Critical Analysis of Domestic Violence Survivors' Support in Ghana: Exploring the Challenges Associated with Providing Formal Intervention for Women

Critical Analysis of Domestic Violence Survivors' Support in Ghana: Exploring the Challenges Associated with Providing Formal Intervention for Women | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Critical Analysis of Domestic Violence Survivors' Support in Ghana: Exploring the Challenges Associated with Providing Formal Intervention for Women Jamal Appiah-Kubi, Emmanuel Brenyah Adomako This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9176582/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Formal institutional responses are critical for protecting the rights and wellbeing of women survivors of domestic violence. In Ghana, the Domestic Violence Act, 2007 (Act 732) mandates comprehensive protection and support for survivors, with the Domestic Violence and Victims Support Unit (DOVVSU) serving as the primary state agency responsible for implementation. However, evidence suggests that the utilization and effectiveness of formal domestic violence support services remain limited. This study explored the factors that constrain DOVVSU’s ability to provide support interventions and the factors that influence women survivors’ decisions not to seek formal assistance. Using a qualitative phenomenological design, data were collected from 10 domestic violence survivors and 10 DOVVSU administrators in the Accra Metropolitan Assembly through interviews. Thematic analysis revealed that while DOVVSU is active in prosecuting perpetrators, the support component of its mandate is significantly undermined by resource constraints, poor infrastructure, limited inter-agency collaboration, inadequate professional capacity, and political interference. Financial burdens, negative prior experiences with formal services, and religious pressures further constrained survivors’ help-seeking. The findings highlight a critical gap between Ghana’s legal commitments and survivors’ lived realities, with significant human rights implications. Domestic violence DOVVSU formal intervention Ghana help-seeking Background Formal interventions are widely recognized as significant for improving the human rights and health outcomes of women survivors of domestic violence (DV). Globally, professional or formal DV intervention agencies include survivor support services, police, housing departments, solicitors, probation departments, health professionals, and homeless hostels (Evans & Feder, 2016 ). Formal intervention services enhance survivors’ functioning and resilience and reduce DV experiences among women (McFarlane et al., 2014 ). Studies show that women in developed countries such as Canada, the United States, and Australia generally report confidence in their ability to access support services, and service utilization rates are relatively high (Ansara & Hindin, 2010 ; Barrett & Pierre, 2011 ; Ford-Gilboe et al., 2015 ; Hegarty et al., 2013 ). In contrast, in Sub-Saharan Africa, access to and use of formal DV intervention services remain limited, as many women who experience DV do not seek help. Although formal support services have been shown to benefit survivors of DV, evidence consistently indicates that most women in Sub-Saharan Africa do not seek formal support services (Mahenge & Stöckl, 2021 ; Tenkorang et al., 2017 ). A recent study by Aboagye et al. ( 2023 ) found that out of a sample of 33,837 women who experienced DV in Africa, only 38% sought help, including both formal and informal services. This study explored challenges associated with the provision of formal intervention through the Domestic Violence and Victims Support Unit (DOVVSU) and the factors that influence women survivors’ of DV decisions not to seek formal interventions. The article starts by exploring the extent of formal institutional intervention for DV in Ghana, followed by literature review on women’s help-seeking behaviours, methods employed for the study, findings, discussions and implications of the study. Formal institutional intervention for DV among women in Ghana In Ghana, formal institutional support services have been established to respond to DV against women. According to Kaburi and Kaburi ( 2023 ), formal intervention services in Ghana include criminal justice services, social services, and quasi-judicial services, such as counselling and mediation. Criminal justice interventions involve the arrest of DV perpetrators by the DOVVSU, a division of the Ghana police service (Kaburi & Kaburi, 2023 ), with detention undertaken in collaboration with the Ghana Legal Aid Board and family tribunal courts (UNHCR, 2023 ). DOVVSU was established in October 1998 in response to the increasing number of reported abuse and assault cases against women and children in Ghana (Ghana Police Service, 2017 ). The unit is mandated to provide free services to the public; protect the rights of vulnerable populations from all forms of abuse; maintain an effective database for crime detection, prevention, and prosecution; treat survivors/complainants and their families with respect and courtesy; professionally record statements; keep survivors informed about their cases and ongoing investigations; and provide crime prevention advice in homes, schools, churches, and markets (Ghana Police Service, 2017 ) DOVVSU provides support as part of its functions in collaboration with institutions like the Department of Social Welfare, the Ark Foundation, and Ghana Health Services (UNHCR, 2023 ). For instance, the DV support service in Ghana under DOVVSU is mandated by law to cover free shelters, medical care, rehabilitation, skill training, and reintegration with family by means of a DV fund (Kaburi & Kaburi, 2023 ). In addition, DOVVSU partners with institutions like the International Federation of Women Lawyers, Women's Initiative for Self-Empowerment and the Commission on Human Rights and Administrative Justice to provide mediation and counselling services for DV survivors in Ghana (Kaburi & Kaburi, 2023 ; UNHCR, 2023 ). While formal intervention services have demonstrated clear benefits for survivors of DV globally, their effectiveness is shaped by the social and institutional contexts in which they operate. In Ghana, the establishment of formal support structures such as DOVVSU reflects a commitment to addressing DV through coordinated institutional responses. However, the presence of these services alone does not guarantee accessibility or effectiveness. Understanding the barriers that constrain both survivors’ use of formal interventions and service providers’ capacity to deliver quality support is therefore essential for evaluating the practical functioning of DV response systems in the Ghanaian context. The effectiveness of organizations mandated to support individuals experiencing DV in Ghana is potentially undermined by multiple barriers operating at both institutional and societal levels (Sedziafa & Tenkorang, 2024 ). Evidence indicates that survivors face several challenges when accessing formal interventions, including the desire to preserve marriages, limited access to specialized support services, negative or dismissive attitudes of service providers, concerns about confidentiality, and inadequate resources (Alvarez et al., 2018 ; Chadambuka & Warria, 2022 ; Evans & Feder, 2016 ). In addition, service providers encounter significant constraints, such as insufficient training, limited education on DV, inadequate understanding of its complexities, and logistical challenges, all of which restrict the quality and effectiveness of services delivered to survivors (Husso et al., 2012 ; Nikupeteri, 2017 ; Odero et al., 2014 ). Help-seeking behavior among DV survivors Despite the establishment of formal institutional mechanisms to address DV in Ghana, women survivors continue to make limited use of available support services. Evidence indicates that women who are affected by DV often do not access institutional support, reflecting broader challenges within the formal intervention system (Sedziafa & Tenkorang, 2024 ). Studies have consistently reported low levels of awareness and utilisation of formal DV intervention services among Ghanaians, largely due to the limited availability and perceived effectiveness of support services (Anyemedu et al., 2020 ; Kaburi & Kaburi, 2023 ; Sedziafa & Tenkorang, 2024 ). Women survivors have expressed doubts about the capacity of DOVVSU to adequately address their needs (Anyemedu et al., 2020 ). While DOVVSU is mandated to provide both protective and support services as Ghana’s primary DV intervention institution, the conditions that affect its mandate to fulfill its support function remain insufficiently examined. Existing research in Ghana has predominantly focused on women’s help-seeking behaviors, barriers to accessing services, disempowerment of survivors who seek formal services, structural challenges and levels of knowledge about formal support mechanisms (Adu-Gyamfi, 2014 ; Baffour et al, 2022 ; Kaburi & Kaburi, 2023 ; Rohn & Tenkorang, 2023 ; Sedziafa & Tenkorang, 2024 ). Consequently, limited attention has been given to understanding why the support component of DOVVSU’s mandate appears underemphasized and the factors that affect survivors’ help-seeking for formal intervention services. Addressing this gap is important for informing policy, ensuring survivor human rights and strengthening institutional responses to DV in Ghana. This study examined the factors that limit DOVVSU from providing support interventions to women survivors of DV, as well as the factors that prevent women survivors from seeking formal interventions from DOVVSU. Methods Research strategy This study employed qualitative research design, a choice made by the researchers to ensure a comprehensive understanding of support services for DV survivors (Creswell, 2013 ). The design, specifically a phenomenological approach, was selected to facilitate the creation of a collective understanding (Zhou et al., 2022 ) of the challenges associated with the provision of formal intervention support for DV survivors and factors that influence women not to seek formal intervention support. Study area and population This study was conducted in the Accra Metropolitan Assembly (AMA), a bustling metropolis with a population of about 2,271,000 (Macrotrends, 2024 ). Notably, this metropolitan area is predominantly inhabited by youth under 24 years old, adding a distinct dimension to our research. The area is inhabited by people from different ethnic groups who engage in various economic activities, including fishing and petty trading (Oteng-Ababio, 2018 ). Like many metropolitan areas, which are melting pots for people from various ethnic backgrounds, Accra is filled with many problems like poverty, DV, and the proliferation of slums. We opted to conduct the study in Accra because of the multiple incidents of DV among the inhabitants (Ajayi & Soyinka-Airewele, 2018 ; Mantey, 2019 ) and the evidence of poor help-seeking behavior by survivors (Rohn & Tenkorang, 2023 ). Despite inhabitants’ experience of violence and the existence of DOVVSU, they are reluctant to seek help from such agencies (Rohn & Tenkorang, 2023 ). We, therefore, explored the challenges encountered by DV survivors in accessing support and the factors that prevent DOVVSU administrators from providing support to the survivors. The current study targeted DV survivors and administrators of DOVVSU who are mandated to provide support services for the survivors. Given that DOVVSU has branches in various parts of AMA, the researchers recruited the administrators and DV survivors from different offices to enhance capturing the realities of participants with different experiences and backgrounds. Sampling technique and sample size The