P009: Violence against health care professionals in Karachi: results from a mixed methods study

Abstract

Introduction: The right to live is the supreme human right and according to Article 3 of the Universal declaration of human rights everyone has a right to life, liberty and security. In Karachi, Pakistan huge numbers of health care professionals (HCP) have been subjected to violence inclusive of money extortion, kidnapping, mental & physical torture, murders etc. A recent study from Karachi’s four major hospitals reported that 72.5% of HCP have experienced abuse (verbal and physical) in the past 12 months. The goal of this study was to develop strategies for preventing violence against health care after collecting baseline data. The objectives of the study were to: Identify the magnitude, threshold and impact of violence against HCPs. Methods: This was a mixed methods study design with a QUAN-QUAL approach. Structured questionnaire was used after pilot testing and filled by the surveyors. Focus group discussion and In-depth interviews were conducted with HCPs, NGOs, Law enforcement agencies, ambulance services, hospital administrators and LHW programs. Frequencies and proportions were compared for different cadres of HCPs for the quantitative data analysis. Thematic content analysis with inductive and deductive reasoning was used for analysing qualitative data. Results: Data on 822 HCPs revealed that 33% had faced violence and 49 % had experienced it, 89% was verbal and 43% was physical abuse, 2% had died and 22% were injured. Ambulance services and physicians were the most common victims of violence. The main reasons were grouped as institutional, behavioral (victims and perpetrators) and general situation of the city. There is high acceptance of violence among HCPs and lack of training in dealing with it was the most common reason given. Sequlae included effects on victim, family, institution and the reporting agencies. The final paper will have complete details on the baseline and the recommendations proposed by the stakeholders. Conclusion: Violence faced by HCP’s is a multifactorial complex issue. There is a dire need to design interventions which can help in addressing the behavioral, Institutional and sociopolitical factors promoting violence among HCP’s. The interventions based on recommendations by the respondents have been developed and implementation has started as a pilot in the city of Karachi.