Facilitators and barriers to routine intimate partner violence screening in antenatal care settings in Uganda. BMC Health Serv Res 2022 Mar 02;22(1):283
Date
03/03/2022Pubmed ID
35232438Pubmed Central ID
PMC8889632DOI
10.1186/s12913-022-07669-0Scopus ID
2-s2.0-85125601498 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
BACKGROUND: Uganda clinical guidelines recommend routine screening of pregnant women for intimate partner violence (IPV) during antenatal care (ANC). Healthcare providers play a critical role in identifying IPV during pregnancy in ANC clinics. This study explored facilitators and barriers for IPV screening during pregnancy (perinatal IPV screening) by ANC-based healthcare workers in Uganda.
METHODS: We conducted qualitative in-depth interviews among twenty-eight purposively selected healthcare providers in one rural and an urban-based ANC health center in Eastern and Central Uganda respectively. Barriers and facilitators to IPV screening during ANC were identified iteratively using inductive-deductive thematic analysis.
RESULTS: Participants had provided ANC services for a median (IQR) duration of 4.0 (0.1-19) years. Out of 28 healthcare providers, 11 routinely screened women attending ANC clinics for IPV and 10 had received IPV-related training. Barriers to routine IPV screening included limited staffing and space resources, lack of comprehensive gender-based violence (GBV) training and provider unawareness of the extent of IPV during pregnancy. Facilitators were availability of GBV protocols and providers who were aware of IPV (or GBV) tools tended to use them to routinely screen for IPV. Healthcare workers reported the need to establish patient trust and a safe ANC clinic environment for disclosure to occur. ANC clinicians suggested creation of opportunities for triage-level screening and modification of patients' ANC cards used to document women's medical history. Some providers expressed concerns of safety or retaliatory abuse if perpetrating partners were to see reported abuse.
CONCLUSIONS: Our findings can inform efforts to strengthen GBV interventions focused on increasing routine perinatal IPV screening by ANC-based clinicians. Implementation of initiatives to increase routine perinatal IPV screening should focus on task sharing, increasing comprehensive IPV training opportunities, including raising awareness of IPV severity, trauma-informed care and building trusting patient-physician relationships.
Author List
Anguzu R, Cassidy LD, Beyer KMM, Babikako HM, Walker RJ, Dickson-Gomez JAuthors
Ronald Anguzu MD, PhD Assistant Professor in the Institute for Health and Equity department at Medical College of WisconsinKirsten M. Beyer PhD, MPH Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Laura Cassidy PhD Associate Dean, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Julia Dickson-Gomez PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
FemaleHumans
Intimate Partner Violence
Mass Screening
Pregnancy
Pregnant Women
Prenatal Care
Uganda