researchers adopted a purposive sampling technique to recruit participants for the study. We adopted this technique because of our interest in recruiting participants who were knowledgeable about help-seeking among DV survivors (Campbell et al.,2020). The current study was part of a doctoral thesis of the lead author. After obtaining authorization from the Ghana Police Service headquarters, the researcher approached DOVVSU branches to introduce himself and explain the study's objectives. Such an introduction was instrumental in recruiting administrators who were interested in the study. The researchers also identified and recruited DV survivors who had sought support from DOVVSU, through referrals by the administrators and direct engagement with clients at the DOVVSU offices. The administrators of DOVVSU were included in the study if they had worked directly with DV survivors for at least three years and were therefore knowledgeable about DOVVSU’s support services and survivors' help-seeking behavior. The inclusion criteria applied to the DV survivors were that they must have been more than 18 years old and had sought help from the DOVVSU within the past two years at the time of data collection. We recruited 20 participants consisting of eight DV survivors and 10 administrators of DOVVSU. The DV survivors were recruited from different communities based on the DOVVSU offices from which they sought help. The administrators were also recruited from different DOVVSU offices within AMA. Data collection The researchers collected data from participants through interviews, a strategy that allowed us to obtain detailed information from participants. These interviews, which lasted for one hour and 30 minutes, were conducted in English or Twi (a dominant language in Ghana), two languages that participants were proficient in at least one of them. The interviews, which were guided by interview guides (Knott et al., 2022 ), focused on DOVVSU’s support services and survivors’ help-seeking behavior. Data collection occurred where participants were comfortable and suitable for recording data, including their homes, parks, and DOVVSU offices through which the survivors were recruited. We collected data from the interviews by taking notes and audio-recording them after seeking permission from the participants (Karimi & Mozaffar, 2018 ). Data Analysis Obtained data were analyzed using Creswell’s ( 2013 ) data analysis spiral, which includes five steps: data organization, data familiarization, development of themes and sub-themes, interpretation of data and definition, and data presentation. Data organization entailed transcribing the audio files and combining them with the notes taken during the interviews. After this, we read through the scripts to familiarize ourselves with the content of each transcript and create themes from them. The themes generated were compared to each other to assess their similarities and differences, a process that led to the emergence of major and minor themes. We then defined the themes and sub-themes presented in the current study and supported them with participant quotations (Ningi, 2022 ). Ethical consideration The current study is developed from the corresponding author’s doctoral dissertation, in which he sought ethical clearance from the Ethics Board of Ankara Yildirim Beyazit University. Besides seeking ethical clearance, the researchers also observed participants’ informed consent, voluntary participation, anonymity and confidentiality, objectivity in reporting findings, avoiding plagiarism, and ensuring the study's trustworthiness. The researchers informed the clients about the nature of the study and any risk they could be exposed to by engaging in it before data collection. Additionally, the participants were given the prerogative to decide whether to participate in the study or not. This was stated clearly at every stage, from their recruitment to data collection. We have also ensured the participants’ anonymity and confidentiality by not attaching any information that could reveal their identity from the information obtained from them. We also emphasized presenting the study’s findings without any form of manipulation. Any existing idea used in the current study has been duly acknowledged to avoid plagiarism. Finally, we actively enhanced the study's trustworthiness by verifying information obtained from the two participant groups through triangulation, member-checking, and ensuring that our personal biases did not influence data collection and interpretation of the data. Findings The current study sought to examine the factors behind DOVVSU’s limited support for DV survivors and factors that influence survivors’ decision not to seek formal support. The findings of the study revealed that while DOVVSU has been active in arresting and sanctioning perpetrators of abuse, there has been limited support for DV survivors. This was evident in the submissions of the DOVVSU administrators, explaining that while DOVVSU seeks to ensure justice for the survivors by prosecuting the perpetrators, the effort to provide the needed support for the survivors has been lagging, leading to inadequate services: You know this place is called Domestic Violence and Victim Support Unit. The domestic violence aspect is there, as in the cases reported. But the support aspect is not there. Though the government and the police service is doing its best, it is not enough…I think they should remove the word ‘support’ in our name and just bring another word there (DOVVSU administrator). Findings from survivors confirm that they received limited support from DOVVSU. The limited support from DOVVSU for DV survivors is due to challenges the agency encounters, which has encumbered its ability to execute the support component of its mandate. The key challenges identified from the analyzed data emanate from DOVVSU and survivors’ situations. Factors contributing to inadequate support for DV survivors Specific factors related to DOVVSU’s setup and operations have inhibited the administrators’ ability to deliver support services for DV survivors. Although DOVVSU has support services for DV survivors, the administrators have not been able to deliver the services as planned. The challenges responsible for this incapacitation are resource constraints, poor facilities and associated discomfort for clients, limited collaboration between DOVVSU and other institutions, limited competence, and political interference. Resource constraint While the DOVVSU administrators were committed to providing services for DV survivors, their effort was compromised by the inadequacy of the resources needed. As a result of the resource constraint, many administrators could not provide survivors’ physical, mental, and emotional needs. As captured below, DOVVSU administrators in many branches could not provide the psychosocial support survivors needed: On the aspect of our clients’ emotional well-being, I will say we have not done much because of the limited resources. As I said, we should have had social workers who would work on emotional issues, but we do not have. So, we do our best. We are laymen in terms of addressing psychosocial needs. But based on our own experiences, we calm our clients down. That is not professional, but under the circumstances, that is how far we can go. (DOVVSU administrator). Given the trauma and mental health issues associated with DV, psychosocial support is crucial to survivors’ recovery and mental well-being. However, with limited professionals such as psychologists and social workers in DOVVSU, survivors did not assess such service. Poor facilities and associated discomfort for clients The study found that DOVVSU branches were mostly located in poor building facilities and associated with sub-standard conditions. Such conditions hindered administrators from providing the support DV survivors needed. For instance, there was inadequate office space for handling DV cases and counseling sessions in a manner that upheld confidentiality, which discouraged survivors from sharing detailed information about their abusive experiences. In such instances, the environment was not congenial for effective service delivery. According to the administrators and survivors, the lack of space led to instances where multiple DVs cases were attended to in the same room, a situation which compromised survivors’ autonomy and the confidentiality of the cases: …It is a problem. Ideally, we should have had confidential rooms where I could tell my whole story without being worried about other people hearing the details. But there was no space for that. I did not feel safe and confident in such a situation. Initially I would leave and return later hoping the number of people in the office would reduce. The officer was nice. Sometimes he could say let’s go out and talk but that was not the best ... With the kind of abuse I suffered, I needed privacy to share my story but there was no privacy. (DV survivor). The poor facilities at many DOVVSU branches caused discomfort for some survivors, which discouraged them from accessing support. Limited collaboration between DOVVSU and other institutions Limited collaboration between DOVVSU and other institutions whose work complement DOVVSU contributed to its limited ability to support DV survivors. As explained earlier, DOVVSU partners with other welfare agencies, including the Department of Social Welfare, to mobilize the resources required to serve its clients. However, the findings revealed that the administrators were sometimes incapacitated in helping DV survivors due to poor cooperation from such agencies. In such instances, the survivors were unable to access the support needed: I think social welfare, but they are not pulling their weight at all. In fact, I do not know their own problem, but whenever you need their help, it is not forthcoming. Maybe they have their own issues. But they should be picking up from where we leave off. Whiles we look at the criminal aspect of issues, they should be looking at the social aspect, and they see how they can help (DOVVSU administrators). Lack of competent social support administrators The findings show that limited competence exhibited by some DOVVSU administrators compromised optimal service provision to DV survivors. This was attributed to the limited competence of some administrators. Such limited competence was manifested in ways such as sheer lack of knowledge on the processes for engaging survivors, limited resourcefulness regarding brokering support, and lack of sensitivity for survivors. While such incompetence was demonstrated by few administrators, it led to ineffectiveness in improving the safety and well-being of DV survivors. The quote below buttresses participants’ view about some DOVVSU administrators’ incompetence: …Within DOVVSU itself, there is a lack of understanding of our mandate… There are many commanders who do not know the mandate of DOVVSU. They just interfere in your cases and things like that …Some officers will trivialize your case and ask you why you are worrying yourself so much… They are not abreast of the law, and they work on emotions (DOVVSU administrator). Political interference Political interference also inhibited DOVVSU from providing support to DV survivors. In situations where political figures are affiliated with perpetrators of DV, they interfered in influencing decisions and actions taken. Such interference shielded abusers from prosecution and other penal measures and contributed to limited psychosocial support for survivors: ... An ordinary political party organizer can just walk in and introduce himself and say he is interested in your case, which is not proper. How are you interested in the case? You are not an official of DOVVSU, but you just come here and try to throw your