Nurses' and midwives' awareness of intimate partner violence‐related mental healthcare and associated factors in Tanzania

Abstract

Although intimate partner violence (IPV) is a significant public health problem in Tanzania, the country's system to provide IPV‐related mental healthcare is not sufficiently prepared to respond to IPV care needs. This study aimed to assess nurses' and midwives' awareness of IPV‐related mental healthcare and associated factors to encourage care provision. A cross‐sectional, anonymous, self‐administered survey was conducted among nurses and midwives in health facilities in the Mbeya region, from December 2018 to January 2019. The questions gauged awareness of IPV‐related mental disorders, availability of screening tools, confidence in providing IPV‐related mental healthcare and the presence of a mental health focal/resource person, in addition to socio‐demographic and institutional characteristics. Of 1,321 nurses and midwives in the region, 662 (50.1%) participated in the study, and the analysis included 568 (85.8%) responses without missing values. The median awareness score was 5 (range: 0–6), and 34.0% of the participants were aware of all six examined IPV‐related mental health disorders. Separate logistic regression analyses were conducted for those working in hospitals and those working in health centres (HCs), assessing potential factors associated with nurses' and midwives' awareness of IPV‐related mental disorders. Among nurses and midwives in hospitals, high professional education (adjusted odds ratio [AOR]: 1.207; 95% confidence interval [CI]: 0.787, 1.852; p = .045) and long work experience (AOR: 1.479; 95% CI: 1.009, 2.169; p = .007) were associated with high awareness of IPV‐related mental disorders. For those in HCs, government ownership (AOR: 3.526; 95% CI: 1.082, 11.489; p = .037) and having a mental health focal/resource person (AOR: 3.251; 95% CI: 1.184, 8.932; p = .036) were associated with high awareness of IPV‐related mental disorders. Appropriate distribution of mental health focal/resource persons is required for improving awareness of IPV‐related mental healthcare provision among nurses and midwives in remote areas of Tanzania.

A Scoping Review on Sexual and Gender-Based Violence Medicolegal Service Provision in East Africa

“…Additionally, some countries in East Africa were mentioned mainly in the context of refugees that had come from that country to other countries in search of humanitarian aid, like refugees from Somalia and South Sudan in refugee camps in Kenya and Uganda ( Amnesty International, 2010 ; Horn, 2010 ; Kawaguchi, 2018 ; Liebling et al, 2020a , 2020b ; Muuo et al, 2020 ; Whelan & Blogg, 2007 ). Our review found that resource constraints and the failure of countries to follow WHO guidance were the most common themes that cut across the research studies on post-SGBV service provision in East Africa, although other issues, such as inconsistent provider training and provider bias, were also significant barriers to adequate service provision ( Ajema et al, 2011 ; Ambikile et al, 2021 ; Amnesty International, 2010 ; Dennis et al, 2019 ; Gatuguta et al, 2018 ; Henttonen et al, 2008 ; Muganyizi et al, 2011 ; Nguyen et al, 2016 ; Odwe et al, 2018 ; Tapesana et al, 2017 ; Whelan & Blogg, 2007 ; Zraly et al, 2011 ).…”

“…(e.g., Manuel et al, 2019). The primary data collection method for understanding medical and legal service provision for IPV survivors was qualitative interviewing, although two studies distributed surveys to medical students, nurses, and midwives (Ambikile et al, 2021;Manuel et al, 2019).…”

“…It was variously defined, such as “a form of interpersonal violence by a spouse or life partner” (e.g., Shumba et al, 2017 ) “violence committed against a woman by her current or former spouse or boyfriend” (e.g., Horn, 2010 ), “violence committed in a present or past relationship.” (e.g., Manuel et al, 2019 ). The primary data collection method for understanding medical and legal service provision for IPV survivors was qualitative interviewing, although two studies distributed surveys to medical students, nurses, and midwives ( Ambikile et al, 2021 ; Manuel et al, 2019 ).…”

“…Two of the papers focused on mental healthcare needs of IPV victims, and these were specifically on screening processes and service provision ( Ambikile et al, 2021 ; Chepuka et al, 2014 ). The remaining papers focused on screening for, responding to, or training for working with IPV cases more generally ( Horn, 2010 ; Maina, 2009 ; Maina & Majeke, 2008 ; Manuel et al, 2019 ; Nguyen et al, 2016 ; Odero et al, 2014 ; Shumba et al, 2017 ; Undie et al, 2016 ).…”

“…The other three papers sampled survivor and non-survivor refugees, survivors, or men and women in general.Several studies cited a lack of knowledge and relevant skills as potential reasons for inadequate service provision. This was often attributed to a lack of targeted trainings, staff shortages, and lacking protocols for case management(Ambikile et al, 2021;Odero et al, 2014;Undie et al, 2016). Additionally, several papers noted the additional challenges associated with treating the mental health impacts of IPV, whether due to societal pressures to resolve issues, poor training of service providers, or a lack of linkages to mental health services(Ambikile et al, 2021;Chepuka et al, 2014;Odero et al, 2014).…”