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Impact of Gender-Based Violence Screening on Identification of Intimate Partner Violence among Women Attending Healthcare Facilities in Nigeria

Abstract

Gender-based violence (GBV) is a major public health and social concern that can have serious consequences for women's physical, psychological, reproductive, and social wellbeing. Intimate partner violence (IPV), including physical, sexual, emotional, and psychological abuse, may remain unidentified when women do not disclose their experiences voluntarily or when healthcare providers do not routinely screen for violence. Women attending healthcare facilities may present with injuries, reproductive health problems, chronic pain, mental health concerns, or other conditions associated with violence without the underlying cause being recognized. Gender-based violence screening within healthcare settings provides an opportunity for trained healthcare professionals to identify women experiencing IPV and connect them with appropriate medical, psychosocial, legal, protection, and social support services. However, inadequate screening protocols, limited provider training, privacy concerns, stigma, fear of retaliation, and weak referral systems may limit effective identification. Against this background, this study investigates the impact of gender-based violence screening on identification of intimate partner violence among women attending healthcare facilities in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Social Ecological Model. The Health Belief Model explains how women's perceptions of susceptibility to violence, perceived severity of its consequences, perceived benefits of screening, perceived barriers, and cues to action may influence disclosure and identification of IPV. Andersen's Behavioral Model explains how individual characteristics, enabling resources, and healthcare needs influence women's interaction with healthcare services and screening processes. The Social Ecological Model emphasizes the influence of individual, interpersonal, healthcare, community, and broader societal factors on the occurrence, recognition, and response to GBV. Collectively, these theoretical perspectives provide a suitable framework for explaining how GBV screening may influence the identification of IPV among women attending healthcare facilities in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise women attending selected primary, secondary, and tertiary healthcare facilities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible women. GBV screening will be assessed using indicators such as availability of routine screening protocols, frequency of screening, use of validated screening tools, healthcare-provider training, privacy during screening, confidentiality procedures, informed participation, documentation practices, and availability of referral arrangements. Identification of IPV will be assessed using indicators such as disclosure of physical, sexual, emotional, or psychological violence, positive screening results, newly identified cases, documentation of IPV, referral for appropriate support, and follow-up of identified cases. Data will be collected using structured questionnaires, validated GBV screening instruments, healthcare records, screening registers, referral records, and relevant facility programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, and patterns of IPV identification. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of GBV screening on IPV identification. Where a quasi-experimental design is adopted, IPV identification rates before and after implementation or expansion of routine GBV screening may be compared, while relevant demographic, socioeconomic, reproductive, and healthcare-related factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that routine gender-based violence screening has a significant positive impact on the identification of intimate partner violence among women attending healthcare facilities in Nigeria. Women attending facilities where systematic GBV screening is implemented are expected to have a higher likelihood of IPV being identified than women attending facilities without routine screening. Screening may create opportunities for healthcare providers to recognize violence that might otherwise remain undisclosed, particularly among women presenting with injuries, reproductive health concerns, chronic pain, or other conditions that may be associated with violence. Early identification may facilitate confidential counselling, medical care, safety planning, psychosocial support, legal assistance, protection services, and appropriate referral. However, inadequate provider training, lack of private consultation spaces, fear of retaliation, stigma, cultural norms, concerns about confidentiality, limited screening resources, and weak referral systems may reduce the effectiveness of GBV screening. The study therefore expects routine, confidential, trauma-informed, and appropriately implemented GBV screening to contribute significantly to improved identification of IPV among women attending healthcare facilities in Nigeria. The study is expected to contribute to the literature on gender-based violence screening, intimate partner violence identification, women's health, healthcare-based violence prevention, reproductive health, survivor-centred care, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, healthcare providers, women's health organizations, social welfare agencies, legal and protection services, development partners, and policymakers regarding strategies for strengthening healthcare-based GBV screening. The study will also provide evidence-based recommendations for integrating routine GBV screening into appropriate healthcare services, training healthcare workers in trauma-informed screening and response, improving privacy and confidentiality, strengthening documentation and referral systems, ensuring availability of psychosocial and protection services, and promoting early identification and comprehensive support for women experiencing intimate partner violence across Nigeria.

Keywords: Gender-based violence screening, intimate partner violence, IPV identification, women, healthcare facilities, GBV screening, women's health, survivor-centred care, violence prevention, reproductive health, Nigeria, public health.