Primary healthcare providers' perceived preparedness to respond to intimate partner violence in the public primary healthcare setting: a cross-sectional study

BACKGROUND: Intimate partner violence (IPV) is the most prevalent form of violence against women globally, leading to various adverse health consequences. Primary healthcare providers (PHCPs) are often the first point of contact for identifying and managing IPV. However, research on PHCPs' responses to IPV in low- and middle-income countries, including Malaysia, remains limited. This study aimed to determine the perceived preparedness to respond to IPV and its associated factors among PHCPs in Malaysia.

METHODS: This cross-sectional study involved 1505 PHCPs selected through multistage stratified cluster random sampling from public primary healthcare clinics in Malaysia. Data were collected via self-administered online surveys using the validated Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS)-Malay tool. Complex sample analysis of descriptive data, general linear model (GLM) and logistic regression were performed. The GLM was used to determine knowledge and opinion score variables predicting the mean perceived preparedness score, whereas multivariable logistic regression identified factors associated with a good level of perceived preparedness to manage IPV. A p-value ≤ 0.05 was considered statistically significant.

RESULTS: Most Malaysian PHCPs (81.0%) had not received any IPV training. Only 29.1% of the PHCPs reported a good level of perceived preparedness, 12.2% had good perceived knowledge, and a mere 8.6% had good actual knowledge. The perceived and actual knowledge, workplace/self-efficacy, and staff constraints scores were positively associated with the preparedness score, whereas the victim understanding score was negatively associated with the preparedness score. Multivariable logistic regression analysis revealed that longer work experience (≥ 10 years) (AOR = 1.70, 95% CI: 1.28-2.26), prior IPV training (AOR = 1.68, 95% CI: 1.12-2.51), previous experience with IPV inquiry (AOR = 1.55, 95% CI: 1.10-2.19), good perceived knowledge (AOR = 15.21, 95% CI: 11.15-20.74), and good actual knowledge (AOR = 1.79, 95% CI: 1.10-2.94) were significantly associated with a good level of perceived preparedness.

CONCLUSIONS: A high percentage of Malaysian PHCPs have not received IPV training, and only a small proportion felt they are prepared to manage IPV, with even fewer possessing adequate knowledge about IPV. These findings highlight the urgent need to prioritize IPV training programs at the primary care level to better equip PHCPs with the knowledge and skills necessary to manage IPV effectively.