Domestic Violence Against BME Women: A Public Health Intervention Plan

This project paper presents an intervention plan for promoting the health of Black and Minority Ethnic (BME) women in the UK, focusing on protection against domestic violence. It provides a rationale for the topic and target group selection, including demographics and epidemiological data on BME groups and domestic violence. The project explores health inequalities and social determinants of health relevant to domestic violence, along with current local government policies and service provisions. Effective interventions are identified, and a detailed intervention plan is developed, addressing ethical considerations, stakeholder analysis, and resource allocation. The study highlights the urgent need for effective interventions to reduce the prevalence of domestic violence among BME women, emphasizing early prevention and support to save lives and reduce societal costs. Desklib offers similar solved assignments for students.

Public Health Promotion Project
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Table of Contents
Chapter 1: Introduction..............................................................................................................3
Aim of the project......................................................................................................................5
Project objective.........................................................................................................................5
Chapter 2: Identified need: Epidemiological data and demographics.......................................7
Health inequalities and social determinants of health................................................................9
Chapter 3: Evidence: Local policies and Service Provision....................................................11
Effective Intervention...............................................................................................................13
Chapter 4: Intervention plan.....................................................................................................15
Ethics........................................................................................................................................16
Stakeholder Analysis................................................................................................................17
Budget/Resources.....................................................................................................................19
Chapter 5: Conclusion..............................................................................................................20
Reference List..........................................................................................................................21
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Chapter 1: Introduction
In this current project paper, an intervention plan for health promotion of the BME group in
UK, emphasizing upon the protection of women against domestic violence. In this context,
the project would include a rationale for selection of the project topic and the target group;
demographics and epidemiological data for the BME groups and domestic violence against
women among women in this group in UK. Further, health inequalities would also be
demonstrated along with social determinants of health in relation to the health promotion
against domestic violence. Further, evidences regarding how this public health issue is
currently being addressed by the local government and other policies as well as service
provisions would be explored, along with the identification of the effective interventions
(Graca, 2017). Further, a clear justification and descriptions of all the methods, tools,
methodologies used for developing the intervention for the currently identified research
problem would be discussed. This plan will further demonstrate the expected outcomes and
conclusion.
In health and social care sector, the key roles and responsibilities of the care workers rely
upon their ability to serve the public and promote their health and wellbeing. Thus, public
health sector in UK is focused upon identifying the health issues among the UK citizen and
device public health policies or undertake interventions for promoting the citizen’s health and
wellbeing. However, significant health disparities remained in UK population, in terms of
health and wellbeing, among different socio-economic groups. According to the 2011 census,
the total UK population was approximately 63,182,000, which has been categorized as the
22md most populated country throughout the world. However, the proportion of different
ethnic and minor communities are staying significantly behind others, in every aspects,
including the health and wellbeing. Instead of undertaking several initiatives by the
government and non-government agencies, it is a persistent issue. Currently, a considerable
part of population in UK is attributable for these minority groups and research suggested that
by 2050, BME (Black, minority ethnic groups) would become up to 30% of the total
population (Fulu et al., 2014). With the increasing population of these groups in UK, the
growing health inequality of these groups with the non-minority groups is becoming a key
concern of the public health care sector in UK. There are several internal and external factors,
which are playing crucial roles in case of the health and social care context.
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Domestic violence is referred to the violence or abuse of a person’s rights by others, in a
domestic setting. It can occur at several form, i.e. physical, psychological, emotional,
financial or sexual. Domestic violence is a key threat to the global society, which is
responsible for enhancing the overall healthcare cost also. In this context, it is noteworthy
that domestic violence against children and women are high in frequency through the world.
However, several agencies working in such contexts have claimed that domestic violence is
mostly difficult to quantify, as it is a widely hidden crime, occurring within house premises.
