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Assessing providers’ level of knowledge, attitudes and practices (KAP) related to violence against women and girls

Information on providers’ knowledge, attitudes and practices can help managers understand what their staff knows and believes about violence, what issues need to be addressed during training, and what resources are lacking in the clinics or health centers. Moreover, this information can be used to document a baseline so that health programmes can measure changes in providers’ knowledge, attitudes, and practices over time.

A couple of ways to collect information on providers’ knowledge, attitudes, and practices, include surveys and gathering qualitative data through group discussions or other participatory methods with providers. Qualitative data can provide an in-depth understanding of providers’ perspectives. Quantitative data makes it easier to measure change over time.

Knowledge attitude and practices surveys of health care providers are useful because they:

  • offer information about whether, how often and when providers have discussed violence with clients; what providers think are the barriers to screening; what providers do when they discover that a client has experienced violence; providers’ discriminatory or stigmatizing attitudes; attitudes toward women who experience violence; knowledge about the consequences of gender-based violence; and what types of training providers have received in the past; and
  • can be used as a convenient pre and post intervention measure.

It is best to use or adapt already designed and validated instruments and questions.

 

Resources:

World Health Organization Multi-country Study on Women’s Health and Domestic Violence against Women (WHO). The survey includes questions to gauge attitudes towards violence against women.  Available in English.

Gender-Equitable Men (GEM) Scale (Horizons and Promundo). The scale measures attitudes toward “gender-equitable” norms, provide information about prevailing norms in a community and the effectiveness of programmes hoping to influence them. Available in English, Spanish and Portuguese.  The scale used in Ethiopia is also available in English.

 

National Community Attitudes towards Violence against Women Survey 2009 (The Victorian Health Promotion Foundation) has subsections focusing on attitudes towards domestic violence and sexual violence using a scale of agreement or disagreement. Available in English.

The Attitudes Towards Rape Victims Scale (The Arizona Rape Prevention and Education Project).  These scales are self administered instruments designed to assess individuals’ attitudes towards rape victims rather than towards rape in general. Available in English

The Sexual Violence Research Initiative compiled a comprehensive package of programme evaluation tools and methods for assessing service delivery, knowledge, attitudes, practices and behaviours in sexual violence projects and services.  By making such materials available to service providers, managers, researchers, policy makers and activists, among others, the hope was that evaluation could be more easily incorporated into project and programme plans. The assessment instruments are drawn from articles in peer-reviewed journals that report findings from evaluations of health care-based services and interventions for women victims/survivors of sexual violence, written in English or Spanish, published between January 1990 and June 2005.  The instruments are available from the evaluation section of sexual violence research initiative website.

Semi-structured interviews with health care providers are useful because they:

  • offer insight into providers’ knowledge, attitudes and practices; and
  • offer the potential for digging deeper into any challenges, barriers, concerns that may affect ability to provide care.

International Planned Parenthood Federation, Western Hemisphere Region’s (IPPF/WHR’s) Survey of Provider Knowledge, Attitudes and Practices (KAP):  This face-to-face interview is designed for administration to women’s health care providers. It focuses on providers’ knowledge, attitudes and practices concerning violence in the lives of their patients. There are approximately 80 questions (most close-ended), that cover a range of topics, including: whether, how often and when providers have discussed violence with clients; what providers perceive of as barriers to screening; what providers do when they identify a client who has experienced violence; attitudes toward women who experience violence; knowledge about the consequences of gender-based violence; and the types of training providers have received in the past. Available in English and Spanish.

Forensic and Medical Care Following Sexual Assault Service Education Programme Evaluation Questionnaire: This questionnaire is designed to assess medical personnel’s knowledge and satisfaction concerning their abilities to treat sexual assault patients, and includes questions such as “How would you rate your ability in forensic evidence collection?”.  It can be self-administered or used as an interview guide.

Qualitative, participatory methods with clinic/ health unit staff including focus group discussions, open-ended stories, mapping, role plays, Venn diagrams and others can be useful, because they:

  • offer insight into provider’s knowledge, attitudes and practices; and
  • offer insight into institutional practices and norms, as well as group dynamics and work flow.

See the section on qualitative methods for ideas and examples of what can be used.