BACKGROUND:
Workplace violence (WPV) against health workers is increasingly recognised as a global public health concern, with over 60% affected. Women, the majority of the primary health care (PHC) workforce, face heightened risks amid gendered occupational hierarchies and intersecting inequalities. Despite its prevalence and consequences for worker wellbeing, safety, and health system performance, empirical and policy-relevant evidence on addressing WPV and its gendered dimensions in African health policy frameworks remains limited, hindering effective policy development and implementation.

METHODS:
This policy analysis examined recognition, definition, and operationalisation of WPV and its gendered dimensions within national/subnational policy architectures in Burkina Faso, Tanzania, and South Africa. Grounded in health policy and systems research, this qualitative policy review was triangulated with a review of global/regional instruments and key informant interviews. Data from policy documents and interviews were systematically analysed using NVivo, via thematic coding on policy recognition, definitions, and responses to WPV. Preliminary

RESULTS:
Cross-site comparisons reveal institutional omissions not as gaps in knowledge but constructed ‘gendered’ ignorance reproducing WPV invisibility and marginalisation in PHC governance. South Africa's extensive but sectorally fragmented policies disperse WPV across labor frameworks, revealing the absence of gender-specific approaches in PHC. Burkina Faso’s legal protections and strategies omit WPV and its gender dimensions in PHC. Tanzania’s robust legislation and gender-responsive workplace harassment strategies erode in PHC implementation, reflecting structural setting-specific inequalities. Textual analyses expose implementation gaps, limited cross-sectoral collaboration, and framing inconsistencies underemphasising structural determinants of WPV in PHC settings, undermining policy coherence and accountability.

CONCLUSIONS:
Findings underscore the imperative for greater conceptual coherence in policy design, responding to the systemic multifaceted ways that enable, sustain, and reproduce WPV in PHC settings. They serve to inform participatory, context-specific interventions and catalyse gender-responsive policies to safeguard PHCWs and bolster workers’ well-being, workforce retention and equitable distribution, and health system strengthening.