TY - JOUR T1 - The magnitude and determinants of violence against healthcare workers in Pakistan JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2019-002112 VL - 5 IS - 4 SP - e002112 AU - Shiraz Shaikh AU - Lubna Ansari Baig AU - Ibrahim Hashmi AU - Mirwais Khan AU - Seemin Jamali AU - Muhammad Naseem Khan AU - Munir Akhtar Saleemi AU - Komal Zulfiqar AU - Sumera Ehsan AU - Iram Yasir AU - Zia ul Haq AU - Lubna Mazharullah AU - Samina Zaib Y1 - 2020/04/01 UR - http://gh.bmj.com/content/5/4/e002112.abstract N2 - Objectives To determine the magnitude and determinants of violence against healthcare workers (HCWs) and to identify the predominant types and causes of violence experienced by them.Methodology A cross-sectional survey based on structured questionnaire adopted from previous surveys and qualitative data was conducted in 4 large cities and 12 districts in 3 provinces of Pakistan. The survey covered 8579 from all cadres of HCWs, including doctors, nurses, technicians, support staff, ambulance workers, vaccinators, lady health visitors, midwives and lady health workers (LHWs). The predictors of overall violence experienced, physical violence experienced and verbal violence experienced were separately analysed for tertiary care hospitals, secondary care hospitals, primary care hospitals and field-level HCWs. Logistic regression was used to compute adjusted ORs with 95% CIs for the association of different factors with the violence experienced.Results More than one-third (38.4%) reported having experienced any form of violence in the last 6 months. Verbal violence was the most commonly experienced form (33.9%), followed by physical violence (6.6%). The main reasons for physical violence were death of patients (17.6%), serious condition of patients (16.6%) and delay in care (13.4%). Among the different types of field HCWs, emergency vehicle operators were significantly more likely to experience verbal violence compared with LHWs (adjusted OR=1.97; 95% CI 1.31 to 2.94; p=0.001). Among hospital HCWs, those working in private hospitals were significantly less likely to experience physical violence (adjusted OR=0.52; 95% CI 0.38 to 0.71; p=0.001) and verbal violence (adjusted OR=0.57; 95% CI 0.48 to 0.68; p=0.001).Conclusion Violence against HCWs exists in various forms among all cadres and at different levels of care. The gaps in capacity, resources and policies are evident. Specific strategies need to be adopted for different types of HCWs to protect them against violence.*The study was conducted under the framework of ICRC’s Healthcare in Danger Initiative for protection of healthcare against Violence ER -