From Daily Practice to Health Policy: The Work of Community Health Agents in Detecting and Responding to Gender-Based Violence as a Social Determinant of Health
1
1 Nursing Department, Fluminense Federal University, Rio das Ostras, Brazil
2
3 Postgraduate Program in Public Health, Federal University of Espírito Santo, São Mateus, Brazil
3
5 Espírito Santo State Department of Health, State Foundation for Innovation in Health, Vitoria, Brazil
4
2 Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
5
4 Espírito Santo State Department of Health, Capixaba Institute of Education, Research and Innovation, Vitoria, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A2345
ABSTRACT
INTRODUCTION:
Primary Health Care (PHC) in Brazil plays a strategic role in addressing violence against women1, recognized as a serious human rights violation and a major social determinant of health, with direct impacts on health equity and social inclusion2. In this context, Community Health Workers (CHWs) act as key links between health services and communities, working closely with socially vulnerable populations in territories where gender-based violence often remains invisible1,3.
OBJECTIVE:
To analyze Community Health Workers’ understanding of gender-based violence against women within the context of Primary Health Care in the municipality of Vitória, Espírito Santo, Brazil.
METHODS:
This exploratory study used a qualitative approach. Data were produced through semi-structured questionnaires with open-ended questions, applied in individually audio-recorded interviews. Data analysis followed a thematic categorization process supported by a conceptual framework grounded in the social determination of health and in the understanding of violence as a social phenomenon.
RESULTS:
Five CHWs participated in the study. The analysis resulted in four categories: “Understanding of violence against women,” revealing socially and culturally shaped interpretations of gender-based violence; “Personal experiences with violence,” showing that these professionals are also affected by gender inequalities in their private lives; “Violence against women in professional practice,” highlighting recognition of women’s silence in communities and challenges to providing inclusive and equitable care3; and “(Lack of) knowledge about mandatory reporting,” exposing weaknesses in understanding compulsory notification as a key public health tool for surveillance, protection of rights, and reduction of health inequities4.
CONCLUSIONS:
CHWs recognize gender-based violence as a recurrent issue in PHC territories, linked to social vulnerability and inequality. However, limited knowledge regarding mandatory reporting weakens the health system’s response. Strengthening continuing education for CHWs is essential to support practices guided by equity, inclusion, and the defense of women’s rights, contributing to more effective PHC responses to gender-based violence.
Primary Health Care (PHC) in Brazil plays a strategic role in addressing violence against women1, recognized as a serious human rights violation and a major social determinant of health, with direct impacts on health equity and social inclusion2. In this context, Community Health Workers (CHWs) act as key links between health services and communities, working closely with socially vulnerable populations in territories where gender-based violence often remains invisible1,3.
OBJECTIVE:
To analyze Community Health Workers’ understanding of gender-based violence against women within the context of Primary Health Care in the municipality of Vitória, Espírito Santo, Brazil.
METHODS:
This exploratory study used a qualitative approach. Data were produced through semi-structured questionnaires with open-ended questions, applied in individually audio-recorded interviews. Data analysis followed a thematic categorization process supported by a conceptual framework grounded in the social determination of health and in the understanding of violence as a social phenomenon.
RESULTS:
Five CHWs participated in the study. The analysis resulted in four categories: “Understanding of violence against women,” revealing socially and culturally shaped interpretations of gender-based violence; “Personal experiences with violence,” showing that these professionals are also affected by gender inequalities in their private lives; “Violence against women in professional practice,” highlighting recognition of women’s silence in communities and challenges to providing inclusive and equitable care3; and “(Lack of) knowledge about mandatory reporting,” exposing weaknesses in understanding compulsory notification as a key public health tool for surveillance, protection of rights, and reduction of health inequities4.
CONCLUSIONS:
CHWs recognize gender-based violence as a recurrent issue in PHC territories, linked to social vulnerability and inequality. However, limited knowledge regarding mandatory reporting weakens the health system’s response. Strengthening continuing education for CHWs is essential to support practices guided by equity, inclusion, and the defense of women’s rights, contributing to more effective PHC responses to gender-based violence.
| eISSN: | 2654-1459 |
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