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A new article in Vol. 3 Iss. 4 of Family Medicine and Community Health by Upston, Poljski and Wirtz looks at the experince of a community health service provider in the prevention of violence against women. Link Health and Community (LinkHC) in Melbourne, Australia, is a not for profit community-based health service provider funded by the national and local governments. It delivers an extensive range of medical, allied health, counseling and dental services, as well as health promotion and service coordination.
Violence against women is a significant public health and human rights issue for women, their families, and the community. One in three Australian women over 15 years of age has experienced physical assault, and nearly one in five has experienced sexual assault. Although violence occurs in public and private settings, violence against women most commonly occurs in homes, at the hands of a current or former intimate partner. In Australia, family violence is the most prevalent form of violence experienced by women.
LinkHC has adopted an innovative approach to its role in the prevention of violence against women. As significant employers in the local community, it recognized that community health services can drive workplace change to enhance gender equity by looking at their own policies, procedures, and workplace culture. LinkHC developed targeted learning opportuities for staff. They also established a committee for the prevention of violence against women, with representation of both women and men, senior management, and consumers to advance both primary and secondary prevention initiatives within and by the organization. In its first year of operation, the committee had integrated gender analysis into policy development and review processes as part of LinkHC’s quality improvement system and established a process for gender auditing and planning across the organization.
Within 1 year, there was a 20 percentage point increase in the number of staff members at LinkHC who agree that gender is relevant to their work, from 54% in February 2014 to 74% in February 2015.
By building on its local and regional partnerships and long-standing work in tertiary prevention, over the past 6 years LinkHC has strategically increased its capacity for secondary and primary prevention, resulting in a ‘whole-of-organization’ approach to the prevention of violence against women. The adoption of a socioecological framework that recognizes that violence against women is caused by the complex interplay of many factors across multiple levels of influence has informed the community health service’s multiple roles in the prevention of violence against women. This encompasses strategies in at three temporal points:
1. Tertiary prevention (response or intervention). Tertiary prevention strategies are those that are applied after violence has occurred, aiming to reduce the consequences and impacts of violence and to prevent recurrence.
2. Secondary prevention (early intervention). Secondary prevention strategies are aimed at early detection of risk or early indicators of the problem. Interventions may target individuals or population subgroups showing early signs of engaging in violent behavior, or becoming a victim of violence, or who may be particularly at risk of developing violent behaviors.
3. Primary prevention. Primary prevention strategies aim to prevent violence before it occurs and include organizational or whole-of-population strategies.
The paper highlights how community health services can play an active role in primary, secondary, and tertiary prevention of violence against women. It demonstrates how a community health service can join forces with other agencies in partnership to prevent or reduce the impact of family violence through collaborative planning and projects. It can facilitate referral and early intervention, and reduce inequities in access for vulnerable groups.
Upston B, Poljski C, Wirtz H; Preventing violence against women with the help of a community health service Family; Medicine and Community Health; DOI: http://dx.doi.org/10.15212/FMCH.2015.0133
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