Screening of women for intimate partner violence: a pilot intervention at an outpatient department in Tanzania

Rose M Laisser,Lennarth Nyström,Gunilla Lindmark,Helen I Lugina,Maria Emmelin

doi:10.3402/gha.v4i0.7288

Abstract

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

Highlights

Study setting We performed the study at the outpatient department (OPD) at Temeke District Hospital (TDH), Temeke district, in the city of Dar es Salaam, Tanzania
We indicated in our category ‘Just asking feels good’ that the health care workers’ (HCWs) expressed to be satisfied with their work when they managed to identify women who experienced Intimate partner violence (IPV) with less effort
This study reported that the HCWs who had previous training on IPV were three times more likely to screen competently than those without

Summary

Introduction

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. Results: Of the 102 women screened, 78% had experienced emotional, physical, or sexual violence. Intimate partner violence (IPV) is one form of interpersonal violence defined as threats, attempts, or actual physical, sexual, or emotional abuse by a current or former partner [1]. According to the WHO multicounty study, 30% of the Tanzanian women in the urban site, who had experienced physical violence, reported having been injured, and out of these 61% had needed health care for their injuries. Of the Tanzanian women, who had ever experienced physical or sexual violence, 11Á12% reported having had suicidal thoughts [16]

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