Gender-Based Violence in Higher Education: An Integrative Review

Background: The phenomenon of gender-based violence is a global phenomenon that affects women negatively, including those in higher education. The scourge of gender-based violence has been highlighted in numerous studies and statistics have shown that instead of decreasing, the incidence the-reof is rising. Aim: To critically analyse research that has been conducted to understand the phenomenon of gender-based violence in higher education. Methodology: The revised integrative review protocol of Whittemore and Knafl was employed in the analysis. A comprehensive search was undertaken for gender-based violence in higher education research conducted and published between 2010 and 2021. Literature indexes in CINAHL, Medline, Pro-quest and Pubmed were searched. Search terms were gender-based, violence, and higher education. The integrative approach was used to conduct the methodological review. A sample of 12 research articles and reports that met the inclusion criteria were analysed. A systematic iterative method was employed to extract and reduce the data in order to draw conclusions. Results: Factors leading to gender-based violence, its effects on the victim and methods to eliminate its occurrence were revealed by the analysis. Conclusion: Becoming aware of factors contributing to gender-based violence and strategies to address this scourge can minimise the occurrence of gender-based violence in higher education institutions. Contribution: Understanding the concepts and strategies to prevent the occurrence of gender-based violence can assist higher education institutions to minimise these incidences.

gender (Kibriya, Tkach, Ahn et al., 2016). Gordon and Collins (2013) define GBV as violence towards minority groups, individuals and/or communities solely based on their gender. This can directly or indirectly result in psychological, physical and sexual traumas, injury, as well as deprivation of their rights as a human being (Gordon & Collins, 2013).
GBV can occur throughout a woman's lifespan, with many reporting their first exposure occurring during childhood or adolescence (Walsh et al., 2015). Globally, it has been incorporated into different types, such as civil and criminal codes (Joseph, 2015;Walsh et al., 2015). The issue of GBV has been in existence for a long period and was detected in different socio-cultural and geographic areas (Joseph, 2015). In 1993, the global conference on human rights held in Vienna highlighted concerns of issues regarding female's lives, psychological integrity, physical bodies and liberty (Junko & Atsuko, 2018). Furthermore, other similar conferences also recognised GBV as an obstacle to the achievement of equity, development and peace (Mahlori, Byrne, & Mabude, 2018;Makhubele, Malesa, & Shika, 2018). GBV is a worldwide major public health issue with detrimental effects on the health of women (Maquibar, Hurtig, Vives-Cases, & Estalella, 2018). According to McCloskey (2016), the term "gender-based violence" (GBV) applies to the sexual or physical abuse of groups targeted, because of their gender or gender roles and their relegation to a lower position of social status or power.
Studies have shown that in South Africa, it is estimated that one in four women are abused by their partners and a higher proportion of women are murdered by their partners than anywhere else in the world (Gordon & Collins, 2013). In a study by Shefer, Clowese and Vergnani (2012) among university students in South Africa, it was found that females engaged in transactional sexual relationships that were characterised by violence with elderly men. Collins, Loots, Meyiwa and Mistrey (2009) argued that the prevalence of the problems tends to be dramatically underestimated and incorrectly identified by authorities. Secondly, many victims do not access support services. Lastly, prospective and repeat perpetrators come to believe that they can operate with impunity, and that their acts are neither deeply antisocial nor criminal, but rather only mildly transgressive matters of individual preference that will not result in any serious repercussions.
Under-reporting of GBV remains a challenge. South Africa has one of the March 2020, when the South African government introduced one of the world's longest and strictest lockdowns in response to the first detected cases of coronavirus, the devastating impact of lockdown on the already severe GBV issue was exposed. The Government's GBV and Femicide Command Centre, a call centre to support victims of GBV, recorded more than 120,000 victims in the first three weeks of the lockdown (Statistics SA, 2021). Systemic gender inequality in the contemporary society has disempowered women and this led to stifling their voices so that they are not heard (Enaifoghe, Dlelana, Durokifa, & Dlamini, 2021).

Problem Identification
The problem identification stage involves defining the problem that the review is focusing on and outlining the purpose of the review (Whittemore & Knalf, 2005). The focus of this integrative review was to provide information on what populations have been studied, to identify contributing factors to GBV, to discover the characteristics of the woman prone to GBV, to determine the effects of GBV and to establish strategies that would help to empower women in higher education. The researcher's interest and focus were brought about by the fact that largely there appeared to be widespread reporting on domestic GBV, with an apparent dearth in studies done on the topic in higher education institutions.
Having observed that GBV also occur in institutions of higher learning the researcher decided to undertake an integrative review of existing studies that focused on this phenomenon.
The following research questions guided this review: 1) What is gender-based violence (GBV)?
2) What factors contribute to GBV in higher education?
3) What are the effects of GBV on the victim?
What strategies could be used to deal with GBV in higher education?

Purpose of This Paper
The aim was to obtain an understanding of factors causing gender-based violence (GBV), its effect and strategies that can be used to empower women in higher education. This integrative review synthesises current GBV research in higher education and identifies gaps in the literature that need further and future research.

