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

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Chepuka, Lignet ; Taegtmeyer, Miriam ; Chorwe-Sungani, Genesis ; Mambulasa, Janet ; Chirwa, Ellen ; Tolhurst, Rachel (2014)
  • Publisher: Co-Action Publishing
  • Journal: Global Health Action, volume 7 (issn: 1654-9880, eissn: 1654-9716)
  • Related identifiers: doi: 10.3402/gha.v7.24816, pmc: PMC4165047
  • Subject: GBV services | f0e481db | mental health | health care providers; intimate partner violence; Malawi; mental health; counselling; GBV services | Intimate Partner Violence and Mental Health | counselling | wa_305 | Malawi | wa_309 | wm_100 | Community Health | intimate partner violence | health care providers

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.Keywords: health care providers; intimate partner violence; Malawi; mental health; counselling; GBV servicesCitation: Glob Health Action 2014, 7: 24816 - ISSUE: This paper is part of the Special Issue: Intimate Partner Violence and Mental Health. More papers from this issue can be found at
  • References (47)
    47 references, page 1 of 5

    1. Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet 2002; 360: 1083 8.

    2. Devries KM, Mak JY, Bacchus LJ, Child JC, Falder G, Petzold M, et al. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med. 2013; 10: e1001439.

    3. Rosen D, Seng J, Tolman R, Mallinger G. Intimate partner violence, depression, and posttraumatic stress disorder as additional predictors of low birth weight infants among low-income mothers. J Interpers Violence 2007; 22: 1305 14.

    4. Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C. 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.

    5. Humphreys C, Thiara R. Mental health and domestic violence: 'I call it symptoms of sbuse'. Br J Soc Work 2003; 33: 209 26.

    6. Jina R, Jewkes R, Hoffman S, Dunkle KL, Nduna M, Shai NJ. Adverse mental health outcomes associated with emotional abuse in young rural South African women: a cross-sectional study. J Interpers Violence 2012; 27: 862 80.

    7. Devries K, Watts C, Yoshihama M, Kiss L, Schraiber LB, Deyessa N, et al. WHO Multi-Country Study Team Violence against women is strongly associated with suicide attempts: evidence from the WHO multi-country study on women's health and domestic violence against women. Soc Sci Med 2011; 73: 79 86.

    8. Bengtsson-Tops A, Tops D. Self-reported consequences and needs for support associated with abuse in female users of psychiatric care. Int J Ment Health Nurs 2007; 16: 35 43.

    9. Tadegge AD. The mental health consequences of intimate partner violence against women in Agaro Town, southwest Ethiopia. Trop Doctor 2008; 38: 228 9.

    10. Gelaye B, Arnold D, Williams MA, Goshu M, Berhane Y. Depressive symptoms among female college students experiencing gender-based violence in Awassa, Ethiopia. J Interpers Violence. 2009; 24: 464 81.

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