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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

A comprehensive model for intimate partner violence in South African primary care: action research

BMC Health Services Research > Ausgabe 1/2012
Kate Joyner, Bob Mash
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-399) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that there are no competing interests.

Authors’ contributions

Conception and design: KJ and RM. Inquiry group process: KJ, RM and co-researchers. Further analysis of data: KJ. Interpretation of data: KJ and RM. Final approval of the article: KJ and RM. Both authors read and approved the final manuscript.



Despite extensive evidence on the magnitude of intimate partner violence (IPV) as a public health problem worldwide, insubstantial progress has been made in the development and implementation of sufficiently comprehensive health services. This study aimed to implement, evaluate and adapt a published protocol for the screening and management of IPV and to recommend a model of care that could be taken to scale in our underdeveloped South African primary health care system.


Professional action research utilised a co-operative inquiry group that consisted of four nurses, one doctor and a qualitative researcher. The inquiry group implemented the protocol in two urban and three rural primary care facilities. Over a period of 14 months the group reflected on their experience, modified the protocol and developed recommendations on a practical but comprehensive model of care.


The original protocol had to be adapted in terms of its expectations of the primary care providers, overly forensic orientation, lack of depth in terms of mental health, validity of the danger assessment and safety planning process, and need for ongoing empowerment and support. A three-tier model resulted: case finding and clinical care provision by primary care providers; psychological, social and legal assistance by ‘IPV champions’ followed by a group empowerment process; and then ongoing community-based support groups.


The inquiry process led to a model of comprehensive and intersectoral care that is integrated at the facility level and which is now being piloted in the Western Cape, South Africa.
Additional file 1: Modified Protocol. IPV assessment tool for use in 1st stage of 2nd tier of model. (DOCX 88 KB)
Additional file 2: Personal Empowerment Group. Personal Empowerment Group Programme. (PDF 1 MB)
Authors’ original file for figure 1
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