Integrative review of the literature on screening for gender‐based violence during pregnancy: Barriers, facilitators, and tools

Abstract

An integrative review of the literature has been developed to explore barriers and facilitators in screening for gender-based violence in pregnant women and identify available tools for this screening. Studies were identified via a systematic search on the PubMed, CINAHL Plus (Cumulative Index of Nursing and Allied Health Literature Complete), Scopus, and LILACS (Latin American and Caribbean Health Sciences Literature) databases and a manual reverse reference search to obtain literature published between 2015 and 2020. The methodology followed the recommendations made by Whittemore & Knafl. The quality of studies was evaluated using the Critical Skills Appraisal Program tool. Twenty-three of the 4202 articles fulfilled the inclusion criteria. The principal barriers identified were lack of training for professionals (mainly nurses and midwives), lack of support policies, and lack of human and material resources. The main facilitators were to increase professional training programs on case detection, availability of effective instruments, and greater investment in resources to guarantee safety and referral of cases. With regard to the available tools, the Abuse Assessment Screen (AAS) continues to be the most widely used, although others such as the Humiliation, Afraid, Rape, and Kick questionnaire (HARK) could be suitable for antenatal care settings.

Addressing Domestic Violence in Antenatal Care Environments in Nepal (ADVANCE) – Study Protocol for a Randomized Controlled Trial Evaluating a Video Intervention on Domestic Violence among Pregnant Women

“…Despite limited evidence of its e cacy, many countries have implemented routine inquiry for the experience of violence during pregnancy. However, there have been challenges in implementation of routine inquiry, including reluctance among health professionals (17). Other barriers to asking about violence in antenatal care include lack of training, time constraints, and insu cient options for assistance and referrals following disclosure (17).…”

“…However, there have been challenges in implementation of routine inquiry, including reluctance among health professionals (17). Other barriers to asking about violence in antenatal care include lack of training, time constraints, and insu cient options for assistance and referrals following disclosure (17). In Nepal, routine inquiry about violence in antenatal care has not been implemented.…”