‘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

Abstract

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.

Antenatal-Based Pilot Psychosocial Intervention to Enhance Mental Health of Pregnant Women Experiencing Domestic and Family Violence in Nepal

“…The design of this study, including data collection tools and techniques, is outlined in more detail in the published protocol paper (Sapkota, Baird, Saito, Rijal, et al, 2019). This paper seeks to describe the quantitative aspect of evaluation of the intervention.…”

Interventions in sexual and reproductive health services addressing violence against women in low- and middle- income countries: a mixed-methods systematic review

“…50 The embedded qualitative study confirmed that women felt empowered, supported, and valued by the counsellor. 51 In contrast, a Peruvian RCT (with some bias concerns) of a 30-minute counselling session with a resource card and external referral had no effect on women’s safety behaviours, health, use of community resources. 35 A Kenyan RCT of up to three 30-35-minute counselling sessions with resource card, safety planning and external referral reduced depression (MD = 7.12; 95% CI 6.21-8.03) and re-exposure to IPV (MD = 13.51; 95% CI 9.99-17.02).…”

“…30 35 Twelve quantitative evaluations were randomised controlled trials (RCTs), 32 34 35 38 40 47 50 52 55 58–60 six were uncontrolled before-after (UBA) studies, 29 30 39 42 46 54 six cross sectional studies, 31 45 49 53 56 57 and one was a controlled before-after evaluation (CBA). 28 Nine qualitative evaluations were components of mixed-methods studies: three embedded in RCTs, 38 44 51 two carried out alongside UBA studies, 30 54 three alongside cross-sectional studies, 49 56 57 and one standalone qualitative study. 33 No two studies of similar design evaluated the same intervention and outcomes.…”

“…35 38 47 52 55 58 59 Of 13 non-randomised studies (all at high risk of bias), only four adequately addressed missing outcome data. 28 29 49 54 Of ten qualitative evaluations, five scored 15 and above on the 20-point CASP checklist, 44 45 49 51 56 indicating relatively high quality of research design and conduct. The main weaknesses were insufficient justification of methods, reporting of recruitment and strategies for neutrality.…”

“…Eight studies across all three interventions categories identified fear of negative consequences as a barrier to identification, disclosure, and engagement in VAW interventions. 30 33 38 44 45 49 51 53…”