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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Training Sri Lankan public health midwives on intimate partner violence: a pre- and post-intervention study

Authors: Achini Chinthika Jayatilleke, Kayoko Yoshikawa, Junko Yasuoka, Krishna C Poudel, Nilani Fernando, Achala Upendra Jayatilleke, Masamine Jimba

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

In many developing countries, intimate partner violence (IPV) training is not available for health providers. As a pioneer among developing countries, in 2009, the Sri Lankan Ministry of Health trained a group of community health providers known as public health midwives (PHMs) on IPV. We evaluated that training program’s efficacy in improving PHMs’ identification and management of IPV sufferers in Kandy, Sri Lanka.

Methods

We conducted this study from August 2009 to September 2010. We used a self-administered structured questionnaire to examine the following variables among 408 PHMs: self-reported IPV practices, IPV knowledge, perceived barriers, perceived responsibility, and self-confidence in identifying and assisting IPV sufferers. We used McNemar’s test to compare PHMs’ pre- and post-intervention IPV practices. Using the Wilcoxon signed-rank test, we compared PHMs’ pre-and post-intervention IPV knowledge, as well as their perceived barriers, responsibility, and self-confidence scores.

Results

The IPV training program improved PHMs’ IPV practices significantly. Six months after the intervention, 98.5% (n = 402) of the 408 PHMs identified at least one IPV sufferer in the previous three months, compared to 73.3% (n = 299) in the pre-intervention (p < 0.001). At post-intervention, 96.5% (n = 387) of the PHMs discussed IPV with identified sufferers and suggested solutions; only 67.3% (n = 201) did so at the pre-intervention (p < 0.001). In addition, after the intervention, there were significant increases (p < 0.001) in the median total scores of PHMs’ IPV knowledge (0.62 vs. 0.88), perceived responsibility (3.20 vs. 4.60), and self-confidence (1.81 vs. 2.75). PHMs’ perceived barriers decreased from 2.43 to 1.14 (p < 0.001).

