Article Text

Original research
Understanding and addressing femicide in Africa: a systematic review of empirical research
  1. Tarique Variava1,
  2. Bianca Dekel2
  1. 1Psychology, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
  2. 2South African Medical Research Council, Tygerberg, Western Cape, South Africa
  1. Correspondence to Mr Tarique Variava; Tarique.variava{at}gmail.com

Abstract

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.

  • Systematic Review
  • PUBLIC HEALTH
  • QUALITATIVE RESEARCH
  • STATISTICS & RESEARCH METHODS

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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STRENGTHS AND LIMITATIONS OF THIS STUDY

  • Language bias in the review may have arisen because of the exclusive inclusion of English-language articles, potentially omitting pertinent research in other languages.

  • The review’s focus on articles published from 1992 to 2021 may omit recent studies, thus affecting its relevance and completeness.

  • The predominance of cross-sectional designs in the reviewed quantitative studies restricted the establishment of causal relationships and the absence of longitudinal studies may have influenced the validity and reliability of the findings.

  • Adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the eight stages outlined by Uman in this review ensures methodological rigour, enhancing its transparency and systematic approach.

  • The employment of a convergent mixed-method systematic review design offers a comprehensive analysis of femicide within the African context, integrating both qualitative and quantitative studies for a more nuanced understanding of the subject.

Introduction

In this study, ‘femicide’ is operationalised as ‘all intimate and non-intimate female homicides’, a definition consistent with the work of Brodie.1 Femicide encompasses a wide range of gender-related killings of women and girls, characterised by nuanced motives and distinctive victim-perpetrator dynamics.2 These killings often arise from entrenched stereotyped gender roles, discrimination, unequal power relations or harmful social norms that prevail in specific contexts.3 Femicide represents the most extreme end of the gender-based violence continuum, typically following prior experiences of physical, sexual or emotional abuse. Its subtypes include intimate femicide, non-intimate femicide, murder in the name of honour and dowry-related killing.2

Recent statistics from the United Nations Office on Drugs and Crime have revealed an alarming femicide in 2021.3 Approximately 81 100 women and girls were intentionally killed, with an estimated 45 000 fatalities committed by intimate partners and other family members. Notably, the rate of intimate partner/family-related homicide in Africa was more than double the global rate, reaching 2.5 deaths per 100 000 females compared with the global rate of 1.1 deaths per 100 000 females. These statistics highlight the urgent need for effective intervention to reduce the incidence of femicides, particularly in Africa.

Against this backdrop of high prevalence, this review aims to provide a comprehensive appraisal, synthesis and contextualisation of the existing research on femicide in Africa. By systematically reviewing the available literature and adhering to rigorous guidelines, such as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this review critically analysed various aspects of femicide research. The primary objective was to inform the development of evidence-based strategies that address the complex and multifaceted nature of femicide in Africa, ultimately contributing to its prevention and reduction.

Material and methods

This study used a convergent mixed-method systematic review research design4 and was registered with the International Prospective Register of Systematic Reviews (PROSPERO) record CRD42021273833 (https://www.crd.york.ac.uk/PROSPEROFILES/273833_PROTOCOL_20210816.pdf).

Review procedure

This systematic review followed the eight stages outlined by Uman5 to improve transparency and reduce bias.

Stage 1: formulate the review question

What methodological approaches are employed in the study of femicides in the African context?

Stage 2: define the inclusion and exclusion criteria

This study employed a purposive sampling technique informed by Sample, Phenomenon of Interest, Design, Evaluation, Research type as proposed by Cooke et al.6 The review included full-text empirical observational or retrospective studies published in English between 1 January 1992 and 30 July 2021, which focused on femicide victims and perpetrators in Africa. Reviews, methodological papers, theoretical papers, editorials and case studies were excluded because of a lack of explicit aims, hypotheses, results or discussion sections. Similarly, grey literature was excluded because it is not peer-reviewed and is usually deemed inferior in quality compared with peer-reviewed studies.7 8

Stage 3: develop the search strategy and locate studies

The search terms used in this study were developed and critically appraised by the Knowledge and Information Service Unit of the South African Medical Research Council.

These search terms guided the identification of potentially relevant articles in the sample and included: (“partner*” OR “spous*” OR “lover*” OR “couple*” OR “co-habiting” OR “common-law” OR “mar*” OR “divorce*” OR “wife*” OR “wive*” OR “girl*” OR “female” OR “husband*” OR “boy*”) AND (“femicide” OR “feminicide” OR “uxoricide” OR “homicide” OR “victim*” OR “violen*” OR “kill*” OR “murder*” OR “death*” OR “die*”) AND (“Afri*”).

