Knowledge, attitudes and practices of health care providers trained in responding to violence against women: a pre- and post-intervention study

• Published in: BMC public health Vol. 21; no. 1; p. 1973
• Main Authors: Arora, Sanjida, Rege, Sangeeta, Bhate-Deosthali, Padma, Thwin, Soe Soe, Amin, Avni, García-Moreno, Claudia, Meyer, Sarah R
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01.11.2021; BioMed Central; BMC
• Subjects: Aggression; Attitudes; Beliefs, opinions and attitudes; Clinical medicine; Confidentiality; Demographic aspects; Design of experiments; Domestic violence; Experimental design; Feasibility studies; Female; Gender; Gender-based violence; Health behavior; Health care; Health care facilities; Health care industry; Health care providers; Health Facilities; Health Knowledge, Attitudes, Practice; Health literacy; Health Personnel; Health services; Humans; India; India; tertiary health care; health system; Infrastructure; Intervention; Knowledge; Medical education; Medical personnel; Midwifery; Multilayers; Public health; Research design; Signs and symptoms; Training; Violence; Violence against women; Womens health; India; Training; Violence against women; Health care providers; India; tertiary health care; health system
• ISSN: 1471-2458; 1471-2458
• 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.