mortality worldwide. TRIAL REGISTRATION NUMBER: PROSPERO registration number: CRD42015030125.