Conclusions

An IPV training program for PHMs improved identification and assistance of IPV sufferers in Kandy, Sri Lanka. This training program has the potential to improve PHMs’ skills in preventing IPV and supporting sufferers in other regions of Sri Lanka. Other developing countries might learn lessons from Sri Lanka’s IPV training.
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Literature
1.
go back to reference Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C. WHO Multi-country Study on Women's Health and Domestic Violence against Women Study Team. Intimate partner violence and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: an observational study. Lancet. 2008;371:1165–72.CrossRefPubMed Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C. WHO Multi-country Study on Women's Health and Domestic Violence against Women Study Team. Intimate partner violence and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: an observational study. Lancet. 2008;371:1165–72.CrossRefPubMed
2.
go back to reference Pallitto CC, García-Moreno C, Jansen HA, Heise L, Ellsberg M, Watts C. WHO Multi-Country Study on Women's Health and Domestic Violence. Intimate partner violence, abortion, and unintended pregnancy: results from the WHO Multi-country Study on Women's Health and Domestic Violence. Int J Gynaecol Obstet. 2013;120:3–9.CrossRefPubMed Pallitto CC, García-Moreno C, Jansen HA, Heise L, Ellsberg M, Watts C. WHO Multi-Country Study on Women's Health and Domestic Violence. Intimate partner violence, abortion, and unintended pregnancy: results from the WHO Multi-country Study on Women's Health and Domestic Violence. Int J Gynaecol Obstet. 2013;120:3–9.CrossRefPubMed
3.
go back to reference World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva, Switzerland: World Health Organization; 2013. p. 50. World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva, Switzerland: World Health Organization; 2013. p. 50.
4.
go back to reference World Health Organization. Preventing intimate partner violence and sexual violence against women. Taking action and generating evidence. Geneva, Switzerland: World Health Organization; 2010. p. 102. World Health Organization. Preventing intimate partner violence and sexual violence against women. Taking action and generating evidence. Geneva, Switzerland: World Health Organization; 2010. p. 102.
5.
go back to reference Feder GS, Hutson M, Ramsay J, Taket AR. Women exposed to intimate partner violence: expectations and experiences when they encounter health care professionals: a meta-analysis of qualitative studies. Arch Intern Med. 2006;166:22–37.CrossRefPubMed Feder GS, Hutson M, Ramsay J, Taket AR. Women exposed to intimate partner violence: expectations and experiences when they encounter health care professionals: a meta-analysis of qualitative studies. Arch Intern Med. 2006;166:22–37.CrossRefPubMed
7.
go back to reference Sugg NK, Thompson RS, Thompson DC, Maiuro R, Rivara FP. Domestic violence and primary health care: attitudes, practices and beliefs. Arch Fam. 1999;8:301–6.CrossRef Sugg NK, Thompson RS, Thompson DC, Maiuro R, Rivara FP. Domestic violence and primary health care: attitudes, practices and beliefs. Arch Fam. 1999;8:301–6.CrossRef
8.
go back to reference Nicolaidis C, Curry M, Gerrity M. Measuring the impact of the voices of survivors program on health care workers' attitudes toward survivors of intimate partner violence. J Gen Intern Med. 2005;20:731–7.CrossRefPubMedPubMedCentral Nicolaidis C, Curry M, Gerrity M. Measuring the impact of the voices of survivors program on health care workers' attitudes toward survivors of intimate partner violence. J Gen Intern Med. 2005;20:731–7.CrossRefPubMedPubMedCentral
9.
go back to reference Papadakaki M, Petridou E, Kogevinas M, Lionis C. Measuring the effectiveness of an intensive IPV training program offered to Greek general practitioners and residents of general practice. BMC Med Educ. 2013;13:2–11.CrossRef Papadakaki M, Petridou E, Kogevinas M, Lionis C. Measuring the effectiveness of an intensive IPV training program offered to Greek general practitioners and residents of general practice. BMC Med Educ. 2013;13:2–11.CrossRef
10.
11.
12.
go back to reference Gutmanis I, Beynon C, Tutty L, Wathen CN, MacMillan HL. Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses. BMC Public Health. 2007;7:12.CrossRefPubMedPubMedCentral Gutmanis I, Beynon C, Tutty L, Wathen CN, MacMillan HL. Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses. BMC Public Health. 2007;7:12.CrossRefPubMedPubMedCentral
13.
go back to reference Jayatilleke AC, Poudel KC, Yasuoka J, Sakisaka K, Jayatilleke AU, Jimba M. Wives attitudes towards gender roles and their experience of intimate partner violence in Sri Lanka. J Interpers Violence. 2011;26:414–33.CrossRefPubMed Jayatilleke AC, Poudel KC, Yasuoka J, Sakisaka K, Jayatilleke AU, Jimba M. Wives attitudes towards gender roles and their experience of intimate partner violence in Sri Lanka. J Interpers Violence. 2011;26:414–33.CrossRefPubMed
14.
go back to reference Jayasuriya V, Wijewardena K, Axemo P. Intimate partner violence against women in the capital province of Sri Lanka: prevalence, risk factors, and help seeking. Violence Against Women. 2011;17:1086–102.CrossRefPubMed Jayasuriya V, Wijewardena K, Axemo P. Intimate partner violence against women in the capital province of Sri Lanka: prevalence, risk factors, and help seeking. Violence Against Women. 2011;17:1086–102.CrossRefPubMed
15.
go back to reference Moonesinghe LN, Rajapaksa LC, Samarasinghe G. Development of a screening instrument to detect physical abuse and its use in a cohort of pregnant women in Sri Lanka. Asia Pac J Public Health. 2005;16:138–44.CrossRef Moonesinghe LN, Rajapaksa LC, Samarasinghe G. Development of a screening instrument to detect physical abuse and its use in a cohort of pregnant women in Sri Lanka. Asia Pac J Public Health. 2005;16:138–44.CrossRef
16.
