Loraine J Bacchus

• PhD Psychiatry
• Professor (Associate) at London School of Hygiene and Tropical Medicine

Background Domestic violence against women (DVAW) is a public health issue and a breach of human rights, yet evidence on effective interventions remains limited, particularly in low-income and middle-income countries. This study aimed to evaluate changes in identification and referral to specialist support associated with system-level strategies im...

Background Domestic violence (DV) is a violation of human rights and a major public health problem that damages the health of women and their families. In the occupied Palestinian territories, 29% of women have a lifetime exposure to intimate partner violence, the most prevalent form of DV. Despite the existence of national policies to prevent and...

Background Domestic violence and abuse (DVA) is a violation of human rights that damages the health and well-being of—gay, bisexual and other men who have sex with men (gbMSM). Sexual health services provide a unique opportunity to assess for DVA and provide support. This study explores the feasibility and acceptability of Healthcare Responding to...

Background There has been much critical reflection among global health researchers about how power imbalances between high-income countries and low- and middle-income country collaborators are perpetuated through research programmes. Research capacity strengthening (RCS) is considered both a mechanism through which to redress structural power imbal...

Background Domestic violence (DV) against women has adverse health consequences and demands a comprehensive healthcare response. Interventions adapted from high-income countries encounter implementation challenges in low-and-middle-income countries, due to diverse socio-cultural, political and economic contexts. This study explored HERA (Healthcare...

The aim was to analyse and improve the Primary Health Care (PHC) response to domestic violence against women (DVAW) by developing, implementing and evaluating an intervention. A pilot study evaluating the before and after of intervention implementation, using mixed methods and carried out in three phases - formative, intervention and evaluation - b...

Resumo O objetivo foi analisar e aprimorar a resposta da Atenção Primária à Saúde (APS) ao cuidado dos casos de violência doméstica contra a mulher (VDCM), desenvolvendo, implementando e avaliando uma intervenção. Pesquisa piloto de avaliação do antes e depois da implementação de uma intervenção, utilizando métodos mistos e realizada em três fases...

Domestic violence (DV) is a global prevalent health problem leading to adverse health consequences, yet health systems are often unprepared to address it. This article presents a comparative synthesis of the health system’s pre-conditions necessary to enable integration of DV in health services in Brazil, Nepal, Sri Lanka and occupied Palestinian T...

Background Studying global health problems requires international multidisciplinary teams. Such multidisciplinarity and multiculturalism create challenges in adhering to a set of ethical principles across different country contexts. Our group on health system responses to violence against women (VAW) included two universities in a European high-inc...

Background Domestic violence (DV) is a violation of human rights and a major public health problem that damages the health of women and their families. In the occupied Palestinian territories, 29% of women have a lifetime exposure to intimate partner violence, the most prevalent form of DV. Despite the existence of national policies to prevent and...

Background Health systems have a critical role in a multi-sectoral response to domestic violence against women (DVAW). However, the evidence on interventions is skewed towards high income countries, and evidence based interventions are not easily transferred to low-and middle-income countries (LMIC) where significant social, cultural and economic d...

Background Research capacity-strengthening is recognized as an important component of global health partnership working, and as such merits monitoring and evaluation. Early career researchers are often the recipients of research capacity-strengthening programmes, but there is limited literature regarding their experience. Methods We conducted a qu...

Background There is an increasing focus on readiness of health systems to respond to survivors of violence against women (VAW), a global human rights violation damaging women’s health. Health system readiness focuses on how prepared healthcare systems and institutions, including providers and potential users, are to adopt changes brought about by t...

There is growing recognition among global health practitioners of the importance of rights-based family planning (FP) programming that addresses inequities. Despite Kenya achieving its national FP target, inequities in access and use of modern FP remain, especially amongst marginalised nomadic and semi-nomadic pastoralist communities. Few studies e...

Collecting data to understand violence against women and children during and after the COVID-19 pandemic is essential to inform violence prevention and response efforts. Although researchers across fields have pivoted to remote rather than in-person data collection, remote research on violence against women, children and young people poses particul...

