Acesso à Rede de Atendimento às mulheres vítimas de violência por parceiro íntimo: uma análise multifacetada

Abstract

This study comprises 4 objectives. To identify variables related to the functioning of the intersectoral network of assistance to women victims of intimate partner violence (IPV). To describe the role of Primary Health Care (PHC) in addressing IPV against women. To identify the profile of IPV against women registered in the Surveillance System of Notifiable Diseases (SINAN) and Police Reports provided by the Public Security Secretariat, from 2018 to 2022, in Manaus/AM. And, to propose a map of the intersectoral assistance network for women victims of IPV with entry point in primary health care in Manaus/AM. It was divided into two Integrative Literature Reviews (ILRs), developed in 6 phases: Formulation of the guiding question; Literature search; Data collection; Critical analysis of the included studies; Discussion of results; and Presentation of the integrative review. A descriptive, cross-sectional, epidemiological study using secondary data sources of IPV against women from SINAN and police reports SISP/AM. And, a PM, constructed from studies 1, 2, and 3. Regarding study 1, variables such as network disarticulation points were identified: Fear, shame, or distrust on the part of the victims; Influence of support networks; Professional unpreparedness for care; Lack of resources and adequate physical structure; among others. Study 2 was divided into 3 paired dimensions: Professional unpreparedness in PHC and Woman-centered care; (Dis)organization structure of PHC and Organizational structure of PHC; Access of women victims of IPV in PHC and The hurdles on the path of women to care in PHC. Study 3 identified that sexual violence is more reported by health services, while psychological and physical violence women are more likely to resort to police records, in SINAN registration it was verified that perpetrators of physical and psychological IPV occur more frequently by spouses and sexual by boyfriends. Study 4 refers to the stages of construction of the assistance network map, consisting of four main services: Health; Public Security; Justice; and Social Assistance. It is concluded that ILRs reveal the complexity of professionals' approach and the importance of the assistance network. It is evident that socio-environmental and cultural characteristics influence victims' adherence to services, highlighting the need for improvements in the quality of care and professional training. Additionally, the differentiation in violence records between health and public security sectors underscores the importance of strengthening the linkage between these services. Study 4, based on integrative reviews and secondary data, aimed at creating a map of the assistance network in Manaus, seeking to provide useful information to the population, especially considering the geographical and social peculiarities of the region. The dissemination of these services, preferably by PHC, should be accompanied by an adequate offer of primary care services to meet the demands of women victims of violence