A new study, which Ifakara Health Institute Research Scientist Hajirani Msuya contributed to, has uncovered alarming levels of intimate partner violence (IPV) in urban slums across low- and middle-income countries (LMICs).

The research, published on e-Clinical Medicine - which is part of THE LANCET Discovery Science, highlights that women living in urban slums face significantly higher IPV rates than those in non-slum urban and rural areas. In 18 of the 34 countries analyzed, over 30% of women reported experiencing IPV.

Ifakara Research Scientist Hajirani Msuya contributed to the study through defining the key terms: physical, sexual, psychological and any IPV; data curation; data analysis; interpretation of the results; article writing and review of the final manuscript.

Both physical, sexual and psychological violence investigated
Intimate partner violence (IPV) refers to harmful behaviors that one partner inflicts on another within a relationship. This study examined three types of IPV: physical IPV, which includes actions such as slapping, kicking, pushing, or even being threatened with a weapon; sexual IPV, which involves forced or coerced sexual acts; and psychological IPV, which includes verbal insults, threats, and humiliation.

Combining both, “any IPV” was also looked at. Msuya and colleagues defined “any IPV” as women who ever experienced at least one type of physical IPV, sexual IPV, and psychological IPV. And this was the primary outcome.

These forms of abuse not only have devastating physical and emotional effects but also contribute to long-term mental health issues and economic hardship for victims.

The study analyzed data from 283,658 women across 34 LMICs, with 14,111 women residing in urban slums. It found that 31.4% of women in urban slums experienced IPV, a rate 5.9 percentage points higher than that of women in non-slum urban areas and 1.2 percentage points higher than in rural areas. 

4 countries, including Tanzania, showed the sharpest rise
Countries such as Sierra Leone, Tanzania, Mali, and Nigeria saw significant increases in IPV rates over time, with Sierra Leone experiencing the sharpest rise.

The study attributes the elevated IPV rates in urban slums to various social and economic factors. One major driver is controlling behavior by husbands or partners, which accounts for 27.2% of the IPV disparities between urban slums and non-slum urban areas. 

Additional contributing factors include poverty, gender inequality, and poor partner relationships. These conditions create an environment where women are more vulnerable to abuse and less likely to access support services.

Reflections: Call for targeted public health interventions
The findings emphasize the urgent need for targeted public health interventions. Addressing harmful partner behaviors, promoting gender equality, and improving socio-economic conditions in urban slums could help reduce IPV rates. 

“Governments and organizations must prioritize policies that empower women, provide safe shelters, and strengthen legal frameworks to protect victims of IPV. Community-based programs and awareness campaigns can also play a crucial role in shifting social norms and reducing acceptance of violence against women.”

Giving his reflections, Ifakara Research Scientist Hajirani Msuya, says: “The elevated IPV prevalence for women in urban slums is influenced by a combination of individual level factors and the broader social environment.” 

“For women, higher levels of gender inequality, such as limited social independence and economic dependence, might increase their vulnerability to IPV.  For men, living in the marginalized context of resource-limited, unequal urban slums—characterized by housing instability, overcrowding, and limited access to services—can increase frustration and powerlessness, leading to harmful behaviour’s like controlling women and alcohol abuse, which raise women’s IPV risk.

“For children; who witness their mothers experiencing IPV are more likely to perpetuate violence in adulthood, exacerbating the cycle of violence in urban slums and fostering an environment where horizontal violence thrives. 

“Both settings require targeted interventions, such as promoting responsible partner behaviour’s and reducing inequalities. Tackling IPV in these disadvantaged areas is crucial for advancing SDG 5 of gender equality and SDG 3 of improving health and well-being for all.”

A Women’s Day link
Msuya has these to say: “As we commemorate International Women’s Day 2025, let this study be a rallying cry for collective action. Let us work together—governments, civil society, and individuals—to dismantle the structures that enable IPV and build a safer, more just world for women everywhere. 

“The time to act is now. Together, we can accelerate progress toward a future where gender equality is not just a goal but a lived reality.”

A wake-up call to policymakers advocates worldwide
This study serves as a wake-up call to policymakers and advocates worldwide. Urban slums are already burdened with poverty and inadequate resources, and high IPV rates only worsen the situation. By acknowledging and addressing this issue, there is hope for a safer and more equitable future for women in these vulnerable communities. 

The full study is available on e-Clinical Medicine – which is part of THE LANCET Discovery Science. It was published on March 6, 2025, read or download it online, here.