Research articles were accessed and searched using four electronic research databases (ProQuest, Web of Science, EBSCO and PubMed) on 1 August 2021.

Stage 4: select the appropriate studies

Two independent reviewers evaluated the titles and abstracts of the identified studies (after duplicates were removed, n=649 778) to determine their eligibility. Studies that did not meet the inclusion criteria were also excluded. The titles, abstracts and full texts of the remaining articles (n=117) were examined to ensure eligibility for inclusion in the sample. After assessing the full text of the remaining articles against the aforementioned inclusion criteria, a few selected articles (n=22) were included in the final sample. A PRISMA flow diagram illustrating the screening process is shown in figure 1.

Figure 1

A four-phase flow diagram

Stage 5: extract the appropriate data

Relevant data, such as the year of publication, research type and study design, were extracted according to Liberati et al.9 In addition, information on country, province or region, study setting, sample and sample size was obtained. Each study included in the sample was then downloaded into a reference manager tool (ie, Zotero) to facilitate assessment using critical appraisal tools and data analytic techniques.

Stage 6: assess the quality of the appropriate studies

Articles in the sample were assessed for potential bias. Quantitative studies meeting the eligibility criteria were evaluated using an adapted version of the Critical Appraisal Skills Programme (CASP) Qualitative Checklist Tool.7 Qualitative studies were assessed using the CASP Qualitative Checklist Tool.10 The results of the quality assessment and performance of the articles on the CASP tools are summarised in online supplemental file 1.

Notably, all but one of the included studies were rated as high quality, with minimal risk of bias, as they scored highly on the CASP tools. Among the qualitative articles, all three achieved a perfect score of 10/10 on the qualitative CASP tool. Among the 19 quantitative articles, 15 scored 10/10, 2 scored 9/10, 1 scored 8/10 and 3 scored 7/10 on the quantitative CASP tool. It should be noted that although one quantitative article received a lower score of 4/10 on the CASP tool, it was retained in the final sample because of the value of its findings.

Stage 7: analyse and interpret the appropriate results

The thematic synthesis method described by Thomas and Harden11 was used to analyse this research’s qualitative and quantitative studies. Thematic synthesis is an adaptation of the thematic analysis technique specifically designed for analysing secondary data sources. This method provides a reliable set of established procedures and analytical tools to facilitate the identification and development of thematic insights within primary research data.11 In line with Booth et al,12 thematic synthesis was chosen as the analytical approach for this study because of its suitability for the overall objective of the review, which was to aggregate existing evidence and identify patterns within the data. Additionally, while thematic synthesis is typically used to synthesise qualitative research findings, it can also be applied to synthesise quantitative research outcomes, especially when heterogeneity exists in the outcome variables and measurements. Thematic synthesis is known for its transparency, which ensures a clear and accessible process that produces easily interpretable outcomes.

A thematic synthesis consists of three stages: (1) coding of text line-by-line, (2) development of descriptive themes and (3) generation of analytical themes. The reflexive thematic analysis approach proposed by Braun et al13 informed the development of descriptive and analytical themes in this study.

Initially, the authors independently familiarised themselves with the extracted data by thoroughly reading it. The codes were then inductively generated based on the data. Candidate themes were then independently developed by collating codes from the dataset and visually mapping them to establish potential themes and their associated subthemes. Candidate themes were then revised and defined to ensure a comprehensive and concise data representation. Finally, both authors critically appraised candidate themes to establish consistency in the analyses.

Stage 8: disseminate the findings

The findings of this study, obtained through a rigorous critical synthesis of the literature on femicides, have significant implications for future research in this field. These findings will be disseminated in conference proceedings to provide a comprehensive overview of the synthesised evidence and recommendations for future research on femicide prevention.

Patient and public involvement

None.

Results

All included studies were published between 1 January 1992 and 30 July 2021. Online supplemental file 2 provides a comprehensive overview of the 22 articles included in the systematic review.

Characteristics of included studies

Geographical distribution

Studies in South Africa: Among the 22 articles included in this study, 19 were conducted in South Africa.14–32 Of the research conducted in South Africa, eight studies had a national scope, providing a comprehensive view of the femicide landscape in South Africa.16–18 21 22 24 26 29 The research also included regional studies focusing on specific areas, with four centred around Gauteng,19 28 31 32 four concentrated on the Western Cape,14 20 25 27 two conducted in the Eastern Cape15 30 and one focused on Kwa-Zulu Natal.23

Studies outside South Africa: The paucity of research outside of South Africa is evident in the limited representation of studies conducted in other African countries. Of the 22 included articles, 2 provided insights into the femicide landscape within the regions of Cairo and Giza in Egypt,33 34 and only 1 explored femicide in Windhoek, Namibia.35

