BANGALORE – RTI International is partnering with Dimagi and the St. John’s Research Institute to expand the use of mobile phone technology to help primary health care workers identify, counsel, and refer women experiencing domestic violence in Bangalore, India.
Supported by the United States Agency for International Development, Mobilise! (Mobile-supported Linkages to Services for Domestic Violence Prevention and Response), builds on a decade-long research effort led by RTI, in collaboration with Bangalore’s St. John’s Research Institute. The research found that 77 percent of young married women who lived in low income neighborhoods of Bangalore and visited municipal primary health centers had experienced physical, psychological, or sexual violence perpetrated by their spouse or another member of their marital family. The study also found that women were willing to disclose violence to an empathic health care worker.
Research with primary health care physicians serving the same neighborhoods revealed that although they were aware of the high prevalence of violence and its adverse impacts on women’s mental and physical health, they felt ill-equipped to respond.
“The rate of domestic abuse we found in Bangalore is staggering,” said Suneeta Krishnan, Ph.D., an epidemiologist and associate director of RTI’s Global Gender Center and the project’s technical lead. “Many women are reluctant to report their abuse or seek help because they are not confident that they will get the support they need. Our research found that primary health care is a critical and timely entry point for identifying domestic violence, but an effective response is contingent on health care workers who are knowledgeable and skilled in responding to women in an empathic and confidential manner.”
At the same time, primary health care workers have numerous responsibilities and time constraints, making it difficult to provide consistent, well-documented, and well-monitored services to women experiencing violence. The project Mobilise!, therefore, aims to refine and develop mobile phone apps that will help standardize this service delivery, and then implement and evaluate whether the mobile phone-supported intervention results in improved identification, management and documentation of domestic violence in primary health care settings in Bangalore.
Based on the type of medical visit, the app displays domestic violence-related prompts for health care workers to explore with patients. The initial questions are indirect to assess the risk of domestic violence; however, health care workers will be prompted to ask more direct questions if risks are identified. For example, if a nurse notices that a pregnant woman is not gaining adequate weight, she is prompted to ask an indirect question such as, “Is there a problem at home that is preventing you from eating enough and gaining weight?”
Through this and other innovations, the Mobilise! project will strengthen domestic violence response at the primary healthcare level and identify ways in which mobile apps may support the effectiveness and scalability of this intervention. The project also plans to engage in advocacy efforts to scale-up and sustain evidence-based responses to the health impacts of domestic violence, especially at the municipal and state levels.