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Enfermería Global
versión On-line ISSN 1695-6141
Enferm. glob. vol.18 no.54 Murcia abr. 2019 Epub 14-Oct-2019
https://dx.doi.org/10.6018/eglobal.18.2.324811
Originals
Violence against rural women: conceptions of professionals in the intersectoral network of care
1Nurse of the Ibiaçá City Hall. Ibiaçá, RS, Brazil
2Nurse. PhD in Nursing. Teacher of Universidade Federal de Santa Maria - Campus Palmeira das Missões. RS, Brazil.
3Nurse. PhD in Sciences. Teacher of Universidade Federal de Santa Maria - Campus Palmeira das Missões. RS, Brazil
4Nurse. Master in Nursing. PhD student at the Nursing Graduate Program of the Universidade Federal de Santa Maria – Campus Santa Maria. RS, Brazil
5Nurse. Master Student of the Nursing Graduate Programo of the Universidade Federal de Santa Maria – Campus Santa Maria. RS, Brazil.
Introduction:
Violence against women in both rural and urban areas requires the coordination of different sectors through a network of care
Objective:
To know the conceptions of professionals of the care network about violence against rural women
Method:
Qualitative research carried out with 26 professionals from the network of care to rural women in situations of violence in four cities of Rio Grande do Sul state, Brazil. Data were generated semi-structured interviews and analyzed using the thematic content analysis
Results:
Professionals related violence against rural women to cultural, generational and gender heterogeneities, which makes violence natural. They pointed to the different types of violence experienced, either physical, psychological, moral, and sexual violence, dependence, deprivation of liberty and intense work hours
Conclusions:
The findings reinforce the gender inequalities that perpetuate the subjugation and submission of rural women
Key words: Violence; Violence against women; Women’s health; Health of the rural population; Inter-sectoral collaboration
INTRODUCTION
Violence against women is a global public health problem that affects approximately one third of the women worldwide, injuring their human rights, restricting their full participation in society and impacting their health and well-being.1Violence against women is defined as any act of violence that causes physical, sexual or psychological harm to women.2
In Brazil, data revealed that 29% of women experienced some situation of violence throughout their lives. Physical violence was cited by 67% of women; followed by psychological violence, by 47%; moral violence, by 36%; and sexual violence, by 15%.3
Violence is present in women's lives in both urban and rural settings. Some features aggravate violence portrayed in rural areas, imposing limits to confronting it. These limits include the distance from collective resources to seek help and support, in addition to the geographical distance from urban centers, where these resources are located.4-5
Another limit refers to the characteristics of the relationships between men and women in rural settings, permeated bymachismo, authoritarianism, and gender heterogeneities.6This context of adversity and exclusion places rural women in a condition that favors violence.
Faced with the complexity and multidimensional character of violence against women, preventing and coping with violence require the articulation of different sectors, through the service network. This refers to the articulated action between governmental/non-governmental institutions/services and the community, covering various areas such as health, education, public safety, social assistance and culture.7
Faced with this problem and the global goal of eliminating all forms of violence against women and girls in the world8, subsidies are sought to develop responses to violence against women in rural settings, based on the perceptions of professionals in the service network.
Thus, this study has as a guiding question: What are the perceptions of network professionals about violence against rural women? The objective is to know the perceptions of professionals of the service network about violence against rural women
MATERIAL AND METHOD
This is a descriptive qualitative research developed in four cities in the state of Rio Grande do Sul, Brazil. Participants were professionals, managers and/or service providers of the service network for rural women in situations of violence. The inclusion criteria were being a professional, manager and/or principal in one of the services and having been working in that position for more than six months. The exclusion criterion was being on vacation or on any kind of leave during the data generation period
Initially, the researcher in charge contacted the managers or principals of services and listed potential participants, who were then contacted. A meeting was scheduled to invite them to participate in the survey. This meeting occurred in the services in which the participants worked, at a previously scheduled time. After these procedures, the study consisted of 26 participants
The areas and services in which participants worked were agriculture - Municipal Secretariat of Agriculture and Enterprise of Technical Assistance and Rural Extension; social assistance - Social Assistance Reference Center, Specialized Social Assistance Reference Center and Women's Municipal Council; health - Regional Coordination of Health and Municipal Health Secretariat; education - Municipal Secretary of Education; and police - Civil Police Station. With the exception of the health area, through Family Health Strategy Units, the other services were located in the urban scenario of the cities
Regarding the characterization of participants, 18 (69.2%) were women and eight (30.8%) men. Regarding training, 23 (88.5%) had completed higher education and three (11.5%) had completed high school. As for the areas in which the participants worked, seven (26.9%) worked in agriculture, six (23.1%) in social assistance, five (19.2%) in the health area, five (19.2%) in the police and three (11.6%) in education.