Study setting

All included studies were conducted in various settings, including prisons,25 27 35 psychiatric hospitals32 and medicolegal laboratories.14–24 26 28–31 33 34

Study designs

The reviewed studies had diverse research designs including both quantitative and qualitative approaches. All 19 quantitative studies employed cross-sectional research designs.14–24 26 28–34 These studies primarily used retrospective correlational and descriptive designs.14–24 26 28–34 By contrast, the qualitative studies included in the review adopted longitudinal25 27 or cross-sectional descriptive research designs,35 with sample sizes ranging from 1035 to 20.25 27 Quantitative studies had larger sample sizes, ranging from 4323 to 6091.30

Phenomenon under investigation

This review focuses on femicides and examines the victims and perpetrators involved. The included papers covered a range of topics. Nine articles reported on femicide victims and provided insights into various aspects related to this phenomenon.16–18 20–22 26 30 31 Five studies provided insights into the victims of both femicides and male homicides, shedding light on the intersection of these two forms of violence.14 15 28 30 31 Additionally, three studies examined the relationship between femicide perpetrators and their victims,19 23 24 while three focused solely on femicide perpetrators, delving into their characteristics and behaviours.25 27 35 Furthermore, one study reported on perpetrators of intimate partner homicide, offering insights into this specific type of femicide,32 while another study examined victims of both femicide and child homicide, exploring the complexities of these cases.29

Thematic synthesis

This systematic review synthesises findings from a range of articles that focus on the multifaceted nature of femicides, particularly in the African context. The thematic synthesis encapsulates insights from three critical areas of inquiry: forensic pathology, police investigations and research into contextual determinants. These diverse strands of investigation, conducted independently and interdependently by forensic pathologists, police officials and researchers, converge to unravel the complexity of femicide cases.

The synthesis underscores the unique contributions of each domain, from detailed forensic evidence provided by pathologists to sociodemographic and psychological profiling by the police and researchers. Central to this exploration is the categorisation of femicide into distinct types, including intimate femicide, non-intimate femicide, sexual femicide and femicide-suicide. This classification system not only deepens our understanding of the various facets of femicide but also underscores the necessity for nuanced and targeted interventions.

Collectively, these inquiries highlight the intricate nature of femicides and the importance of employing multidisciplinary approaches to effectively comprehend and address this critical issue. The following section delves into the specifics of these findings, illustrating the multifaceted dynamics at play in femicide incidents and the imperative for comprehensive and coordinated responses.

Forensic pathology insights

Postmortem reports

Forensic pathologists have provided crucial insights through detailed postmortem reports.14–24 26 28–31 33 34 These reports revealed significant information regarding the cause and manner of death, injury patterns, toxicology findings and pregnancy status of femicide victims.

Academic influence on forensic practices

The association between forensic pathologists and academic institutions has been highlighted as a key factor for enhancing the quality and reliability of forensic data.14–24 26 28–31 33 34 This connection ensures that pathologists are well trained and have access to the necessary resources, leading to standardisation and quality assurance in forensic practice.

Police investigation findings

Sociodemographic and situational factors

Police investigations were instrumental in gathering sociodemographic data of both victims and perpetrators (in femicide-suicide cases).16–24 26 28–30 34 Factors such as relationship status, race, age, educational background and employment status were also examined. Situational aspects such as the timing, location and circumstances of femicide incidents, including substance use, were also considered.

Research initiatives on contextual determinants

Childhood trauma and offender behaviour

Research has shed light on the relationship between early childhood trauma and later violent behaviour among femicide offenders.25 27 32 35 Experiences of emotional, physical and sexual abuse have been reported, particularly in school and caregiver settings.

Gang involvement and violence adoption

The loss of primary caregivers and subsequent gang involvement emerged as significant factors influencing femicide offenders’ behaviour.25 27 Joining gangs often leads to the adoption of violent social identities driven by the need for belonging, affirmation and respect.

Discussion

This systematic review offers a comprehensive synthesis of the current knowledge on femicide, focusing on the unique regional nuances of its occurrence in Africa. By examining research conducted in an African context, this review provides valuable insights into the multifaceted nature of femicide and its relevance to the African continent. However, this review has identified significant gaps in the existing literature on process-driven approaches to investigating fatal violence committed by men against women.

