Community perceptions of causes of violence against young women in Botswana: fuzzy cognitive mapping

Violence against young women is a problem worldwide. Understanding its causes in a particular setting can inform context-specific interventions. We used Fuzzy cognitive mapping (FCM), a visual method for collating local knowledge about causes of health outcomes, to explore community views of factors that cause or prevent violence against young women in rural communities in southeast Botswana. In three communities, groups of young men, young women, older men, and older women built maps (68 participants and 12 maps in total) of factors they believed increased or decreased the risk of violence against young women. Trained local facilitators guided group sessions, drawing the reported factors as nodes linked by weighted arrows indicating the direction and strength of causal relationships among factors. Fuzzy transitive closure calculated the influence of each factor on others, considering direct and indirect connections. We combined maps by groups of stakeholders and condensed individual factors into categories which emerged from an inductive thematic analysis. The categories labelled conflict in relationships and parenting and family issues had the strongest influences on increasing violence across all maps. These categories were also common intermediaries between other causal categories and violence. The categories labelled women being disrespectful or uncooperative and transactional and intergenerational sex were the third and fourth strongest risk categories overall. Prominent protective concepts included a stronger legal framework and strengthening the role of local traditional leadership, with greater prominence on the maps of older participants. The most influential risk and protective categories were consistent across young men, young women, older men, and older women. FCM was feasible and acceptable with different stakeholders in Botswana. Fuzzy cognitive maps can inform community discussions, for example, of conflictive gender norms, family dynamics or healthier relationships, and are useful to build theories on how to act on the causes of violence against young women.