weight around. An assembly member will come and say, I want to intervene… If you do not give in, he will move to the next step. They keep moving up and up. And the structure of our system is centralized, based on rank. So your boss has a boss, and that boss also has a boss. So if they want to serve their interest, the best thing is to take the case from you, which they have the power to do (DOVVSU administrator). The findings demonstrate challenges that inhibit DOVVSU from responding to DV and supporting survivors in coping with the health risks and associated trauma. Factors that encumber formal help seeking from DOVVSU Survivors of DV did not seek formal intervention from DOVVSU due to financial burden, negative previous experience from seeking formal support, and religious constraints. Financial burden The findings revealed that women with DV experiences bore some financial burdens in seeking support from DOVVSU. According to participants, DV survivors were supposed to provide a medical report that verified their abuse. However, many survivors could not produce it because of the cost of carrying out a medical examination. This prevented such survivors from seeking help from DOVVSU and the administrators from exercising their responsibilities such as investigating reported abuse cases and offering survivors the needed support: I had to bear the cost of the medical examination needed for the medical report. If I was aware of such cost, I probably would not have gone to seek their help… I think the agency should pay for the medical examination bill. It is expensive for people like me… And they need the medical report to even start working on your case. I had to call people to get the money to pay (DV survivor). This DOVVSU administrator reported that medical reports from hospitals were prerequisite for processing abuse cases, the absence of which presents as a setback in terms of showing evidence for any support for survivors. These vulnerable clients are expected to pay for their medical examination. You can tell some of them cannot pay. But we need the medical report to start the case… That has been a problem because sometimes we the personnel here at DOVVSU use our own resources to support, and how far can we do that? The hospital will demand for money before they endorse those medical examination forms, and it is a severe setback (DOVVSU administrator) This finding portrays the importance of funds as a prerequisite for seeking help from DOVVSU. It also explained a major limitation in DOVVSU’s operations for their inability to financially support DV survivors to secure medical reports. Negative previous experiences from seeking formal support The findings show that some DV survivors had limited interest in seeking help from DOVVSU due to their dissatisfaction in previous encounters with administrators at the agency. Their unpleasant experiences included negative utterances from the administrators and limited support received. A former client of DOVVSU said: Some officials make you feel bad when you go there to report cases. They look at your appearance and pass some comments. It is like you invited the person to sexually abuse you…Many of the officials are extremely polite and professional, but few do not talk to you with respect and empathy…Already, I felt bad talking about the ordeal my own family member took me through, and I did not get the support I needed. I felt ashamed. (DV survivor). Religious constraints Analyzed data showed that the practice of religion in Ghana influenced DV survivors’ willingness and ability to seek support from DOVVSU. While religion in itself has not condoned violence, some actions taken, and decisions made by religious leaders restricted survivors from reporting abuse cases and seeking help from DOVVSU. Although some DV survivors were willing to seek support from DOVVSU, their religious leaders discouraged them from taking such actions: The second time he [ex-husband] beat me, I wanted to report it to DOVVSU, but my pastor talked me out of it, just like the first time. He promised he would talk to him. They kept saying that…things like “once you tell DOVVSU the public can know about it, and your family and our church will be disgraced”. They say things like that to discourage you. And when you don’t listen, it is as if you are disobeying your spiritual leaders. That is why I continued to live with him and suffer in silence. It took a lot of confidence for me to report him eventually (DV survivor). The administrators also corroborated religious leaders’ inhibition of survivors’ help-seeking, citing instances where some religious leaders meddled in cases reported and compromised their adjudication and support provision for the survivors: Discussion of findings This study examined the institutional and survivor-related factors that limit the provision and utilization of formal DV intervention services in Ghana, with a particular focus on DOVVSU. Institutional gaps encumbering support The findings reveal a significant gap between the legal and policy intent of Ghana’s DV framework and the practical realities of service delivery and help-seeking. The findings showed institutionally related factors that limit the provision of formal support services, including resource constraints, poor infrastructural facilities, limited collaboration between DOVVSU and other institutions, a lack of competent social support administrators, and political interference. In addition, survivor-related factors found include financial burden on survivors, negative previous experiences, and religious constraints. Ghana’s Domestic Violence Act (Act 732) was enacted to provide comprehensive protection for survivors of DV, including physical, sexual, psychological, and economic abuse. The Act mandates the state to ensure survivor protection, access to justice, medical care, psychosocial support, shelters, and rehabilitation, supported by the establishment of a Domestic Violence Fund (Republic of Ghana, 2007 ). In principle, the Act adopts a rights-based and survivor-centered approach, positioning DV as a public concern rather than a private family matter. However, the findings of this study indicate that the support component of this legal mandate remains unavailable. While DOVVSU has been relatively effective in addressing the criminal justice dimension of DV, particularly arrest and prosecution, the support and recovery functions envisaged under Act 732 are largely unmet. Participants’ accounts of limited psychosocial care, lack of shelters, financial barriers to medical reporting, and poor inter-agency coordination suggest that the Domestic Violence Fund and allied support structures are either under-resourced or inadequately operationalized. This mirror concerns raised by other studies (Kaburi & Kaburi, 2023 ; Sedziafa & Tenkorang, 2024 ) that argue that Ghana’s DV response framework is characterized by strong legal symbolism but weak institutional capacity. DOVVSU was established to provide integrated protection and support for survivors of DV, child abuse, and related offences. Its mandate extends beyond law enforcement to include counselling, referral, coordination with social welfare and health institutions, and survivor protection (Ghana Police Service, 2017 ). The present findings, however, demonstrate that DOVVSU’s operations are heavily skewed toward policing functions, with limited capacity to deliver survivor-centered support. Key institutional barriers identified, including resource constraints, poor infrastructure, and lack of trained psychosocial professionals, significantly undermine DOVVSU’s ability to fulfil its support mandate. These findings are consistent with earlier studies documenting inadequate staffing, logistical deficits, and role ambiguity within DOVVSU (Anyemedu et al., 2020 ; Kaburi & Kaburi, 2023 ). The reported absence of social workers and psychologists within DOVVSU offices is particularly concerning, given the complex trauma associated with DV and the centrality of psychosocial care to survivor recovery (Chu et al., 2024 ). From an institutional theory perspective, these constraints reflect structural weaknesses within the broader social protection system, where legal mandates are not matched by sustained political commitment, funding, and professional capacity (Gottschalk & Hamerton, 2024 ). As Sedziafa and Tenkorang ( 2024 ) argue, such conditions constitute a form of structural violence, whereby institutional failures systematically disadvantage survivors despite formal legal protections. Institutional shortcomings discourage help seeking The study further highlights how institutional shortcomings intersect with survivors' lived realities to discourage formal help-seeking. Financial barriers, particularly the cost of obtaining medical reports, emerged as a critical deterrent, contradicting the intent of Act 732, which envisages state-supported access to medical care for survivors. Similar findings have been reported in Ghana and other Sub-Saharan African contexts, where poverty and cost-sharing requirements limit access to justice and health services for survivors (Adu-Gyamfi, 2014 ; Rohn & Tenkorang, 2023 ). Additionally, negative prior experiences with DOVVSU, including perceived insensitivity, breaches of confidentiality, and inadequate support, further eroded survivors’ trust in formal institutions. These experiences align with the theory of legal cynicism, which suggests that repeated exposure to ineffective or disrespectful institutional responses reduces individuals’ willingness to engage with formal systems (Oliveira & Jackson, 2021 ). Survivors’ accounts of stigma and retaliation from family and community members also reinforce findings from previous studies indicating that DV reporting in Ghana often attracts social sanctions rather than support (Ajayi & Soyinka-Airewele, 2018 ; Rohn & Tenkorang, 2023 ). Religious norms and leadership emerged as significant factors shaping survivors’ help-seeking decisions. Although religion does not inherently condone violence, the current study revealed instances where religious leaders discouraged reporting to DOVVSU in favor of private reconciliation, framing formal reporting as shameful or spiritually inappropriate. This finding corroborates earlier research demonstrating how religious authority in Ghana can reinforce silence, endurance, and marital preservation at the expense of survivor safety (Sedziafa & Tenkorang, 2024 ). From a socio-ecological perspective, these religious influences operate at the community and societal levels, interacting with institutional gaps to restrict survivors’ access to formal support. When combined with inadequate state protection, such pressures compel many survivors to remain in abusive relationships, exhibit non-help seeking behavior, or withdraw from legal processes altogether. Implications of study findings The findings of this study resonate with feminist and structural theories of violence, which locate DV not only in individual relationships but within broader systems of gender inequality, institutional neglect, and power imbalances (Namy et al, 2017 ; Rose et al, 2023 ). The marginalization of survivor support within DOVVSU reflects entrenched prioritization of punitive justice over care-based interventions, a pattern observed in many low-resource settings (Husso et al., 2012 ). Additionally, help-seeking theory suggests that survivors are more likely to engage in formal services when they perceive them as accessible, trustworthy, and beneficial (Saint Arnault & Woo, 2018 ). The convergence of financial costs, poor service experiences, and socio-cultural discouragement identified in this study helps explain the persistently low utilization of formal DV services in Ghana, despite the existence of robust legal frameworks. The findings