Auckland University of Technology, Auckland, New Zealand.
Inquiry. 2023 Jan-Dec;60:469580221146832. doi: 10.1177/00469580221146832.
COVID-19 pandemic planning and response has resulted in unprecedented upheaval within health systems internationally. With a concern for increasing frequency and escalation of family violence, the so called "shadow pandemic," we wondered how health system violence intervention programs were operating during this time. In Aotearoa New Zealand, the Ministry of Health Violence Intervention Program (VIP), using a systems approach, seeks to reduce and prevent the health impacts of family violence and abuse through early identification, assessment, and referral of victims presenting to designated health services. In this qualitative descriptive study, we explored how the VIP program was impacted during the first year of the COVID-19 pandemic. Forty-one VIP coordinators and managers representing 15 of the 20 New Zealand District Health Boards and the National VIP Team participated. Across 12 focus groups (8 face to face and 4 via Zoom) and 7 individual interviews (all via Zoom) participants shared their experience navigating systems to support frontline health providers' responsiveness to people impacted by family violence during the pandemic. In our reflexive thematic analysis, we generated 3 themes: Responding to the moment, valuing relationships, and reflecting on the status quo. Our findings demonstrate the dynamic environment in which participants found creative ways to adapt to the uncertainty and engage with communities to re-shape interventions and ensure continued implementation of the program. At the same time, challenges within the system prior to the pandemic were brought into view and highlighted the need for action. These included, for example, the need for improved engagement with Māori (Indigenous people of Aotearoa New Zealand) to address long-standing health inequities. Having quality essential services for those impacted by family violence that engages with local knowledge and networks and routinely copes with uncertainty will strengthen our systems to minimize risk of harm during emergencies.
COVID-19 大流行的规划和应对措施在国际范围内对卫生系统造成了前所未有的动荡。由于担心家庭暴力的频率和严重程度不断增加，即所谓的“影子大流行”，我们想知道在此期间卫生系统的暴力干预计划是如何运作的。在新西兰，卫生部的暴力干预计划（VIP）采用系统方法，通过对到指定卫生服务机构就诊的受害者进行早期识别、评估和转介，旨在减少和预防家庭暴力和虐待对健康的影响。在这项定性描述性研究中，我们探讨了 VIP 计划在 COVID-19 大流行的第一年是如何受到影响的。来自 20 个新西兰地区卫生局和国家 VIP 团队中的 15 个的 41 名 VIP 协调员和管理人员参加了研究。在 12 个焦点小组（8 个面对面和 4 个通过 Zoom）和 7 个个人访谈（全部通过 Zoom）中，参与者分享了他们在大流行期间为支持一线卫生提供者对受家庭暴力影响的人做出反应而在系统中导航的经验。在我们的反思性主题分析中，我们生成了 3 个主题：应对当下、重视关系和反思现状。我们的研究结果表明，参与者所处的环境充满活力，他们找到了富有创意的方法来适应不确定性，并与社区合作，重新调整干预措施，确保计划的持续实施。与此同时，大流行前系统中存在的挑战也凸显出来，需要采取行动。例如，需要加强与毛利人（新西兰的土著民族）的接触，以解决长期存在的健康不平等问题。为受家庭暴力影响的人提供优质的基本服务，这些服务能够与当地知识和网络相契合，并能常规应对不确定性，这将增强我们的系统，最大限度地减少紧急情况下的伤害风险。
