Violence intervention within the health system using a nationally-consistent, multi-agency, comprehensive approach

Background New Zealand has implemented a nationally-consistent, multi-agency, comprehensive approach to early identification of family violence (FV) within the health system. The violence intervention programme (VIP) system... [ view full abstract ]

Background
New Zealand has implemented a nationally-consistent, multi-agency, comprehensive approach to early identification of family violence (FV) within the health system. The violence intervention programme (VIP) system evolved from the release of the Ministry of Health’s (MoH) Guidelines in 2002; in 2016 these Guidelines were refreshed and published as the Family Violence Assessment and Intervention Guideline; child abuse and intimate partner violence.

Objective:
To describe the systems approach used in VIP in all 20 District Health Boards (DHBs).

Method
The VIP’s use of evidence, expert opinion and quality improvement processes has enhanced the national and regional systems. The systems include funding for DHBs, template policies, documentation forms, referral forms, posters, cue cards, standardised training package for frontline clinicians, technical advisors and quality improvement tools, including a national evaluation. The health sector intervention is delivered in partnership with community agencies; interagency relationships are enhanced through formal memorandum of understanding, local interagency relationships and joint training.

Since 2007, when a national programme was formally established, the system supporting the clinical response for FV has continued to evolve and expand. Clinicians are trained in child protection and routine questioning for intimate partner violence (IPV). When abuse is identified the intervention includes: providing support, completing a health and risk assessment (dual assessment for child abuse and neglect (CAN) and IPV), safety planning, documentation and referral to specialist community agencies.

Results
Since 2003, the national evaluation results assessing DHBs' responsiveness to FV have increased; IPV from 20 to 92 (out of 100) and CAN from 37 to 93 (median scores). In 2016, DHBs have the VIP infrastructure required, achieved through significant system development.

Conclusion
The VIP is closely aligned to national strategies for FV, including vulnerable children; this presentation profiles the programme's systems and demonstrates its alignment and contribution to key national strategy outputs.