Background Health systems have a critical role in a multi-sectoral response to domestic violence against women (DVAW). However, the evidence on interventions is skewed towards high income countries, and evidence based interventions are not easily transferred to low-and middle-income countries (LMIC) where significant social, cultural and economic d...

Introducing best practice approaches to help nursing students identify and respond to patients who are/have been exposed to intimate partner violence (IPV) is instrumental to their professional development. The objectives of this study are to gather preliminary data from the American Association for the Colleges of Nursing (AACN) affiliated schools...

Objectives To synthesise evidence on the effectiveness, cost-effectiveness and barriers to responding to violence against women (VAW) in sexual and reproductive health (SRH) services in low/middle-income countries (LMICs). Design Mixed-methods systematic review. Data sources Medline, Embase, Psycinfo, Cochrane, Cinahl, IMEMR, Web of Science, Popl...

Despite a well-established understanding of the mental and physical health consequences associated with exposure to childhood abuse, the active voices of survivors are rarely present in shaping, conducting and disseminating research. To explore the extent and quality of involvement with adult survivors of childhood abuse in the UK, we performed a s...

Objectives. To synthesise evidence on the effectiveness, cost-effectiveness, and barriers to responding to violence against women (VAW) in sexual and reproductive health (SRH) services in low- and middle-income countries (LMICs). Design. Mixed-methods systematic review. Data sources. Medline, Embase, Psycinfo, Cochrane, Cinahl, IMEMR, Web of Scienc...

There exist significant inequities in access to family planning (FP) in Kenya, particularly for nomadic and semi-nomadic pastoralists. Health care providers (HCP), are key in delivering FP services. Community leaders and religious leaders are also key influencers in women’s decisions to use FP. We found limited research exploring the perspectives o...

Background To our knowledge, no studies exist on the influence of nomadic pastoralist women’s networks on their reproductive and sexual health (RSH), including uptake of modern family planning (FP). Methods Using name generator questions, we carried out qualitative egocentric social network analysis (SNA) to explore the networks of four women. Net...

Child marriage is associated with adverse health and social outcomes for women and girls. Among pastoralists in Kenya, child marriage is believed to be higher compared to the national average. This paper explores how social norms and contextual factors sustain child marriage in communities living in conflict-affected North Eastern Kenya. In-depth i...

Background A health system response to domestic violence against women is a global priority. However, little is known about how these health system interventions work in low-and-middle-income countries where there are greater structural barriers. Studies have failed to explore how context-intervention interactions affect implementation processes. H...

Background There is growing recognition of the health sector’s potential role in addressing domestic violence (DV) against women. Although Brazil has a comprehensive policy framework on violence against women (VAW), implementation has been slow and incomplete in primary healthcare (PHC), and little is known about the implementation challenges. This...

In humanitarian settings, timely access to care is essential for survivors of gender-based violence (GBV). Despite the existence of GBV support services, challenges still exist in maximising benefits for survivors. This study aimed to understand the characteristics of violence against women and explore barriers and facilitators to care-seeking for...

Background Domestic violence (DV) damages health and requires a global public health response and engagement of clinical services. Recent surveys show that 27% of married Palestinian women experienced some form of violence from their husbands over a 12 months' period, but only 5% had sought formal help, and rarely from health services. Across the g...

Background: In conflict-affected settings, women and girls are vulnerable to gender-based violence (GBV). GBV is associated with poor long-term mental health such as anxiety, depression and post-traumatic stress disorder (PTSD). Understanding the interaction between current violence and past conflict-related violence with ongoing mental health is...

Background There is limited evidence on the relationship between disability, experiences of gender-based violence (GBV), and mental health among refugee women in humanitarian contexts. Methods A cross-sectional analysis was conducted of baseline data ( n = 209) collected from women enrolled in a cohort study of refugee women accessing GBV response...

