比较巴西、巴勒斯坦被占领土、尼泊尔和斯里兰卡卫生系统整合家庭暴力服务的准备情况。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Health policy and planning Pub Date : 2024-06-03 DOI:10.1093/heapol/czae032
Manuela Colombini, Satya Shrestha, Stephanie Pereira, Beatriz Kalichman, Prabhash Siriwardhana, Tharuka Silva, Rana Halaseh, Ana Flavia d'Oliveira, Poonam Rishal, Pusp Raj Bhatt, Amira Shaheen, Nagham Joudeh, Thilini Rajapakse, Abdulsalam Alkaiyat, Gene Feder, Claudia Garcia Moreno, Loraine J Bacchus
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引用次数: 0

摘要

家庭暴力(DV)是全球普遍存在的健康问题,会对健康造成不良影响,但卫生系统往往没有做好应对准备。本文对巴西、尼泊尔、斯里兰卡和巴勒斯坦被占领土(OPT)卫生系统将家庭暴力纳入卫生服务所需的先决条件进行了比较综述。我们采用卫生系统准备框架进行了跨国比较分析。数据收集涉及多种数据来源,包括与各利益相关方的定性访谈、与妇女的焦点小组讨论、结构化设施观察以及对医疗服务提供者的调查。我们的研究结果凸显了政策和实践中存在的不足,而这些不足是有效的家庭暴力应对措施亟待解决的问题。常见的准备差距包括对家庭暴力的指导不明确且有限、领导不支持以及培训和资源有限。大多数医疗服务提供者认为自己没有做好准备,缺乏指导,并且感觉得不到管理人员及其医疗系统的支持和保护。在巴西,大多数医疗服务提供者认为他们应该对家庭暴力案件做出反应,而在斯里兰卡,许多医疗服务提供者却不愿意这样做。这些组织和服务提供方面的挑战反过来也影响了医疗服务提供者应对家庭暴力案件的方式,使他们没有信心,对自己的知识不确定,对自己的角色不确定。此外,医疗服务提供者对家庭暴力和性别规范的个人信仰和价值观也影响了他们的应对动机和能力,促使一些人成为 "积极分子",而另一些人则不愿干预,并容易指责妇女。我们的综述还指出,由于妇女对医疗服务提供者的信任度较低,她们在使用家庭暴力医疗服务方面存在差距。我们的概念框架表明了制定明确政策的重要性,并强调了让系统各个层面的领导层参与进来以重塑挑战并加强常规做法的必要性。未来的研究还应确定如何解决妇女对家庭暴力求助的理解和需求。
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Comparing health systems readiness for integrating domestic violence services in Brazil, occupied Palestinian Territories, Nepal and Sri Lanka.

Domestic violence (DV) is a global prevalent health problem leading to adverse health consequences, yet health systems are often unprepared to address it. This article presents a comparative synthesis of the health system's pre-conditions necessary to enable integration of DV in health services in Brazil, Nepal, Sri Lanka and occupied Palestinian Territories (oPT). A cross-country, comparative analysis was conducted using a health systems readiness framework. Data collection involved multiple data sources, including qualitative interviews with various stakeholders; focus-group discussions with women; structured facility observations; and a survey with providers. Our findings highlight deficiencies in policy and practice that need to be addressed for an effective DV response. Common readiness gaps include unclear and limited guidance on DV, unsupportive leadership coupled with limited training and resources. Most providers felt unprepared, lacked guidance and felt unsupported and unprotected by managers and their health system. While in Brazil most providers felt they should respond to DV cases, many in Sri Lanka preferred not to. Such organizational and service delivery challenges, in turn, also affected how health providers responded to DV cases leaving them not confident, uncertain about their knowledge and unsure about their role. Furthermore, providers' personal beliefs and values on DV and gender norms also impacted their motivation and ability to respond, prompting some to become 'activists' while others were reluctant to intervene and prone to blame women. Our synthesis also pointed to a gap in women's use of health services for DV as they had low trust in providers. Our conceptual framework demonstrates the importance of having clear policies and highlights the need to engage leadership across every level of the system to reframe challenges and strengthen routine practices. Future research should also determine the ways in which women's understanding and needs related to DV help-seeking are addressed.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
期刊最新文献
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