CEHAT - Centre for Enquiry into Health and Allied Themes, Mumbai, India.
Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
BMC Public Health. 2021 Nov 1;21(1):1973. doi: 10.1186/s12889-021-12042-7.
Violence against women is a serious public health concern, and is highly prevalent globally, including in India. Health-care providers [HCPs] can play an important role in addressing and reducing negative consequences of violence against women. We implemented a pre-post intervention study of HCP training in three tertiary care facilities in Maharashtra, India.
The study used a pre-post intervention design with assessment of HCPs' (n = 201) knowledge, attitudes, perceived preparedness and practice at three time points: before training, after training and at 6 months follow- up.
Total median score of knowledge about common signs and symptoms of violence (8.89 vs, 10.00), attitudes towards acceptability of violence (9.05 vs. 10.00), individual (6.74 vs. 10.00) and system level preparedness (6.11 vs. 8.14) improved from pre to post- training. The generalized estimating equation [GEE] model, adjusted for age, sex, site and department, showed an improvement in knowledge, attitudes and preparedness post- training. The change from pre to 6 months follow- up was not significant for attitude.
This package of interventions, including training of HCPs, improved HCPs' knowledge, attitudes and practices, yet changes in attitudes and preparedness did not sustain over time. This study indicates feasibility and positive influence of a multi-component intervention to improve HCP readiness to respond to violence against women in a low-resource setting. Future phases of intervention development include adapting this intervention package for primary and secondary health facilities in this context, and future research should assess these interventions using a rigorous experimental design. Finally, these results can be used to advocate for multi-layered, systems-based approaches to strengthening health response to violence against women.
暴力侵害妇女是一个严重的公共卫生问题，在全球范围内普遍存在，包括在印度。医疗保健提供者（HCPs）可以在解决和减少暴力侵害妇女的负面影响方面发挥重要作用。我们在印度马哈拉施特拉邦的三家三级保健机构实施了一项 HCP 培训的前后干预研究。
该研究采用前后干预设计，在三个时间点评估 HCPs 的知识、态度、感知准备和实践情况：培训前、培训后和 6 个月随访。
关于暴力常见迹象和症状的知识总中位数评分（8.89 与 10.00）、对暴力可接受性的态度（9.05 与 10.00）、个人（6.74 与 10.00）和系统层面的准备（6.11 与 8.14）从培训前到培训后均有所提高。广义估计方程（GEE）模型，调整了年龄、性别、地点和部门，显示出培训后知识、态度和准备的改善。从培训前到 6 个月随访的态度变化不显著。
包括培训 HCP 在内的一揽子干预措施，提高了 HCP 的知识、态度和实践，但态度和准备的变化并没有随着时间的推移而持续。这项研究表明，在资源匮乏的环境中，多组分干预措施可以提高 HCP 应对暴力侵害妇女的准备情况，具有可行性和积极影响。未来干预措施的发展阶段包括在这一背景下为初级和二级保健设施改编这一干预措施包，未来的研究应使用严格的实验设计评估这些干预措施。最后，这些结果可用于倡导多层面、基于系统的方法，加强对暴力侵害妇女行为的卫生应对。
