Intimate partner violence and primary health care workers: screening and management

To assess knowledge, attitude and management practices on intimate partner violence (IPV) in primary care practice and determine barriers to screening, safety concerns and prior training of health workers.

Self administered questionnaire interview of 298 health workers from 104 health facilities in the 33 local government areas of Oyo state.

Health workers underestimated IPV, 80% estimated that less than 10% of women in their practice experience violence. Only 35% (105) screened routinely for IPV, while 43% (129) had ever identified a victim. Response of health workers when they found oppressed women were often (64.5%) limited to treatment of injuries. Many (66.1%) believed it was an intrusion into patient's private life to inquire about violence. Ninety per cent (270) expressed concern for their personal safety if they were to discuss with the oppressed or perpetrators. Many (74.8%) believed that they could assist men who perpetrate violence, while 92.3% believed they could assist abused women. Only 18.8% (56) had ever received training on violence. Health workers with previous training on IPV were three times more likely to screen (AOR 2.66; 95%CI: 1.52-4.63), while the more senior cadre were more likely (AOR 1.62; 95% CI: 1.13-2.81) to have identified an oppressed woman. Although not significant, females had better knowledge and attitudes than men (OR 0.67; 0.96-2.94 and 0.78; 0.44-1.40).

Health workers were willing to discuss IPV, but lacked fundamental knowledge on IPV. Training efforts that focus on screening and comprehensive management are urgently required.