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. 2020 Apr 15;5(4):e002112.
doi: 10.1136/bmjgh-2019-002112. eCollection 2020.

The magnitude and determinants of violence against healthcare workers in Pakistan

Shiraz Shaikh  1 , Lubna Ansari Baig  2 , Ibrahim Hashmi  1 , Mirwais Khan  3 , Seemin Jamali  4 , Muhammad Naseem Khan  5 , Munir Akhtar Saleemi  6 , Komal Zulfiqar  7 , Sumera Ehsan  8 , Iram Yasir  7 , Zia Ul Haq  5 , Lubna Mazharullah  1 , Samina Zaib  1
Affiliations

The magnitude and determinants of violence against healthcare workers in Pakistan

Shiraz Shaikh et al. BMJ Glob Health. .

Abstract

Objectives: To determine the magnitude and determinants of violence against healthcare workers (HCWs) and to identify the predominant types and causes of violence experienced by them.

Methodology: A cross-sectional survey based on structured questionnaire adopted from previous surveys and qualitative data was conducted in 4 large cities and 12 districts in 3 provinces of Pakistan. The survey covered 8579 from all cadres of HCWs, including doctors, nurses, technicians, support staff, ambulance workers, vaccinators, lady health visitors, midwives and lady health workers (LHWs). The predictors of overall violence experienced, physical violence experienced and verbal violence experienced were separately analysed for tertiary care hospitals, secondary care hospitals, primary care hospitals and field-level HCWs. Logistic regression was used to compute adjusted ORs with 95% CIs for the association of different factors with the violence experienced.

Results: More than one-third (38.4%) reported having experienced any form of violence in the last 6 months. Verbal violence was the most commonly experienced form (33.9%), followed by physical violence (6.6%). The main reasons for physical violence were death of patients (17.6%), serious condition of patients (16.6%) and delay in care (13.4%). Among the different types of field HCWs, emergency vehicle operators were significantly more likely to experience verbal violence compared with LHWs (adjusted OR=1.97; 95% CI 1.31 to 2.94; p=0.001). Among hospital HCWs, those working in private hospitals were significantly less likely to experience physical violence (adjusted OR=0.52; 95% CI 0.38 to 0.71; p=0.001) and verbal violence (adjusted OR=0.57; 95% CI 0.48 to 0.68; p=0.001).

Conclusion: Violence against HCWs exists in various forms among all cadres and at different levels of care. The gaps in capacity, resources and policies are evident. Specific strategies need to be adopted for different types of HCWs to protect them against violence.*The study was conducted under the framework of ICRC's Healthcare in Danger Initiative for protection of healthcare against Violence.

Keywords: health services research; health systems.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Reasons for physical violence experienced (n=567).
Figure 2
Figure 2
Reasons for verbal violence experienced (n=2909).
See this image and copyright information in PMC

References

    1. WHO document World report on violence and health. Available: www.who.int/violence_injury_prevention/violence/world_report/en/
    1. Health policy and Economic Research Unit, British Medical Association . Violence at work: the experience of UK doctors. London: BMA house, 2003.
    1. Conseil international des infirmières Guidelines on coping with violence in the workplace. Geneva: International Council of Nurses, 1999.
    1. World Health Organization Violence: a public health priority. global consultation on violence and health, 1996.
    1. Al-Omari H. Physical and verbal workplace violence against nurses in Jordan. IntNurs Rev 2015. - PubMed

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