go back to reference Bourke-Martignon J. Violence against women in Sri Lanka: implementation of the convention on the elimination of all forms of discrimination against women by Sri Lanka, (Committee on the Elimination of Discrimination Against Women, Twenty-sixth Session, January 14 – February 1, 2002, Colombo, Sri Lanka). Geneva, Switzerland: World Organization Against Torture; 2002. p. 54. Bourke-Martignon J. Violence against women in Sri Lanka: implementation of the convention on the elimination of all forms of discrimination against women by Sri Lanka, (Committee on the Elimination of Discrimination Against Women, Twenty-sixth Session, January 14 – February 1, 2002, Colombo, Sri Lanka). Geneva, Switzerland: World Organization Against Torture; 2002. p. 54.
17.
go back to reference Subramanium P, Sivayogan S. The prevalence and patterns of wife beating in the Trincomalee District in eastern Sri Lanka. Southeast Asian J Trop Med Public Health. 2001;32:186–95. Subramanium P, Sivayogan S. The prevalence and patterns of wife beating in the Trincomalee District in eastern Sri Lanka. Southeast Asian J Trop Med Public Health. 2001;32:186–95.
18.
go back to reference Senanayake H, Goonawardene M, Ranatunga A, Hattotuwa R, Amarasekara S, Amarasinghe I. Achieving millennium development goals 4 and 5 in Sri Lanka. BJOG. 2011;118 Suppl 2:78–87.CrossRefPubMed Senanayake H, Goonawardene M, Ranatunga A, Hattotuwa R, Amarasekara S, Amarasinghe I. Achieving millennium development goals 4 and 5 in Sri Lanka. BJOG. 2011;118 Suppl 2:78–87.CrossRefPubMed
19.
go back to reference Family Health Bureau. Annual report on family health Sri Lanka - 2010. Colombo. Sri Lanka: Ministry of Health; 2011. p. 52. Family Health Bureau. Annual report on family health Sri Lanka - 2010. Colombo. Sri Lanka: Ministry of Health; 2011. p. 52.
20.
go back to reference UNFPA Sri Lanka. 7th Country Program from 2008 to 2012. Colombo, Sri Lanka: United Nations Population Fund Sri Lanka Office; 2007. p. 7. UNFPA Sri Lanka. 7th Country Program from 2008 to 2012. Colombo, Sri Lanka: United Nations Population Fund Sri Lanka Office; 2007. p. 7.
24.
go back to reference Bott S, Guedes A, Claramunt MC, Guezmes A. Improving the Health Sector Response to Gender Based Violence: A Resource Manual for Health Care Professionals in Developing Countries. Western Hemisphere Region: International Planned Parenthood Federation; 2010. p. 221. Bott S, Guedes A, Claramunt MC, Guezmes A. Improving the Health Sector Response to Gender Based Violence: A Resource Manual for Health Care Professionals in Developing Countries. Western Hemisphere Region: International Planned Parenthood Federation; 2010. p. 221.
25.
go back to reference Fisher D, Lang KS, Wheaton J. Training Professionals in the Primary Prevention of Sexual and Intimate Partner Violence: A Planning Guide. Atlanta, GA: Centers for Disease Control and Prevention; 2010. p. 86. Fisher D, Lang KS, Wheaton J. Training Professionals in the Primary Prevention of Sexual and Intimate Partner Violence: A Planning Guide. Atlanta, GA: Centers for Disease Control and Prevention; 2010. p. 86.
26.
go back to reference World Health Organization. Responding to Intimate Partner Violence and Sexual Violence Against Women: WHO Clinical and Policy Guidelines. Geneva, Switzerland: World Health Organization; 2013. p. 56. World Health Organization. Responding to Intimate Partner Violence and Sexual Violence Against Women: WHO Clinical and Policy Guidelines. Geneva, Switzerland: World Health Organization; 2013. p. 56.
27.
go back to reference Jayatilleke AC, Poudel KC, Yasuoka J, Jayatilleke AU, Jimba M. Review: intimate partner violence in Sri Lanka. BioScience Trends. 2010;4:90–5.PubMed Jayatilleke AC, Poudel KC, Yasuoka J, Jayatilleke AU, Jimba M. Review: intimate partner violence in Sri Lanka. BioScience Trends. 2010;4:90–5.PubMed
28.
go back to reference Field A. Discovering Statistics Using SPSS. 3rd ed. London, England: Sage Publications; 2009. p. 552–3. Field A. Discovering Statistics Using SPSS. 3rd ed. London, England: Sage Publications; 2009. p. 552–3.
29.
go back to reference Moskovic CS, Guiton G, Chirra A, et al. Impact of participation in a community-based intimate partner violence prevention program on medical students: a multi-center study. J Gen Intern Med. 2008;23:1043–7.CrossRefPubMedPubMedCentral Moskovic CS, Guiton G, Chirra A, et al. Impact of participation in a community-based intimate partner violence prevention program on medical students: a multi-center study. J Gen Intern Med. 2008;23:1043–7.CrossRefPubMedPubMedCentral
30.
go back to reference Baird K, Salmon D, White PA. Five year follow-up study of the Bristol pregnancy domestic violence program to promote routine enquiry. Midwifery. 2013;29:1003–10.CrossRefPubMed Baird K, Salmon D, White PA. Five year follow-up study of the Bristol pregnancy domestic violence program to promote routine enquiry. Midwifery. 2013;29:1003–10.CrossRefPubMed
31.
go back to reference Grimshaw J, Campbell M, Eccles M, Steen N. Experimental and quasi-experimental designs for evaluating guideline implementation strategies. Fam Pract. 2000;17 Suppl 1:S11–6.CrossRefPubMed Grimshaw J, Campbell M, Eccles M, Steen N. Experimental and quasi-experimental designs for evaluating guideline implementation strategies. Fam Pract. 2000;17 Suppl 1:S11–6.CrossRefPubMed
32.
go back to reference Yarnell J, Epidemiology and prevention. Epidemiology and Prevention: A System Based Approach. 1st ed. New York, United States of America: Oxford University Press; 2007. p. 308. Yarnell J, Epidemiology and prevention. Epidemiology and Prevention: A System Based Approach. 1st ed. New York, United States of America: Oxford University Press; 2007. p. 308.
33.
go back to reference Shefet D, Dascal-Weichhendler H, Rubin O, et al. Domestic violence: a national simulation-based educational program to improve physicians' knowledge, skills and detection rates. Med Teach. 2007;29:133–8.CrossRef Shefet D, Dascal-Weichhendler H, Rubin O, et al. Domestic violence: a national simulation-based educational program to improve physicians' knowledge, skills and detection rates. Med Teach. 2007;29:133–8.CrossRef
Metadata
Title
Training Sri Lankan public health midwives on intimate partner violence: a pre- and post-intervention study
Authors
Achini Chinthika Jayatilleke
Kayoko Yoshikawa
Junko Yasuoka
Krishna C Poudel
Nilani Fernando
Achala Upendra Jayatilleke
Masamine Jimba
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1674-9

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