The health services sector provides a unique window of opportunity to address the needs of abused women. The health care system is essential to the prevention and response to violence against women because most women come into contact with them at some point in their lives. (Poverty Reduction and Economic Management Network/World Bank, 2006). The health sector is a critical component of a coordinated response—it is frequently the first point of contact with any formal system for women experiencing abuse and may be the only intervention they seek. Whether victims disclose abuse or not, every clinic visit could present an opportunity to ameliorate the effects of violence and help prevent future incidents. Health services can strengthen a coordinated response through one-stop centres, integrated services within a facility or through coordinated referrals to other health facilities, to list only a few examples. All of this can facilitate easier, quicker and more comprehensive access to vital support for victims/survivors of violence.
Sexual and reproductive health care, particularly HIV/AIDS prevention, may be helpful to integrate within a coordinated response to violence against women. Violence against women is a risk factor for HIV infection and women may also be targeted for violence by partners and community members once knowledge about their HIV status has become public (Ellsberg & Betron, 2010).
To be effective components of a coordinated response, health sector strategies should:
? Embody a system-wide approach that includes strengthening policies and protocols; upgrading infrastructure to ensure privacy and adequate medical supplies; training staff to ask about and respond appropriately to gender-based violence; providing emotional support, free emergency medical treatment and preventive health care and crisis intervention; assessing women’s level of danger; documenting of cases; dealing with stigmatizing attitudes and practices; and utilizing referral networks (Heise et al., 1999);
? Advance laws, policies and protocols to provide comprehensive health care (including in sexual and reproductive health and HIV-related services) and improve the quality and scope of services available to victims/survivors of violence;
? Invest in equipment to complement efforts increasing victims/survivors’ access to updated services (e.g. resources such as private rooms, free transportation, forensic and other examination equipment, medical supplies, rape kits, emergency contraception, post-exposure prophylaxis for sexually transmitted infections and HIV, etc.), as well as targeted employment of trained and skilled service providers;
? Improve monitoring and evaluation systems for ensuring quality health care services through participatory and systematic mechanisms involving women and girl users and community groups; and
? Clinics and public-health community-based education (including HIV/AIDS and adolescent sexual and reproductive health interventions) should incorporate violence against women in programming, providing general information on the issue, raising-awareness on legal rights and availability of services.
See the Health Core Elements and Quality Guidelines for a more detailed description of the health sector’s response to violence against women in line with good practices.
See the Health module for detailed information on gaps in the health care system response to violence against women and girls and best practices in improving this response. Additionally, see the Health care, social workers & other helping professionals section of Implementing laws in the Legislation module.