Needs and unmet needs for support services for recently pregnant intimate partner violence survivors in Ethiopia during the COVID-19 pandemic.
Needs and unmet needs for support services for recently pregnant intimate partner violence survivors in Ethiopia during the COVID-19 pandemic.
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DOI：
10.1186/s12889-023-15634-7
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发表时间：
2023-04-20
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
作者：
在全球范围内，2-14%的妇女在怀孕期间遭受亲密伴侣暴力。及时应对IPV对于减轻相关的不良健康后果至关重要。在埃塞俄比亚等低收入和中等收入国家，获得有限的IPV支持服务的障碍普遍存在；主要障碍包括不信任、污名化和自责，并使妇女不愿透露自己的经历。针对COVID-19的感染控制措施有可能进一步破坏IPV服务的获取。2020年10月至11月，对24名近期怀孕期间经历IPV的妇女进行了深入的定性访谈，以了解COVID-19大流行期间埃塞俄比亚IPV幸存者的需求和未满足的需求。训练有素的定性采访者使用结构化的笔记工具来探索经验，同时允许快速分析及时的结果。归纳主题分析确定了紧急主题，并将其组织成矩阵进行综合。定性主题围绕IPV服务知识展开；妇女寻求服务的经验；获得服务方面的挑战；COVID-19对资源获取的影响；以及IPV幸存者持续未满足的需求。值得注意的是，很少有妇女将她们所经历的暴力视为怀孕特有的暴力，大多数妇女提到在COVID-19限制之前和期间长期遭受IPV。在我们的研究中，大多数IPV幸存者严重依赖他们的家庭和朋友的非正式网络来保护和帮助他们解决暴力问题。虽然正式的IPV服务在大流行期间一直开放，但限制措施导致人们认为无法获得服务，这种看法使幸存者不愿寻求帮助。幸存者进一步指出，缺乏综合和量身定制的服务是长期未得到满足的需求。研究结果表明，对正式IPV支持的认识和利用一直很低，并敦促未来的政策努力通过减少社会文化障碍扩大服务来解决未满足的需求。COVID-19影响了使用正式和非正式支持系统的机会，突出了对适应性强的远程服务提供和上游暴力预防的需求。公共卫生干预措施必须加强正规和非正规资源之间的联系，以满足IPV幸存者在其家乡社区接受医疗、社会心理和法律支持方面未得到满足的需求。
Globally, 2–14% of women experience intimate partner violence (IPV) during pregnancy. Timely response to IPV is critical to mitigate related adverse health outcomes. Barriers to accessing limited IPV support services are pervasive in low- and middle-income countries (LMICs), such as Ethiopia; key barriers include mistrust, stigmatization, and self-blame, and discourage women from disclosing their experiences. Infection control measures for COVID-19 have the potential to further disrupt access to IPV services. In-depth qualitative interviews were undertaken from October-November 2020 with 24 women who experienced IPV during recent pregnancy to understand the needs and unmet needs of IPV survivors in Ethiopia amid the COVID-19 pandemic. Trained qualitative interviewers used a structured note-taking tool to allow probing of experiences, while permitting rapid analysis for timely results. Inductive thematic analysis identified emergent themes, which were organized into matrices for synthesis. Qualitative themes center around knowledge of IPV services; experiences of women in seeking services; challenges in accessing services; the impact of COVID-19 on resource access; and persistent unmet needs of IPV survivors. Notably, few women discussed the violence they experienced as unique to pregnancy, with most referring to IPV over an extended period, both prior to and during COVID-19 restrictions. The majority of IPV survivors in our study heavily relied on their informal network of family and friends for protection and assistance in resolving the violence. Though formal IPV services remained open throughout the pandemic, restrictions resulted in the perception that services were not available, and this perception discouraged survivors from seeking help. Survivors further identified lack of integrated and tailored services as enduring unmet needs. Results reveal a persistent low awareness and utilization of formal IPV support and urge future policy efforts to address unmet needs through expansion of services by reducing socio-cultural barriers. COVID-19 impacted access to both formal and informal support systems, highlighting needs for adaptable, remote service delivery and upstream violence prevention. Public health interventions must strengthen linkages between formal and informal resources to fill the unmet needs of IPV survivors in receiving medical, psychosocial, and legal support in their home communities.
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