It is also reported that women often do not want to report the incidents to the police, due to
fear or family pressure; as a result, these cases are underreported during surveys, interviews
or other domestic violation estimation procedures. The prevalence data provided by Crime
Survey of England and Wales offered that 1.2 million women have experienced domestic
violence at the end of March 2017; whereas, it has also been revealed that 4.3 million women
between 16 to 59 years old have experienced domestic violence (Gill and Banga, 2008).
However, it is also noteworthy that the above-mentioned data do not consider some crucial
context and impact in formation, like “whether the violence caused fear”, “who were the
repeat victims” and “who experienced violence in a context of power and control”. Upon
taking these factors into consideration, the nature of domestic violence become more
apparent.
In this context, Womens Aid (2018) claimed that the position of BME women in confronting
violence is different. In case of BME population, the domestic violence might not be
condoned by all family members, however, infrequently challenged or questioned by the
family members. In some cases, the women are unable to differentiate the reason behind their
violence experience, whether it is for their black and minority ethnicity or it is for being
woman. Whatever the experiences, the women from Black, Asian or minority ethnic
communities are more likely to face additional barriers to receive required help. If a BME
woman attempts to escape from a domestic violence context, the experience might be
complexed with racism, which is prevalent in the UK. It is also a reason, why the ethnic and
minority people are unwilling or less willing to seek help from statutory agencies like police,
social services or housing authorities, as they would further gain racist response. In the public
health and social care sector also, the care service providers also offer responses depending
upon particular cultural, ethnic or religious biasness or stereotypes. In this context, it is
noteworthy that in some cases, the service providers may avoid intervening for the fear of
being perceived as racist. Institutional racism is on high degree in this UK context. While
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escaping from abuse by other members of the family, the women face the barrier related the
fear of being rejected by her community.
Within last 15 years greater interventions by the state has been undertaken on the domestic
violence against BME women. However, in this context, Gill and Banga (2008) reviewed
government initiatives as well as local authorities, who undertook initiatives against domestic
violence against women and found that the UK government as well as the public authorities
are not effectively protecting the rights of BME victims of domestic violence or offering
adequate support to the service providers for serving the BME victims and protecting them
against domestic violence. Further, Graca (2017) highlighted that domestic violence costs
£16 billion in UK economy, however, political measures and severity of the cases have
reduced the services as well as rights of the survivors, who attempted to escape abuse. While
reviewing prevalence of domestic violence, it has been revealed that two women are killed by
their partner or ex-partner per week in England and Wales, on an average. The severe and
uncontrolled cases lead to homicide and suicide cases, which cost £1 million. Thus, it has
been revealed that more investment in early intervention, prevention and recovery from
domestic violence, especially in case of the BME groups, would save lives, as well as reduce
the economic as well as human costs to the society. It has also been revealed that these types
of investments are needed for women from the BME communities on an urgent basis, who
have identified with a higher level of domestic homicide, known as ‘honour killings’ and
abuse driven suicide. While there is a significant negative impact of unequal “legal aid,
housing, policing, social services and welfare benefits” for women in UK, BME women and
girls are having the worst service and facing the highest barriers to have services.
Considering the current scenario, it has been revealed that there is an urgent need for
developing the effective intervention to reduce the prevalence rate through the
implementation or early preventive measures against domestic violence, specifically taking
BME women into consideration (Globalcommunities.org, 2018). Thus, the current study is
focusing upon identifying and proposing intervention for addressing this issue in UK public
healthcare.
Aim of the project
The aim of the current project is to explore the current status of domestic violence against
women among BME group in UK and to devise an intervention plan against the issue.
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Project objective
Based on the above-mentioned aim of the current health promotion project, the following
project objectives have been developed:
 To explore the current status of domestic violence against the BME group in UK
 To identify the key social determinants of health responsible for health inequalities in the
communities
 To assess the effectiveness of the existing policies and practice related to the domestic
violence against women, devised for protecting BME group in UK
 To devise intervention for promoting health of BME group in UK and reducing domestic
violence against women in this minority group
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Chapter 2: Identified need: Epidemiological data and demographics
The key target population selected for this public health promotion project is the Black and
ethnic minority group in the UK, known BME community. It has been revealed that the
proportion of UK population from BME communities is expected to reach up to 30% in 2050,
upon doubling within the next decade. The five largest distinct ethnic groups under the BME
groups include “Pakistani, Black African, Black Caribbean, Bangladeshi and Indian” in UK.