Research Design and Methods
An integrated review of existing literature on GBV in higher education was undertaken. The literature was searched for studies focused on the notion utilising a methodical review based on the integrated methodology of Whittemore and Knafl (2005). This method allowed papers with a variety of study designs, such  Whittemore and Knafl (2005) developed a five-stage framework, namely issue identification, literature search, data evaluation, data analysis and presentation. This integrative approach was used to analyse and summarise studies on GBV with the focus in higher education.

Data Search Stage
The search for literature was the second part of the review process, which detailed the tactics utilised to gather relevant material on the topic of interest (Whittemore & Knalf, 2005). To ensure that articles published at the end of 2020 were included, the data search (gathering) stage was completed in 2020 and completed in the first two weeks of January 2021. During this stage, searches were conducted using the following electronic databases: 1) Cumulative Index to Nursing and Allied Health Literature (CINAHL); 2) Medline; 3) EBSCO host; and 4) Proquest. Key search terms were GBV and higher education. Publications were included if the topic addressed GBV in higher education, participants in the studies were university students, the design was either qualitative or quantitative, the language was English and the date of publication was between January 2013 and January 2021. The goal of focusing on research published after January 2013 was to examine the literature that best represented: 1) the current GBV challenges experienced by women in higher education; 2) physical and psychological elements; and 3) measures employed to empower women. Publications were eliminated if they were unpublished (dissertations and theses), written in a language other than English, participants were not higher education students and they were not empirical research studies (discussion and review papers). After deleting duplicates, the search revealed ( Figure 1) 400 items, of which 325 remained. Thirty of the 75 articles did not match the inclusion requirements because the topic was unclear.  The remaining 45 publications were thoroughly examined, either by reading the abstract or the entire article and 33 were deemed to be ineligible for inclusion and 12 articles were analysed.

Data Search Prisma
The data that was excluded involved articles that discussed GBV generally. The data did not provide information that answered the questions asked and, therefore, would not provide the information that was sought. Secondly, if the outcomes did not outline information that would yield strategies on how GBV can be eliminated and empower women.

Data Evaluation Stage
The data evaluation stage encompassed assessing the quality of primary sources using a methodical approach that includes the application of quality criteria appraisal tools (Whittemore & Knalf, 2005). For this review, the author worked independently to check the titles and abstracts, then went on to study thoroughly each of the papers to ensure accuracy of data evaluation. In-depth reviewing of publications meeting the inclusion criteria was undertaken. The seven articles were then evaluated for quality using either a quantitative or qualitative critical appraisal tool (Law, Stewart, Pollock et al., 1998;Letts, Wilkins, Law et al., 2007).
Review criteria for quantitative studies included study purpose, design, sample size, outcomes, interventions, results, conclusions and implications. Review criteria for qualitative studies included study purpose, qualitative design, sampling framework, data collection methods and data analysis. The aim of this integrative review was done following a set criterion in order to summarize past empirical and theoretical literature, discover patterns for observed patterns and provide a more comprehensive understanding of phenomenon of GBV, especially in higher education institutions. Additionally, the intention was to make a case for further investigation and research, highlighting gaps in knowledge and asking questions that need to be answered for the betterment of the approaches to addressing GBV.
The appraised papers were separately examined by a co-worker to enhance the trustworthiness of the review. Thereafter, the researcher and coder met several times to examine the critical appraisal forms and assist with the critique and summarising each article. Concerns relating to the critical appraisal review were explored until an agreement was reached, when there were any misunderstandings.
Additionally, each study was ranked on the level of evidence using a 7-level scale ranging from Level 1 (systematic review or meta-analysis of randomised Policy on men and gender equality must: promote human rights; including the rights of women and girls; remain accountable to and in dialogue with women's rights movements and organisations; scaling up school-based; gender equality curricula including discussions of GBV; engaging men via women's economic empowerment.

Data Analysis Stage
Data from primary sources were organised, classified and summarised during the data analysis process to form an integrated conclusion regarding the research problem under investigation (Whittemore & Knalf, 2005). In this review, a matrix was created that detailed the population being examined, the GBV contributing variables, the characteristics of women who are vulnerable to GBV and women's empowerment strategies. The matrix was then filled with content collected from the articles. The data was then organised and classified utilising a constant comparative method to integrate and analyse the results. The contributing factors were found to be cultural, for example gender stereotyping and the power men still have over women, lack of economic strength and poverty which makes women vulnerable, political factor in that there are fewer opportunities and reluctance to discuss GBV and effect changes in policy, or to adopt measures to combat gender-based violence and support equality and lastly legal factors whereby gender-based violence is perceived in many societies as shameful and involving weak women, with many victims still being considered guilty of attracting violence against themselves through their behaviour.

Review Presentation
Data presentation was the last step in the integrative review process. Researchers offer readers specific details from each of the main sources in order to demon-  (Whittemore & Knalf, 2005).
The following subheadings were used to organise the articles in this review, namely author, date of publication, country, study design and findings ( Table 2). The findings of each study were combined to produce a comprehensive summary of what is known about GBV in higher education and how to prevent it.