underscore the urgent need to realign Ghana’s DV response system with the original intent of Act 732. Strengthening DOVVSU’s support function requires sustained investment in infrastructure, professional staffing (particularly social workers and psychologists), enforcement of confidentiality standards, and effective activation of the Domestic Violence Fund. Improved inter-agency collaboration and protection from political interference are also critical to restoring survivor confidence in formal institutions. Without addressing these systemic issues, the gap between law and lived experience will persist, limiting the effectiveness of Ghana’s DV response and undermining survivors’ human rights. Conclusion Overall, the findings indicate that DV survivors in Ghana face systemic barriers that limit their ability to fully realize their human rights, despite the existence of protective legislation. Gaps in institutional capacity, resource allocation, and service coordination constrain survivors’ access to protection, care, and effective remedies, leaving many unable to benefit from the rights guaranteed under national law. These shortcomings disproportionately affect economically and socially vulnerable women, reinforcing inequality and undermining substantive justice. The persistence of such barriers signals a broader state responsibility to move beyond legal recognition toward meaningful implementation, ensuring that DV responses uphold survivors’ dignity, safety, and equal access to justice in practice. Declarations The co-authors declare that they solely developed this manuscript and that they do not have any competing interests or conflicts of interest regarding the research from which this manuscript was developed. Ethical Approval This manuscript was developed from data collected by the corresponding author in his doctoral dissertation research. Ethical approval was obtained from the Ethical Review Board of Ankara Yildirim Beyazit University (Study Number: 2021-256). Funding Statement The authors did not receive support from any organization for the submitted work. The research project for which this manuscript was developed was self-funded by the corresponding author. Conflict of Interest Disclosure All the co-authors do not have any competing interests or conflicts of interest regarding the research from which this manuscript was developed. Availability of data and materials Data based on which this manuscript was developed cannot be shared publicly because of sensitive information from a vulnerable population. However, components that can be shared will be made available upon request. References Aboagye, R.G., Seidu, A.A., Cadri, A., Salihu, T., Arthur-Holmes, F., Sam, S.T., et al. (2023). Ending violence against women: Help-seeking behaviour of women exposed to intimate partner violence in sub-Saharan Africa. 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Journal of Family Issues, 41 (12), 1–23. Baffour, F. D., Adomako, E. B., Darkwa Baffour, P., & Henni, M. (2022). Coping strategies adopted by migrant female head-load carriers who experienced IPV. Victims and Offenders , 17(1), 139-159. Barrett, B. J., & Pierre, M. S. (2011). Variations in women’s help seeking in response to intimate partner violence: findings from a Canadian population-based study. Violence Against Women, 17 (1), 47. Campbell, S., Greenwood, M., Prior, S., Shearer, T., Walkem, K., Young, S., ... & Walker, K. (2020). Purposive sampling: complex or simple? Research case examples. Journal of Research in Nursing , 25 (8), 652-661. Chadambuka, C., & Warria, A. (2022). Intimate partner violence: understanding barriers in seeking formal support services in a rural area in Zimbabwe. Journal of Family Violence, 37 (3), 521-532. Chu, Y. C., Wang, H. H., Chou, F. H., Hsu, Y. F., & Liao, K. L. (2024). Outcomes of trauma‐informed care on the psychological health of women experiencing intimate partner violence: a systematic review and meta‐analysis. Journal of Psychiatric and Mental Health Nursing, 31 (2), 203-214. Creswell, J.W. (2013). Qualitative inquiry and research design: Choosing among five approaches, 3rd edition . Los Angeles: Sage Publication. Evans, M. A., & Feder, G. S. (2016). Help‐seeking amongst women survivors of domestic violence: A qualitative study of pathways towards formal and informal support. Health Expectations, 19 (1), 62-73. Ford-Gilboe, M., Varcoe, C., Noh, M., Wuest, J., Hammerton, J., Alhalal, E., & Burnett, C. (2015). Patterns and predictors of service use among women who have separated from an abusive partner. Journal of Family Violence, 30 , 419-431. Ghana Police Service. (2017). Domestic Violence and Victims Support Unit (DOVVSU) mandate and functions . Available at :https://police.gov.gh/en/index.php/domestic-violence-victims-support-unit-dovvsu/#:~:text=DOVVSU%20is%20expected%20to%2C%20among,effective%20database%20for%20crime%20detection%2C Gottschalk, P., Hamerton, C. (2024). Institutional Theory Perspectives . In: Corporate Social License. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-031-45079-2_3 Hegarty, K., O’Doherty, L., Chondros, P., Valpied, J., Taft, A., Astbury, J., … Gunn, J. (2013). Effect of type and severity of intimate partner violence on women’s health and service use: Findings from a primary care trial of women afraid of their partners. Journal of Interpersonal Violence, 28 , 273. Husso, M., Virkki, T., Notko, M., Holma, J., Laitila, A., & Mäntysaari, M. (2012). Making sense of domestic violence intervention in professional health care. Health and Social Care in the Community, 20 (4), 347-355. Kaburi, R. M., & Kaburi, B. B. (2023). Formal support services and (dis) empowerment of domestic violence victims: perspectives from women survivors in Ghana. BMC Women's Health, 23 (1), 539. Karimi, M. N., & Mozaffar, M. (2018). A Mixed-Method Inquiry into Three Techniques of Data-gathering in Language Teacher Supervision: Video-taping, Audio-taping and Field notes. The International Journal of Humanities , 25 (4), 18-40. Knott, E., Rao, A. H., Summers, K., & Teeger, C. (2022). Interviews in the social sciences. Nature Reviews Methods Primers , 2 (1), 73. https://doi.org/10.1038/s43586-022-00150-6 Macrotrends (2024). Accra, Ghana Metro Area Population 1950-2024. Available at: https://www.macrotrends.net/global-metrics/cities/21107/accra/population#:~:text=The%20metro%20area%20population%20of,a%201.71%25%20increase%20from%202020. Mahenge, B., & Stöckl, H. (2021). Understanding women’s help-seeking with intimate partner violence in Tanzania. Violence Against Women, 27 (6-7), 937-951. Mantey, E. E. (2019). Domestic violence in Ghana: The attitudes of male victims of Accra. African Journal of Social Work , 9 (1). McFarlane, J., Symes, L., Maddoux, J., Gilroy, H., & Koci, A. (2014). Is length of shelter stay and receipt of a protection order associated with less violence and better functioning for abused women? Outcome data 4 months after receiving services. Journal of Interpersonal Violence, 29, 2748. Namy, S., Carlson, C., O'Hara, K., Nakuti, J., Bukuluki, P., Lwanyaaga, J., ... & Michau, L. (2017). Towards a feminist understanding of intersecting violence against women and children in the family. Social Science and Medicine, 184, 40-48. Nikupeteri, A. (2017). Professionals’ critical positionings of women as help-seekers: Finnish women’s narratives of help-seeking during post-separation stalking. Qualitative Social Work, 16 (6), 793–809. https://doi.org/10.1177/1473325016644315 Ningi, A. I. (2022). Data presentation in qualitative research: The outcomes of the pattern of ideas with the raw data. International Journal of Qualitative Research , 1 (3), 196-200. Odero, M., Hatcher, A. M., Bryant, C., Onono, M., Romito, P., Bukusi, E. A., & Turan, J. M. (2014). Responses to and resources for intimate partner violence: qualitative findings from women, men, and service providers in rural Kenya. Journal of Interpersonal Violence, 29 (5), 783-805. Oliveira, T. R., & Jackson, J. (2021). Legitimacy, trust and legal cynicism: A review of concepts. Tempo Social, 33 (3), 113-145. Oteng-Ababio, M. (2018). ‘The oil is drilled in Takoradi, but the money is counted in Accra’: The paradox of plenty in the oil city, Ghana. Journal of Asian and African Studies, 53 (2), 268-284. https://doi.org/10.1177/0021909616677371 Republic of Ghana. (2007). Domestic Violence Act, 2007 (Act 732). Accra: Government of Ghana.https://ir.parliament.gh/bitstream/handle/123456789/2448/ACT%20732.pdf?seque nce=1&isAllowed=y Rohn, E., & Tenkorang, E. Y. (2023). Structural and institutional barriers to help-seeking among female victims of intimate Partner violence in Ghana. Journal of family violence , 38 (5), 815-827. https://doi.org/10.1007/s10896-022-00433-2 Rose, E., Mertens, C., & Balint, J. (2023). Structural Problems Demand Structural Solutions: Addressing Domestic and Family Violence. Violence Against Women, 30 (14), 3633-3655. https://doi.org/10.1177/10778012231179212 Saint Arnault, D., & Woo, S. (2018). Testing the influence of cultural determinants on help- seeking theory. American Journal of Orthopsychiatry, 88 (6), 650. Sedziafa, A. P., & Tenkorang, E. Y. (2024,). Institutional challenges to delivering domestic violence services in Ghana: A case of structural violence? Women's Studies International Forum,104 , 102894. Tenkorang, E. Y., Sedziafa, A. P., & Owusu, A. Y. (2017). Does type and severity of violence affect the help-seeking behaviors of victims of intimate partner violence in Nigeria?. Journal of Family Issues, 38 (14), 2026-2046. UNHCR (2023). Ghana: Domestic Violence Victim Support Unit (DOVVISU), formerly the Women and Juvenile Unit (WAJU), established by the Ghanaian police and whether it provides protection to women in Ghana. Available at: https://webarchive.archive.unhcr.org/20230528214444/https://www.refworld.org/docid/45f147367.html. Zhou, S., Wei, L., Hua, W., He, X., & Chen, J. (2022). A qualitative study of phenomenology of perspectives of student nurses: experience of death in clinical practice. BMC Nursing, 21 (1), 74. https://doi.org/10.1186/s12912-022-00846-w Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 08 May, 2026 Reviewers agreed at journal 24 Apr, 2026 Reviewers invited by journal 24 Apr, 2026 Editor assigned by journal 29 Mar, 2026 Submission checks completed at journal 29 Mar, 2026 First submitted to journal 20 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9176582","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":633922665,"identity":"978f5a77-99a7-4e81-9c8b-e29060d21d65","order_by":0,"name":"Jamal Appiah-Kubi","email":"data:image/png;base64,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","orcid":"","institution":"California State University, San Bernardino","correspondingAuthor":true,"prefix":"","firstName":"Jamal","middleName":"","lastName":"Appiah-Kubi","suffix":""},{"id":633922667,"identity":"3c871d63-ab19-4dad-b2b2-eb8927387f16","order_by":1,"name":"Emmanuel Brenyah Adomako","email":"","orcid":"","institution":"University of Wollongong","correspondingAuthor":false,"prefix":"","firstName":"Emmanuel","middleName":"Brenyah","lastName":"Adomako","suffix":""}],"badges":[],"createdAt":"2026-03-20 08:11:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9176582/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9176582/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108494215,"identity":"5599f0f6-392f-4094-abdf-ba24e0ca1681","added_by":"auto","created_at":"2026-05-05 10:03:08","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":247502,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9176582/v1/62e2b668-4207-4201-b2ac-c2bbbf948652.