Jo Spangaro, Anthony Zwi, Mary-Anne Frail, and Jennifer Ruane, Research Team Conducting the NSW Aboriginal and Antenatal Screening Impact Study

bw-3We are inspired by the importance and challenge of working in the field of gender-based violence. Although we have worked in many different contexts (service provision, information and education, advocacy), locally, nationally and internationally, we remain committed for two reasons. First, we come across so many stories of strength and bravery and we wish to give visibility to this resilience.  Second, we seek to bridge the worlds of research, policy and practice and contribute something useful to services on the ground.

Jo Spangaro, Anthony Zwi, Mary-Anne Frail and Jennifer Ruane work together as a team on the Aboriginal and Antenatal Screening Impact Study (NAAnSI) at the University of New South Wales. Jo and Anthony, with another two colleagues Alison Rutherford and Jane Koziol-McLain, designed the project and provide the overall direction. Mary-Anne and Jen work in the field, approaching women in antenatal clinics to see if they are eligible and interested in participating in an interview, and then conduct the interviews.

Jo Spangaro graduated as a social worker in 1984 and was immediately drawn to working in gender-based violence based on the knowledge she had gained while studying. Initially she worked as a counsellor in sexual assault response services and later with perpetrators of child sexual assault – as an educator, as a policy advisor and manager.  In 2010, Jo completed a PhD, which examined the consequences of current NSW Health policy for routinely screening pregnant women in relation to intimate partner violence. Since then she has, with Anthony, who supervised her PhD, completed a systematic review of sexual violence in times of conflict and other humanitarian crises.

Anthony Zwi was born in South Africa and completed his medical degree and a PhD in occupational health at the University of the Witwatersrand in Johannesburg. This background led him to explore and challenge the impact of violence (including acts of violence committed at times of political conflict and war) on health, as well as health and social systems, a theme he has followed throughout his working life. He was co-editor of the ‘World Report on Violence and Health’, published by the World Health Organization in 2002, and cited extensively across disciplines on why we must address violence as a determinant of health and well-being.

Mary-Anne Frail is a proud Ngemba woman from Brewarrina in Western NSW, with a strong passion for informing and empowering people in relation to their human rights and always fighting for the prevention of domestic violence not only for her own people, but for all races.  Mary Anne’s Aboriginal heritage and cultural skills are an essential strength of the research project which is aiming for half of the participant sample to be Aboriginal women. Before joining the NAAnSI team, Mary-Anne worked for the Women’s Legal Service of NSW in the Indigenous Women’s Legal Program. She is also a talented DJ who worked for many years on Koori Radio.

Jennifer Ruane has a degree in social science from Ireland where she lived until moving to Australia. She then completed a Masters in International Development at the University of New South Wales.  She has extensive experience in counselling and supporting women who have experienced domestic violence. Most recently she has worked with refugees and women seeking asylum through the Australian Red Cross.

The NAAnSI study builds on Jo and Anthony’s earlier work and aims to understand how women decide whether or not to disclose intimate partner violence during the process of screening which is now part of health policy in many countries, taking place when women first present for antenatal care. This routine screening recognises that violence inflicted by an intimate partner is a hidden phenomenon and that although many women who experience it have a range of health problems, the abuse itself often remains undisclosed to anybody and is often undetected by heath care providers.  The earlier research indicates that approximately 14% of women who suffer from abuse elect to remain silent about this.

Screening occurs when new patients present and their medical and social histories are recorded. A small number of standardised questions about recent experiences of abuse are incorporated into this process. This highlights the importance of health workers being well trained and confident of their ability to assist patients through direct support or referral, and of trust on the part of patients who need to know that the services and advice they seek is being provided by people who are trustworthy and committed to doing more good than harm.

The current study is being conducted in three antenatal clinics in the greater Sydney area and five Aboriginal and Maternal Infant Health Services in Sydney and other locations in NSW. The results will provide answers to questions such as: How do women who are the victims of abuse decide whether they feel it is safe enough to speak about it? What do they think will happen as a result of them being asked directly about their experiences? Do they believe it will make any positive difference? Is the current policy meeting its goals of identifying and helping women who are being abused during pregnancy to prevent harm to baby and mother?

Jo, Anthony, Mary-Anne and Jennifer all want to be sure that when it comes to intimate partner violence, their research will result in the creation of safer environments for women, especially at this exciting but vulnerable time when a new life is developing.


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