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Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi

Chepuka, Lignet, Taegtmeyer, Miriam, Chorwe-Sungani, Genesis, Mambulasa, Janet, Chirwa, Ellen and Tolhurst, Rachel (2014) 'Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi'. Global Health Action, Vol 7, e24816.

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Abstract

Background and objectives: This study explores the perceptions of a wide range of stakeholders in Malawi towards the mental health impact of intimate partner violence (IPV) and the capacity of health services for addressing these.

Design: In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted in three areas of Blantyre district, and in two additional districts. A total of 10 FGDs, 1 small group, and 14 IDIs with health care providers; 18 FGDs and 1 small group with male and female, urban and rural community members; 7 IDIs with female survivors; and 26 key informant interviews and 1 small group with government ministry staff, donors, gender-based violence service providers, religious institutions, and police were conducted. A thematic framework analysis method was applied to emerging themes.

Results: The significant mental health impact of IPV was mentioned by all participants and formal care seeking was thought to be impeded by social pressures to resolve conflict, and fear of judgemental attitudes. Providers felt inadequately prepared to handle the psychosocial and mental health consequences of IPV; this was complicated by staff shortages, a lack of clarity on the mandate of the health sector, as well as confusion over the definition and need for ‘counselling’. Referral options to other sectors for mental health support were perceived as limited but the restructuring of the Ministry of Health to cover violence prevention, mental health, and alcohol and drug misuse under a single unit provides an opportunity.

Conclusion: Despite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience.

Item Type: Article
Additional Information: This paper is part of the Special Issue: Intimate Partner Violence and Mental Health. More papers from this issue can be found at http://www.globalhealthaction.net
Subjects: W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care
WA Public Health > Health Problems of Special Population Groups > WA 305 Mental health of special population groups
WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
WM Psychiatry > WM 100 General works
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.3402/gha.v7.24816
Depositing User: q Moody
Date Deposited: 03 Dec 2014 10:40
Last Modified: 06 Feb 2018 13:08
URI: http://archive.lstmed.ac.uk/id/eprint/4569

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