The status of BME women in confronting violence is unique. The reason behind their
violence is that they are not employed and do not have their own disposable income, live in
poor house, lack education and awareness as well as opportunities for progress (Siddiqui,
2016). Further, isolation is facilitated by their language barrier and cultural differences with
the local citizens, which make them ill equipped to escape violence. Most of the black
minority ethnic women escaping domestic violence experience social exclusion like
unemployment, poverty, poor housing, lack of access to education and neighbourhood. In
most cases, the BME women are unable to contact with community care service or social
service, as they are unable to speak English and they event cannot make a phone call and seek
help from any external agency. 1 in 5 BME has been reported to have no resource to public
funds. The combined barrier of limited access to legal and other services, lack of knowledge
about own rights, language barrier, abuse by extended family member, lack of financial
independence, fear of social exclusion makes the victim to feel unable to speak out about the
domestic violence publicly.
Further, in many cases, the minority women leaving their homes, experience risk unknown to
most white women. It is because, in UK, every white person visualizes every black and
minority ethnic people to be subject to immigration control. The BME women, who have
escaped from their houses due to domestic violence, without taking passport, marriage
certificate, nationality documents etc. usually face significant difficulties regarding security
and migration (Femi-Ajao et al., 2018). It has also been observed that some women have
been threatened with deportation for not carrying marriage certificate. Most of the refuges are
not equipped to offer expert counselling at this status.
Lack of knowledge about their own rights is a key issue, why the BME women are unable to
escape the abuse. For instance, from Asia Sub-Continent and parts of Africa, the lack of
knowledge significantly hinders their independent and contacts with others, who may help
them to get out of the situation. Further, the inefficient language skill is another factor
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limiting socialization and enhancing their isolation. For instance, it has been revealed that a
quarter of total BME women needs an interpreter to communicate effectively. Additionally,
some women are also ignorant of their rights and responsibilities. Managing diversified-
cultural/religious needs is difficult in the context of BME related domestic violence. Often
the BME women perceive or experience that they are shunned and shunted around statutory
agencies. They often end up in BAWSO, experiencing domestic violence along with mental
and physical health problems. For instance, BAWSO also provides a large cultural diversity
among refugees (Bawso.org.uk, 2018). In addition, for BME women, who are leaving the
community to seek help against the domestic violence, may be subjected to unstoppable
consequences having an impact on the rest of her and her children’s lives.
While the BME group women are excessively impacted by specific forms of domestic
violence, including forced marriage and “honour” based violence, the violence experiences
are often overlapping and intersecting. It has been revealed from national studies that instead
of being likely to experience abuse as other ethnic groups, this research identifies that the
level of disclosing the incidents are for BME victims are considerably lower compared to the
other population. For instance, a national dataset of 42000 cases revealed that the BME
communities are suffering abuse 1.5 times longer than others, prior seeking help.
The recent Crime Survey of England and Wales data revealed that one in four women in
England and Wales experienced domestic violence in their lifetimes and 8% suffer domestic
violence per year. The report has also been reported that the Home Office data reflected that
UK police is receiving a domestic assistance call per minute, however, only 35% domestic
violence cases have been reported to the police. Further, in BME community, the data
revealed even more even more severe. It is because the survey data revealed that this minority
group women are experiencing significantly higher rate of domestic violence, i.e. homicide
and they are approximately three times more likely to commit suicide compared to other
women in UK.
In case of BME communities in UK, the Home Office revealed that the domestic violence
includes some cultural specific forms of harms, which have huge negative impact upon the
BME women, these include “forced marriage, dowry related ab use, female genital
mutilation, honour based or related domestic violence” (Siddiqui, 2018).
