Barriers for domestic violence screening in primary health care centers

Backgrounds: Violence against women is an important public health problem that draws attention of a wide spectrum of clinicians. However, multiple barriers undermine the efforts of primary health care workers to screen battered women. Objectives: Reveal barriers that might impede screening of women for domestic violence and compare the list of barriers of physicians and nurses. Methods: An observational cross-sectional study was carried out in primary health care centers located in two randomly selected health regions in Kuwait. The study involved all available physicians (210) and nurses (464) in the selected centers. The overall response rate was 54.3%. A selfadministered questionnaire was used for data collection. Results: Barriers related to the battered woman herself topped the list of ranks for both physicians (92.9 ±19.7%) and nurses (85.9 ± 17.6%), P = 0.02, followed by women culture in general (89.5 ±17.2% for physician and 83.8 +20.8% for nurses, P = 0.38), then health administration barriers (78.7 ±22.4% for physician and 72.5± 26.4% for nurses, P = 0.04). Barriers related to the examiner appeared at the bottom of the list (67.8 ± 26.9% for physician and 69.9 ± 28.6% for nurses, P = 0.01). Conclusion: Medical staff face major barriers in screening for domestic violence against women in the primary health care centers. Specifically tailored programs are required to enhance both knowledge and skills of the health care staff about the screening process. Infrastructure and physical environment needs modification to facilitate screening of women.