2
|
Sprague C, Woollett N, Parpart J, Hatcher AM, Sommers T, Brown S, Black V. When nurses are also patients: Intimate partner violence and the health system as an enabler of women's health and agency in Johannesburg. Glob Public Health 2015; 11:169-83. [PMID: 25833744 DOI: 10.1080/17441692.2015.1027248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
While violence against women is a recognised global health problem, women's agency in marginalised settings is poorly understood, particularly in relation to health systems. We explored agency as a practical and theoretical construct through qualitative research among 20 nurses with direct or indirect experiences of intimate partner violence (IPV) in Johannesburg. Interviews conducted from August 2013 to March 2014 generated rich descriptions from respondents in five health facilities. Nurses' self-reported IPV matched national prevalence of 24-31%. Findings revealed the way in which agency is enacted by nurses, allowing them the economic means to leave abusive partnerships, yet disabling them from agency and health promotion in their workplace. At the same time, nurses expanded agentic possibilities for patients by enabling a national response to IPV within South African health clinics - one that is largely undocumented. We posit that nurses can serve as important agentic actors in public health systems in low- and middle-income country settings by assisting patients to address IPV, even in the absence of targeted training and guidelines. To ensure the health and well-being of women experiencing IPV, nurses should be supported by the health sector to respond skilfully to patients and to safely process their own experiences of violence.
Collapse
Affiliation(s)
- Courtenay Sprague
- a Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies , University of Massachusetts Boston , Boston , MA , USA.,b College of Nursing and Health Sciences , University of Massachusetts Boston , Boston , MA , USA.,c Faculty of Health Sciences , Wits Reproductive Health and HIV Institute, University of the Witwatersrand , Hillbrow (Johannesburg) , South Africa
| | - Nataly Woollett
- c Faculty of Health Sciences , Wits Reproductive Health and HIV Institute, University of the Witwatersrand , Hillbrow (Johannesburg) , South Africa
| | - Jane Parpart
- a Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies , University of Massachusetts Boston , Boston , MA , USA.,d Department of Political Science , Stellenbosch University , Stellenbosch , South Africa
| | - Abigail M Hatcher
- c Faculty of Health Sciences , Wits Reproductive Health and HIV Institute, University of the Witwatersrand , Hillbrow (Johannesburg) , South Africa.,e Bixby Center for Global Reproductive Health , University of California San Francisco , San Francisco , CA , USA
| | - Theresa Sommers
- a Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies , University of Massachusetts Boston , Boston , MA , USA
| | - Shelley Brown
- a Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies , University of Massachusetts Boston , Boston , MA , USA.,f Department of Health Sciences , Boston University , Boston , MA , USA
| | - Vivian Black
- c Faculty of Health Sciences , Wits Reproductive Health and HIV Institute, University of the Witwatersrand , Hillbrow (Johannesburg) , South Africa
| |
Collapse
|