umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Screening of women for intimate partner violence: a pilot intervention at an outpatient department in Tanzania
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0002-5095-3454
Show others and affiliations
2011 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 4, Article nr 7288- p.Article in journal (Refereed) Published
Abstract [en]

Intimate partner violence (IPV) is a public health problem in Tanzania with limited health care interventions.

OBJECTIVES: To study the feasibility of using an abuse screening tool for women attending an outpatient department, and describe how health care workers perceived its benefits and challenges.

METHODS: Prior to screening, 39 health care workers attended training on gender-based violence and the suggested screening procedures. Seven health care workers were arranged to implement screening in 3 weeks, during March-April 2010. For screening evaluation, health care workers were observed for their interaction with clients. Thereafter, focus group discussions (FGDs) were conducted with 21 health care workers among those who had participated in the training and screening. Five health care workers wrote narratives. Women's responses to screening questions were analyzed with descriptive statistics, whereas qualitative content analysis guided analysis of qualitative data.

RESULTS: Of the 102 women screened, 78% had experienced emotional, physical, or sexual violence. Among them, 62% had experienced IPV, while 22% were subjected to violence by a relative, and 9.2% by a work mate. Two-thirds (64%) had been abused more than once; 14% several times. Almost one-quarter (23%) had experienced sexual violence. Six of the health care workers interacted well with clients but three had difficulties to follow counseling guidelines. FGDs and narratives generated three categories Just asking feels good implied a blessing of the tool; what next? indicated ethical dilemmas; and fear of becoming a 'women hospital' only indicated a concern that abused men would be neglected.

CONCLUSIONS: Screening for IPV is feasible. Overall, the health care workers perceived the tool to be advantageous. Training on gender-based violence and adjustment of the tool to suit local structures are important. Further studies are needed to explore the implications of including abuse against men and children in future screening.

Place, publisher, year, edition, pages
CoAction Publishing, 2011. Vol. 4, Article nr 7288- p.
Keyword [en]
intimate partner violence, health care workers, abuse screening, Tanzania
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-49724DOI: 10.3402/gha.v4i0.7288ISI: 000299012700009PubMedID: 22028679OAI: oai:DiVA.org:umu-49724DiVA: diva2:456834
Funder
FAS, Swedish Council for Working Life and Social Research, 2006-1512
Note

Forskningsfinansiär/funding agency: Swedish Agency for Research Cooperation, SAREC.

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

Open Access in DiVA

Screening of women for intimate partner violence: a pilot intervention at an outpatient department in Tanzania(371 kB)157 downloads
File information
File name FULLTEXT02.pdfFile size 371 kBChecksum SHA-512
ba51436cf4a71b236d4c0ca2a0cd1854e809ddd0ff6254c7c06b2608febe01813a5420c63d5d2eae8c23d35e6b614e9eadd9009a9df8df6e204f5eccd8fd3b92
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Laisser, Rose MNyström, LennarthEmmelin, Maria
By organisation
Epidemiology and Global Health
In the same journal
Global Health Action
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 157 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 97 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf