Exploring the Complex Pathway of the Primary Health Care Response to Intimate Partner Violence in New Zealand
Date
Authors
Gear, Claire
Eppel, Elizabeth
Koziol-Mclain, Jane
Supervisor
Item type
Journal Article
Degree name
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
Abstract
Background: Integrating sustainable responses to intimate partner violence in health care is a persistent and complex problem internationally. New Zealand holds a leading role, having established national health system infrastructure for responding to intimate partner violence within hospital and selected community settings. However, resources for, and engagement with, the primary health care sector has been limited. The present study focuses on what affects a sustainable response to intimate partner violence within New Zealand primary health care settings. Methods: Utilising complexity theory, we reconceptualised a sustainable primary health care response to intimate partner violence as a complex adaptive system. To explore interactions between agents, we analysed the function(s) of key policy, strategy, guideline and evaluation documents informing intimate partner violence responsiveness in health care. We chronologically threaded these documents together by their function(s) to show how discourse influencing intimate partner violence responsiveness emerges from agent interactions. Results: This paper presents a complexity informed implementation narrative of the New Zealand health system response to intimate partner violence across the last two decades, focused on the participation of the primary health care sector. We demonstrate how competing discourses have contributed to system gaps and unintended consequences over time. Our findings consider implications for a sustainable response to intimate partner violence in primary health care and call attention to system interactions that challenge a whole health system approach in New Zealand. Conclusions: Use of complexity theory facilitates an innovative perspective of a persistent and complex problem. Given the complexity of the problem and New Zealand's leadership, sharing the lessons learnt is critical for the international community involved in developing health care system approaches to intimate partner violence.Description
Keywords
Complex adaptive system, Complexity theory, DHB District Health Board, Discourse, Document analysis, E Tu Whānau Programme of Action for Addressing Family Violence, GP General Practitioner, IPV intimate partner violence, Implementation, Intimate partner violence, MOH Ministry of Health, Narrative, Policy-making, Primary health care, Sustainability, Health Policy & Services, 4402 Criminology, 44 Human Society, Health Services, Behavioral and Social Science, Clinical Research, Violence Research, 1117 Public Health and Health Services, 1605 Policy and Administration, 4206 Public health
Source
Health Research Policy and Systems, ISSN: 1478-4505 (Print); 1478-4505 (Online), BMC, 16(99), 99-. doi: 10.1186/s12961-018-0373-2
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Rights statement
© 2018 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.