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Critical Analysis of Domestic Violence Survivors' Support in Ghana: Exploring the Challenges Associated with Providing Formal Intervention for Women","fulltext":[{"header":"Background","content":"\u003cp\u003eFormal interventions are widely recognized as significant for improving the human rights and health outcomes of women survivors of domestic violence (DV). Globally, professional or formal DV intervention agencies include survivor support services, police, housing departments, solicitors, probation departments, health professionals, and homeless hostels (Evans \u0026amp; Feder, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Formal intervention services enhance survivors\u0026rsquo; functioning and resilience and reduce DV experiences among women (McFarlane et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Studies show that women in developed countries such as Canada, the United States, and Australia generally report confidence in their ability to access support services, and service utilization rates are relatively high (Ansara \u0026amp; Hindin, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Barrett \u0026amp; Pierre, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Ford-Gilboe et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Hegarty et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn contrast, in Sub-Saharan Africa, access to and use of formal DV intervention services remain limited, as many women who experience DV do not seek help. Although formal support services have been shown to benefit survivors of DV, evidence consistently indicates that most women in Sub-Saharan Africa do not seek formal support services (Mahenge \u0026amp; St\u0026ouml;ckl, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Tenkorang et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). A recent study by Aboagye et al. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) found that out of a sample of 33,837 women who experienced DV in Africa, only 38% sought help, including both formal and informal services. This study explored challenges associated with the provision of formal intervention through the Domestic Violence and Victims Support Unit (DOVVSU) and the factors that influence women survivors\u0026rsquo; of DV decisions not to seek formal interventions. The article starts by exploring the extent of formal institutional intervention for DV in Ghana, followed by literature review on women\u0026rsquo;s help-seeking behaviours, methods employed for the study, findings, discussions and implications of the study.\u003c/p\u003e\n\u003ch3\u003eFormal institutional intervention for DV among women in Ghana\u003c/h3\u003e\n\u003cp\u003eIn Ghana, formal institutional support services have been established to respond to DV against women. According to Kaburi and Kaburi (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), formal intervention services in Ghana include criminal justice services, social services, and quasi-judicial services, such as counselling and mediation. Criminal justice interventions involve the arrest of DV perpetrators by the DOVVSU, a division of the Ghana police service (Kaburi \u0026amp; Kaburi, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), with detention undertaken in collaboration with the Ghana Legal Aid Board and family tribunal courts (UNHCR, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). DOVVSU was established in October 1998 in response to the increasing number of reported abuse and assault cases against women and children in Ghana (Ghana Police Service, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The unit is mandated to provide free services to the public; protect the rights of vulnerable populations from all forms of abuse; maintain an effective database for crime detection, prevention, and prosecution; treat survivors/complainants and their families with respect and courtesy; professionally record statements; keep survivors informed about their cases and ongoing investigations; and provide crime prevention advice in homes, schools, churches, and markets (Ghana Police Service, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2017\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eDOVVSU provides support as part of its functions in collaboration with institutions like the Department of Social Welfare, the Ark Foundation, and Ghana Health Services (UNHCR, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). For instance, the DV support service in Ghana under DOVVSU is mandated by law to cover free shelters, medical care, rehabilitation, skill training, and reintegration with family by means of a DV fund (Kaburi \u0026amp; Kaburi, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In addition, DOVVSU partners with institutions like the International Federation of Women Lawyers, Women's Initiative for Self-Empowerment and the Commission on Human Rights and Administrative Justice to provide mediation and counselling services for DV survivors in Ghana (Kaburi \u0026amp; Kaburi, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; UNHCR, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile formal intervention services have demonstrated clear benefits for survivors of DV globally, their effectiveness is shaped by the social and institutional contexts in which they operate. In Ghana, the establishment of formal support structures such as DOVVSU reflects a commitment to addressing DV through coordinated institutional responses. However, the presence of these services alone does not guarantee accessibility or effectiveness. Understanding the barriers that constrain both survivors\u0026rsquo; use of formal interventions and service providers\u0026rsquo; capacity to deliver quality support is therefore essential for evaluating the practical functioning of DV response systems in the Ghanaian context.\u003c/p\u003e \u003cp\u003eThe effectiveness of organizations mandated to support individuals experiencing DV in Ghana is potentially undermined by multiple barriers operating at both institutional and societal levels (Sedziafa \u0026amp; Tenkorang, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Evidence indicates that survivors face several challenges when accessing formal interventions, including the desire to preserve marriages, limited access to specialized support services, negative or dismissive attitudes of service providers, concerns about confidentiality, and inadequate resources (Alvarez et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Chadambuka \u0026amp; Warria, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Evans \u0026amp; Feder, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). In addition, service providers encounter significant constraints, such as insufficient training, limited education on DV, inadequate understanding of its complexities, and logistical challenges, all of which restrict the quality and effectiveness of services delivered to survivors (Husso et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Nikupeteri, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Odero et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eHelp-seeking behavior among DV survivors\u003c/h2\u003e \u003cp\u003eDespite the establishment of formal institutional mechanisms to address DV in Ghana, women survivors continue to make limited use of available support services. Evidence indicates that women who are affected by DV often do not access institutional support, reflecting broader challenges within the formal intervention system (Sedziafa \u0026amp; Tenkorang, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Studies have consistently reported low levels of awareness and utilisation of formal DV intervention services among Ghanaians, largely due to the limited availability and perceived effectiveness of support services (Anyemedu et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Kaburi \u0026amp; Kaburi, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Sedziafa \u0026amp; Tenkorang, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Women survivors have expressed doubts about the capacity of DOVVSU to adequately address their needs (Anyemedu et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile DOVVSU is mandated to provide both protective and support services as Ghana\u0026rsquo;s primary DV intervention institution, the conditions that affect its mandate to fulfill its support function remain insufficiently examined. Existing research in Ghana has predominantly focused on women\u0026rsquo;s help-seeking behaviors, barriers to accessing services, disempowerment of survivors who seek formal services, structural challenges and levels of knowledge about formal support mechanisms (Adu-Gyamfi, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Baffour et al, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Kaburi \u0026amp; Kaburi, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Rohn \u0026amp; Tenkorang, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Sedziafa \u0026amp; Tenkorang, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Consequently, limited attention has been given to understanding why the support component of DOVVSU\u0026rsquo;s mandate appears underemphasized and the factors that affect survivors\u0026rsquo; help-seeking for formal intervention services. Addressing this gap is important for informing policy, ensuring survivor human rights and strengthening institutional responses to DV in Ghana. This study examined the factors that limit DOVVSU from providing support interventions to women survivors of DV, as well as the factors that prevent women survivors from seeking formal interventions from DOVVSU.\u003c/p\u003e \u003c/div\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eResearch strategy\u003c/h2\u003e \u003cp\u003eThis study employed qualitative research design, a choice made by the researchers to ensure a comprehensive understanding of support services for DV survivors (Creswell, \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e). The design, specifically a phenomenological approach, was selected to facilitate the creation of a collective understanding (Zhou et al., \u003cspan class=\"CitationRef\"\u003e2022\u003c/span\u003e) of the challenges associated with the provision of formal intervention support for DV survivors and factors that influence women not to seek formal intervention support.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy area and population\u003c/h3\u003e\n\u003cp\u003eThis study was conducted in the Accra Metropolitan Assembly (AMA), a bustling metropolis with a population of about 2,271,000 (Macrotrends, \u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e). Notably, this metropolitan area is predominantly inhabited by youth under 24 years old, adding a distinct dimension to our research. The area is inhabited by people from different ethnic groups who engage in various economic activities, including fishing and petty trading (Oteng-Ababio, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e). Like many metropolitan areas, which are melting pots for people from various ethnic backgrounds, Accra is filled with many problems like poverty, DV, and the proliferation of slums.\u003c/p\u003e \u003cp\u003eWe opted to conduct the study in Accra because of the multiple incidents of DV among the inhabitants (Ajayi \u0026amp; Soyinka-Airewele, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e; Mantey, \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e) and the evidence of poor help-seeking behavior by survivors (Rohn \u0026amp; Tenkorang, \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e). Despite inhabitants’ experience of violence and the existence of DOVVSU, they are reluctant to seek help from such agencies (Rohn \u0026amp; Tenkorang, \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e). We, therefore, explored the challenges encountered by DV survivors in accessing support and the factors that prevent DOVVSU administrators from providing support to the survivors. The current study targeted DV survivors and administrators of DOVVSU who are mandated to provide support services for the survivors. Given that DOVVSU has branches in various parts of AMA, the researchers recruited the administrators and DV survivors from different offices to enhance capturing the realities of participants with different experiences and backgrounds.