Healthcare Worker Experience and the Challenges in Screening for Intimate Partner Violence Among Women Who Use Antiretroviral Therapy and Other Health Services in Wolaita Zone, Ethiopia: A Phenomenological Study

Abstract

Background

Intimate partner violence is a crime against humanity. This study aimed to explore the experiences and challenges in screening for intimate partner violence among women who use antiretroviral therapy and other health services in Wolaita Zone in Ethiopia.

Methods

A descriptive phenomenological qualitative study design was used, and 16 in-depth interviews were conducted with healthcare workers from 19 health facilities who were providing healthcare services in Wolaita Zone. We selected participants purposively until data saturation was reached. Colaizzi’s descriptive phenomenological method was used for the data analysis, and the Open Code software was used to assist with the data coding. We maintained the scientific rigour of credibility, transferability, dependability, and confirmability.

Results

Analysis of the study data identified the following five themes: type of IPV identified by HCWs among women, provider-related barriers, healthcare system barriers, patient-level barriers, and providers’ recommendations for improvements. Issues that emerged from these findings were a gap in medico-legal report provision, absence of a separate record-keeping for IPV cases, lack of client follow-up, absence of routine assessment of violence for women who have injuries, and lack of specific coordination with an external organisation. Moreover, the absence of staff training, weak referral systems, and a shortage of necessary medical equipment challenged IPV screening.

Conclusion

This study has shown that there are healthcare provider and health system challenges relating to screening clients for intimate partner violence in Wolaita Zone. Provision of separate record-keeping of intimate partner violence cases in the healthcare facilities, standardising the medico-legal reporting system, improving women’s access to education, and executing more gender-equitable policies, are needed. Moreover, the inclusion of intimate partner violence-specific policy frameworks in national legislation is necessary.

Keywords:

• healthcare workers
• intimate partner violence
• screening
• Wolaita Zone

Data Sharing Statement

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

We obtained ethical approval from the Biomedical Research Ethics Committee (BREC) of the University of KwaZulu-Natal (BREC Ref No: BE387/18) and the Institutional Review Board approval from Wolaita Sodo University under the Ref No: WSU15/04/147 (12 Sep. 2018). Written consent was obtained from individual participants.

Acknowledgments

We thank the University of KwaZulu-Natal (UKZN), South Africa, for the grant they provided to conduct this research. Our gratitude also goes to data collectors, supervisors, and study participants. We also like to thank Dr. Bereket Yakob, former UKZN student, for the provision of books that helped us on the process of developing design and analysis.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Authors’ Information

MM is a Ph.D. candidate at the school of Nursing and Public Health, University of KwaZulu-Natal, South Africa.

NK is a lecturer (Ph.D.) in the School of Nursing and Public Health, University of KwaZulu-Natal, South Africa.

MT is an honorary professor in the School of Nursing and Public Health, University of KwaZulu-Natal, South Africa.

Disclosure

All authors declare that they have no conflicts of interest for this work.

Additional information

Funding

The University of KwaZulu-Natal, College of Health Science, has funded this research.