LILIA BLIMA SCHRAIBER
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina - Líder
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Obstacles and facilitators to primary health care offered to women experiencing domestic violence: a systematic review(2020) D'OLIVEIRA, Ana Flavia Pires Lucas; PEREIRA, Stephanie; SCHRAIBER, Lilia Blima; GRAGLIA, Cecilia Guida Vieira; AGUIAR, Janaina Marques de; SOUSA, Patricia Carvalho De; BONIN, Renata GranussoSystematic review of the literature addressing obstacles and facilitators for the care of women, in situations of domestic violence (DV) in primary health care (PHC) in Brazil. The bibliographic review found 1,048 references. The analysis encompassed 39 articles complying with the inclusion and exclusion criteria. The material was centered on representations and beliefs of practitioners. The main obstacles were related to: conceptualizing DV as a health issue, resulting into difficulties to identify the problem and managing care encounters; lack of training and teamwork; scarce intersectoral network, fear and lack of time. The facilitators were mainly: introducing a gender and human rights perspective, bonding and embracement, teamwork and multisectoral work. Despite the potential of PHC to address the issue, few studies considered perspectives of management and financing, considered as key to overcome the problems pointed out.
- Primary health care and the specialized care services to women in situation of violence: expectations and mismatches in the voice of professionals(2023) AGUIAR, Janaina Marques de; SCHRAIBER, Lilia Blima; PEREIRA, Stephanie; GRAGLIA, Cecilia Guida Vieira; KALICHMAN, Beatriz Diniz; REIS, Marina Silva dos; LIMA, Nayara Portilho; AZEREDO, Yuri Nishijima; D'OLIVEIRA, Ana Flavia Pires LucasNetworking plays a central role in assisting women in situations of violence. This study analyzes how different the work perspectives are for Primary Care professionals and specialized services professionals in the areas of social and law assistance, and public security in the city of Sao Paulo, Brazil. Semi-structured interviews were carried out with 16 professionals from specialized services and 46 from the health sector. The axes for a thematic analysis were: what professionals know and think about services other than their own; their performance based on that; and their expectations. The findings revealed insufficient knowledge of the different services, resulting in communication difficulties as well as wrong referrals to other services, based on how other services would ideally work. We concluded that each sector is autonomous and its services start from its own field of action to define what would be best for women. The set works more like a mesh of services than a network.
- FEAR AND SHAME AS BARRIERS TO OVERCOME DOMESTIC VIOLENCE GENDER(2015) TERRA, Maria Fernanda; D'OLIVEIRA, Ana Flavia Pires Lucas; SCHRAIBER, Lilia BlimaThe objective is to understand - by means of the vulnerability concept - how the feelings of fear and shame associated with violent situations have an impact on the possibilities of women overcoming gender-based domestic violence. Although these feelings are considered a problem and are expressed according to each woman's personal viewpoint, this article argues that the relationship between them and gender-based domestic violence is not an individual problem; rather it is a social and cultural violation of human rights. Based on sixteen interviews with women with a history of domestic violence, the vulnerability concept was used to analyse the relationship between the subjective perspectives of the interviewees and the programmatic and social components that make these women vulnerable. This is turn permitted the analyse of women's social representations in relation to violence and to the means of confronting it, as well as women's objective and subjective relationship with health services.
- Temporal Relationship Between Intimate Partner Violence and Postpartum Depression in a Sample of Low Income Women(2013) FAISAL-CURY, Alexandre; MENEZES, Paulo Rossi; D'OLIVEIRA, Ana Flavia Pires Lucas; SCHRAIBER, Lilia Blima; LOPES, Claudia S.To estimate whether there is a temporal association between Postpartum Depression (PPD) and intimate partner violence (IPV), and to assess the potential role of social support on this relationship. A cross-sectional study was conducted between January 2006 and March 2007 with 701 low income women who received prenatal and postpartum care in primary health care units of the public sector in So Paulo, Brazil. The Self-Report Questionnaire (SRQ-20) was used to assess the presence of PPD. Structured standardized questionnaires were used to assess IPV and social support. The prevalence of PPD was estimated with a 95 % confidence interval. Crude and adjusted prevalence ratios were calculated using Poisson regression to examine the association between PPD and exposure variables. Values of p < 0.05 were considered statistically significant. The prevalence of PPD was 27.9 % (95 %CI 24.6:31.2). The prevalence of psychological IPV was 38.6 %, physical IPV 23.4 %, and sexual IPV 7.1 %. The multivariate analysis showed that PPD was strongly associated with current psychological and physical/sexual violence, after controlling for confounding factors, and less so with past (prenatal or lifetime) IPV. Presence of social support was an independent protective factor for PPD. Identifying and addressing intimate partner violence, including psychological violence, in the postpartum period should be considered as part of a comprehensive approach to caring for new mothers.
