Culturally appropriate women-centred interventions can help healthcare systems respond to domestic violence, research has found. HERA (Healthcare Responding to Violence and Abuse) has been co-developing and evaluating a domestic violence and abuse healthcare intervention in low- and middle-income countries for the past five years.
The Group was co-led by the University of Bristol and London School of Hygiene & Tropical Medicine. Specific country studies were led by the University of Sao Paulo (Brazil), Kathmandu University (Nepal), An-Najah National University (occupied Palestinian territories), and University of Peradeniya (Sri Lanka). Domestic violence and abuse (DVA) against women is a significant concern in each of these countries, with a prevalence of 23 per cent in Brazil, 27 per cent in Nepal, 29 per cent in the occupied Palestinian territories (oPt), and 24 per cent in Sri Lanka.
Following implementation of the HERA programme, rates of identification of DVA in participating health services increased by 78 per cent in Brazil, 100 per cent in Nepal and 69 per cent in Sri Lanka. There was a 24 per cent decrease in identification of women experiencing DVA in the oPt, partly due to escalating violence in the Israeli occupation.
Healthcare worker confidence and motivation to address domestic violence improved, with healthcare workers reporting increases in their readiness to identify, inquire about and respond to domestic violence by documenting cases, making referrals, and offering ongoing support. In Nepal, there was a slight decrease in healthcare worker confidence to offer ongoing support due to the healthcare clinics becoming Covid isolation wards.