A Situational Analysis of Serbian strategy for implementation of Primary Health care in Family Violence

Snezana Knezevic, Bosiljka Đikanović, Carmen Fernandez Alonso, Raquel Gomez Bravo, Lodewijk Pas

Keywords: Domestic Violence, Gender Violence, Detection, Counselling, Advocacy, Care management

The aim of this study was to identify strategies and approaches for dealing with family violence (FV) within primary health care (PHC) in Serbia.

Research questions:
What is an optimal model for response to domestic violence?

A situational analysis included scoping review of relevant national documents, publications and reports for dealing with FV in PHC in Serbia, and key-persons inquiry. The analysis was conducted as a national contribution to the international study ‘Improving response of primary health care to family violence’ (IMOCAFV). Keywords used for scoping review searching were Family Violence, Intimate Partner Violence, Child Abuse and Elder Abuse. The key-persons inquiry was conducted through the standardized online questionnaire developed within IMOCAFV project, where open-ended responses were coded and qualitative data analyzed.

In a scoping review we identified 1408 documents (protocols, laws, procedures, good practice guidelines, reports, research papers, strategies, analyses and other). After applying inclusion criteria, 29 documents were retained as relevant, including useful descriptions for health care standards applicable to Primary care. The most important identified documents were Special Protocol for dealing with gender-based violence in PHC (2011), Special protocol for dealing with child abuse (2009), both issued by Ministry of Health, and the report “Gender-based violence against older women (65+)”, issued by Red Cross (2021).
The Key-person Questionnaire was answered by 25 respondents: medical doctors (15), social workers (1), NGO activist (1), nurses (5), psychologist (1), and other (2). Majority (72.2%) stated that intervention programs in this field were at this moment related to primary prevention of domestic and gender-based violence, with a need to strengthen collaborative care.

Strategies for dealing with FV within PHC will defined at national level using discussion of results in nominal groups to establish an optimal model for care in PHC. Proposals will be thereafter submitted in three Delphi rounds online.

Points for discussion:
1. How to provide an efficient response to domestic violence in Primary Health Care?

2. What is needed as strategies and health policy level to actively promote and support this?

3. Is the qualitative methodology followed an efficient contribution for international research?