Journal of Forensic Psychology

Impact of Domestic Violence, Endogamy and Divorce on Women’s Health Before and After COVID-19

¹Department of Sociology, Landmark University, Omu-Aran, Nigeria
Department of Agricultural Economics, Landmark University, Omu- Aran, Nigeria
²Department of Crop and Soil Sciences, Landmark University, Omu-Aran, Nigeria
³Department of Agricultural Extension and Rural Development, Landmark University, Omu-Aran, Nigeria
⁴Department of Computer Science, Landmark University, Omu-Aran, Nigeria
⁵Department of Animal Science, Landmark University, Omu-Aran, Nigeria
^*Correspondence: Abigail Affiong Mkperedem, Department of Sociology, Landmark University, Omu-Aran, Nigeria, Email:

Received: 14-Jul-2022, Manuscript No. JFPY-22-17454; Editor assigned: 18-Jul-2022, Pre QC No. JFPY-22-17454(PQ); Reviewed: 09-Aug-2022, QC No. JFPY-22-17454; Revised: 17-Aug-2022, Manuscript No. JFPY-22-17454(R); Published: 24-Aug-2022, DOI: 10.35248/2475-319X.22.7.237

Introduction

Marriage is a universal institution considered to having sacred, ethical and social importance in the society. Dating back to the first man and woman in history, making it a respected entity greatly protected by diverse religious body, culture, laws, norms, as well as social values. In Nigeria, the protection of the sacredness of this institution is contained in the African Charter on Human and People’s Rights (Ratification and Enforcement) Act, Section 18, CAP A9, of the 2004 Laws of the Federation of Nigeria. Divorce is also contained in the Laws of the Federation of Nigeria as the annulment of an existing nuptial relationship exclusively by legal means and allowable for few special reasons which are approved accurately in the bylaw and have to be proven before the court by the party requesting the termination.

While the focal point of any marital union is happiness and bliss like the fairies, some persons soon realizes that marriage could become the worst nightmare of their existence. For most individuals, the defense of matrimony by traditions and religious conviction creates an eternal trap with no escape route. In some cultural practices in Northern Nigeria, the females have no say on their marital choice due to the long standing cultural practice involving forced/child marriages and betrothal at birth. Either by choice or by force, once a marriage has been contracted, the annulment of such union is considered a taboo. The utter opposition of marital annulment by every single grouping in a society produces an unjust dual standard of rejection and religious lack of interest of the female gender; For instance, the edict opposing bigamy which is a common happening with the male gender, as well as religious devotees has in no way been invoked; as well as the approval for men to keep mistresses in the customary Nigerian tradition is acknowledged by both male and female gender alike, but the opposite of this nuptial values are put in place for Nigerian women.

Prior to the emergence of COVID-19 as a public health emergency of global significance, violence was a common experience for most Nigerian women in domestic setting, with 243 million women and girls suffering abuse from an intimate partner globally [1-3]. A woman’s resolution to divorce her husband is not taken calmly as the cost of annulment is more brutal for women, making such a woman feel trapped amid the deep sea and the ocean where choosing between enduring a miserable or violent union or face the shame and stigmatization that awaits her becomes the dilemma. Serkalem found that social relationships of divorced women with their relatives and friends are impacted upon by their divorce status [4]. Similarly, Igbinovia noted that the reality of marriage termination is psychologically and mentally demoralizing to women particularly as they mostly put in everything in their lives into the marriage [5].

Before COVID-19, many women could escape the clutch of a failing marriage due to the man’s absence from home through work, friends and family visits or any other societal activities. Now, with the lockdown, women in abusive relationship not only have to face then COVID-19 pandemic but also the indirect consequences of living within arm’s reach with their abusers due to the COVID-19 lockdown.

With the rate of violence against women in intimate relationships escalating during this pandemic, Nigeria needs to support women’s marital partners as well as separation choices [6]. Also appropriate communication strategies, economic, social and healthcare support should be provided to women in divorce stages.

While, statutory marriage is a willingly completed contractual union involving a man and a woman, thus monogamy devoid of exceptions and proposed for eternity, yet inability to give birth or unintentional infertility topped the reasons noted by Osiki, Salami and Bakare for marriage instability, given the cultural expectation associated with marriage in the typical Nigerian perspective. Similarly, Okunola reported that child bearing is the main concern for a married African man, as a baby is thought of to be influential to the establishment of a durable relationship. Mgbodile reported that entering into marriage expecting an infinite celebratory is a demand to encounter the frustration of a youngster who dreams of an infinite flow of ice creams. This made Hornby, Mirror to define divorce as the lawful termination of nuptials or the absolute fall apart or ending of matrimony through authorized way [7-12].

