Healthcare provider experiences interacting with survivors of intimate partner violence: A qualitative study to inform survivor-centered approaches

Abstract

Background: Intimate partner violence (IPV) remains a pervasive form of gender-based violence (GBV) that is largely undisclosed, especially among women seeking healthcare services in Uganda. Prioritizing survivor needs, preferences, and rights may improve IPV disclosure. This study explores healthcare worker experiences from provider-patient interactions with survivors seeking antenatal care services (ANC) in Uganda. Methods: In-depth interviews were conducted among twenty-eight experienced healthcare providers in a rural and an urban-based ANC clinic in Eastern and Central Uganda. Providers were asked what they viewed as the needs and fears of women identified as having experienced any form of IPV. Iterative, inductive/deductive thematic analysis was conducted to discover themes regarding perceived needs, fears, and underlying contextual issues experienced by IPV survivors. Results: According to healthcare providers, IPV survivors are unaware of available support services, and need economic empowerment. Providers reported that some survivors were concerned for their personal safety, and the consequences of IPV disclosure including community stigma, retaliatory abuse, marriage loss, and losing partners’ financial support. Women survivors also blamed themselves for IPV. Contextual factors underlying survivor concerns included the socio-economic environment, namely, social, and cultural norms condoning violence, household poverty, and survivors’ unawareness of their human rights. Conclusions: We underscore a need to empower IPV survivors by prioritizing their needs, preferences, and rights. Results highlight opportunities to create a conducive healthcare environment that fosters IPV disclosure while addressing survivors’ immediate medical and psychosocial needs, and safety concerns. Re-framing GBV prevention and response programming strategies in Uganda towards survivor-centered approaches is recommended.