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Striving to make a difference: health care worker experiences with intimate partner violence clients in Tanzania
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.ORCID iD: 0000-0002-5095-3454
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2009 (English)In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 30, no 1-2, 64-78 p.Article in journal (Refereed) Published
Abstract [en]

In this article we describe health care workers' (HCWs') experiences and perceptions of meeting clients exposed to intimate partner violence (IPV). Qualitative content analysis of in-depth interviews from 16 informants resulted in four main themes. The first, "internalizing women's suffering and powerlessness," describes HCWs' perceptions of violence, relating it to gender relations. The second, "caught between encouraging disclosure and lack of support tools," refers to views on possibilities for transparency and openness. The third, "Why bother? A struggle to manage with limited resources," illustrates the consequences of a heavy workload. Last; "striving to make a difference," emphasizes a desire to improve abilities to support clients and advocate for prevention.

Place, publisher, year, edition, pages
2009. Vol. 30, no 1-2, 64-78 p.
Keyword [en]
domestic violence; women; perceptions; prevention; midwives
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-21790DOI: 10.1080/07399330802523618PubMedID: 19116822OAI: diva2:211886
Available from: 2009-04-20 Created: 2009-04-20 Last updated: 2015-04-29Bibliographically approved
In thesis
1. Prevention of intimate partner violence: community and healthcare workers´ perceptions in urban Tanzania
Open this publication in new window or tab >>Prevention of intimate partner violence: community and healthcare workers´ perceptions in urban Tanzania
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Intimate partner violence (IPV) against women is public health and human rights concern. The studies forming this thesis seek to understand healthcare worker and community attitudes and perceptions about IPV; their role in support, care and prevention of IPV, and the feasibility of introducing routine screening for IPV among women attending healthcare.

Methods: Four interrelated studies were conducted in Temeke District, Dar es Salaam, Tanzania: 1) a content analysis of 16 in-depth interviews with healthcare workers about their experiences of meeting IPV clients, 2) a grounded theory analysis of seven focus group discussions that explore community perceptions, 3) a cross sectional study of 657 healthcare workers and students to understand their attitudes and perceptions about IPV and future roles in care and support, and 4) evaluation of a pilot intervention that introduces routine screening in an outpatient department. The pilot intervention included screening of 102 women, ten observations of healthcare worker interactions with women clients, three focus group discussions, and five narratives written by healthcare workers about their experiences with the screening tools.

Results: Gender inequalities, attitudes, and poverty intersect in the explanation of IPV. Healthcare workers view low economic status among women, rigid gender norms, and stigma that influences women to stay in violent relationships. Alcohol abuse, multiple sexual partners and low levels of income among men were cited as triggers for IPV episodes. Between 20-67% of healthcare workers and students report meeting IPV clients at work. More than 9o% observed clients with unexplained feelings of sadness and/or loss of confidence. Resource and training limitations, heavy workloads and low salaries constrain services. A strong desire to make a difference in the care and support of IPV clients was present, but violence as a hidden agenda with a client resistance to disclosure was a challenge. The community study shows a transition in gender norms is making violence against women less acceptable.

Conclusions and suggestions: Healthcare workers and the community strongly wish and are committed to support IPV prevention. Both groups understood the meaning, provocative factors and some IPV effects. This awareness contributes to their desire to be part of a change. At the central level, prevention of IPV should be on the governments’ policy agenda and should be prioritised. Education about gender-based violence must be incorporated into the curricula of healthcare workers. At community level, advocacy is necessary for changing harmful gender norms and measures to combat women’s poverty. Men should be engaged at all levels. Provision of information on the human rights perspectives of IPV should be strengthened and related to other types of violence.

Place, publisher, year, edition, pages
Umeå: Umeå university, 2011. 54 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1460
Intimate partner violence, healthcare workers, perceptions, gender norms, social support, prevention, Tanzania
National Category
Medical and Health Sciences
Research subject
Public health
urn:nbn:se:umu:diva-49743 (URN)978-91-7459-321-1 (ISBN)
Public defence
2011-12-02, Sal 135, Byggnad 9 A, Allmänmedicin, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Available from: 2011-11-18 Created: 2011-11-16 Last updated: 2015-04-29Bibliographically approved

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Laisser, Rose MNyström, LennarthEmmelin, Maria
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