Although the Nigerian constitutional enactment is such that encourages freedom, unfortunately, cultural and religious differences make this practice unworkable. Nigeria has over 250 ethnic groups. Each ethnic group has a different cultural and religious practice which impacts upon individuals’ choice of marriage partners. While endogamy refers to the system of marriage within one’s own tribe, religion, or social class, religion refers to a particular system of faith and worship. Among the Nigerian society, mixed marriages have been problematic in many relationships. Therefore, the central purpose of this paper is to look at how socially constructed endogamous marriage, domestic violence and divorce impacts upon the Nigerian woman’s health.

Literature Review

In Nigeria, the degree of divorce and separation has been reported to have risen following the advent of schooling and urbanization, however, White and Booth discovered the proportion of marriage annulment above a four-year period was considerably high for individuals who remarry compared to first time married partners, making education and urbanization a rather not too sufficient motivation for marriage dissolution. In a similar observation, almost 32 percentages of spouses would split-up before the wedding reaches five years and almost 63 percentages before ten years wedding anniversary, Martin and Bumpass; National Centre for Health Statistics [13-16].

Diverse scholars deduced that there is a connection between religious exercises and marriage instability. For example, while, Isiugo-Abanihe, Tilson and Larsen discovered in their research that Muslim marriages were more stable compare to Christian ones; Brandson noted that, in the Nigerian society, the opposite was the case, making cultural factors such as religion, ethnicity, family and inability to bear a child factors influencing the dissolution of marriages. Mbiti corroborated by positing that upon the death of a woman, she will basically be forgotten as no one relative of hers will commit to memory her existence. This reveals the societal recognized tag on a marital union is dependent on child bearing. A divorce study conducted in Ethiopia discovered that 95 percent of wives who failed to give birth in their first marriage end up divorcing within twenty years, while 85 percent divorce within the first five years [17-20].

The labeling texts expound that societies construct set of laws for controlling behaviours; as the attribution of behaviours to either be compliant or abnormal is culturally determined. Becker stated that deviance is created by social groups existing within a society, and the violation or deviation from these set rules leads to the ascription of the deviant tag. Durkheim also noted that deviance is an action which negates the society’s acceptable shared beliefs by any member resulting in the deviant being punished. The ethnic and cultural background of spouses has an effect on the stability of the marriage and the instability. Historically, for example, endogamy had a good impact on matrimonial permanence, being that endogamous unions are firmly rooted in the social relations and established bylaws present in the society, making annulment a less likely event, however, what makes exogamy sociologically relevant lies in its dynamic nature currently breaking through the boundaries of culture and socioeconomic standard [21-24].

In all societies there are set of laws used in controlling people’s behaviours. The implementation of these bylaws allows for some behaviours which neglates the social accepted way of life to be defined as abnormal or deviance. Scholars in the area of deviance such as Beckerand Hagan assumes the “deviant” tag is an attribution to an individual by another who considers the behavior of the former to be different from the societal way of life; simply phrased “deviance, like beauty, is in the eyes of the beholder”, This entails that behaviours are labeled deviant simply when a different individual identifies it to be abnormal. According to Becker and Lemert, the labeling tag is officially endorsed through agents of social control and unofficially through the interactions between community members who follow communal set of laws. Advocates of labeling theory have thrown more lights on the harmful effects of labeling an individual; thus, the necessity to look into how divorcees are labeled deviant members of the society [25-31].

Previous studies on dissolution of marriage in focused on the impacts of separation on the academic performance of the children. Similarly, Adegoke, Maciver and Dimkpa dwelt on determinants of separation but little emphasis is drawn to the role of endogamous indoctrination on marital sustainability in the millennial. As Amato, Fomby, Cherlin, Opara observed that divorce is consequential for family organization, having varied repercussion for both adults and children. Therefore, this paper thus seeks to explore the social construction of marriage and divorce by religion and culture [31-38].

