Interventions addressing violence against women in health services: An overview of systematic reviews regarding barriers and facilitators to implementation

BACKGROUND: Violence against women is a global issue rooted in gender inequities, requiring coordinated responses within the healthcare system. However, both providers and users face significant challenges in effectively implementing interventions to address it. OBJECTIVES: To synthesize and critically discuss, from the perspectives of professionals and users, the barriers and facilitators to implementing interventions addressing violence against women within healthcare services. SEARCH STRATEGY: This umbrella review combined the Joanna Briggs Institute's method and the Evidence Synthesis for Health Policy. The search was conducted from databases (PubMed, Biblioteca Virtual em Saúde (BVS), PsycInfo, Scopus, Embase, Web of Science, and the Cochrane Library). SELECTION CRITERIA: Systematic reviews were included if they allowed for the analysis of individual, relational, contextual, and cultural factors involved in the interventions. DATA COLLECTION AND ANALYSIS: Data extraction focused on study characteristics and findings related to implementation barriers and facilitators. A narrative synthesis was undertaken, enabling a discussion of recommendations for policy, research, and practice. MAIN RESULTS: Among the 11 systematic reviews, primary studies from high-income countries were noted, with a notable emphasis on primary healthcare services. The successful implementation of interventions is shaped by a complex interplay of individual, relational, cultural, and systemic factors. Key determinants influencing implementation included workforce education, providers' and survivors' feelings, healthcare provider attitudes, prevailing cultural norms, and institutional support mechanisms. CONCLUSIONS: The implementation of interventions requires a comprehensive approach that takes into account the complex nuances influencing the success of efforts to address violence against women in healthcare settings.