Institutional environment and willingness to report gender-based violence among Kenyan medical training college students

Abstract

The institutional context shapes students' views on the safety, confidentiality, fairness and value of reporting gender-based violence (GBV). Drawing on the Ecological Model of violence and Institutional Betrayal Theory, this study examined how the institutional environment can impact on the willingness to report serious GBV among students of the Kenya Medical Training College (KMTC) where systemic barriers and hierarchical structures can make it difficult to report formally. The study was conducted by using an analytical cross section research design with the pre-service students of health training as the research population. The respondents were 478 people who were sampled by multistage sampling techniques (stratified and systematic random sampling). The main data collection tool was a structured questionnaire that was anonymous and online, with qualitative triangulation questions. The quantitative data were analysed using descriptive and inferential statistics and qualitative data were analysed using a thematic approach. The results showed that 87.9% of the students surveyed were willing to report serious GBV to authorities. Bivariate analysis showed that policy awareness (χ² = 106.84, p < .001), reporting mechanisms (χ² = 82.73, p < .001), institutional trust (χ² = 123.45, p < .001), physical campus safety (χ² = 34.43, p < .001), support-service availability (χ² = 8.07, p = .045), and GBV prevention campaigns (χ² = 5.45, p = .020) were significantly associated with willingness to report. After multivariate logistic regression, institutional trust (aOR = 17.60, p < .001) and policy awareness (aOR = 11.55, p = .008) were the only two factors that remained significant. Qualitative results confirmed requests for independent tribunals and revealed concerns for potential for retaliation and confidentiality breaches by lecturers. This study finds that attitudes towards reporting GBV are not only related to the availability of reporting channels, but also to the institutional trust and the perceived fairness. These findings highlight the need for survivor-focused institutional approaches that include the use of independent disciplinary systems, anonymous online reporting mechanisms, bi-annual climate assessments, and Crime Prevention Through Environmental Design (CPTED) principles for a safe campus.