<p>Healthcare Worker Experience and the Challenges in Screening for Intimate Partner Violence Among Women Who Use Antiretroviral Therapy and Other Health Services in Wolaita Zone, Ethiopia: A Phenomenological Study</p>

Abstract

Background: Intimate partner violence is a crime against humanity. This study aimed to explore the experiences and challenges in screening for intimate partner violence among women who use antiretroviral therapy and other health services in Wolaita Zone in Ethiopia. Methods: A descriptive phenomenological qualitative study design was used, and 16 in-depth interviews were conducted with healthcare workers from 19 health facilities who were providing healthcare services in Wolaita Zone. We selected participants purposively until data saturation was reached. Colaizzi's descriptive phenomenological method was used for the data analysis, and the Open Code software was used to assist with the data coding. We maintained the scientific rigour of credibility, transferability, dependability, and confirmability. Results: Analysis of the study data identified the following five themes: type of IPV identified by HCWs among women, provider-related barriers, healthcare system barriers, patient-level barriers, and providers' recommendations for improvements. Issues that emerged from these findings were a gap in medico-legal report provision, absence of a separate record-keeping for IPV cases, lack of client follow-up, absence of routine assessment of violence for women who have injuries, and lack of specific coordination with an external organisation. Moreover, the absence of staff training, weak referral systems, and a shortage of necessary medical equipment challenged IPV screening. Conclusion: This study has shown that there are healthcare provider and health system challenges relating to screening clients for intimate partner violence in Wolaita Zone. Provision of separate record-keeping of intimate partner violence cases in the healthcare facilities, standardising the medico-legal reporting system, improving women's access to education, and executing more gender-equitable policies, are needed. Moreover, the inclusion of intimate partner violence-specific policy frameworks in national legislation is necessary.

Intimate Partner Violence: Views and Perspectives of Young Women at Maputo-city Secondary Schools, Mozambique

“…Most of these studies show that male partners are the main perpetrators of violence against women and physical violence is one of the most frequently reported forms of violence, which is used to inflict pain (Aboagye et al, 2021; Coll et al, 2020; Cruz et al, 2014; INE e MISAU, 2013; Russell et al, 2014; Shamu et al, 2016). The experiences of health workers also indicate a high number of women presenting with wounds, bruises and scars due to IPV (Lawoko et al, 2013; Meskele et al, 2020). We note, however, that women in this study mainly reported physical and sexual violence, with less emphasis on psychological abuse.…”

“…In Mozambique, as in many other African countries, the services to address IPV are not specific for young women (Governo de Mocambique, 2012; Lawoko et al, 2013; Meskele et al, 2020). The opportunity for those young women in dating or in occasional relationships or those initiating relationships and experiencing IPV to seek help may be limited.…”

Healthcare Workers’ Experiences and Challenges in Managing Gender-Based Violence Among HIV-Positive Women Living in Southern, Tanzania: A Qualitative Study

“… 22 Known challenges are the service providers’ attitudes, perceptions, and lack of knowledge about GBV. 10 , 22 , 23 GBV screening is also impacted by the absence of GBV-specific training in national medical curricula, awareness of the scope of the GBV problem, and not knowing what to do when women disclose GBV impact HCWs level of confidence in asking question. 10 , 24–26 …”

“…In addition, a poor referral system between different support services, and a lack of specific GBV clinics to support integrated services has been reported as a barrier to GBV screening. 10 , 22 , 25 GBV-supporting networks are reported to be ineffective and uncoordinated, which may discourage GBV survivors from seeking solutions. 10 , 27 …”

Health providers readiness in managing intimate partner violence in public health institutions, Ethiopia

“…Indeed, previous studies have reported lack of guidelines, organizational policies, separate recording, and registration, limited facilitated IPV training for providers, lack of referral network and specific referral systems or follow-up and delay in medico-legal reports for IPV victims were health system barriers that affected provider readiness in managing IPV [17,21,22].…”