ArticleSSM - health systems2025
A multi-country mixed method evaluation of the HERA (Healthcare Responding to Domestic Violence and Abuse) intervention: A comparative analysis.
Article in SSM - health systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Missed opportunities in health sector responses to violence against women and girls: a comparative mixed-methods study in Albania and Brazil.BMJ global health · 2026Article
- Strategies to address reproductive coercion and intimate partner violence in Nairobi family planning services: qualitative client and provider perspectives.Sexual and reproductive health matters · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
Abstract
Background: Domestic violence (DV) against women has adverse health consequences and demands a comprehensive healthcare response. Interventions adapted from high-income countries encounter implementation challenges in low-and-middle-income countries, due to diverse socio-cultural, political and economic contexts. This study explored HERA (Healthcare Responding to Violence and Abuse) implementation, that aimed to strengthen the healthcare response to DV in Brazil, Nepal, the occupied Palestinian territory (oPt), and Sri Lanka. Methods: Parallel mixed method study (2019 - 2022). Quantitative data included the Provider Intervention Measure (PIM), training attendance records and DV documentation before and after the intervention. Qualitative data included semi-structured interviews with providers and DV survivors, field notes and stakeholder meetings. Data were integrated at the level of interpretation and reporting using a narrative approach, drawing on theories of Complex Adaptive Systems and sensemaking. Results: HERA enhanced healthcare provider readiness to address DV and fostered a women-centred approach. The interaction between HERA and the diverse contexts impacted the reciprocal relationship between sensemaking and sensegiving within health systems, leading to adaptive behaviours among providers and women. This included mediation practices, negotiating DV documentation, modified roles, and containment of DV cases within the clinic. Normative gender roles, normalised DV attitudes, biomedical sensemaking frameworks, community violence, austerity policies, scarce resources, and weak leadership and management support affected implementation success. Conclusion: It is important to consider the interplay between context and intervention goals during development, implementation and evaluation of health system responses to DV. Managers require specific intervention components to support organisational change. Culturally appropriate support for women should acknowledge limitations to their agency.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.