Geographical gap

One notable gap identified in the reviewed literature is the significant bias towards South Africa, where the majority of included studies were conducted. This is accompanied by limited representation from other African countries. The concentration of studies in South Africa raises concerns about the generalisability of the findings to the broader African context. This notable bias towards South Africa is primarily influenced by the development and implementation of the National Strategic Plan on Gender-based Violence and Femicide,36 which has directed substantial attention and resources towards femicide research within the country.37 Femicide, as a phenomenon, is undeniably influenced by the complex interplay between diverse sociocultural, economic and political factors. These factors exhibit considerable variation across distinct African regions. Limited representation from other nations restricts the capacity of this review to develop a comprehensive and nuanced understanding of the prevalence, underlying determinants and repercussions of femicide on the African continent. Future research should prioritise conducting studies in a wider range of African countries to capture the regional nuances and dynamics of femicides more accurately. This approach is pivotal in comprehending the region-specific intricacies and dynamics of femicide, thereby contributing to a more comprehensive understanding of this grave issue.

Research design gap

Another significant gap identified in this review was the predominance of cross-sectional research designs among the included studies. Although cross-sectional designs are valuable in providing a snapshot of femicide incidents, they exhibit inherent limitations in establishing causal relationships and comprehending long-term trends. This shortcoming calls attention to the need for greater emphasis on longitudinal research methodologies, which can provide valuable insights into the temporal dimensions of femicides. These studies offer the potential to unearth patterns, elucidate causal links and identify effective intervention strategies. Addressing this gap in research design is crucial for advancing our understanding of femicide and developing evidence-based strategies for its prevention and intervention.

Limited exploration of perpetrators

Although this review focused primarily on femicide victims, it revealed a limited exploration of femicide perpetrators in the reviewed literature. A thorough understanding of individual characteristics, motivations and background is crucial for developing effective prevention and intervention strategies. To address this gap, future research should investigate the profiles and behaviours of femicide perpetrators. This can help to identify risk factors, warning signs and potential avenues for intervention and prevention programmes. Such investigations have the potential to illuminate critical aspects including risk factors, warning signs and avenues for the design and implementation of targeted interventions and prevention programmes. By filling this research gap, scholars and policy-makers can make significant progress in understanding and addressing the complex phenomenon of femicide.

Strengths and limitations

An essential strength of this review is its explicit commitment to expanding the scope of femicide research beyond the traditional focus on intimate partner femicide in European and American contexts.38 Specifically, this review focuses on methodological approaches to femicide research, particularly in an African context. It is important to emphasise that while there has been only one systematic review with a global perspective,39 it exclusively examined intimate partner femicide. This highlights the limited breadth of previous global assessments, which have mostly focused on a single subcategory within the spectrum of femicide. However, it is important to acknowledge the limitations of this study. First, we restricted our inclusion criteria to English-language studies and excluded relevant studies published in other languages. Second, the review focused on studies conducted within a specific time frame, which may have resulted in the omission of recent studies. Third, while we aimed to provide a comprehensive overview of femicide research in Africa, the diversity of research designs and settings in the included studies raises concerns regarding the generalisability and applicability of the findings. Fourth, the predominance of quantitative research designs in the included studies has implications for the types of data collected and their ability to draw causal conclusions. Cross-sectional designs limit the establishment of causal relationships, whereas retrospective designs may affect the validity and reliability. Lastly, it is worth noting that grey literature, which includes non-peer-reviewed sources, was excluded from this review to maintain a high level of methodological rigour. However, it is important to recognise and acknowledge the significant breadth and role of grey literature in the context of femicide research and prevention. Grey literature, which includes reports, policy documents, working papers and other non-peer-reviewed materials, often offers timely, practical and on-the-ground insights that are crucial for understanding and addressing femicide. These sources frequently provide valuable perspectives and data that may not be available in academic publications, including insights from practitioners, policy-makers and communities directly affected by femicide. Although not covered in this review, the contribution of grey literature to femicide research and its role in informing effective prevention strategies are acknowledged. The exclusion of this type of evidence from the current synthesis does not diminish its importance in providing a comprehensive understanding of femicide and guiding efforts towards its prevention. Despite these limitations, this review makes a significant contribution to the academic literature on femicide in Africa by addressing critical issues, providing methodological insights and identifying urgent research directions. This urges international attention and action to effectively address this pressing issue, and researchers can use these insights to refine their approaches and conduct more rigorous investigations in this field.

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

Ethics statements

Patient consent for publication

Ethics approval

This research is that of a systematic review that used published empirical articles in the public domain. Thus, ethical clearance was not required and this study did not involve data collection from human participants.

References

Supplementary materials

  • Supplementary Data

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Footnotes

  • Contributors TV conceived and designed the study, collected, analysed and extracted the data, and contributed to interpreting the results. Additionally, TV read the paper, provided critical feedback, approved its submission, and acts as guarantor. BD assisted TV in conceiving and designing the study, collecting, analysing and extracting the data, and contributed to interpreting the results. Likewise, BD read the paper, provided critical feedback and approved its submission.

  • Funding The financial assistance of the South African Medical Research Council towards this research is hereby acknowledged. Award/grant number is not applicable.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.