# **3. FACILITATORS AND BARRIERS WOMEN EXPERIENCE IN ACCESSING FORMAL VAW SERVICES**

In this section, data from in-depth interviews with users from the four selected centers providing psychosocial services are analyzed. The purpose of these interviews was to understand the experiences of women living in situations of violence and factors that influence their decisions to reach out to formal support services. By identifying the barriers and facilitators of women’s help-seeking, women’s experiences can inform policies that improve the accessibility and effectiveness of services and, ultimately, provide better and more comprehensive protection and support to survivors.

## 3.1 **Profiles and context of interviewees**

Although the profile of the interviewees was heterogeneous, most of the women were white, with low levels of education and aged between 40-59 years. Most were not working at the time of their interview.<sup>12</sup> Almost all cases contained elements of psychological violence, such as controlling behavior, insults and threats. Most cases involved physical and sexual violence. Most women interviewed had suffered at the hands of more than one aggressor over the course of their lives. Interviewees notably described violent family contexts with more than one case of domestic violence in their households or in their original families, some of which involved other survivors such as small children or older family members.

Many women described how their arrival at the support center (CIAM) was triggered by a recent episode of violence and how, after a series of sessions with the social worker or psychologist, they recognized the extent of the abuse they were experiencing or that they had suffered several other episodes of abuse throughout their lives. This process of “discovery” shows the workings of ingrained naturalization of domestic violence, which must not be understood as a particular experience (Campbell et al. 1998, Campbell et al. 1999, Kirkwood 1992, Moss et al. 1997). As shown in other research, this is partly due to the fact that physical abuse is often so intertwined with psychological and sexual degradation that it becomes virtually indistinguishable to the women themselves (Ellsberg et al. 2001). Women pass through various stages of recognition of violence before they are able to take action to overcome it (Landenburger 1989). Research shows that it is only after guided reflection and time that many women are able to reframe their experiences and see them through a de-naturalized lens (Brown 1997, Landenburger 1989, WHO 2019).

Partners and ex-partners were the most common perpetrators of violence, but some women also reported violence at the hand of siblings, children and grandchildren, overwhelmingly male. The descriptions of the relationships between women and their abusers were complex, embedded in close family ties and often in relationships of financial and emotional dependence. One woman (63-years old) in Nova Iguaçú described her experience in this way: “In my house, I was the one taking care of the kids, but I didn’t have the right to buy my own underwear. He even provided for my underwear, because I had no access to money. I didn’t work, because he took me out of my job when we got married, he told me I had to leave

> 12 As noted in the section delineating this research, interviews were conducted during business hours, possibly precluding younger working women from participating.  Income quintile is not strictly correlated with exposure to VAW. In most surveys in Latin America reviewed in PAHO 2012, women in the highest wealth quintile reported the lowest rates of physical or sexual intimate partner violence. At the same time, the prevalence of intimate partner violence did not decline steadily as wealth increased in most countries. Instead, most countries showed the highest prevalence rates among women in the third- or fourth-income quintiles (Bolivia 2003, El Salvador 2008, Guatemala 2008/9, Haiti 2005/6, Nicaragua 2006/7, and Peru 2007/8).

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