Nigerian law and the marriage culture

In Nigeria, a unique legal heterogenecity characterizes the rule governing marriage and divorce. There is the statutory law founded upon the Western policies, imbibed with little changes from the colonialist; and the customary law, greatly made up of by the diverse local traditional bylaws existing in the various Nigerian communities. In the Northern part of the country, Islamic or Sharia law which theoretically represents a different aspect of the law is being upheld, but practically, the Sharia law is greatly influence by the customary laws, thus, making the boundary between these two (statutory and customary) systems unclear. However, these marriage laws represent significantly, the diverse traditions and religious principles which barely agree. The relatives of the couples barely identify with a union that does not have the traditional norms as a legitimate marriage.

Issues emerge during marriage annulment, due to the differences in requirements under customary and statutory law. Repeatedly, it has been assumed that the present marriage and divorce statues governing monogamy makes it superior to customary polygamous marriages. A number of scholars proposed for an incorporation of these marriage systems as a way to resolve their inconsistencies. Authors like the then legal draftsman of the State noted that while it is our duty to safeguard our cultural norms as we attempt building the Nigerian nation; where a specific norm is inacceptable to the general public, it is the responsibility of the state to reform it [39]. Although, the promotion of the matrimonial causes act in 1970 allowed for the common law/legal unions, Islamic/Maliki marriages, and customary/traditional marriages to coexist alongside each other, it is now very essential and necessary to reform the laws governing conjugal ties in the country as the common law of marriage in Nigeria came as a result of colonial invasion from the British.

Lord Penzance also noted in Hyde V. Hyde LR.I PD, 130 that marriage is “the voluntary union for life between one man and one woman to the exclusion of all others” [40]. Under the law, marriage is normally regarded as a civil agreement usually written, emotionally and financially binding to both partners, with the conditions for annulment explicitly stated in the law. Whether or not conjugal relationships are for eternity as declared by Lord Penzance remains a debatable subject nevertheless, the Matrimonial Causes Act (MCA) produced a casement into equality opportunity as opposed to being ensnared in a psychological and or physically abusive marriage for Nigerian women. Although, it contains a common rule forbidding divorce proceedings from occurring within the first two years of the marriage contract without permission from the court, except on the basis that the union has broken down irrevocably. This policy deliberately makes annulment procedure burdensome in order to discourage divorce in the society.

A family can be likened to be a mirror image of systems theory, in which every member is a subject affecting the behavioral disposition of one another. Although, interdependent on each other for survival, every member still possess some degree of independence [41]. This explained marriage in the Nigerian traditional setting as a result of negotiations, a relationship between a man and a woman including their kinsmen, entailing, apart from the wedding ceremonial activities, the transfer of property from the man to the woman’s family. Making customary unions a concluded pact between the families of the couples rather than between the partners themselves and the permission of the parties, particularly the woman, to the relationship is not necessary [42].

Gender based violence and COVID-19 lockdown

In a study conducted by Afifi, Al-Muhaideb, Hadish, Ismail, and Al-Qeamy on impact of domestic violence on married women’s health in Eastern Saudi Arabia [43]. The lifetime domestic violence prevalence was 39.3 percent, 35.9 percent, 17.9 percent and 6.9 percent were emotionally, physically and sexually violated. Prior to the interview, a lower rate (32.7 percent) of recent abuse was recorded; 29.1 percent, 22.8 percent and 11.8 percent of women were mentally, physically and sexually abused. Women who were beaten and kicked in the abdomen during pregnancy stood at eleven and seven percentages. Perceived awful health, disease, abortion, hemorrhage, and body mass index in women were perceived to be essentially a result of continuous violence in the study. The odds of feeling dizzy (OR=1.93), vaginal bleeding (OR=1.83), movement and activity problems, pain, drugs intake (OR=1.95), and stress were some of the latest violence that amplified women’s visitation to medical professionals. 41.4 percent of the women put up with the abuses without speaking up or seeking help.

Similarly, adverse materno-fetal outcomes were considered the result of physical violence experienced by 21 percent pregnant women in a study carried out by Rachana, Suraiya, Hisham, Abdulaziz, and Hai [44]. Further, Tashkandi, and Rasheed found that 57.7% of women attending the Primary Health Care Centers (PHCCs) in Madinah have been married and has experienced abused. While, 32.8 percent were emotionally abused, one quarter suffered physical abuse. Of these women, only 36.7 percent had informed, or discussed the issue with their primary care physician [45].

