 The study found that there is a lack of political recognition for DV in Brazil, resulting in it being seen as a lower priority compared to other health issues. Additionally, the organizational structure of the PHC system in Sao Paulo prioritized the number of consultations and household visits as the main performance indicators, making it difficult to legitimize healthcare providers' time to address DV. At the individual level, healthcare providers reported lack of time and knowledge of how to respond, as well as fears of dealing with DV.