Journal Article

A comprehensive model for intimate partner violence in South African primary care: action research

Joyner, Kate, Mash, Bob

2012

Overview

Background Despite extensive evidence on the magnitude of intimate partner violence (IPV) as a public health problem worldwide, insubstantial progress has been made in the development and implementation of sufficiently comprehensive health services. This study aimed to implement, evaluate and adapt a published protocol for the screening and management of IPV and to recommend a model of care that could be taken to scale in our underdeveloped South African primary health care system. Methods Professional action research utilised a co-operative inquiry group that consisted of four nurses, one doctor and a qualitative researcher. The inquiry group implemented the protocol in two urban and three rural primary care facilities. Over a period of 14 months the group reflected on their experience, modified the protocol and developed recommendations on a practical but comprehensive model of care. Results The original protocol had to be adapted in terms of its expectations of the primary care providers, overly forensic orientation, lack of depth in terms of mental health, validity of the danger assessment and safety planning process, and need for ongoing empowerment and support. A three-tier model resulted: case finding and clinical care provision by primary care providers; psychological, social and legal assistance by ‘IPV champions’ followed by a group empowerment process; and then ongoing community-based support groups. Conclusion The inquiry process led to a model of comprehensive and intersectoral care that is integrated at the facility level and which is now being piloted in the Western Cape, South Africa.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Action research / Casualties / Co-operative inquiry / Conjugal violence / Domestic Violence / Family planning / Family violence / Female / Femicide / Health Administration / Health aspects / Health facilities / Health Informatics / Health sciences / Health services / Health Services Research / Health systems / Health systems and services in low and middle income settings / Humans / Interpersonal violence / Intimate partner violence / Male / Maternal & child health / Medical care / Medical personnel / Medical referrals / Medicine / Medicine & Public Health / Mental disorders / Mental health / Mental health care / Models, Theoretical / Nurse practitioners / Nurses / Nursing Research / Physicians / Premature labor / Primary care / Primary Health Care / Public Health / Qualitative Research / Research Article / Rural areas / Self-Help Groups / Sexually transmitted diseases / South Africa / Spouse abuse / Spouse Abuse - diagnosis / Statistics / STD / Surveys / Wife abuse / Women / Womens health