Prior to the advent of COVID-19, four and 12 percent of pregnant women were reported to have been beaten during pregnancy in most World Health Organization’s Multi-county study locations, with Saudi and Nigeria recording a 21 and 63.2 percent higher incidences of domestic violence among pregnant women (Gyuse, Ushie, Etukidem; Rachana, Suraiya, Hisham, Abdulaziz, & Hai). Domestic violence is now regarded not just as a significant public health issue affecting victims (women’s) health but a breach of fundamental human rights [46-48].

In addition to increasing the odds of suffering pain, stress, dizziness, drugs intake; Bonomi, Anderson, Rivara, and Thompson found health care utilization (emergency department, pharmacy, and specialty care) was associated with women experiencing physical and nonphysical intimate partner violence. These women also suffered greater anxiety and depression risk, ill-health, injuries, induced abortion, and hemorrhage, yet, the protocols involved in escaping from an unhealthy marriage is not favorable to the women irrespective of the detrimental health effects of violence during pregnancy [49-51].

Fear of financial hardship, divorce, societal backing of women subjugation, societal label on children from single mothers and hope that the abuser would eventually stop are the most revered reasons women experiencing abuse do not report, seek help or leave their abusers [52]. While some women use active strategies to exploit their husbands needs as a means to guarantee their safety as well as that of their children, Schuler, and Islam found that some others believed that wives abuse by husbands are acceptable [53].

During the COVID-19 pandemic, local and global figures showed heightened increment in the number of Domestic Violence (DV) cases, yet, studies by Boserup, McKenney, Elkbuli, Bradbury-Jones, Isham; Campbell, Fraser, and Lennard, showed an under reporting of DV cases due to factors such as fear, cultural and religious doctrines [54].

Jessica and Camron in an assessment of gender based violence and COVID-19 in the Federal capital territory, Lagos, and Ogun States where total lockdown was first recorded a 297% increment in DV cases between March and April 2020. Preliminary information in 24 states also revealed a total of 346 GBV incidents were reported in March and a 56 percent (794) increment was recorded in April [55].

The Domestic and Gender Violence Response Team run by the Lagos State Government noted that 390 cases were reported in the month of March alone. Lagos State Domestic and Sexual Violence Response Team (DSVRT) also indicated a three-fold helpline caller increment within one month of the lockdown.

Social constructions of marriage in religion

Though, both popular religions (Christianity and Islam) emphasized that men are to be good to their wives, of which Prophet Mohammed (Peace be upon him) in Hadith No. 1923 prohibited men from slapping their wives’ faces, belittling them, or telling them despicable words. Violence against women was not deemed an epidemic worthy of international recognition or consideration over two decades ago.

The constructionist idea is one that connotes how society establishes set of laws guiding human behavior within the social environment. Glass noted that it was a method used in constructing and preserving social order among individuals living in that community. Labeling takes place when the action of a person is tagged by a different individual as abnormal or deviant. The idea of “rewards” and “sanctions/punishments” is the notable input by Glass on how social constructions within a society are followed [56]. In the course of communications between the people in a society, meanings are connected to thoughts and things. Over time, new members of the society, learn these communal and approved ideas, ideals and way of life, on the other hand, to make sure these socially constructed ideals are strictly followed; benefits or punishments are given to children. Consequently, individuals who adhere to these traditional and religious ideals are rewarded while persons who defy these established ideas are punished or labeled, leading to the reinforcement of such constructions in the society.

As stated in all the four institutions of Sunni and Shia law, interfaith unions are allowed only between a Muslim man and a non-Muslim woman from the People of the Book (which is, Christianity and Jewish) and not vice versa. In various Muslim predominant States, interfaith unions are forbidden, and or considered an illicit social affair; this is apart from relationships between a male Muslim to a Jew-or-Christian woman. The proscription against interfaith relationship is inculcated into children from young age, consequently, the thought sounds nearly absurd. When such relationships seldom occur they are regarded as hapless social misfortune, thus, generating strain or hostility within the families involved and the religious community extensively. Such relationships are not condoned but simply endured by the families.

Wed not idolatresses till they believe; for lo! A believing bondwoman is better than an idolatress though she please you; and give not your daughters in marriage to idolaters till they believe, for lo! A believing slave is better than an idolater though he please you. These invite unto the Fire, and Allah invited unto the Garden and unto forgiveness by His grace, and expounded thus His revelations to mankind that haply they may remember [57].

In contrast, to the above scripture, Quran 5 verse 5 produces the textual foundation for the Muslim tenet which permits the Muslim man to be joined in interfaith union with Jewish or Christian women, but forbids Muslim women entering into such relationships:

As to marriage, you are allowed to marry the chaste from among the believing women and the chaste from among those who have been given the Book before you (are lawful for you); provided that you have given them their dowries, and live with them in honor, not in fornication, nor taking them as secret concubines [58].