For the generation of data, semi-structured interviews were used, for which a script with two axes was developed. The first one was composed of closed questions related to the sociodemographic and training data of the participants, and the second consisted of open questions about the object of study
The interviews were previously scheduled, carried out individually in a private place in the service itself. They were audio recorded, lasting in average one hour. Data generation occurred from December 2013 to June 2014 and was ended based on the criterion of thematic saturation.9
Data analysis was performed through the thematic content analysis, constituted by three chronological poles.10Before beginning the analysis, the entire empirical material was transcribed, constituting thecorpusof the research. In the first pole, pre-analysis, attentive listening of the recordings and floating reading of thecorpuswas performed. In the second pole, the exploration of the material was made, thecorpuswas cut/encoded in record units and context units. Then, the record units were reunited by similarities of meaning and read again, constituting the categories. The third pole encompassed the treatment of results, inference and interpretation. Inferences and interpretations about the results were proposed.10
The research was approved by the Local Research Ethics Committee under Opinion no. 514 865. The study met the ethical precepts of the Declaration of Helsinki and Resolution no. 466/2012 of the National Health Council, which applies to studies with human beings. Thus, participants were clarified about the objectives of the research through the Informed Consent Form, which was signed in two copies. In order to guarantee the anonymity, participants were identified with the letter "P" for participant, followed by increasing numeric numerals to represent the sequence of the interviews conducted and the corresponding record unit
RESULTS
From the analysis of the data, two categories emerged, namely Violence against rural women: cultural and generational aspects, gender heterogeneities and naturalization, and Violence against rural women: the different types of violence to which they are subjected
Professionals’ perceptions are supported by the "word cloud" (Figure 1), whose words express the essence of the central ideas of the study
Violence against rural women: cultural and generational aspects, gender heterogeneities and naturalization
This category gathers findings that indicate that violence against rural women is associated with cultural and generational aspects and to gender heterogeneities, which leads to the naturalization of violence
Participants revealed that violence against rural women is linked to cultural issues perpetuated in rural settings. They mentioned that this violence is experienced for several generations within the same family
[In the rural area]it seems that they accept it[violence]because it is cultural.(P7RU1)
Many women see it as normal, because my father used to beat my mother too.(P2RU8)
There is the cultural issue, as they[rural women]understand they deserve[violence]because it happened to my mother, it will happen to my daughter.(P26RU6)
That woman was raised in that system of violence and cannot discern what violence is and what is not. (P3RU3)
Another aspect concerns the relations between men and women in the rural setting, based onmachismo, patriarchy and male domination, which traditionally naturalize the superiority of man and the submission of women
Violence against women is very much a sexist issue.(P21RU6)
I am a man, you have to be submissive. (P12RU2)
The patriarchal control of man is real. (P19RU2)
Because they have lived together since childhood with violence in the family, many rural women end up not recognizing such situations as violence, but seem them as natural
I can see it but they do not even know they are suffering violence.(P25RU2)
For them, it is okay, so it does not appear much for society, but we know it is real.(P11RU4)
Violence against rural women: the different types of violence to which they are subjected
This category shows the different types of violence that rural women experience
One of the types of violence mentioned refers to physical violence, manifested by visible marks, such as bruises on the face. It is perpetrated by men, especially the husband and/or partner, through the use of physical strength or objects
We see many women with marks on their faces, bruises.(P17RU2)
Situations arise that the man beats the woman with objects and sometimes with his own physical strength. (P20RU1)
These are more examples: the slap, the punch, the kick.(P6RU3)
Other types of violence correspond to moral and psychological violence, through words that belittle and demean the woman. These words are considered by the participants as aggressive as or more serious than physical violence
Often women do not suffer physical violence, but they suffer from psychological harassment and this is also violence[...]. (P8RU2)
In some cases, it’s not about physical, but emotional violence [...]. It’s also an aggression[...]. (P13RU1)
Moral violence is one of the worst types. (P14RU1)
Words to convince the woman that she has no value [...], hurting her with words. (P8RU3)
Sexual violence is another type of violence reported, seen as the obligation to have sex
She has to have sex whenever he wants. (P2RU7)
According to the participants, the dependence on the husband also characterizes a type of violence that tends to preclude their independence and the breaking of the situation of violence
