A Community-Supported Clinic-Based Program for Prevention of Violence against Pregnant Women in Rural Kenya

Abstract

Objective. Pregnant women are especially vulnerable to adverse outcomes related to HIV infection and gender-based violence (GBV). We aimed at developing a program for prevention and mitigation of the effects of GBV among pregnant women at an antenatal clinic in rural Kenya. Methods. Based on formative research with pregnant women, male partners, and service providers, we developed a GBV program including comprehensive clinic training, risk assessments in the clinic, referrals supported by community volunteers, and community mobilization. To evaluate the program, we analyzed data from risk assessment forms and conducted focus groups (n = 2 groups) and in-depth interviews (n = 25) with healthcare workers and community members. Results. A total of 134 pregnant women were assessed during a 5-month period: 49 (37%) reported violence and of those 53% accepted referrals to local support resources. Qualitative findings suggested that the program was acceptable and feasible, as it aided pregnant women in accessing GBV services and raised awareness of GBV. Community collaboration was crucial in this low-resource setting. Conclusion. Integrating GBV programs into rural antenatal clinics has potential to contribute to both primary and secondary GBV prevention. Following further evaluation, this model may be deemed applicable for rural communities in Kenya and elsewhere in East Africa.

Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low‐ and Middle‐Income Countries: A Comparative Health Systems and Service Analysis

“…; Joyner and Mash ; Turan et al. ). Six studies were conducted in Africa: five in South Africa (Jacobs and Jewkes ; Joyner and Mash and ; Matseke and Peltzer ; Rees, Zweigenthal, and Joyner ) and one in Kenya (Turan et al.…”

Intimate partner violence and engagement in HIV care and treatment among women

“…Yet, despite calls for violence screening and intervention within HIV care and treatment programs, few HIV clinics have IPV-specific protocols in place [98]. HIV care and treatment programmes can draw upon existing guidelines for screening and responding to IPV in the health sector [91,99], or can look to a growing number of specialist programmes that address IPV alongside HIV [100][101][102][103]. To ensure that women benefit from medical advances, future studies should develop and test interventions to address IPV within HIV clinical care.…”

Relationship Power and Sexual Violence Among HIV-Positive Women in Rural Uganda

“…At the structural level, policy-makers have called for anti-violence programs that are integrated within healthcare services such as HIV testing and counseling [71]. HIV care and treatment programs can draw upon existing guidelines for screening and responding to IPV in the health sector [72, 73] or can turn to a growing number of programs that address IPV alongside HIV [74–76]. Other structural approaches such as economic empowerment and gender transformative interventions may be promising options [77, 78] and could be adapted or intensified for HIV-positive women.…”