Barriers to addressing domestic, sexual, and gender‐based violence against pregnant Indigenous Peruvian women: A comparison of intramural and extramural healthcare workers
Yuliana Mercedes De La Cruz‐Ramirez, Augusto Felix Olaza‐MaguiñaAbstract
Objective
To compare the barriers to addressing domestic, sexual, and gender‐based violence (DSGBV) against pregnant Indigenous Peruvian women between intramural and extramural healthcare workers.
Methods
A comparative cross‐sectional study was conducted with 182 workers from the Huaylas Sur Health Network (Ancash, Peru), who reported barriers in their records of care for DSGBV cases involving pregnant Indigenous women during the last 5 years. A questionnaire was administered virtually between October and December 2025 through a form, after the virtual registration of voluntary informed consent and approval by an ethics committee. The study used SPSS program version 24, Chi‐squared test with a significance level of 0.05, odds ratio (with 95% confidence interval), and a multivariable logistic regression model.
Results
All institutional, cultural, and personal barriers showed a statistically significant difference regarding the frequency of their occurrence between intramural and extramural healthcare workers ( P < 0.05). Furthermore, after adjusting for potential confounding variables, it was determined that the barriers independently associated with the healthcare setting in which workers addressed DSGBV were bureaucratic care protocols, scarcity of human, material, and financial resources, lack of intersectoral cooperation, distrust and fear toward healthcare workers, presence of myths related to DSGBV, lack of knowledge of Indigenous languages, absence of support from Indigenous authorities, lack of specialized training, work overload, fear of retaliation by perpetrators, and frustration and/or emotional exhaustion ( P < 0.05).
Conclusion
Intramural and extramural healthcare workers from the Huaylas Sur Health Network face distinct barriers when addressing DSGBV against pregnant Indigenous women. This is evidenced not only by differences in barrier frequency but also by an independent association with the healthcare setting where care was provided, thus necessitating multisectoral interventions.