Abstract
BackgroundIn many developing countries, intimate partner violence (IPV) training is not available for health providers. As a pioneer among developing countries, in 2009, the Sri Lankan Ministry of Health trained a group of community health providers known as public health midwives (PHMs) on IPV. We evaluated that training program’s efficacy in improving PHMs’ identification and management of IPV sufferers in Kandy, Sri Lanka.MethodsWe conducted this study from August 2009 to September 2010. We used a self-administered structured questionnaire to examine the following variables among 408 PHMs: self-reported IPV practices, IPV knowledge, perceived barriers, perceived responsibility, and self-confidence in identifying and assisting IPV sufferers. We used McNemar’s test to compare PHMs’ pre- and post-intervention IPV practices. Using the Wilcoxon signed-rank test, we compared PHMs’ pre-and post-intervention IPV knowledge, as well as their perceived barriers, responsibility, and self-confidence scores.ResultsThe IPV training program improved PHMs’ IPV practices significantly. Six months after the intervention, 98.5% (n = 402) of the 408 PHMs identified at least one IPV sufferer in the previous three months, compared to 73.3% (n = 299) in the pre-intervention (p < 0.001). At post-intervention, 96.5% (n = 387) of the PHMs discussed IPV with identified sufferers and suggested solutions; only 67.3% (n = 201) did so at the pre-intervention (p < 0.001). In addition, after the intervention, there were significant increases (p < 0.001) in the median total scores of PHMs’ IPV knowledge (0.62 vs. 0.88), perceived responsibility (3.20 vs. 4.60), and self-confidence (1.81 vs. 2.75). PHMs’ perceived barriers decreased from 2.43 to 1.14 (p < 0.001).ConclusionsAn IPV training program for PHMs improved identification and assistance of IPV sufferers in Kandy, Sri Lanka. This training program has the potential to improve PHMs’ skills in preventing IPV and supporting sufferers in other regions of Sri Lanka. Other developing countries might learn lessons from Sri Lanka’s IPV training.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1674-9) contains supplementary material, which is available to authorized users.
Highlights
In many developing countries, intimate partner violence (IPV) training is not available for health providers
We evaluated the efficacy of the IPV training program to improve public health midwives (PHMs)’ identification and management of IPV sufferers in the Kandy district of Sri Lanka
To examine the predictive validity of the PHMs’ perceived barriers, perceived responsibility, and selfconfidence scales, we examined the correlations of the PHMs’ IPV knowledge scores with their perceived barriers, responsibility, and self-confidence scores using Spearman’s rank correlation coefficient
Summary
Intimate partner violence (IPV) training is not available for health providers. As a Several barriers might prevent health providers from recognizing IPV, including lack of IPV training, lack of time, fear of offending women, lack of self-confidence in IPV identification, and lack of skills in responding to IPV disclosures [6,7,8]. Lack of IPV training is an important barrier preventing health providers from recognizing IPV [8,9]. IPV training programs have significantly improved health providers’ recognition and management of IPV sufferers in developed countries [8,9,10,11,12]. In many developing countries, IPV training is not available for health providers, and health providers rarely recognize or support IPV sufferers in health care settings [4,6]. When sufferers disclose IPV, health providers hesitate to get involved and are reluctant to help them because IPV is not usually considered a health concern [4,7]
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