The key statistics related to the issue revealed that the “domestic violence accounts for 17%
of all the violent crimes through England and Wales”, which costed approximately £23
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billion in 2001. The British Crime survey also revealed that 54% of rapist were former or
current partners of the victims. 30% of the domestic violence victims in BME groups usually
start experiencing or escalating the issue since their pregnancy. On the other hand, in 30 to
66% cases, along with the woman, children are also subjected to secondary violence. As
stated before, the reports also highlighted that the repeat victimisation is more common
among BME women, other than any other types of crime. It has also been highlighted among
the demographic studies that the victims, after leaving a violent partner or at the moment of
separation, are the highest risk of homicide (Chantler et al., 2018). Further, 47% female
homicide victims were killed by their current or former partner. Further, during 2004, 15000
households have been accepted through local authorities in England and owed to
homelessness duty, where the reason behind homelessness was escape to violence,
representing 13% of all homeless acceptances in England in 2004.
Health inequalities and social determinants of health
Health inequalities need to be addressed, while developing a research project. In this context,
it is noteworthy that due to the increased health inequalities, UK government is not taking
specific steps to address this issue and minimize the consequences. The health inequalities in
UK is usually seen among the whites and non-white communities, who are mostly migrants,
i.e. have migrated from other nations and living in UK. However, addressing health
inequality among these two communities is crucial to device health strategies accordingly. In
this context, it is noteworthy that health inequality is not only accountable for the
compromised health outcomes of the community members, rather also affects the health
status of the other communities as well as the health status of the overall nation. Thus, it has
been revealed from the above discussion that identifying the health inequalities are important
in the case of the current project. It is because, the current project is working with the health
inequality of the black and minority ethnic community in UK. In this context, it is noteworthy
that the health inequalities among different communities often related to the social
determinants of health (World Health Organization, 2018).
The social determinants of health have been defined as the conditions in the social
environment, in which people born, grow, live, work and age. Further, it has also been
revealed that these social determinants of health are such conditions, which are shaped
through the distribution of power, money, social status, resources at global, national and local
level. Further, it has also been revealed that these conditions are significantly responsible for
health inequalities among different communities. For instance, in developed, developing as
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well as under developed countries, the unfair and avoidable differences among the health
status of the different communities have been seen to develop or cause such differences,
which are attributable to the social determinants of health. Thus, considering the social
determinants of health is crucial, while conducting a public health research study. The
international organization WHO have identified and proposed the key social determinants of
health. It has been seen that economy and social conditions play significant role in
determining the social determinants of health for a community, living in a society with others
from other different communities. Further, it has also been argued that these factors are health
promoting factors revealed from the living and working condition of a person’s life, like the
distribution of income, wealth, power and influence; instead of playing the role of risk factors
for individual including behavioural risk factors or genetics, influencing the risk for the
disease or vulnerability to the injury or disease of the person. Some key social determinants
of health suggested by WHO Europe are “the social gradient, stress, early life, social
exclusion, work, unemployment, food, social support, addiction, food, transportation,
addiction, income and income distribution etc.” However, the determinants may vary
significantly according to the contexts. According to the World Health Organization, the
unequal distribution of health damaging experiences is not natural phenomenon in any sense,
rather, a result of the combination of the “bad politics, unfair economic arrangements and
poor social policies” (World Health Organization, 2018).
