Abstract
BACKGROUND: Domestic violence (DV) against women is a pervasive public health issue that profoundly impacts their physical, mental and social well-being, with sub-Saharan Africa experiencing heightened challenges due to patriarchal norms, resource limitations, and cultural stigma. Despite efforts to address DV, gaps remain in understanding the factors influencing women survivors’ formal help-seeking behaviours in Mozambique. METHODS: A cross-sectional study was conducted in 2017 with 282 women aged 15–49 years in Maputo City, Mozambique. Using a structured questionnaire adapted from WHO and DHS tools, data on sociodemographic characteristics, knowledge, attitudes, and practices related to DV and help-seeking were collected through home-based interviews. Descriptive statistics and logistic regression models were employed to identify associations of care-seeking behaviour, with education level analyzed as a critical variable. RESULTS: Education was a key determinant of formal help-seeking among DV survivors. Women with secondary education were over three times (OR = 3.12, 95% CI: 1.78–5.48) and those with higher education nearly four times (OR = 3.70, 95% CI: 1.44–9.52) more likely to seek care compared to those with primary education. Knowledge of DV types, consequences, and care services significantly increased care seeking. Awareness of physical violence as a type of DV raised the odds by 8 times (OR = 8.10, 95% CI: 2.2–20.2), while awareness of sexual and psychological violence raised the odds by 1.7 (OR = 1.7, 95% CI: 0.88–3.43) (OR = 1.23, 95% CI: 0.75–2.00) and 1.2 (OR = 1.23, 95% CI: 0.75–2.00). Positive attitudes and practices like assisting or advising others also strongly influenced behaviour. CONCLUSIONS: Despite the availability of formal DV services, persistent barriers such as lack of awareness and limited access hinder their effective utilization. These results underscore the need for targeted interventions that prioritise education and awareness to bridge gaps in access to support services and improve outcomes for DV survivors in Mozambique. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-026-04322-4.