Table 3. Adaptation of the DV Intervention According to the Key Barriers Affecting Systems Readiness .

Building Blocks	Key Barriers Affecting Systems Readiness	Adaptations to DV Intervention Content
Governance and leadership	DV policies are loose and broad	Provide clear information on guidelines and referral flow during training. Develop and disseminate leaflets detailing Standard Operating Procedures and care flows.
	Managers do not prioritize DV	Include/invite managers in the DV training. Discuss how to consider DV as a performance indicator in consultative committee.
	Productivity goals affect identification and consultation times for DV	Lower expectations, keep DV response simple: how to ask and how to respond and refer quickly – using role-plays.
Health workforce Service delivery Health information systems	Lack of clear professional roles	Intervention clarifies roles for all health professionals, managers and NPV teams.
	Lack of clear protocol and flows	Establish an agreed protocol and flow based on current policies and international evidence.
	Lack of empathy around women’s choices leading to blaming and pushing ‘solutions’ onto survivors using own values and beliefs	Use interactive game (‘In your shoes’ Brazilian version) and role plays to ensure healthcare providers understand women and act more person centred.
	Weakness and low visibility of NPV	Special training for the group to reinforce their role.
	Providers fear of family retaliation	Discuss infrastructure to guarantee confidentiality, safety plan for women and providers (including home visits), and clarify manager’ support in relation to safety.
	Lack of clarity regarding the mandatory report to the epidemiological surveillance	Discuss the importance of epidemiological surveillance, how to complete the form and clarify how the data is used.
Coordination	Lack of knowledge about intersectoral network and limited collaboration	Organize introductory meetings between specialized services and NPV teams.

Abbreviations: PHC, primary healthcare; NPV, violence prevention nucleus; DV, domestic violence.