This article presents a case study of research in Dadaab, Kenya to highlight some of the relevant challenges encountered while conducting gender-based violence research in humanitarian settings. A longitudinal mixed-methods design was used to evaluate a comprehensive case-management intervention in the refugee complex near the border of Kenya and S...

Background Increasing attention has been paid on health systems readiness around domestic violence (DV), a global health issue leading to adverse health consequences. This article aims to present a comparative synthesis of the health system pre-conditions necessary to enable integration of services for domestic violence in Brazil and Palestine. Me...

Background A health system response to domestic violence against women is a global priority. However, little is known about whether or how they work in LMICs where there are greater structural barriers. HERA (HEalthcare Responding to violence and Abuse) aimed to strengthen the primary healthcare response to domestic violence in the West Bank of Pal...

Background Violence against women (VAW) damages health and requires a global public health response and engagement of clinical services. Recent surveys show that 27% of married Palestinian women experienced some form of violence from their husbands over a 12 month’s period, but only 5% had sought formal help, and rarely from health services. Across...

Background Domestic violence (DV) damages health and requires a global public health response and engagement of clinical services. Recent surveys show that 27% of married Palestinian women experienced some form of violence from their husbands over a 12 month’s period, but only 5% had sought formal help, and rarely from health services. Across the g...

Background Domestic violence (DV) damages health and requires a global public health response and engagement of clinical services. Recent surveys show that 27% of married Palestinian women experienced some form of violence from their husbands over a 12 month’s period, but only 5% had sought formal help, and rarely from health services. Across the g...

Background: Domestic violence (DV) damages health and requires a global public health response and engagement of clinical services. Recent surveys show that 27% of married Palestinian women experienced some form of violence from their husbands over a 12 month’s period, but only 5% had sought formal help, and rarely from health services. Across the...

Background: Domestic violence (DV) damages health and requires a global public health response and engagement of clinical services. Recent surveys show that 27% of married Palestinian women experienced some form of violence from their husbands over a 12 month’s period, but only 5% had sought formal help, and rarely from health services. Across the...

Background Domestic violence (DV) damages health and requires a global public health response and engagement of clinical services. Recent surveys show that 27% of married Palestinian women experienced some form of violence from their husbands over a 12 month’s period, but only 5% had sought formal help, and rarely from health services. Across the g...

Digital technologies provide opportunities for advancing sexual and reproductive health and services but also present potential risks. We propose 4 steps to reducing potential harms: (1) consider potential harms during intervention design, (2) mitigate or minimize potential harms during the design phase, (3) measure adverse outcomes during implemen...

Domestic violence (DV) against women is a widespread violation of human rights. Adoption of effective interventions to address DV by health systems may fail if there is no readiness among organizations, institutions, providers and communities. There is, however, a research gap in our understanding of health systems' readiness to respond to DV. This...

Background: Mobile phones for health (mHealth) hold promise for delivering behavioral interventions. We evaluated the effect of automated interactive voice messages promoting contraceptive use with a focus on long-acting reversible contraceptives (LARCs) among women in Bangladesh who had undergone menstrual regulation (MR), a procedure to "regulat...

Abstract Background Little is known about the prevalence and correlates of intimate partner violence (IPV) among gay, bisexual and other men who have sex with men (GBMSM) in the UK. The aim of this study was to investigate the prevalence of IPV, associations of socio-economic and psychosocial factors with IPV, and the association of IPV with depres...

The Domestic Violence Enhanced Home Visitation (DOVE) intervention used in the Perinatal Nurse Home Visiting Intervention Enhanced With mHealth Technology (RCT: R01HD071771) is a nurse-lead evidenced-based intervention that has been shown to decrease violence overtime. This summative mixed-methods impact evaluation is intended to provide insight to...

Background Malaysia has rising dengue incidence. World Health Organization clinical practice guidelines for managing dengue have been adapted by the Ministry of Health in Malaysia, with evidence of good awareness by clinicians. However, dengue mortality has not reduced. This study aimed to explore the challenges of dengue management for Medical Off...

