Gender based violence: knowledge and attitudes of health care providers in Nicaragua
Rodríguez-Bolaños, R.de.los.Angeles.; Márquez-Serrano, M.; Kageyama-Escobar, Mía.de.la.Luz.
Salud Publica de Mexico 47(2): 134-144
2005
ISSN/ISBN: 0036-3634 PMID: 15889639 Document Number: 256412
From April to June 2003, a cross-sectional study was conducted to assess the knowledge and attitudes of health care personnel towards the identification and referral of gender-based violence (GBV) victims. In addition, the barriers to identification and referral of GBV victims were identified and the levels of knowledge about Norms and Procedures for Intra-Family Violence Care by health care personnel of the Nicaragua Ministry of Health (Ministerio de Salud de Nicaragua, MINSA) were assessed. Health care professionals, including physicians, nurses and nursing technical aides (n=213), in five of 17 Local Systems of Integral Attention from the Integral Program of Attention for Women, Children and Adolescents in the primary level of attention in MINSA participated in the study. The results showed that 76.06% opposed GBV. The factors associated with opposition to GBV were: medical profession (odds ratio, OR=6.5; 95% confidence interval, CI=2.70-15.82), having a middle (OR=4.3; 95% CI=1.87-10.26) or high level (OR=3.3; 95% CI=1.03-10.75) of knowledge about intra-family violence guidelines and the closeness to relatives or friends who were victims of GBV (OR=3.2; 95% CI=1.56-6.80). The lack of training on the subject (59.9%), fear of getting involved in legal issues (52.6%), and the concept of violence as a private affair rather than a social one (50.7%), constituted the most important barriers to providing medical care. It is concluded that health care personnel generally have high values regarding the rejection of GBV. However, there are barriers that show persisting traditional beliefs, such as considering violence to be a personal issue. To ensure a substantial improvement in attitudes, better training is needed in medical schools with an emphasis on the gender perspective. The findings of the present study will allow improvements in health care reforms at the first level of care in the health sector in Nicaragua.