Interventions for reducing and/or controlling domestic violence among pregnant women in low- and middle-income countries: a systematic review

Sapkota, Diksha; Baird, Kathleen; Saito, Amornrat; Anderson, Debra

doi:10.1186/s13643-019-0998-4

Cited by 32 publications

(45 citation statements)

References 46 publications

(111 reference statements)

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“…The objectives and findings of this review are broadly in agreement with those of a recent systematic review [20], which aimed to identify and assess the effectiveness of interventions currently available for women living in LMIC who report domestic violence. The limited quantity of data found across both systematic reviews reflects the observation that screening and interventions for domestic violence in LMIC is not often part of routine antenatal and postnatal care; a recognition of the importance of introducing such interventions is just starting to emerge, and uptake is relatively slow.…”

Section: Limitations Of the Studymentioning

confidence: 68%

Interventions for women who report domestic violence during and after pregnancy in low- and middle-income countries: a systematic literature review

Daley

McCauley

Broek

2020

BMC Pregnancy Childbirth

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Background: Domestic violence is a leading cause of social morbidity and may increase during and after pregnancy. In high-income countries screening, referral and management interventions are available as part of standard maternity care. Such practice is not routine in low-and middle-income countries (LMIC) where the burden of social morbidity is high. Methods: We systematically reviewed available evidence describing the types of interventions, and/or the effectiveness of such interventions for women who report domestic violence during and/or after pregnancy, living in LMIC. Published and grey literature describing interventions for, and/or effectiveness of such interventions for women who report domestic violence during and/or after pregnancy, living in LMIC was reviewed. Outcomes assessed were (i) reduction in the frequency and/or severity of domestic violence, and/or (ii) improved physical, psychological and/or social health. Narrative analysis was conducted. Results: After screening 4818 articles, six studies were identified for inclusion. All included studies assessed women (n = 894) during pregnancy. Five studies reported on supportive counselling; one study implemented an intervention consisting of routine screening for domestic violence and supported referrals for women who required this. Two studies evaluated the effectiveness of the interventions on domestic violence with statistically significant decreases in the occurrence of domestic violence following counselling interventions (488 women included). There was a statistically significant increase in family support following counselling in one study (72 women included). There was some evidence of improvement in quality of life, increased use of safety behaviours, improved family and social support, increased access to community resources, increased use of referral services and reduced maternal depression. Overall evidence was of low to moderate quality. Conclusions: Screening, referral and supportive counselling is likely to benefit women living in LMIC who experience domestic violence. Larger-scale, high-quality research is, however, required to provide further evidence for the effectiveness of interventions. Improved availability with evaluation of interventions that are likely to be effective is necessary to inform policy, programme decisions and resource allocation for maternal healthcare in LMIC. Trial registration: Systematic review registration number: PROSPERO CRD42018087713.

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Section: Limitations Of the Studymentioning

confidence: 68%

Interventions for women who report domestic violence during and after pregnancy in low- and middle-income countries: a systematic literature review

Daley

McCauley

Broek

2020

BMC Pregnancy Childbirth

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“…Considering the social stigma related to seeking help from DFV services and minimal funding in this area [8,10], integrating DFV program into routine ANC and/or PMTCT counselling services can be a potential cost-effective strategy to improve response mechanisms against DFV in resource-constrained settings like Nepal. Such integrated approach of service delivery has been recommended in literature as well [13,41].…”

Section: Discussionmentioning

confidence: 99%

“…However, sufficient evidence does not exist to guide health care providers (HCPs) and policy makers on the best way to address the needs of victims. A recent review about interventions targeting DFV among pregnant women in low-and middle-income countries (LMICs) identified some beneficial effects of screening and supportive counselling with a provision of referral to support services [13], in alignment with previous findings [14,15]. In a resource limited setting such as Nepal, where services for DFV are insufficient in number or are just emerging [8], screening for DFV alone can be a good initiative to inform women about DFV and the appropriate referrals of victims could contribute to an improvement in their health and well-being [15,16].…”

mentioning

confidence: 99%

“…In a resource limited setting such as Nepal, where services for DFV are insufficient in number or are just emerging [8], screening for DFV alone can be a good initiative to inform women about DFV and the appropriate referrals of victims could contribute to an improvement in their health and well-being [15,16]. Antenatal care (ANC) has been the recommended setting for implementation of such a screening and referral intervention [13,17].…”