This chapter presents a case study of a woman in a rural area experiencing intimate partner violence. She visits the family physician when the effects of intimate partner violence start taking a toll on her overall health. The physician, however, does not recognize the indicators of exposure to intimate partner violence nor does he conduct any IPV...

Objective We reviewed cohort studies to determine the magnitude and temporal direction of the association between recent intimate partner violence (IPV) and a range of adverse health outcomes or health risk behaviours. Design Systematic review and meta-analysis. Methods Medline, EMBASE and PsycINFO were searched from the first record to November...

Reports of gender-based violence (GBV) are common in camps for refugees and displaced populations. In the Dadaab refugee camps in north-eastern Kenya, the International Rescue Committee (IRC) and CARE International (CARE) implement programmes that aim to both respond to and prevent GBV. A cornerstone of this work has been to train refugees, known a...

Cambridge Core - Obstetrics and Gynecology, Reproductive Medicine - High-Risk Pregnancy - edited by David James

Intimate partner violence (IPV) and child maltreatment (CM) by a parent or caregiver are prevalent and overlapping issues with damaging consequences for those affected. This scoping review aimed to identify opportunities for greater coordination between IPV and CM programmes in low- and middle-income countries (LMIC). Nine bibliographic databases w...

Background: Intimate partner violence (IPV) is common during pregnancy and the postpartum. Perinatal home visitation provides favorable conditions in which to identify and support women affected by IPV. However, the use of mHealth for delivering IPV interventions in perinatal home visiting has not been explored. Objective: Our objective was to c...

Development of joint displays is a valued approach to merging qualitative and quantitative findings in mixed methods research. This study aimed to illustrate a case series mixed methods display and the utility of using mixed methods for broadening our understanding of domestic violence and abuse. Using a convergent design, 532 gay and bisexual men...

Development of joint displays is a valued approach to merging qualitative and quantitative findings in mixed methods research. This study aimed to illustrate a case series mixed methods display and the utility of using mixed methods for broadening our understanding of domestic violence and abuse. Using a convergent design, 532 gay and bisexual men...

This study explored women’s experiences of being screened for intimate partner violence and receiving an intervention during perinatal home visits in urban and rural settings in the USA. Twenty-six women were recruited from the DOVE (Domestic Violence Enhanced Home Visit) intervention trial to participate in a nested qualitative interpretive study....

This cross-sectional survey measured adult experience and perpetration of negative and potentially abusive behaviours with partners and its associations with mental and sexual health problems, drug and alcohol abuse in gay and bisexual men attending a UK sexual health service. Of 532 men, 33.9% (95% CI: 29.4-37.9) experienced and 16.3% (95% CI: 13....

Background Domestic violence and abuse is recognised globally as a pervasive public health issue, but there is less research in relation to gay and bisexual men. This study aimed to measure the occurrence of negative and potentially abusive behaviour and associations with health problems in gay and bisexual men; and pilot test an educational interv...

Objective To measure the experience and perpetration of negative behaviour, including domestic violence and abuse (DVA), and investigate its associations with health conditions and behaviours in men attending general practice. Design Cross-sectional questionnaire-based study conducted between September 2010 and June 2011. Setting 16 general pract...

Background Pregnancy and the postpartum is a time of increased risk for intimate partner violence (IPV). Pre and postnatal home visitation provide an opportunity for preventive and early intervention. Little is known about the best methods for identifying and supporting abused women in home settings that maintains privacy, is sensitive, and accura...

Background Pregnancy and the postpartum may be a time of increased risk for intimate partner violence (IPV). Pre and postnatal home visitation provide an opportunity for preventive and early intervention. Little is known about the best methods for identifying and supporting abused women in home settings that maintains privacy, is sensitive, and a...

Self-inflicted injuries are one of the major causes of disease burden and death globally. Understanding the extent to which this is associated with childhood sexual abuse (CSA) exposure can help inform prevention strategies. We aimed to quantify to what extent CSA was associated with incident suicide attempts in men and women. We searched 20 health...