Rural women depend on their husbands to live.(P10RU2)
The woman, because of the dependence to the man, ends up not having money.(P21RU5)
[...]they want to get out of this situation, but they do not have the financial conditions.(P23RU2)
Participants pointed out that another type of violence is deprivation of liberty, in which the woman is prevented from leaving the home and participating in groups and councils
I believe there is a certain imprisonment of women, deprivation of liberty.(P12RU2)
There are many men who make it difficult for women to participate in groups, in councils.(P14RU5)
Keeping these women inside the house. (P9RU1)
Rural women's working hours are also referred to as a type of violence, characterized by the domestic work that the woman performs alone and by the work in the field, developed with the husband. One of the participants calls the work of rural woman as slave labor
The woman from the countryside has a double journey [...] working inside the house and in poor conditions, and still having to work at the field [...]. She works together with her husband.(P25RU1)
When the woman only stays in the house, some say: she does nothing. It is a violence, the double, triple working hours.(P26RU3)
I consider it an aggression to be a slave to work.(P16RU2)
DISCUSSION
The speeches reveal that, in the rural scenario, violence against women is influenced by the cultural issues that permeate the daily life of the families, leading to the occurrence of violence throughout the generations
In this sense, the difficulty imposed by cultural barriers in recognizing situations of violence is visible, since women understand that they must resign themselves to the reality imposed to them.11Thus, rural culture often minimizes and hides the recognition of violence
The historical reproduction of violence is due to the presence of violence in the life of women from childhood, from family relations.12Still, because their mothers consider the experience of violence in the family as natural, they pass on to their daughters that this is a usual and accepTable situation, legitimizing it
In this scenario, strongly influenced bymachismoand patriarchy, it is culturally allowed that the man prevail over his wife and thus exert violence. The patriarchal ideology that regulates gender roles places women in a subordinate position.13-14This promotes the perpetuation of aggressive behavior by men and leaves women vulnerable to experiencing violence.13 15
Gender roles have been socially and historically constructed, rooted in the relations of power and authority between men and women16, making violence against women, especially those living in the rural areas, seem natural
The naturalization of violence is frequent, by a culture that propagates the image of the woman as the one that accepts being dominated by the man. In this way, violence is expressed in all spheres of women's lives and ends up reproducing in everyday life as natural. In this perspective, a study pointed out that women report the existence of social norms that determine that they are submissive to their partner.17
The woman who lives with violence feels bound to this reality, since it is inbuilt into her identity that women have the duty to accept and to submit to what is imposed by men. This naturalization makes the man dominate the different aspects of women's life and body, especially those women in the rural scenario
Participants cited the different types of violence that rural women are susceptible to, including physical violence. Several studies have pointed out that rural women experience this violence, which is especially perpetrated by their intimate partner.6 13 15A study with rural and urban women pointed out that the proportion of rural women who suffered physical violence was significantly higher than that of urban women.18
The use of physical violence by men is a construction that begins even in their infancy, when they are instigated to play games that encourage the use of physical strength, through fights and use of weapons, while girls are encouraged to play with dolls, for example. In this context, gender inequalities are reinforced, according to which the woman has to be fragile and delicate and the man is strong and has the power
Psychological and moral violence, also cited by participants as types of violence against rural women, are reported in other studies.6 13 18 19One of them, developed with rural women in Pakistan, showed that 65% of them experienced different types of violence, with psychological violence being the most common.19
Corroborating with the present study, other investigations show that these violence are manifested through insults, humiliation, cursing and contempt for women.6 13 20These words are employed with the purpose of making them feel worthless, and women consider this type of violence as more intense than physical violence.20
In seeking to convince women that they do not have value, the aggressor leads them to believe that they are not able to live without him, which makes it difficult for them to escape the situation of violence. Thus, the aggressor practices this type of violence seeking to intimidate the woman, pressing her to remain in the cycle of violence.14Psychological and moral violence have several repercussions on the lives of women, such as the reduction of self-esteem, which may imply, among others, the development of mental disorders such as anxiety and depression.
