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Table 3 Result Categories and Sub-categories extracted from Focus Group Discussion and In-depth Interview

From: The role of primary healthcare physicians in violence against Women intervention program in Indonesia

Category: The participants’ perception of Violence Against Women (VAW)
Sub-CategoryQuotes
Correct perception of VAW caseIn my personal perception, violence against women is not physical only, but perhaps also mentally. For example, in a domestic relationship, when the husband is yelling at his wife, it’s also a part of violence or domestic violence. It could also happen to their child. So, in my personal opinion, it is not only just physical but also psychological violence”. (R2)
Incorrect perception of VAW case or doubtBut if she got violence from the parent in law, is it included (in VAW)?” (R2)
“… and there was one case, a girl in senior high school, got a stab in her stomach by her school friend... But other than that, I never found any violence against women cases or domestic violence; maybe they are afraid or ashamed to visit Puskesmas (PHC). But in that girl’s case, because it has already liquid flowing from her abdomen, I referred her to the hospital” (R3)
Category: The participants’ recognition of VAW intervention program at their Puskesmas
Sub-CategoryQuotes
The physician recognized the programYes, we have the program in our Puskesmas, the PIC for the program is our midwife” (R1)
The physician did not recognize the programI think the program exists, but we never know because we never have the case…” (R3)
Category: Physicians’ action when they discover a suspected VAW case
Sub-CategoryQuotes
Providing physical treatment to the patient (of physical violence case)As a doctor, I gave her therapy at that time, and I suggested her to report the case to the police officer.” (R2)
Reporting to the relating parties, such as teacher, school headmaster, and the police officerI suggested her to report the case to her teacher because I think if the case involved the police officer, it became complicated.” (R3)
Referring to hospitalFor the complete examination purposes, I referred the children to the hospital” (R4) – (Sexual harassment case on a female toddler)
Peaceful settlement“… because they didn’t want to proceed to legal suing, the perpetrator is their relatives though…” (CP2)
Category: Barriers faced by the physicians in managing suspected violence against women cases
Sub-CategoryQuotes
No training availableAll participants mentioned that they never received any training related to VAW intervention (altogether)
We couldn’t call it training, because if it was training, then it should be intensive, but it was almost like only material refreshing” (PP6)
No Standard Operational Procedure (SOP) availableif it is SOP, it seems not existed” (R1-R5 altogether)
Actually, I had socialized it to the head of PHC about the intervention pathway… it existed. So, if there’s a violence case, we will know where to go…” (CP2)
“… we have no official SOP yet, but we have reported it to the sector level for the VAW case management” (DF6)
Inadequacy of physicians in PuskesmasSometimes it depends…, because there were so many patients in the Puskesmas, and the doctor is only one, so it’s impossible for us to give education to the patients, it takes too long... and when you just alone, you have to handle hundreds of patients, until what time do we have to work? So, that’s why we never explore deeper; we focus more on the main complaint… (R3)
Lack of infrastructure (no private room)One room for two programs. That situation made the patient unable to tell us the story. We couldn’t even determine whether she is “miss or Mrs.,” they became ashamed because there were so many people in the room, two doctors, nurses, and also male nurses” (R3)
We take the patient to a special room; we have HIV counseling room, or Nutrition Counselling room, whatever empty room available for us to be able to interview the patient privately” (DF6)
Visum et Repertum (VeR) or forensic medical examination cannot be conducted in PuskesmasThis is one thing that we frequently ask because PHC is actually also able to do that (VeR), for example, physical examination. But, the investigator and the Police Department don’t want that. So, legal or approved visum (forensic medical examination) is the result of the forensic unit in the hospital. Meanwhile, the request is quite a lot, and the visum cost is very expensive” (CP2)
Yesss… if in the (Malang) regency PHC can do (VeR), why in the city we can’t do that?” (CP3)
Attention scarcity among stakeholdersWe didn’t blame Puskesmas because perhaps District Health Offices rarely conduct evaluations on this program. We will try to remind them through coordination meetings later…” (CP2)
  1. R1 – R5: Physician who worked in Puskesmas (Primary Healthcare Center); CP1 – CP2 – CP3: Confirming person from other stakeholder; DF: Physician from experienced PHC; PP: Program Coordinator from experienced PHC (midwife)