\u003c/p\u003e\n\u003ch3\u003eSampling technique and sample size\u003c/h3\u003e\n\u003cp\u003eThe researchers adopted a purposive sampling technique to recruit participants for the study. We adopted this technique because of our interest in recruiting participants who were knowledgeable about help-seeking among DV survivors (Campbell et al.,2020). The current study was part of a doctoral thesis of the lead author. After obtaining authorization from the Ghana Police Service headquarters, the researcher approached DOVVSU branches to introduce himself and explain the study's objectives. Such an introduction was instrumental in recruiting administrators who were interested in the study. The researchers also identified and recruited DV survivors who had sought support from DOVVSU, through referrals by the administrators and direct engagement with clients at the DOVVSU offices. The administrators of DOVVSU were included in the study if they had worked directly with DV survivors for at least three years and were therefore knowledgeable about DOVVSU’s support services and survivors' help-seeking behavior. The inclusion criteria applied to the DV survivors were that they must have been more than 18 years old and had sought help from the DOVVSU within the past two years at the time of data collection. We recruited 20 participants consisting of eight DV survivors and 10 administrators of DOVVSU. The DV survivors were recruited from different communities based on the DOVVSU offices from which they sought help. The administrators were also recruited from different DOVVSU offices within AMA.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eThe researchers collected data from participants through interviews, a strategy that allowed us to obtain detailed information from participants. These interviews, which lasted for one hour and 30 minutes, were conducted in English or Twi (a dominant language in Ghana), two languages that participants were proficient in at least one of them. The interviews, which were guided by interview guides (Knott et al., \u003cspan class=\"CitationRef\"\u003e2022\u003c/span\u003e), focused on DOVVSU’s support services and survivors’ help-seeking behavior. Data collection occurred where participants were comfortable and suitable for recording data, including their homes, parks, and DOVVSU offices through which the survivors were recruited. We collected data from the interviews by taking notes and audio-recording them after seeking permission from the participants (Karimi \u0026amp; Mozaffar, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eObtained data were analyzed using Creswell’s (\u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e) data analysis spiral, which includes five steps: data organization, data familiarization, development of themes and sub-themes, interpretation of data and definition, and data presentation. Data organization entailed transcribing the audio files and combining them with the notes taken during the interviews. After this, we read through the scripts to familiarize ourselves with the content of each transcript and create themes from them. The themes generated were compared to each other to assess their similarities and differences, a process that led to the emergence of major and minor themes. We then defined the themes and sub-themes presented in the current study and supported them with participant quotations (Ningi, \u003cspan class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical consideration\u003c/h3\u003e\n\u003cp\u003e The current study is developed from the corresponding author’s doctoral dissertation, in which he sought ethical clearance from the Ethics Board of Ankara Yildirim Beyazit University. Besides seeking ethical clearance, the researchers also observed participants’ informed consent, voluntary participation, anonymity and confidentiality, objectivity in reporting findings, avoiding plagiarism, and ensuring the study's trustworthiness. The researchers informed the clients about the nature of the study and any risk they could be exposed to by engaging in it before data collection. Additionally, the participants were given the prerogative to decide whether to participate in the study or not. This was stated clearly at every stage, from their recruitment to data collection. We have also ensured the participants’ anonymity and confidentiality by not attaching any information that could reveal their identity from the information obtained from them. We also emphasized presenting the study’s findings without any form of manipulation. Any existing idea used in the current study has been duly acknowledged to avoid plagiarism. Finally, we actively enhanced the study's trustworthiness by verifying information obtained from the two participant groups through triangulation, member-checking, and ensuring that our personal biases did not influence data collection and interpretation of the data.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eFindings\u003c/h2\u003e \u003cp\u003eThe current study sought to examine the factors behind DOVVSU’s limited support for DV survivors and factors that influence survivors’ decision not to seek formal support. The findings of the study revealed that while DOVVSU has been active in arresting and sanctioning perpetrators of abuse, there has been limited support for DV survivors. This was evident in the submissions of the DOVVSU administrators, explaining that while DOVVSU seeks to ensure justice for the survivors by prosecuting the perpetrators, the effort to provide the needed support for the survivors has been lagging, leading to inadequate services:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eYou know this place is called Domestic Violence and Victim Support Unit. The domestic violence aspect is there, as in the cases reported. But the support aspect is not there. Though the government and the police service is doing its best, it is not enough…I think they should remove the word ‘support’ in our name and just bring another word there\u003c/em\u003e (DOVVSU administrator).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003cp\u003eFindings from survivors confirm that they received limited support from DOVVSU. The limited support from DOVVSU for DV survivors is due to challenges the agency encounters, which has encumbered its ability to execute the support component of its mandate. The key challenges identified from the analyzed data emanate from DOVVSU and survivors’ situations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eFactors contributing to inadequate support for DV survivors\u003c/h2\u003e \u003cp\u003eSpecific factors related to DOVVSU’s setup and operations have inhibited the administrators’ ability to deliver support services for DV survivors. Although DOVVSU has support services for DV survivors, the administrators have not been able to deliver the services as planned. The challenges responsible for this incapacitation are resource constraints, poor facilities and associated discomfort for clients, limited collaboration between DOVVSU and other institutions, limited competence, and political interference.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eResource constraint\u003c/h2\u003e \u003cp\u003eWhile the DOVVSU administrators were committed to providing services for DV survivors, their effort was compromised by the inadequacy of the resources needed. As a result of the resource constraint, many administrators could not provide survivors’ physical, mental, and emotional needs. As captured below, DOVVSU administrators in many branches could not provide the psychosocial support survivors needed:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eOn the aspect of our clients’ emotional well-being, I will say we have not done much because of the limited resources. As I said, we should have had social workers who would work on emotional issues, but we do not have. So, we do our best. We are laymen in terms of addressing psychosocial needs. But based on our own experiences, we calm our clients down. That is not professional, but under the circumstances, that is how far we can go.\u003c/em\u003e (DOVVSU administrator).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003cp\u003eGiven the trauma and mental health issues associated with DV, psychosocial support is crucial to survivors’ recovery and mental well-being. However, with limited professionals such as psychologists and social workers in DOVVSU, survivors did not assess such service.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003ePoor facilities and associated discomfort for clients\u003c/h2\u003e \u003cp\u003eThe study found that DOVVSU branches were mostly located in poor building facilities and associated with sub-standard conditions. Such conditions hindered administrators from providing the support DV survivors needed. For instance, there was inadequate office space for handling DV cases and counseling sessions in a manner that upheld confidentiality, which discouraged survivors from sharing detailed information about their abusive experiences. In such instances, the environment was not congenial for effective service delivery. According to the administrators and survivors, the lack of space led to instances where multiple DVs cases were attended to in the same room, a situation which compromised survivors’ autonomy and the confidentiality of the cases:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e…It is a problem. Ideally, we should have had confidential rooms where I could tell my whole story without being worried about other people hearing the details. But there was no space for that. I did not feel safe and confident in such a situation. Initially I would leave and return later hoping the number of people in the office would reduce. The officer was nice. Sometimes he could say let’s go out and talk but that was not the best ... With the kind of abuse I suffered, I needed privacy to share my story but there was no privacy.\u003c/em\u003e (DV survivor).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003cp\u003eThe poor facilities at many DOVVSU branches caused discomfort for some survivors, which discouraged them from accessing support.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eLimited collaboration between DOVVSU and other institutions\u003c/h2\u003e \u003cp\u003eLimited collaboration between DOVVSU and other institutions whose work complement DOVVSU contributed to its limited ability to support DV survivors. As explained earlier, DOVVSU partners with other welfare agencies, including the Department of Social Welfare, to mobilize the resources required to serve its clients. However, the findings revealed that the administrators were sometimes incapacitated in helping DV survivors due to poor cooperation from such agencies. In such instances, the survivors were unable to access the support needed:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eI think social welfare, but they are not pulling their weight at all. In fact, I do not know their own problem, but whenever you need their help, it is not forthcoming. Maybe they have their own issues. But they should be picking up from where we leave off. Whiles we look at the criminal aspect of issues, they should be looking at the social aspect, and they see how they can help\u003c/em\u003e (DOVVSU administrators).