Facilitators and barriers to routine intimate partner violence screening in antenatal care settings in Uganda.
Facilitators and barriers to routine intimate partner violence screening in antenatal care settings in Uganda.
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DOI：
10.1186/s12913-022-07669-0
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发表时间：
2022-03-02
影响因子：
2.8
通讯作者：
Dickson-Gomez J
中科院分区：
文献类型：
--
作者：
Anguzu R;Cassidy LD;Beyer KMM;Babikako HM;Walker RJ;Dickson-Gomez J
乌干达临床指南建议在产前护理期间对孕妇进行亲密伴侣暴力的例行筛查。医疗保健提供者在ANC诊所识别妊娠期间的IPV方面发挥着关键作用。本研究探讨了促进者和障碍，IPV筛查在怀孕期间（围产期IPV筛查）的ANC为基础的医护人员在乌干达。我们在乌干达东部和中部的一个农村和一个城市的ANC健康中心分别对28名有目的地选择的医疗保健提供者进行了定性深入访谈。ANC期间IPV筛查的障碍和促进因素采用归纳演绎主题分析迭代确定。参与者提供ANC服务的中位数（IQR）持续时间为4.0（0.1-19）年。在28名医疗保健提供者中，11名妇女定期接受产前检查诊所的IPV检查，10名接受了IPV相关培训。常规IPV筛查的障碍包括人员配备和空间资源有限，缺乏全面的基于性别的暴力（GBV）培训以及提供者不了解怀孕期间IPV的程度。促进者是GBV协议的可用性和供应商谁知道IPV（或GBV）工具往往使用它们来定期筛选IPV。医护人员报告说，需要建立病人的信任和一个安全的ANC诊所环境，以便披露。ANC临床医生建议创造机会进行分诊级别的筛查，并修改用于记录妇女病史的患者ANC卡。一些提供者表示担心，如果实施虐待的伴侣看到报告的虐待行为，他们的安全或报复性虐待可能会受到影响。我们的研究结果可以为加强GBV干预措施的努力提供信息，重点是增加ANC临床医生的常规围产期IPV筛查。实施增加常规围产期IPV筛查的举措应侧重于任务分担，增加全面的IPV培训机会，包括提高对IPV严重程度的认识，创伤知情护理和建立信任的医患关系。在线版本包含补充材料，可通过10.1186/s12913-022-07669-0获得。
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. 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. 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. 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. The online version contains supplementary material available at 10.1186/s12913-022-07669-0.
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作者：
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DOI：
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