Sexual violence was reported by the participants as another type of violence against rural women, in line with findings of a study developed with community health workers.6The fact that the husband and/or partner compels the woman to have sex is a way of making her fulfill her role as a wife, satisfying his wishes, and again demarcating the gender inequalities present in the male-female relationship
Participants mention both the financial and the affective dependence of women as types of violence against rural women, which have repercussions on the difficulty of women to overcome situations of violence and thus leading them to consent with violence for various reasons. One of these reasons is that they do not feel prepared to face the challenges of living without the financial support of their husbands. This situation worsens when they have children,6because they believe that children would suffer if they, as mothers, leave the relationship.17Another reason is the desire to keep the family together.5
Deprivation of liberty is another type of violence against rural women, in which the man, through his position of superiority, hinders and even prevents the woman from enjoying activities outside the domestic environment, since in rural settings women’s tasks are linked to the home and men’s to public life
Thus the difficulty of keeping in contact with other people, due to geographic distance and the man’s control, makes it difficult for women to seek help to break up situations of violence. The place where the woman lives is usually away from other homes and resources, creating an obstacle to contact with others.21
Double and triple working hours performed by women in rural settings are also named as one of the types of violence.22These working hours are associated with the unequal division of labor, which places women in a position to take care of the home, the children and the husband and/or partner, and also carrying out activities in the field. As for man, as provider of the family, they are responsible for farming, which has direct income generation.6On the other side, since women are involved in activities that do not directly contribute to income, their work is invisible
Rural women's working days are tied to gender inequalities, in which women are subordinate to men, and their work is therefore envisaged as help, even if they work as much or more than men.21Thus, social and work organization reverberates in the suffering of women due to the overload of work and invisibility thereof.23
Although many types of violence cited by professionals also target women living in the urban setting, there are singularities in the rural setting that aggravate all types of violence. These are associated with a sociocultural construction that reinforces the fragility and resignation of women before men. The women in this scenario often have low schooling and excessive working hours, and their social circle becomes restricted to the members of the family. Added to this situation, care and support services are almost exclusively located in the urban setting, geographically distant from rural areas. This hinders the possibilities of women fighting against violence in this scenario
The limitations of this research are related to descriptive qualitative studies, mainly because it has been developed locally, which impairs the generalization of the findings. Despite this, we consider that the research reached its objectives and may raise reflection among professionals of the service network about violence against rural women. These professionals can articulate to develop strategies that contemplate the specificities of this population. One of the strategies would be to deconstruct the naturalization of violence against women in this context. Making violence visible to those who experience it can facilitate its confrontation
Further studies can be developed with participative methodological approaches whose participants are the rural women themselves in situations of violence
CONCLUSIONS
The results revealed that professionals conceive violence against rural women as closely related to cultural and generational aspects and gender heterogeneities, leading to the naturalization of violence in this scenario. The professionals’ conceptions point to the different types of violence that rural women experience daily, namely physical, psychological, moral and sexual violence, dependence, deprivation of freedom and double and triple working hours. These types of violence reinforce rural inequalities, especially gender inequalities, which perpetuate women's subjugation.
This study alerts to the naturalization of violence by the women who experience it and to the urgency of overcoming socio-culturally established gender inequalities. It also points out to the importance of the service network, so that through the incorporation of joint actions, strategies are developed that result in the comprehensive care of rural women in situations of violence.
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Received: May 15, 2018; Accepted: June 02, 2018