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eLack of competent social support administrators\u003c/h2\u003e \u003cp\u003eThe findings show that limited competence exhibited by some DOVVSU administrators compromised optimal service provision to DV survivors. This was attributed to the limited competence of some administrators. Such limited competence was manifested in ways such as sheer lack of knowledge on the processes for engaging survivors, limited resourcefulness regarding brokering support, and lack of sensitivity for survivors. While such incompetence was demonstrated by few administrators, it led to ineffectiveness in improving the safety and well-being of DV survivors. The quote below buttresses participants’ view about some DOVVSU administrators’ incompetence:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e…Within DOVVSU itself, there is a lack of understanding of our mandate… There are many commanders who do not know the mandate of DOVVSU. They just interfere in your cases and things like that …Some officers will trivialize your case and ask you why you are worrying yourself so much… They are not abreast of the law, and they work on emotions\u003c/em\u003e (DOVVSU administrator).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003ePolitical interference\u003c/h2\u003e \u003cp\u003ePolitical interference also inhibited DOVVSU from providing support to DV survivors. In situations where political figures are affiliated with perpetrators of DV, they interfered in influencing decisions and actions taken. Such interference shielded abusers from prosecution and other penal measures and contributed to limited psychosocial support for survivors:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e... \u003cem\u003eAn ordinary political party organizer can just walk in and introduce himself and say he is interested in your case, which is not proper. How are you interested in the case? You are not an official of DOVVSU, but you just come here and try to throw your weight around. An assembly member will come and say, I want to intervene… If you do not give in, he will move to the next step. They keep moving up and up. And the structure of our system is centralized, based on rank. So your boss has a boss, and that boss also has a boss. So if they want to serve their interest, the best thing is to take the case from you, which they have the power to do\u003c/em\u003e (DOVVSU administrator).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003cp\u003eThe findings demonstrate challenges that inhibit DOVVSU from responding to DV and supporting survivors in coping with the health risks and associated trauma.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eFactors that encumber formal help seeking from DOVVSU\u003c/h2\u003e \u003cp\u003eSurvivors of DV did not seek formal intervention from DOVVSU due to financial burden, negative previous experience from seeking formal support, and religious constraints.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eFinancial burden\u003c/h2\u003e \u003cp\u003eThe findings revealed that women with DV experiences bore some financial burdens in seeking support from DOVVSU. According to participants, DV survivors were supposed to provide a medical report that verified their abuse. However, many survivors could not produce it because of the cost of carrying out a medical examination. This prevented such survivors from seeking help from DOVVSU and the administrators from exercising their responsibilities such as investigating reported abuse cases and offering survivors the needed support:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eI had to bear the cost of the medical examination needed for the medical report. If I was aware of such cost, I probably would not have gone to seek their help… I think the agency should pay for the medical examination bill. It is expensive for people like me… And they need the medical report to even start working on your case. I had to call people to get the money to pay\u003c/em\u003e (DV survivor).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003cp\u003eThis DOVVSU administrator reported that medical reports from hospitals were prerequisite for processing abuse cases, the absence of which presents as a setback in terms of showing evidence for any support for survivors.\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eThese vulnerable clients are expected to pay for their medical examination. You can tell some of them cannot pay. But we need the medical report to start the case… That has been a problem because sometimes we the personnel here at DOVVSU use our own resources to support, and how far can we do that? The hospital will demand for money before they endorse those medical examination forms, and it is a severe setback\u003c/em\u003e (DOVVSU administrator)\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003cp\u003eThis finding portrays the importance of funds as a prerequisite for seeking help from DOVVSU. It also explained a major limitation in DOVVSU’s operations for their inability to financially support DV survivors to secure medical reports.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eNegative previous experiences from seeking formal support\u003c/h2\u003e \u003cp\u003eThe findings show that some DV survivors had limited interest in seeking help from DOVVSU due to their dissatisfaction in previous encounters with administrators at the agency. Their unpleasant experiences included negative utterances from the administrators and limited support received. A former client of DOVVSU said:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eSome officials make you feel bad when you go there to report cases. They look at your appearance and pass some comments. It is like you invited the person to sexually abuse you…Many of the officials are extremely polite and professional, but few do not talk to you with respect and empathy…Already, I felt bad talking about the ordeal my own family member took me through, and I did not get the support I needed. I felt ashamed.\u003c/em\u003e (DV survivor).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eReligious constraints\u003c/h2\u003e \u003cp\u003eAnalyzed data showed that the practice of religion in Ghana influenced DV survivors’ willingness and ability to seek support from DOVVSU. While religion in itself has not condoned violence, some actions taken, and decisions made by religious leaders restricted survivors from reporting abuse cases and seeking help from DOVVSU. Although some DV survivors were willing to seek support from DOVVSU, their religious leaders discouraged them from taking such actions:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eThe second time he [ex-husband] beat me, I wanted to report it to DOVVSU, but my pastor talked me out of it, just like the first time. He promised he would talk to him. They kept saying that…things like “once you tell DOVVSU the public can know about it, and your family and our church will be disgraced”. They say things like that to discourage you. And when you don’t listen, it is as if you are disobeying your spiritual leaders. That is why I continued to live with him and suffer in silence. It took a lot of confidence for me to report him eventually\u003c/em\u003e (DV survivor).\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e \u003cp\u003eThe administrators also corroborated religious leaders’ inhibition of survivors’ help-seeking, citing instances where some religious leaders meddled in cases reported and compromised their adjudication and support provision for the survivors:\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion of findings","content":"\u003cp\u003eThis study examined the institutional and survivor-related factors that limit the provision and utilization of formal DV intervention services in Ghana, with a particular focus on DOVVSU.\u003c/p\u003e\u003ch2\u003eInstitutional gaps encumbering support\u003c/h2\u003e\u003cp\u003eThe findings reveal a significant gap between the legal and policy intent of Ghana’s DV framework and the practical realities of service delivery and help-seeking. The findings showed institutionally related factors that limit the provision of formal support services, including resource constraints, poor infrastructural facilities, limited collaboration between DOVVSU and other institutions, a lack of competent social support administrators, and political interference. In addition, survivor-related factors found include financial burden on survivors, negative previous experiences, and religious constraints.\u003c/p\u003e\u003cp\u003eGhana’s Domestic Violence Act (Act 732) was enacted to provide comprehensive protection for survivors of DV, including physical, sexual, psychological, and economic abuse. The Act mandates the state to ensure survivor protection, access to justice, medical care, psychosocial support, shelters, and rehabilitation, supported by the establishment of a Domestic Violence Fund (Republic of Ghana, \u003cspan class=\"CitationRef\"\u003e2007\u003c/span\u003e). In principle, the Act adopts a rights-based and survivor-centered approach, positioning DV as a public concern rather than a private family matter.\u003c/p\u003e\u003cp\u003eHowever, the findings of this study indicate that the support component of this legal mandate remains unavailable. While DOVVSU has been relatively effective in addressing the criminal justice dimension of DV, particularly arrest and prosecution, the support and recovery functions envisaged under Act 732 are largely unmet. Participants’ accounts of limited psychosocial care, lack of shelters, financial barriers to medical reporting, and poor inter-agency coordination suggest that the Domestic Violence Fund and allied support structures are either under-resourced or inadequately operationalized. This mirror concerns raised by other studies (Kaburi \u0026amp; Kaburi, \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e; Sedziafa \u0026amp; Tenkorang, \u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e) that argue that Ghana’s DV response framework is characterized by strong legal symbolism but weak institutional capacity. DOVVSU was established to provide integrated protection and support for survivors of DV, child abuse, and related offences. Its mandate extends beyond law enforcement to include counselling, referral, coordination with social welfare and health institutions, and survivor protection (Ghana Police Service, \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e). The present findings, however, demonstrate that DOVVSU’s operations are heavily skewed toward policing functions, with limited capacity to deliver survivor-centered support.\u003c/p\u003e\u003cp\u003eKey institutional barriers identified, including resource constraints, poor infrastructure, and lack of trained psychosocial professionals, significantly undermine DOVVSU’s ability to fulfil its support mandate. These findings are consistent with earlier studies documenting inadequate staffing, logistical deficits, and role ambiguity within DOVVSU (Anyemedu et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e; Kaburi \u0026amp; Kaburi, \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e). The reported absence of social workers and psychologists within DOVVSU offices is particularly concerning, given the complex trauma associated with DV and the centrality of psychosocial care to survivor recovery (Chu et al., \u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e). From an institutional theory perspective, these constraints reflect structural weaknesses within the broader social protection system, where legal mandates are not matched by sustained political commitment, funding, and professional capacity (Gottschalk \u0026amp; Hamerton, \u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e). As Sedziafa and Tenkorang (\u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e) argue, such conditions constitute a form of structural violence, whereby institutional failures systematically disadvantage survivors despite formal legal protections.