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Chapter 3: Evidence: Local policies and Service Provision
There are several local policies and services provided to victims of domestic violence in UK,
including the black and minority communities in UK. In this context, it is noteworthy that the
desire for preventing the domestic violence and provide supportive services to the victims
have influenced a number of change implementation within the legal and policy framework
of the UK, since 1970s. this concluded with the implementation of the multi-agency approach
in 1990s, which is still in practice today. However, through these policies change
implementation, not always the specific needs of immigrants and minority community
women have been considered. In this context, Islington.gov.uk (2014) identified that
immigrant and BME women are representing a set of vulnerabilities, which seeks specific
strategies to support them in the contexts of domestic violence, which are associated with
social, structural and individual variables. Rather, in some cases, policies and legislations on
domestic violence in UK is having negative impact upon the women escaping these. In
March 2016, UK government have pledged £80 million to the support services against
domestic violence, including the women in BME communities, through its latest policy. In
2017, “a crime of coercive and controlling behaviour in an intimate or family relationship has
been introduced under Serious Crime Act 2015”, for acknowledging the repetitive and
insidious nature of domestic violence, which is high rate among BME communities. This
scheme was preceded by several initiatives for giving local protection to the vulnerable group
against domestic violence, which include “Domestic Violence Disclosure Scheme, Domestic
Violence Protection Orders and Domestic Violence Protection Notices”. The key aim of these
initiatives was to allow prompt action from the police to protect victims, while allowing the
victims to safeguard their interests. In this context, the DVPN and DVPOs have been
designed for offering respite to the victims for deciding the “application of non-molestation
and occupation orders should not shift the onus of protection from the state to the victim”.
However, these are the civil orders and cannot be utilized instead of the criminal law
provisions. However, without adequate support from the victims, the procedure can be
difficult, which is seen in most of the cases of BME women, who lack their own confidence
to carry on the legal and policy service related procedure against their domestic culprit
(Islington.gov.uk, 2014).
Further, the Domestic Violence, Crime and Victims Act 2004 (DVCVA) has been
demonstrated by the Home Office as the “the biggest overhaul of the law on domestic
violence in the last 30 years”. However, the application of this law for the immigrants and the
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BME communities are not considerably straightforward. Further, in 2014, the “Domestic
Violence Disclosure Scheme” has been rolled out through England and Wales, which aimed
to the enhancement of the protection of the domestic violence victims, allowing the people to
identify whether there is a history of violence for their new partner and categorizing under a
‘right to ask’ and a ‘right to know’ category.
More recently, the British government has been promoting a systematic effort for promoting
multi-agency work in this field, for acknowledging the complex needs of the victims, based
on which the delivery of support service should be done. The recent developments of the UK
government introduced to the FLA along with the implementation of the DVCVA and the
establishment of several institutions, for putting these changes into practice, like Specialist
Domestic Violence Courts (SDVCs), Multi-Agency Risk Assessment Conferences
(MARACs), Independent Domestic Violence Advisors (IDVAs) and MASHs (Multi-Agency
Safeguarding Hubs). However, the multi-agency policy approach against domestic violence
has been raised with four concerns related to “differences in power, resources, working ethos
and practices between the various participating agencies”.
There are several governments as well as non-government agencies, which are offering a
range of support services for the BME women, who survived the domestic violence or abuse
in UK. In this context, the Angelou centre is such an organization, offering support services
to the women and other domestic violence victims via offering cultural and linguistically
diverse advice, information, advocacy through the case, group support for women,
therapeutic care, parenting support, recovery training, group activities and counselling for
women and children (Angelou-centre.org.uk, 2018). The ‘wrap around’ support offered by
the organization has been developed in partnership with a wide range of relevant statutory
and voluntary agencies. Further, BAWSO is a voluntary organization in Wales, which is
offering specialist services to the domestic violence victims and BME women, who are at risk
of “Female Genital Mutilation, Forced Marriage, Honour Based Violence and Human
Trafficking”. It is a “Welsh Government Accredited Support Provider”, which is delivering
the specialist services through the projects, supporting more than 4000 BME every year in
Wales. They also offer housing support for the BME women, who escape domestic violence,
followed by the consulting, identification and referral to improve safety, therapeutic care and
socialization. Women’s Aid is another organization, which helps the BME women to get
services against domestic violence, upon overcoming the barriers they usually face to get
these services. For instance, barriers like funding issues, cultural and linguistic issues as well
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