Abstract
BackgroundViolence against women is an international public health concern and a violation of women’s rights. Domestic violence can first occur, and increase in frequency and severity, during and after pregnancy. Healthcare providers have the potential to identify and support women who experience domestic violence. We sought to investigate the knowledge and perceptions of domestic violence among doctors who provide routine antenatal and postnatal care at healthcare facilities in Pakistan. In addition, we explored possible management options from policy makers, and enabling factors of and barriers to the routine screening of domestic violence.MethodsSemi-structured key informant interviews were conducted with doctors (n = 25) working in public and private hospitals and with officials involved in domestic violence policy development (n = 5) in Islamabad, Pakistan. Transcribed interviews were coded and codes grouped into categories. Thematic framework analysis was undertaken to identify emerging themes.ResultsMost doctors have a good awareness of domestic violence and a desire to help women who report domestic violence during and after pregnancy. Enabling factors included doctors’ ability to build rapport and trust with women and their suggestion that further education of both healthcare providers and women would be beneficial. However, domestic violence is often perceived as a “family issue” that is not routinely discussed by healthcare providers. Lack of resources, lack of consultation time and lack of effective referral pathways or support were identified as the main barriers to the provision of quality care.ConclusionsDoctors and policy advisors are aware of the problem and open to screening for domestic violence during and after pregnancy. It is suggested that the provision of a speciality trained family liaison officer or healthcare provider would be beneficial. Clear referral pathways need to be established to provide quality care for these vulnerable women in Pakistan.
Highlights
Violence against women is an international public health concern and a violation of women’s rights
Domestic violence during pregnancy is associated with poor health outcomes for both the woman and her unborn baby including maternal injury or death; and pregnancy complications such as placental abruption, premature rupture of membranes, preterm labour, low birth weight and stillbirth [5,6,7,8,9,10,11]
The participants worked in different settings with four based in private hospitals, 16 in government funded hospitals and 6 who currently worked in both settings
Summary
Violence against women is an international public health concern and a violation of women’s rights. Domestic violence can first occur, and increase in frequency and severity, during and after pregnancy. Healthcare providers have the potential to identify and support women who experience domestic violence. We sought to investigate the knowledge and perceptions of domestic violence among doctors who provide routine antenatal and postnatal care at healthcare facilities in Pakistan. It is recognised that domestic violence can often first occur, and increase in frequency and severity for women during and after pregnancy [4]. Repeated health care attendance for non-related reasons commonly occurs where a woman is experiencing domestic violence [11]. Domestic violence is still considered a taboo subject in many countries, including Pakistan, resulting in a hidden burden of ill-health in women [12]
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