\u003c/p\u003e\u003ch2\u003eInstitutional shortcomings discourage help seeking\u003c/h2\u003e\u003cp\u003eThe study further highlights how institutional shortcomings intersect with survivors' lived realities to discourage formal help-seeking. Financial barriers, particularly the cost of obtaining medical reports, emerged as a critical deterrent, contradicting the intent of Act 732, which envisages state-supported access to medical care for survivors. Similar findings have been reported in Ghana and other Sub-Saharan African contexts, where poverty and cost-sharing requirements limit access to justice and health services for survivors (Adu-Gyamfi, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e; Rohn \u0026amp; Tenkorang, \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAdditionally, negative prior experiences with DOVVSU, including perceived insensitivity, breaches of confidentiality, and inadequate support, further eroded survivors’ trust in formal institutions. These experiences align with the theory of legal cynicism, which suggests that repeated exposure to ineffective or disrespectful institutional responses reduces individuals’ willingness to engage with formal systems (Oliveira \u0026amp; Jackson, \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e). Survivors’ accounts of stigma and retaliation from family and community members also reinforce findings from previous studies indicating that DV reporting in Ghana often attracts social sanctions rather than support (Ajayi \u0026amp; Soyinka-Airewele, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e; Rohn \u0026amp; Tenkorang, \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eReligious norms and leadership emerged as significant factors shaping survivors’ help-seeking decisions. Although religion does not inherently condone violence, the current study revealed instances where religious leaders discouraged reporting to DOVVSU in favor of private reconciliation, framing formal reporting as shameful or spiritually inappropriate. This finding corroborates earlier research demonstrating how religious authority in Ghana can reinforce silence, endurance, and marital preservation at the expense of survivor safety (Sedziafa \u0026amp; Tenkorang, \u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e). From a socio-ecological perspective, these religious influences operate at the community and societal levels, interacting with institutional gaps to restrict survivors’ access to formal support. When combined with inadequate state protection, such pressures compel many survivors to remain in abusive relationships, exhibit non-help seeking behavior, or withdraw from legal processes altogether.\u003c/p\u003e\u003ch2\u003eImplications of study findings\u003c/h2\u003e\u003cp\u003eThe findings of this study resonate with feminist and structural theories of violence, which locate DV not only in individual relationships but within broader systems of gender inequality, institutional neglect, and power imbalances (Namy et al, \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e; Rose et al, \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e). The marginalization of survivor support within DOVVSU reflects entrenched prioritization of punitive justice over care-based interventions, a pattern observed in many low-resource settings (Husso et al., \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e). Additionally, help-seeking theory suggests that survivors are more likely to engage in formal services when they perceive them as accessible, trustworthy, and beneficial (Saint Arnault \u0026amp; Woo, \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e). The convergence of financial costs, poor service experiences, and socio-cultural discouragement identified in this study helps explain the persistently low utilization of formal DV services in Ghana, despite the existence of robust legal frameworks.\u003c/p\u003e\u003cp\u003eThe findings underscore the urgent need to realign Ghana’s DV response system with the original intent of Act 732. Strengthening DOVVSU’s support function requires sustained investment in infrastructure, professional staffing (particularly social workers and psychologists), enforcement of confidentiality standards, and effective activation of the Domestic Violence Fund. Improved inter-agency collaboration and protection from political interference are also critical to restoring survivor confidence in formal institutions. Without addressing these systemic issues, the gap between law and lived experience will persist, limiting the effectiveness of Ghana’s DV response and undermining survivors’ human rights.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOverall, the findings indicate that DV survivors in Ghana face systemic barriers that limit their ability to fully realize their human rights, despite the existence of protective legislation. Gaps in institutional capacity, resource allocation, and service coordination constrain survivors\u0026rsquo; access to protection, care, and effective remedies, leaving many unable to benefit from the rights guaranteed under national law. These shortcomings disproportionately affect economically and socially vulnerable women, reinforcing inequality and undermining substantive justice. The persistence of such barriers signals a broader state responsibility to move beyond legal recognition toward meaningful implementation, ensuring that DV responses uphold survivors\u0026rsquo; dignity, safety, and equal access to justice in practice.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe co-authors declare that they solely developed this manuscript and that they do not have any competing interests or conflicts of interest regarding the research from which this manuscript was developed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis manuscript was developed from data collected by the corresponding author in his doctoral dissertation research. Ethical approval was obtained from the Ethical Review Board of Ankara Yildirim Beyazit University (Study Number: 2021-256).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive support from any organization for the submitted work.\u003c/p\u003e\n\u003cp\u003eThe research project for which this manuscript was developed was self-funded by the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest Disclosure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the co-authors do not have any competing interests or conflicts of interest regarding the research from which this manuscript was developed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData based on which this manuscript was developed cannot be shared publicly because of sensitive information from a vulnerable population. However, components that can be shared will be made available upon request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAboagye, R.G., Seidu, A.A., Cadri, A., Salihu, T., Arthur-Holmes, F., Sam, S.T., et al. (2023). Ending violence against women: Help-seeking behaviour of women exposed to intimate partner violence in sub-Saharan Africa. \u003cem\u003ePLoS ONE 18\u003c/em\u003e(10): e0291913.\u003c/li\u003e\n \u003cli\u003eAdu-Gyamfi, E. (2014). Challenges undermining domestic violence victims\u0026apos; access to justice in Mampong municipality of Ghana. \u003cem\u003eJL Pol\u0026apos;y and Globalization, 27\u003c/em\u003e, 75.\u003c/li\u003e\n \u003cli\u003eAjayi, L. A., \u0026amp; Soyinka-Airewele, P. (2018). 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A qualitative study of phenomenology of perspectives of student nurses: experience of death in clinical practice. \u003cem\u003eBMC Nursing, 21\u003c/em\u003e(1), 74. https://doi.org/10.1186/s12912-022-00846-w\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-human-rights-and-social-work","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jhrw","sideBox":"Learn more about [Journal of Human Rights and Social Work](http://link.springer.com/journal/41134)","snPcode":"41134","submissionUrl":"https://submission.springernature.com/new-submission/41134/3","title":"Journal of Human Rights and Social Work","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Domestic violence, DOVVSU, formal intervention, Ghana, help-seeking","lastPublishedDoi":"10.21203/rs.3.rs-9176582/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9176582/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eFormal institutional responses are critical for protecting the rights and wellbeing of women survivors of domestic violence. In Ghana, the Domestic Violence Act, 2007 (Act 732) mandates comprehensive protection and support for survivors, with the Domestic Violence and Victims Support Unit (DOVVSU) serving as the primary state agency responsible for implementation. However, evidence suggests that the utilization and effectiveness of formal domestic violence support services remain limited. This study explored the factors that constrain DOVVSU\u0026rsquo;s ability to provide support interventions and the factors that influence women survivors\u0026rsquo; decisions not to seek formal assistance. Using a qualitative phenomenological design, data were collected from 10 domestic violence survivors and 10 DOVVSU administrators in the Accra Metropolitan Assembly through interviews. Thematic analysis revealed that while DOVVSU is active in prosecuting perpetrators, the support component of its mandate is significantly undermined by resource constraints, poor infrastructure, limited inter-agency collaboration, inadequate professional capacity, and political interference. Financial burdens, negative prior experiences with formal services, and religious pressures further constrained survivors\u0026rsquo; help-seeking. The findings highlight a critical gap between Ghana\u0026rsquo;s legal commitments and survivors\u0026rsquo; lived realities, with significant human rights implications.\u003c/p\u003e","manuscriptTitle":"Critical Analysis of Domestic Violence Survivors' Support in Ghana: Exploring the Challenges Associated with Providing Formal Intervention for Women","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-05 08:35:00","doi":"10.21203/rs.3.rs-9176582/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-08T08:06:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"284111521580236578026702464040221135770","date":"2026-04-24T07:40:19+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-24T07:20:34+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-30T03:26:47+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-30T03:26:18+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Human Rights and Social Work","date":"2026-03-20T08:04:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-human-rights-and-social-work","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jhrw","sideBox":"Learn more about [Journal of Human Rights and Social Work](http://link.springer.com/journal/41134)","snPcode":"41134","submissionUrl":"https://submission.springernature.com/new-submission/41134/3","title":"Journal of Human Rights and Social Work","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"f2b597a4-190b-4f1e-9369-f3edd9f78924","owner":[],"postedDate":"May 5th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-08T08:06:36+00:00","index":14,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-05T08:35:00+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-05 08:35:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9176582","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9176582","identity":"rs-9176582","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}