Health Care Providers Views on Identifying and Responding to South Asian Women Experiencing Family Violence: A Qualitative Meta Synthesis

Abstract

Family violence (FV) is a universal public health problem in South Asia with negative-health outcomes for South Asian women. Health care providers (HCPs) play a pivotal role in identifying and supporting women experiencing FV, but little is known about their experiences with South Asian women. A systematic review was conducted to explore and address health care providers’ views on identification and response to South Asian women experiencing FV. Nine online databases, reference lists were searched, and a priori inclusion and exclusion criteria were applied independently by two reviewers. A meta-synthesis approach was utilized to integrate findings from qualitative studies. Eight studies involving 250 participants met the inclusion criteria. Studies were published between 2007 and 2020 within South Asian countries (Pakistan, India, and Sri Lanka) and one study from the USA and UK. The meta-synthesis identified three themes: Context of societal norms and attitudes towards women in South Asia; Influence of family honor, Privacy and shame; and Concern about health care provider’s personal safety. Findings revealed that FV is often perceived as a normal routine issue and is considered a “private issue” in South Asian society. Family honor and values play a pivotal role in silencing women experiencing FV as disclosure is considered shameful and disgrace to family honor. Furthermore, health care providers avoid intervening in FV cases due to risk for their personal safety. Finally, this review provides the evidence to support a specific framework for FV interventions among south Asian women for policy makers and practitioners.

Transforming health settings to address gender‐based violence in Australia

“…Asking general questions about relationships followed by questions about behaviour (eg, hitting, controlling behaviour, humiliation) or feelings (eg, fear, unsafe) are more likely to elicit disclosures than asking stigmatising‐type questions (eg, “are you experiencing domestic or sexual violence?”) 37 . If domestic violence is disclosed, then asking specifically about sexual violence is suggested to elicit disclosure of these hidden experiences, 38 although in some cultures sexual violence is a taboo subject 39,40 . For Indigenous women, indirect questions and conversational interactions that are collaborative and responsive are recommended 41 as more appropriate than direct questions.…”

Honour Killing and Criminal Justice System in Pakistan

“…Pakistan is considered a patriarchal society, and honour-based violence (HBV) is embedded deep into the social fabric. 16 According to the HRCP (2022), the number of women killed in Punjab in the last ten years in the name of honour is 2,966, of which only 176 were killed in 2022. 17 Domestic issues, marriage choice, and illicit relations were the main causes of these murders.…”

South Asian women’s lived experiences of health care after disclosure of family violence: A qualitative meta-synthesis review

“…According to research, the clinical context is viewed by some HCPs as an optimal site for FV identi cation and response since there is trust in the relationship (26). Therefore, health care providers and policymakers are best positioned to collaborate and support women by assisting survivors through the implementation of effective intervention in the health care system (27).…”