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At the time, the NFP training curriculum included minimal information about assessing IPV, client safety and the effects of IPV on children.
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In 2006, we performed a qualitative study regarding Tanzanian health care workers' (HCWs) experiences of meeting IPV clients.
Ethnographic studies have documented the prevalence of history of abuse (i.e., history of childhood abuse, IPV, and client-perpetrated violence) and of HIV infection among FSWs in various international settings [ 15– 17].
Wechsberg et al. [ 17] found that sex workers in South Africa with a history of abuse (childhood, IPV, and client-perpetrated) had a fear of future victimization and discomfort with the relationship dynamics with men, which in turn led to increased substance abuse and greater sexual risk.
It is this relationship that may facilitate nurse home visitors' abilities to ask about IPV and increase clients' comfort levels in disclosing IPV exposure [ 28].
NFP clients, nurses and stakeholders identified the need for modifications to the existing NFP program; this led to the development of an intervention that includes universal and targeted components to assist NFP nurses in addressing IPV with their clients.
The use of mHealth technology may increase the sensitivity of screening instruments and reduce communication barriers between HVs and clients regarding IPV, as well as enhance implementation of IPV interventions and allow for a more standard delivery of an intervention.
Women with PTSD reported more general aggression, IPV perpetration, and IPV victimization.
Therefore, as part of the IPV intervention, nurses screen clients for mental health and substance use concerns with tools already in use at the local site.
Each nurse who participated confirmed that she had experience in assessing clients for their exposure to IPV or with working with an NFP client who had disclosed a history of current or past abuse.
The identified gaps were seen as challenges resulting from an inadequate work environment in terms of structures and adequate skills to attend clients identified with IPV experiences.
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