- Historical changes in the intersectoral network of services targeted at violence against women - Sao Paulo, Brazil(2020) AGUIAR, Janaina Marques de; D'OLIVEIRA, Ana Flavia Pires Lucas; SCHRAIBER, Lilia BlimaViolence against women has gained space in the political agenda, driven by the women's movement, with the making of public policies targeted at assistance for women. We analyze the results of a study carried out in the city of SAO Paulo, Brazil, with professionals from the specialized intersectoral services network, focusing on the changes that have occurred due to the Maria da Penha Law. Data show that, in spite of the expansion of the services that provide assistance, defense and protection for women, there are difficulties concerning integrated work in professionals' actions and interaction, which hinders the outline of a common assistance project the most important principle for a networked action. The conclusion is that overcoming these difficulties is a challenge in the current political context of degeneration of the services and weakening of public policies targeted at women's rights.
article 2 Citação(ões) na Scopus The gender perspective and health professionals: notes from the Brazilian collective health field(2014) SCHRAIBER, Lilia Blima; D'OLIVEIRA, Ana Flavia Pires LucasWe examine the incorporation of the gender perspective in the health field, considering scientific production, health policies and programs and everyday professional practices within the health services. These distinct layers are necessary given the different possibilities each presents for the incorporation of gender. In scientific production, we identify increasing inclusion of the gender perspective, but with little methodological use of the concept; in health policies and programs, the incorporation of the gender perspective is not comprehensive and varies temporally; and in professional practices, incorporation is anchored more in practical knowledge than in a technical and scientific basis. In the daily work of health professionals, this set of difficulties generates different tensions regarding the scientific and technological basis and the moral basis for intervention.- Gestores de saúde e o enfrentamento da violência de gênero contra as mulheres: as políticas públicas e sua implementação em São Paulo, Brasil(2018) BATISTA, Karina Barros Calife; SCHRAIBER, Lilia Blima; D'OLIVEIRA, Ana Flavia Pires LucasThe study focuses on policies to deal with violence against women in the city of Sao Paulo, Brazil. The objectives were to map the public policies and the proposals for institutional organization of a network of comprehensive care, in addition to analyzing the implementation of these policies, highlighting the health sector, with reports by administrators and policymakers. The study addresses the relationship between management practice and the public policy provisions, the weight of administrators' personal values and perspectives, and the weight of the sod ally dominant discourse in decision-making for implementation of these policies. Data were produced through semi-structured interviews with 32 administrators working at different levels in the institutional organization of the Municipal Health Department, including some policymakers in the state and national scenarios. The body of data were submitted to thematic content analysis, examining each of the interviews and relating them to the literature and conceptual framework. The study concludes that health administrators, as agents of practices, are influenced by the prevailing structures and beliefs and reference to their social and historical context for decision-making. However, when they relate to such structures, they are also capable of intervening in the ways care is produced and provided for women in situations of violence, especially by addressing the training and awareness-raising processes and new references concerning recognition of women's rights as human rights.
- An evidence-based primary health care intervention to address domestic violence against women in Brazil: a mixed method evaluation(2023) BACCHUS, Loraine J.; D'OLIVEIRA, Ana Flavia Pires Lucas; PEREIRA, Stephanie; SCHRAIBER, Lilia Blima; AGUIAR, Janaina Marques de; GRAGLIA, Cecilia Guida Vieira; BONIN, Renata Granusso; FEDER, Gene; COLOMBINI, ManuelaBackgroundHealth 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 differences exist. We evaluated feasibility and acceptability of implementation of an intervention (HERA-Healthcare Responding to Violence and Abuse) to improve the response to DVAW in two primary health care clinics (PHC) in Brazil.MethodsThe study design is a mixed method process and outcome evaluation, based on training attendance records, semi-structured interviews (with 13 Primary Health Care (PHC) providers, two clinic directors and two women who disclosed domestic violence), and identification and referral data from the Brazilian Epidemiological Surveillance System (SINAN).ResultsHERA was feasible and acceptable to women and PHC providers, increased providers' readiness to identify DVAW and diversified referrals outside the health system. The training enhanced the confidence and skills of PHC providers to ask directly about violence and respond to women's disclosures using a women centred, gender and human rights perspective. PHC providers felt safe and supported when dealing with DVAW because HERA emphasised clear roles and collective action within the clinical team. A number of challenges affected implementation including: differential managerial support for the Nucleo de Prevencao da Violencia (Violence Prevention Nucleus-NPV) relating to the allocation of resources, monitoring progress and giving feedback; a lack of higher level institutional endorsement prioritising DVAW work; staff turnover; a lack of feedback from external support services to PHC clinics regarding DVAW cases; and inconsistent practices regarding documentation of DVAW.ConclusionTraining should be accompanied by system-wide institutional change including active (as opposed to passive) management support, allocation of resources to support roles within the NPV, locally adapted protocols and guidelines, monitoring progress and feedback. Communication and coordination with external support services and documentation systems are crucial and need improvement. DVAW should be prioritised within leadership and governance structures, for example, by including DVAW work as a specific commissioning goal.
- Violência institucional, autoridade médica e poder nas maternidades sob a ótica dos profissionais de saúde(2013) AGUIAR, Janaina Marques de; D'OLIVEIRA, Ana Flavia Pires Lucas; SCHRAIBER, Lilia BlimaThe current article discusses institutional violence in maternity hospitals from the health workers' perspective, based on data from a study in the city of Sao Paulo, Brazil. Eighteen health workers from the public and private sectors were interviewed, including obstetricians, nurses, and nurse technicians. A semi-structured interview was used with questions on professional experience and the definition of violence. The analysis revealed that these health workers acknowledged the existence of discriminatory and disrespectful practices against women during prenatal care, childbirth, and the postpartum. Examples of such practices cited by interviewees included the use of pejorative slang as a form of ""humor"", threats, reprimands, and negligence in the management of pain. Such practices are not generally viewed by health workers as violent, but rather as the exercise of professional authority in what is considered a ""difficult"" context. The institutional violence is thus trivialized, disguised as purportedly good practice (i.e., ""for the patient's own good""), and rendered invisible in the daily routine of care provided by maternity services.