Research Populations and Samples
The population in the reviewed studies included largely female participants. The larger number were students and female academics, who were recruited from universities and colleges.

Physical
Acute repercussions of GBV accidents include bruising, broken bones, brain Furthermore, physical abuse has not only psychological but also bodily consequences that include severe injuries that may result in death. Physically abused women are more likely to have high blood pressure, fear of proximity, suicide, alcoholism, drug misuse and low self-esteem, according to the findings of new research (Mahlori et al., 2018).
Psychological GBV victims have higher levels of anxiety, despair, low self-esteem, feelings of hopelessness and post-traumatic stress symptoms. The psychological and health consequences of GBV exposure can be translated into monetary expenses for the individuals involved, as well as for societies. Women who have been physically assaulted are more likely to have social isolation, post-traumatic stress disorder PSTD, panic attacks, sleeping difficulties and eating disorders. In a study by Gordon and Collins (2013), it was found that a culture of fear was created among women and was promoted by the unwillingness of authorities to respond adequately to GBV in South Africa.

Other effects
Victims also missed lectures, dropped a course, switched lecturers or supervisors and filed a disciplinary complaint, among other things. Missing work, reporting the incident to a line manager and filing a disciplinary complaint or grievance were among the effects presented by employees.

How to Prevent GBV
Building gender equality and addressing general acceptance of violence are two specific techniques that might be implemented (Gevers, Jama-Shai, & Sikweyiya, 2013). Davids (2020) contends that a comprehensive framework for the prevention of GBV is required. Higher education institutions are supposed to have policies on sexual harassment and related topics with no exceptions. Institutions are hesitant to approach GBV for fear of jeopardising their reputation. The GBV prevention framework should make a point of identifying contextual norms, structures and cultures that reinforce gender bias and discrimination.
According to Richards and Kafonek (2017), prevention programmes that are comprehensive, theory-driven, encourage positive relationships, are socio-culturally relevant, use varied teaching methods, are delivered in sufficient dosage, are well-timed, with well-trained staff and include the needed outcome evaluation.
The notion is that the institutional GBV programme should be led by campus safety officers. Additionally, preventative programmes should identify and target students and personnel who are in need or in danger (Richards & Kafonek, 2017). According to Joseph (2015), the efficiency of GBV regulations is determined by how well they are implemented by colleges and universities. Academics, campus management, personnel and students must all buy into prevention programmes. Campus-wide campaigns must provide a clear message about GBV's intolerance, the consequences for students who break related behaviour standards and the support and services available to victims.

Discussion
Establishment Males have been placed at the centre of decision-making, leadership and the occupation of political and productive arenas due to patriarchy (Akala & Divala, 2016). Women's voices are muffled by the attitudes of those in positions of authority and the victim-blaming culture. The Government should increase the authority of the legal system so that it can deal appropriately with cases of domestic violence by enacting or enforcing laws that safeguard the rights of abused partners. The programmes should also encourage the abused party to disclose the abuse and seek assistance in order to put an end to it (Makhubele et al., 2018). Creating or enhancing institutional systems that allow women to report incidents of violence against them in a secure and confidential setting, without fear of punishment or retaliation, is more important than ever. It is critical that the Government construct, refine, develop and fund training programmes for judicial, legal and medical reasons and to sensitise police officials about the nature of GBV and ensure that victims are treated fairly (DoHET, 2019; RAPSSA, 2017).

One strategic objective of DoHET (Department of Highers Education and
Training] is to improve the safety of students and staff in higher education in-  (Todorova, 2018). Collins et al. (2009) argued that there is an urgent need for efficient, accessible and trusted 24-hour crisis response services that have a single contact point known to all staff and students that should mobilise the appropriate psychological, medical, forensic, social and security support without placing any additional stress on the victim. Social spaces should discourage activities like the consumption of alcohol and drugs, provision of platforms to role models who embody misogynistic, sexist and racist; attitudes and events (corporate alcohol branding events) that predispose to violent, hateful and harmful behaviour (Collins et al., 2009). Peacock and Barker (2014) are of the view that men need to be involved in the drive to address GBV. However, engaging men for gender equality should not detract from efforts to empower women and is supportive of and furthers progress toward strengthening the commitment of national justice systems to end GBV.

Recommendations
This integrative review provides vital information about the concept of gender-based violence (GBV). Becoming aware of contributing factors to GBV in institutions of higher education, incorporating its causes and effects on the victim and how it can be prevented. Prevention of GBV requires the will from all stakeholders to eliminate this scourge actively and collaboratively from society.
Addressing GBV is a complex issue requiring multi-faceted responses and commitment from all stakeholders, including government and civil society. Violence

Limitations
There were several methodological limitations to the study. Some studies did not provide detailed information about the sample characteristics. There is limited national data that exists and documentation of the extent of GBV on campuses.
The few studies that have been undertaken are also specific to universities (and often particular faculties) and focus almost exclusively on students' experiences of sexual harassment and rape. There is a paucity of studies undertaken in higher education institutions in South Africa.

Conflicts of Interest
The author declares no conflict of interest.