Views of primary health care providers of the challenges to screening for intimate partner violence, Egypt

Abstract

Background: Health care providers can play an important role in detection of intimate partner violence within health services but barriers exist. Aims: This study aimed to determine the barriers that health care providers in Fayoum, Egypt consider prevent them from screening for intimate partner violence. Methods: This was a cross-sectional study between June 2018 and January 2019. The sample was health care providers (doctors, nurses, social workers and community workers) selected from government primary care centres in all seven districts of Fayoum. A validated Arabic version of the Domestic Violence Health Care Provider Survey was used to collect data. Results: A total of 385 health care providers (92.7% women) agreed to participate (78.6% response rate). Just over half of the participants did not have access to social workers or community workers or strategies to help victims of intimate partner violence. None had received training on screening for domestic violence. More than half (59.7%) thought that investigating the cause of intimate partner violence was not part of medical practice. Sex was significantly associated with perceived self-efficacy, while age and occupation were significantly associated with referral management and health providers' attitude. Conclusion: Primary health care providers perceived many barriers to screening for intimate partner violence. Training on screening for and managing intimate partner violence should be part of the professional development for all health care providers. An effective referral system is 1 / 12 WHO EMRO | Views of primary health care providers of the challenges to screening for intimate partner v needed that ensures comprehensive services for victims.

Intimate Partner Violence; Are Saudi Physicians in Primary Health Care Setting Ready to Identify, Screening, and Respond?

“…Similar findings have been reported in Saudi Arabia, Egypt, and Canada, which revealed that gaps in providers’ knowledge and the lack of IPV training are the key factors limiting physicians’ practice of screening. 22 , 35 , 36 …”

“…Similar findings have been reported in Saudi Arabia, Egypt, and Canada, which revealed that gaps in providers' knowledge and the lack of IPV training are the key factors limiting physicians' practice of screening. 22,35,36 Additionally, participants in the present study perceived a variety of workplace challenges that might play a significant role in detecting and dealing with abused women, such as a lack of enough time and private space in their workplace to discuss and assist the victim. This highlights the responsibility of the health institution in providing the appropriate infrastructure and resources for assisting physicians, including local protocols, adequate time, and a private area to deal with abused women.…”

“…[19][20][21] The primary health care (PHC) setting is the ideal place to detect IPV cases, as it is the first level to contact the health care system. 22 However, one of the biggest obstacles to the NFSP program's implementation is the insufficiency of skilled medical professionals to handle IPV patients. 23 The Physicians' readiness to identify IPV has been studied in different countries, which revealed that health care providers had insufficient knowledge and preparedness to identify and properly respond to IPV.…”

“…Physicians' confidence in IPV referring pathways and resources is a key component of the perceived support system, which is linked to a higher rate of IPV screening. 22,37 Disparately our participants were unaware of IPV referral resources and the concerned referral agencies. Low referral levels were also reported in Saudi and US studies.…”

Capability, Opportunity, Motivation, and Behaviour (COM-B) model association with Egyptian dentists’ reporting of suspected abuse

“…Previous research showed that dentists without training to manage suspected abuse were less likely to know how to report suspected abuse than those with training [ 35 ]. Also, prior studies including Egyptian physicians [ 30 ] and primary health care workers [ 36 ] similarly showed that health professionals needed training to be familiar with rules and supporting bodies so there seems to be a consensus that this training gap needs to be filled. Training that focuses on promoting positive attitudes towards reporting and increases awareness of existing laws, policies, and agencies in local context may lead to more reporting than training which aims exclusively at increasing the knowledge of the manifestations of abuse and how to identify abuse victims.…”