Intimate partner violence (IPV) among men who have sex with men (MSM) is a significant problem. Little is known about the association between IPV and health for MSM. We aimed to estimate the association between experience and perpetration of IPV, and various health conditions and sexual risk behaviours among MSM. We searched 13 electronic databases...

To examine the evidence of association between intimate partner physical or sexual violence (IPV) victimization and alcohol consumption in women. We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies released before 6 June 2013. Studies providing an estimate of association between violence and alcohol consum...

Background Domestic violence in men who have sex with men (MSM) is common and associated with adverse health consequences. This study aims to (i) explore the nature and impact of domestic abuse in gay and bisexual men attending a UK sexual health clinic and (ii) explore men’s views on routine enquiry for domestic abuse by health practitioners. Meth...

Between 15.4% and 51% of men who have sex with men (MSM) have experienced domestic violence (DV). The adverse health consequences of DV are well documented for women victims, but little is known about the association between DV and health outcomes for men who have sex with men. We aimed to establish if MSM exposed to DV had higher odds of experienc...

Data from 81 countries was used to estimate global prevalence of intimate partner violence against women.

Details of longitudinal studies included in the review. (DOCX)

PRISMA checklist. (DOCX)

List of databases searched and example search strategy. (DOCX)

Depression and suicide are responsible for a substantial burden of disease globally. Evidence suggests that intimate partner violence (IPV) experience is associated with increased risk of depression, but also that people with mental disorders are at increased risk of violence. We aimed to investigate the extent to which IPV experience is associated...

Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed ch...

This paper reports on an evaluation of a domestic violence intervention in the maternity and sexual health services of a UK hospital. The intervention encompassed guidelines, staff training, inclusion of routine enquiry for domestic violence with all patients, and referral of women disclosing violence to an on-site advocacy service. An “assumption...

We aimed to describe the prevalence of intimate partner violence (IPV) during pregnancy across 19 countries, and examine trends across age groups and UN regions. We conducted a secondary analysis of data from the Demographic and Health Surveys (20 surveys from 15 countries) and the International Violence Against Women Surveys (4 surveys from 4 coun...

To identify maternity and sexual healthcare professionals' training needs regarding routine enquiry for domestic abuse. A cross-sectional survey, part of a theory-based evaluation of a routine enquiry for domestic abuse intervention in a South London teaching hospital. Two hundred and twenty-eight maternity professionals (68% of staff) and 46 sexua...

We aimed to describe the prevalence of intimate partner violence (IPV) during pregnancy across 19 countries, and examine trends across age groups and UN regions. We conducted a secondary analysis of data from the Demographic and Health Surveys (20 surveys from 15 countries) and the International Violence Against Women Surveys (4 surveys from 4 coun...

This resource presents a penetrating and thought provoking analysis of the forensic mental health system - how it operates, the people involved, the problems inherent in such a system, and the huge ethical dilemma of depriving an individual of their freedom. It brings together a range of specialists, each with considerable experience, who describe...

Hollow-up of the un-trcatcd condition is generally considered not feasible due to ethical considerations and the ability of the un-treated addict to obtain treatment elsewhere. The absence of any organised drug services in the North West of England in the early 80s provided an opportunity to study the course and outcome of help-seeking addicts who...

The two objectives were: (1) to identify, appraise and synthesise research that is relevant to selected UK National Screening Committee (NSC) criteria for a screening programme in relation to partner violence; and (2) to judge whether current evidence fulfils selected NSC criteria for the implementation of screening for partner violence in health-c...

Domestic violence (DV) affects around one in four women in the UK. This study aimed to determine the prevalence of DV and the associations with sociodemographic and sexual behaviour variables in female attendees of an inner-city genitourinary (GU) medicine clinic. In this cross-sectional survey, 177 of 380 women (46.6%) disclosed a history of abuse...