142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Barriers to routine screening for intimate partner violence in health care settings in Haiti

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 11:18 AM - 11:30 AM

Anastasia Gage, PhD , Global Health Systems and Development, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
Josue Deleon, MSc , College Universitaire de Christianville, Grand Goave, Haiti
Jean Guy Honore, MD , Clinique- H˘pital Le Messie, Port-au-Prince, Haiti
Background: Although many health professional organizations and practitioners endorse universal screening of clients for intimate partner violence (IPV), little is known about barriers to the practice in low-income countries.  This study examined barriers to IPV universal screening among health care providers, female clients and community members in the Department of Artibonite, Haiti. 

Methods: Semi-structured face-to-face in-depth interviews were conducted with 41 health care providers and 43 female clients  in family planning/reproductive health services in six health facilities, and  21 community members.  The sampling design was purposeful and included a mix of education and age groups.  Transcripts were analyzed using NVivo version 10.

Results: More than half of the participants supported a policy of routine screening for IPV in health care settings. Four categories of IPV-screening barriers were identified: provider, health system, community, and patient. Provider-related barriers included fear of offending or stigmatizing patients, concern for personal and patient safety, fear of unintended psychological impacts of disclosure on victims, and lack of basic training in routine screening and counseling of violence victims.  Health system-related barriers included lack of tools and materials for conducting routine screening.  Community- and client-related barriers included the culture of silence around and lack of knowledge of IPV, privacy and confidentiality concerns, women’s economic dependence on male partners, lack of services for victims and punishment of perpetrators, embarassment, shame, humiliation, fear, and attitudes.

Conclusions: Barriers to IPV screening were numerous. Community awareness raising and health care provider training are necessary to improve the health care response to IPV.

Learning Areas:

Program planning
Provision of health care to the public
Public health or related research

Learning Objectives:
List ten barriers to routine screening for intimate partner violence in Haiti Describe differences in perceived barriers between health care providers, reproductive health clients, and community members

Keyword(s): Domestic Violence, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the principal investigator of the study and of the Tulane University component of the USAID-funded Population and Reproductive Health Associate Award. My research interests have include intimate partner violence. I have published journal articles on this topic, designed curricula for the monitoring and evaluation of intimate partner violence prevention and mitigation programs, and recently collaborated in implementing a curriculum on dating violence prevention among high school students in Haiti. I am Associate Professor.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.