MANAGEMENT OF INTIMATE PARTNER VIOLENCE (IPV): PHYSICIANS’ READINESS IN SOUTHWESTERN NIGERIA OLALEYE AO, JAGUN OO, AJOSE AA, SOKEYE EO, OMOTOSHO A, EKOR.

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MANAGEMENT OF INTIMATE PARTNER VIOLENCE (IPV): PHYSICIANS’ READINESS IN SOUTHWESTERN NIGERIA OLALEYE AO, JAGUN OO, AJOSE AA, SOKEYE EO, OMOTOSHO A, EKOR O. Babcock University Teaching Hospital, Ilishan-Remo, Nigeria

INTRODUCTION Intimate partner violence [IPV] is an issue of global concern, with women and girls being more affected. Historically called domestic violence (dv), it includes violence that is perpetrated by intimate partners and other family members, and that is manifested through physical abuse, sexual abuse, psychological abuse, economic abuse, and acts of omission. As it is generally under-reported, physicians play an important role in the identification, management and support of such victims.

OBJECTIVES To: Assess the knowledge of physicians about intimate partner violence Evaluate physicians’ readiness for the management of intimate partner violence Identify barriers encountered by physicians in screening for intimate partner violence in Ogun state, southwestern Nigeria.

METHODS A cross-sectional survey of 200 medical doctors working in the four tertiary hospitals in ogun state was conducted. Data collection - standardized self-administered structured questionnaire which consisted of the PREMIS* toolkit and modified DVHPSS** questionnaires. Sections: respondent profile, background (including perceived preparedness and knowledge), actual knowledge and opinions. Data analyzed using the SPSS version 17 package *Physician readiness to manage intimate partner violence survey **domestic violence healthcare providers’ survey scales

RESULTS Respondents -157 (77.5%) physicians, 140 appropriate for analysis Mean age years; Average duration of practice - 8.1years. No previous domestic violence training % Most expressed a positive attitude towards helping abused victims but felt poorly prepared to ask relevant questions about IPV (38.5%) or to fulfil state reporting requirements if abuse was disclosed (55.7%). Perceived knowledge on these issues and on referral sources for IPV victims was also minimal. Barriers to management encountered by respondents include poor access to information on IPV management, inadequate knowledge of referral sources and perception of victim personality as a factor for IPV.

OCCUPATIONAL PROFILE OF RESPONDENTS

MEAN NUMBER OF PATIENTS SEEN WEEKLY Mean number of patients seen weekly Frequency N = 140 Percent Not seeing patients < – – ≥

LEVEL OF KNOWLEDGE BY CADRE DesignationPoor (%)Fair (%)Good (%)Total Consultant 5 (31.3 )10 (62.5)1 (6.3)16 Senior registrar 6 (30.0)13 (65.0)1 (5.0)20 Junior registrar24 (29.6)55 (67.9)2 (2.5)81 Senior Medical Officer 1 (14.3)6 (85.7)-- (0.0)7 Medical/Dental officer 5 (45.5)6 (54.5)-- (0.0)11 House Officer2 (40.0)3 (60.0)-- (0.0)5 Total43 (30.7)93 (66.4)4 (2.9)140

PERCEIVED PREPARATION/READINESS OF PHYSICIANS

PERCEIVED KNOWLEDGE OF PHYSICIANS

CONCLUSION Physicians in Ogun state have inadequate knowledge of IPV, and require more access to information on its management. Though their attitude towards IPV victims is generally positive, further education is necessary to correct misconceptions. Development and dissemination of institutional protocols for IPV management and state legal reporting procedures will help improve physicians’ competence for managing IPV victims.

REFERENCES Council on ethical and judicial affairs, American Medical Association. Physicians and domestic violence: ethical considerations. JAMA 1992; 267(23): Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH; WHO multi country study on women’s health and domestic violence against women study team. Prevalence of intimate partner violence: findings from the WHO multi country study on women’s health and domestic violence. Lancet. 2006;368 (9543): John IA, Lawoko S. Assessment of the structural validity of the domestic violence healthcare providers’ survey questionnaire: using a Nigerian sample. Journal of injury and violence research 2010;2: Doi: /jivr.V2i2.41 John IA, Lawoko S, Svanström L, Mohammed AZ. Health care providers' readiness to screen for intimate partner violence in northern Nigeria. Violence Vict. 2010; 25(5): Kaye DK, Mirembe F, Bantebya G. Perceptions of health care providers in Mulago hospital on prevention and management of domestic violence. Afr Health Sci 2005; 5(4): Short LM, Alpert E, Harris JM, Surprenant ZI. A tool for measuring physician readiness to manage intimate partner violence. Am J rev Med 2006; 30(2): 173–180. Sprague et al. Barriers to screening for intimate partner violence. Women health 2012; 52[6]: