Abstract
BackgroundViolence against women is a serious public health concern, and is highly prevalent globally, including in India. Health-care providers [HCPs] can play an important role in addressing and reducing negative consequences of violence against women. We implemented a pre-post intervention study of HCP training in three tertiary care facilities in Maharashtra, India.MethodsThe study used a pre-post intervention design with assessment of HCPs’ (n = 201) knowledge, attitudes, perceived preparedness and practice at three time points: before training, after training and at 6 months follow- up.ResultsTotal median score of knowledge about common signs and symptoms of violence (8.89 vs, 10.00), attitudes towards acceptability of violence (9.05 vs. 10.00), individual (6.74 vs. 10.00) and system level preparedness (6.11 vs. 8.14) improved from pre to post- training. The generalized estimating equation [GEE] model, adjusted for age, sex, site and department, showed an improvement in knowledge, attitudes and preparedness post- training. The change from pre to 6 months follow- up was not significant for attitude.ConclusionsThis package of interventions, including training of HCPs, improved HCPs’ knowledge, attitudes and practices, yet changes in attitudes and preparedness did not sustain over time. This study indicates feasibility and positive influence of a multi-component intervention to improve HCP readiness to respond to violence against women in a low-resource setting. Future phases of intervention development include adapting this intervention package for primary and secondary health facilities in this context, and future research should assess these interventions using a rigorous experimental design. Finally, these results can be used to advocate for multi-layered, systems-based approaches to strengthening health response to violence against women.
Highlights
Violence against women is a serious public health concern, and is highly prevalent globally, including in India
A multivariable generalised Generalized estimating equation (GEE) model was fitted with knowledge, attitudes and practice scores as dependent variables and time, department, sex, age, centre and site
A recent systematic review of trials of HCP training to improve IPV response found that of the 19 included studies, three quarters of all studies were conducted in the USA, and no studies were conducted in Asia [45]
Summary
Violence against women is a serious public health concern, and is highly prevalent globally, including in India. Violence against women is a pervasive and highly prevalent health and social problem, with estimates showing that almost one-in-three women globally have experienced physical and/or sexual violence by an intimate partner or non-partner sexual violence in their lifetime [1]. It is a public health problem with significant implications for women’s mental, physical and social wellbeing [2]. This is despite widespread evidence that suggests that both formal and informal support systems can play a crucial role in mitigating consequences of violence against women [9, 10]
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