Schraiber L, d Oliveira A, França JI, Strake S, de Oliveira E. A violência contra mulheres: Demandas espontâneas e busca ativa em unidade básica de saúde. [Violence against women: spontaneous claims and active search in community health centers]. Saúde e Sociedade [Health and Society] ( São Paulo , Brazil ) 2000; 9(1/2): 3-15.

Objectives: To evaluate claims of violence made by female users of a public, community-based health center. To contrast spontaneous claims versus results derived from an active search.

Methodology: Quantitative-qualitative, through participant observation, analysis of medical reports, focus groups, and questionnaires.

Results: The questionnaires from an active search (survey) permitted greater detection of violence than did the study of clinical histories. In responses to the questionnaires, 56.8% of 322 cases disclosed instances of violence as the foremost occurrence in womens lives. Of this total, 15.2% of violent episodes occurred during the last year. In contrast, from analysis of clinical histories, only 8.5% disclosed cases of violence. These data revealed that in spontaneous claims and clinical consultations, womens likelihood of reporting violence was much less than in the active pursuit of violence.

The data analysis also revealed the need for healthcare services to develop a general approach to violence, as well as specific measures of care, so that violence committed against women can be recorded and healthcare workers can offer a suitable means of resolving the situation. Only a part of this response lies in healthcare services; other responses require legal action and human rights efforts.

Conclusions: Health services need to be reorganized t o make violence against women visible. This reorganization should institute effective channels of communication in clinical care and interfaces among health, human rights, and the private lives of women.