Although, the Quranic manuscript do not spell out the identity of ‘those who have received the Scripture before you’ at present the customary explanation of this Quranic verse produces two somewhat undeserving things, which erodes the Quranic fundamental liberal humanistic thrust. Firstly, it restricted the term ‘people of the book’ or ‘those who have been given the Scripture before you’ to only the Jewish and Christians.

Secondly, it bordered the tolerability of interfaith union to marital relationships between Muslim men with the Jews or Christian women, leaving the women in the shadows of nonexistence. Although, Islamic scholars accepted the inexistence of specific reasons in Quranic texts or teachings of the Prophet allowing or prohibiting the Muslim women marriage with the ‘people of the book’, Ibn Achour assumed it can be attributed to the correlation (al quiass) and agreement (Ijma) of scholars of all eras. Muslim commentators and jurists protected this lop-sided agreement of interfaith union on the basis that the man will control the child rearing process to ensure they become Muslims automatically, whereas, the woman will be subject to her husband’s governance which might impact upon her faith, but, in accordance to the Islamic injunctions, if the contractual individuals in marriage is free from the list of forbidden ways of matrimony, as specified in the Quran, thus, (Quran, 4:22-23) differences in tribe, belief, class, and financial standing ought not be an opposition to their marriage, as long as the non-Muslim partner has evidently disowned idolatry, hence, a matrimonial relationship between a Muslim and non- Muslim does not break any fundamental principle of Islam [59].

The Bible recorded in 2 Corinthians 6:14 that Christians ought not to be ‘yoked’ with unbelievers and also, in the book of Deuteronomy 7:3-4, God did give an instruction on interfaith relationship.

You shall not intermarry with them, giving your daughters to their sons or taking their daughters for your sons, for they would turn away your sons from following me, to serve other gods. Then the anger of the LORD would be kindled against you, and he would destroy you quickly [60].

Though, Jesus Christ did not say anything about inter-caste or inter-religious marriage as He does not belong to a religion or caste, it was recorded that Apostle Peter was told by the Lord a second time in a vision in Acts 10:15: “What God hath cleansed, that call not thou common or unclean”. Yet, Paul did mention with the emphasis on spiritual life.

To the rest I say (I, not the Lord) that if any brother has a wife who is an unbeliever, and she consents to live with him, he should not divorce her. If any woman has a husband who is an unbeliever, and he consents to live with her, she should not divorce him. For the unbelieving husband is made holy because of his wife, and the unbelieving wife is made holy because of her husband. Otherwise your children would be unclean, but as it is, they are holy [61,62].

Social construction of divorve in Nigeria customary and religious law

The customary non-Islamic rule of nuptial relationships and annulment is a set of laws created and due to continuous practice, are socially acknowledged requisites in a society. This set of laws is rooted in the religious practices and cultural mores providing the structure of such community with control over its member’s actions. Though the disparity may not be visible in performance, it represents elements of cultural ideals protected, secured and transferred from one generation unto another, with specific changes. As noted by Kasunmu and Salacuse, Gluckman, customary bylaw is not challengeable; it constantly changes to correspond to the dynamics of social life [63-65].

Islamic union is not a venerated bond but a civil agreement nevertheless, includes several religious fundamentals such as the requiring the husband to paying the dower (mahr, sadaq) and maintaining the woman, therefore, annulment can be executed without a court system. Nevertheless, the recognized power to truly annul the matrimonial contract known as the talaq is unilaterally restricted as exaction is the exclusive reserve of the man [66]. Talaq, is a frequent out of court separation mechanism involving the woman’s rejection by the husband requiring no additional official necessities other than the husband’s declaration of annulment either explicitly (talaq pronouncement or an imitative) or indirectly (‘I reject you as my wife’), possibly in the wife’s and other people presence but not compulsorily so [67].

Christian ministers brought the religious ideals of matrimony and family law to the Nigerian societies with the Yoruba’s active as Protestants, while the Catholics rooted in the midst of the Ibo (Igbo) [68]. In the sixteenth century, the Protestant churches tenets controlled the marital laws but prior to this, the laws were governed by the Roman Catholic ideologies where strict monogamous public wedding in the eyes of a church official legalized the nuptials and matrimony was regarded as a revered union bringing a man and a woman together, hence unbreakable, especially after consummation. However, (1 Corinthians 7:15) stated “But if the unbelieving partner separates, let it be so. In such cases the brother or sister is not enslaved. God has called you to peace”.

