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Community perceptions of intimate partner violence: a qualitative study from urban Tanzania
Muhimbili University of Health and Allied Sciences (MUHAS), Midwifery School, Dar es Salaam, Tanzania .
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).ORCID iD: 0000-0002-5095-3454
Bugando University College of Health Sciences, Archbishop Antony Mayalla School of Nursing, Mwanza Tanzania.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Lund, Sweden.
2011 (English)In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 11, 13Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Intimate partner violence against women is a prevailing public health problem in Tanzania, where four of ten women have a lifetime exposure to physical or sexual violence by their male partners. To be able to suggest relevant and feasible community and health care based interventions, we explored community members' understanding and their responses to intimate partner violence.

METHODS: A qualitative study using focus group discussions with 75 men and women was conducted in a community setting of urban Tanzania. We analysed data using a grounded theory approach and relate our findings to the ecological framework of intimate partner violence.

RESULTS: The analysis resulted in one core category, "Moving from frustration to questioning traditional gender norms", that denoted a community in transition where the effects of intimate partner violence had started to fuel a wish for change. At the societal level, the category "Justified as part of male prestige" illustrates how masculinity prevails to justify violence. At the community level, the category "Viewed as discreditable and unfair" indicates community recognition of intimate partner violence as a human rights concern. At the relationship level, the category "Results in emotional entrapment" shows the shame and self-blame that is often the result of a violent relationship. At the individual level, the risk factors for intimate partner violence were primarily associated with male characteristics; the category "Fed up with passivity" emerged as an indication that community members also acknowledge their own responsibility for change in actions.

CONCLUSIONS: Prevailing gender norms in Tanzania accept women's subordination and justify male violence towards women. At the individual level, an increasing openness makes it possible for women to report, ask for help, and become proactive in suggesting preventive measures. At the community level, there is an increased willingness to intervene but further consciousness-raising of the human rights perspective of violence, as well as actively engaging men. At the macro level, preventive efforts must be prioritized through re-enforcement of legal rights, and provision of adequate medical and social welfare services for both survivors and perpetrators.

Place, publisher, year, edition, pages
BioMed Central, 2011. Vol. 11, 13
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine Gender Studies
Identifiers
URN: urn:nbn:se:umu:diva-49723DOI: 10.1186/1472-6874-11-13ISI: 000208607800013PubMedID: 21501506OAI: oai:DiVA.org:umu-49723DiVA: diva2:456833
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2006-1512
Note

This study was performed with support from the Swedish Agency for Research Cooperation, Sida/SAREC. The authors acknowledge the very important administrative support from Umea University and Muhimbili University of Health and Allied Sciences, as well as community groups in Temeke District, Dar es Salaam, Tanzania. We also appreciate the support from the Centre for Global Health at Umea University, FAS and the Swedish Council for Working Life and Social Research ( grant number. 2006-1512).

Available from: 2011-11-16 Created: 2011-11-16 Last updated: 2017-12-08Bibliographically 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.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1460
Keyword
Intimate partner violence, healthcare workers, perceptions, gender norms, social support, prevention, Tanzania
National Category
Medical and Health Sciences
Research subject
Public health
Identifiers
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)
Opponent
Supervisors
Available from: 2011-11-18 Created: 2011-11-16 Last updated: 2015-04-29Bibliographically approved

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