ObjectiveThe goal of this study was to explore the surveillance data about mandatory reporting diseases, included in the official information systems, and evaluate the historical trend analysis in prisoners in Brazil.DesignA time trends study was performed using secondary data from prisons’ health units.SettingNationwide representative data of Brazilian prisoners obtained from 2007 to 2014 health and prison information systems database were analysed. These data are carried out by units identified as prison health facilities.Primary outcome measuresDiseases diagnosis and individual data were available at the National System of Disease Notification (in Portuguese SINAN), Mortality Information System (in Portuguese SIM) and Prison Registration Systems (in Portuguese INFOPEN and GEO prisons). Analyses of the notification data performed in the SINAN at the national level. SINAN was consolidated with SIM, INFOPEN and GEO prison data.ResultsA total of 23 235 cases of compulsory disease notification causing morbidity were reported in prison units in Brazil; of these cases, 20 003 (85.6%) were men and 3362 (14.4%) were women. Over time, the proportion of prisoners increased from 1.92 per 1000 inhabitants in 2007 to 2.77 per 1000 inhabitants in 2014 (rising trend). From a total of 27 states, 12 of them presented a growth in disease notifications, 14 were stable and in only one state was there a decrease in notifications. There was an increase in notifications in the country as a whole. Tuberculosis (64.4%), dengue (9.1%), AIDS (9.0%) and viral hepatitis (5.9%) were among the most frequently reported diseases during the study period.ConclusionDespite showing stable tendencies, our results show high rates of diseases in Brazilian prisons. Prison health services should not be isolated but integrated into regional and national health and justice systems.
Background Gender-based domestic violence has gained significant visibility in recent years and is currently considered a priority in the field of public health. This preliminary, qualitative study explores how social norms and professional regulations impact the attitudes and practices of health workers and criminal justice professionals regarding domestic violence against women in Brazil and Norway. Methods A total of 16 semi-structured, in-depth interviews were conducted; eight in two different cities in Brazil, and eight in two different cities in Norway. In each country, four health workers and four criminal justice professionals were interviewed. We focused on the participants’ experiences with cases of domestic violence, their perceptions of their professional responsibilities, as well as the challenges they encounter. We analysed the transcribed interviews using a focused open coding process. Findings The participants ranged in age from 32 to 59. All of them worked, with and without supervision, in cases involving domestic violence victims. In all four study locations, the professionals felt that they had not received enough training in how to handle domestic violence. Some medical doctors reported becoming personally detached over time, especially when the victims did not admit that their injuries were due to domestic violence. In the Brazilian cities, some professionals reported that women who were beaten by their partners were themselves responsible for the situation. This was not the case in the Norwegian cities. Both countries have laws and regulations that have been put in place to guide professionals who provide services to victims of domestic violence. For many reasons, professionals do not always follow these regulations. For the Norwegian health workers, confidentiality was an important factor explaining why they did not always report suspected domestic violence to the police. For the Brazilian health workers, the fear of having to testify in court, and thus potentially being vulnerable to violence themselves, was a factor that made some not want to involve the justice system. In both countries, the participating professionals reported the need for closer collaboration with social workers and mental health specialists, since domestic violence is closely related to both social norms in the communities and to individual psychological factors. Conclusion Individual characteristics and experiences, the emphasis on confidentiality and the fear of repercussions may affect the way health and criminal justice workers perceive and deal with domestic violence cases. The findings in the study thus indicate that personal psychological factors and social norms concerning the acceptability of domestic violence are critical risk factors for women, and that a multi-professional approach is needed. The findings from this preliminary study can serve as background for larger and more comprehensive studies of how professionals handle cases of domestic violence.
OBJETIVE: To estimate the prevalence of psychological, physical, and sexual violence perpetrated against women by their intimate partner (IP) in Quilombola communities located in Espírito Santo State, Brazil. METHODS: The data is from a population-based cross-sectional study of Quilombola women conducted from 2017 to 2018. In-person interviews collected information on women’s sociodemographic characteristics, behaviors, and their experience of violence perpetrated by their IP. The analysis used chi-square test and hierarchical logistic regression. RESULTS: 219 women (94.8% of the invited ones) agreed to participate in the study. 59.0% (95%CI: 5.25–65.5) reported psychological violence; 41% (95%CI: 34.5–47.5) physical violence; and 8.2% (95%CI: 4.6–11.8) sexual violence. Psychological violence was associated with having three or more sexual partners in life, when compared to those who had up to two partners (p = 0,009), and previous violence involving other people outside of family increased the chance of suffering psychological violence by an IP more than nine times (p ≤ 0.001). Regarding physical violence, the association with use of barrier contraception (p = 0.031) and having a partner with other sexual partners (p = 0.024) were protective factors for IP violence. Having 3 or more sexual partners in the last 12 months (p = 0.006), partner using illicit drugs (p = 0,006), and alcoholism in the family (p = 0,001), increased the chance of suffer physical violence by the partner. Sexual violence perpetrated by the IP was associated with miscarriage (p = 0.016), partner using drugs (p = 0.020), and gynecological symptoms (p = 0.045). CONCLUSIONS: These results showed the high frequency of intimate partner violence in Quilombola women and highlight the importance of reducing social and race inequities for interrupting the culture of violence against women.
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