For Protestants who saw matrimony as an eternal bond not just as a ritual, termination of such union is a taboo, which can, nevertheless, be disbanded on account of adultery or willful abandonment by any of the partner. This idea, which was supported by several Biblical passages, produced the credo of the marital offence. Consequently, divorce contained the punishment for the offending partner who had cracked the union meant to end in forever. The attack on the social order justified the annulment of a marriage not the matrimonial friction between partners. Once the spiritual, social and lawful institution of marriage is breached by one partner, the other partner ought not to be obligated to maintain the conjugal bond with the wrongdoer. The infringement on individuals’ privacy by a communal influence makes conjugal breakdown a community concern hence confirming the notion that the doctrine of matrimonial offence is to a great extent not interested in the matrimonial collapse rather in how the wrongdoing of one partner disrupts the social order.

In certain customary laws for example, the woman, needs to provide a stronger reason than simple adultery by the husband for her divorce case to be approved, while the committing adultery alone by the wife can be an adequate rationale for the husband to send the women packing. Consequently, the Matrimonial Cause Acts unfortunately is believed to not reflect the traditional African beliefs by refusing to appeal with this classing [69,70].

Arguably, divorcing an infertile woman has been asked to be legalized in the Nigerian Matrimonial Cause Acts procreation is considered the primary reason for marriages in African homes Matrimonial Cause Acts so that the man can remarry a woman for the accomplishment of this fundamental function [71-78].

Discussion and Conclusion

This study concludes that mankind is, potentially, one family, and different religious beliefs correspond to varied reaction surrounded by the inscrutability of the cosmos. Cultural pluralism is not a vice that requires removal but can be likened to diverse languages of the spirit involving religious diversity; therefore, they can co-exist similar to diverse normal languages.

In as much as upheld prejudices on the basis of religious beliefs, traditional practices, ethnicity, class, etc. are indispensable, it will continue to hamper upon the oneness of humanity in all aspects, thereby, making the hostility towards mixed unions the ultimate hindrance to the realization of a unified human race. The oneness of the human family will stay deficient if plurality of religion continually exists as an overwhelming obstacle opposing the coming together of individuals’ who desire to spend together till eternity.

Recommendations

Arguably, marriages between different cultural and religious backgrounds can be open to the elements of misunderstanding that may, consequently lead to divorce. However, marriage instability is a general concern to be tackle by all couples who intend to live a happy ever after so; the most vital thing is to possess a partnership mindset at every level, principally nurtured by civility. Therefore, the study recommends that;

1. Individuals from different tribes, castes, religions and culture should be able to willingly create bonds of companionship and devotion, without fear of being ostracized or labeled.

2. Every individual’s marital choice should be respected by family members and the society at large whether such choice negates interfaith or the ethnic group of such persons.

3. Children at certain age should be allowed to exercise freedom of religious sovereignty with personal conviction as no spiritual doctrine can be justified within a scientific rational to be superior to the other. This can be attained by tolerance and accepting the multiplicity of religious beliefs not as a spike in the rose but as diverse flora in the patch of humanity.

4. No man should try patronizing God by attempting to establish His existence thus relegating base on religious and cultural belief as true belief is by no means the result of indoctrinating followers; it emanates out of man’s genuine depth, not the routine and conformist chanting of a doctrine, rather a genuine and zealous pursuit for the truth, guided by prayers and the spirit of meekness to bring him to God.

5. When deciding on marriage partner, young adults should not feel obligated to satisfy societal and religious creeds in order to avoid being labeled as deviants but rather, they should be guided with serenity, clarity and wisdom, to enable them take full responsibility for their choices and actions.

Disclosure

Availability of data and materials

All data generated or analysed during this study are included in this published article.

Competing interests

The authors declare that they have no conflict of interests.

Funding

This study did not receive any funding in any form

Acknowledgments

The authors would like to thank Prof. Rev. Stephen Olugbemiga OWA, Mr. Isaac Akintoyese Oyekola, Dr. Olayinka Onayemi, Oluwaseyi Ibijola; Awobusuyi Ayoade; Oludipe Emmanuel and all participant enrollees, and the HCFs/HCPs for their roles in the success of the study.

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