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confidence: 99%

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‘We don’t see because we don’t ask’: Qualitative exploration of service users’ and health professionals’ views regarding a psychosocial intervention targeting pregnant women experiencing domestic and family violence

et al. 2020

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IntroductionGiven the relative recency of Domestic and Family Violence (DFV) management as a field of endeavour, it is not surprising that interventions for addressing DFV is still in its infancy in developing countries. In order to maximise the success of an intervention, it is important to know which aspects of the intervention are considered important and helpful by service providers and service users. This study, therefore, examined the acceptability of an antenatalbased psychosocial intervention targeting DFV in Nepal and explored suggestions for improving the program in future. Materials and methodsIntervention participants and health care providers (HCPs) were interviewed using semistructured interviews. Data were audio-recorded and thematic analysis was used to analyse the data. Final codes and themes were identified using an iterative review process among the research team. ResultsThemes emerging from the data were grouped into domains including perceptions towards DFV, impact of the intervention on women's lives and recommendations for improving the program. DFV was recognised as a significant problem requiring urgent attention for its prevention and control. Intervention participants expressed that they felt safe to share their feelings during the counselling session and got opportunity to learn new skills to cope with DFV.

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“…Cultural beliefs normalizing VAW reinforce the lack of support for survivors and exacerbate the challenges of proper health care delivery to survivors. Other challenges to providing a health system response include inadequate infrastructure and lack of coordination between the health sector and other sectors [ 12 – 14 ]. Several governments have begun to focus on putting in place structural support systems for survivors.…”

Section: Introductionmentioning

confidence: 99%

Mapping the health systems response to violence against women: key learnings from five LMIC settings (2015–2020)

et al. 2021

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Background Violence against women (VAW) is a global challenge, and the health sector is a key entry point for survivors to receive care. The World Health Organization adopted an earlier framework for health systems response to survivors. However, documentation on the programmatic rollout of health system response to violence against women is lacking in low and middle-income countries. This paper studies the programmatic roll out of the health systems response across select five low- and middle-income countries (LMIC) and identifies key learnings. Methods We selected five LMIC settings with recent or active programming on national-level health system response to VAW from 2015 to 2020. We synthesized publicly available data and program reports according to the components of the WHO Health Systems Framework. The countries selected are Bangladesh, Brazil, Nepal, Rwanda, and Sri Lanka. Results One-stop centers were found to be the dominant model of care located in hospitals in four countries. Each setting has implemented in-service training as key to addressing provider knowledge, attitudes and practice; however, significant gaps remain in addressing frequent staff turnover, provision of training at scale, and documentation of the impact of training. The health system protocols for VAW address sexual violence but do not uniformly include clinical and health policy responses for emotional or economic violence. Providing privacy to survivors within health facilities was a universal challenge. Conclusion Significant efforts have been made to address provider attitudes towards provision of care and to protocolize delivery of care to survivors, primarily through one-stop centers. Further improvements can be made in data collection on training impact on provider attitudes and practices, in provider identification of VAW survivors, and in prioritization of VAW within health system budgeting, staffing, and political priorities. Primary health facilities need to provide first-line support for survivors to avoid delays in response to all forms of VAW as well as for secondary prevention.

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Interventions for reducing and/or controlling domestic violence among pregnant women in low- and middle-income countries: a systematic review

Cited by 32 publications

References 46 publications

Interventions for women who report domestic violence during and after pregnancy in low- and middle-income countries: a systematic literature review

Interventions for women who report domestic violence during and after pregnancy in low- and middle-income countries: a systematic literature review

‘We don’t see because we don’t ask’: Qualitative exploration of service users’ and health professionals’ views regarding a psychosocial intervention targeting pregnant women experiencing domestic and family violence

Mapping the health systems response to violence against women: key learnings from five LMIC settings (2015–2020)

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