WHO’s Strategy to Tackle Gender-Based Violence in Healthcare

What is Gender-Based Violence?

Gender-based violence refers to harmful acts directed at an individual based on their gender. While both men and women can be victims of GBV, it disproportionately affects women and girls. The violence takes multiple forms, including physical, sexual, emotional, psychological, and economic abuse. According to WHO, one in three women globally will experience physical or sexual violence in their lifetime, often from intimate partners (https://www.who.int/news-room/fact-sheets/detail/violence-against-women).

GBV is a major public health issue because it not only impacts the immediate physical and psychological well-being of survivors but also leads to long-term health consequences such as sexually transmitted infections (STIs), unwanted pregnancies, and mental health disorders like depression and anxiety. WHO's approach recognizes that addressing this issue requires both preventive measures and an effective healthcare response.

WHO’s Framework for Addressing GBV

WHO’s strategy to tackle gender-based violence is built upon a multi-tiered approach that focuses on:

1. Health System Strengthening
   WHO aims to enhance the healthcare system's ability to respond to GBV by training healthcare professionals, improving healthcare facilities, and integrating GBV-related services into existing health services. This strategy ensures that survivors receive timely and appropriate medical, psychological, and legal support.
2. Prevention of Gender-Based Violence
   Prevention is key to reducing the incidence of GBV. WHO advocates for community-based initiatives, educational programs, and policies that address the root causes of GBV, such as gender inequality and harmful cultural norms.
3. Supporting Survivors
   The care and support of GBV survivors include immediate medical assistance, psychological counseling, and legal aid. WHO emphasizes a patient-centered approach where confidentiality, empathy, and respect are paramount.
4. Data Collection and Research
   Accurate data on the prevalence, causes, and effects of GBV is essential for developing evidence-based interventions. WHO works with various governments and organizations to improve data collection systems to guide policy formulation and resource allocation.

Health System Responses to GBV

One of the core components of WHO’s approach is integrating GBV services into healthcare systems. Health professionals are often the first point of contact for survivors, making it crucial for them to be equipped with the skills and knowledge to offer appropriate care.

Training Healthcare Workers

WHO has developed guidelines and protocols for training healthcare workers in identifying and managing cases of GBV. Medical professionals need to understand the physical and psychological effects of GBV, know how to conduct sensitive screenings, and be familiar with referral processes for further support.

Training includes:

• Screening for violence: Routine screening in reproductive health services can help identify survivors of GBV who may not voluntarily disclose their experiences.
• First-line support: WHO recommends the "LIVES" approach (Listen, Inquire about needs, Validate, Ensure safety, and Support), which provides a framework for healthcare workers to offer compassionate, non-judgmental support (https://www.who.int/publications/i/item/9789240027743).
• Referral systems: Referrals to social, legal, and psychological support services are essential to a comprehensive response.

Improving Healthcare Facilities

WHO advocates for the development of healthcare facilities equipped to address the specific needs of GBV survivors. This includes:

• One-stop centers: These provide medical, psychological, and legal services in one location to reduce the burden on survivors.
• Confidentiality and Safety: Ensuring that survivors feel safe and that their information is kept confidential is paramount in creating a trusting environment.

Prevention of Gender-Based Violence

Preventing GBV requires addressing its root causes—primarily gender inequality and harmful societal norms. WHO’s prevention strategies focus on changing societal attitudes and behaviors through community engagement and education.

Community-Based Programs

Community-based programs that challenge gender stereotypes, promote gender equality, and empower women are critical to preventing GBV. WHO supports programs that:

• Engage men and boys: Since men are often the perpetrators of GBV, programs that engage men and boys in discussions about masculinity, consent, and respect for women can be highly effective.
• Promote women's empowerment: Economic empowerment, education, and leadership opportunities for women reduce their vulnerability to violence.
• Raise awareness: Educational campaigns that inform communities about the consequences of GBV and legal rights help create a supportive environment for survivors and deter future violence.

Legal and Policy Interventions

Laws that criminalize gender-based violence, protect survivors, and hold perpetrators accountable are crucial. WHO works with governments to strengthen legal frameworks that support the prevention of GBV and the protection of survivors. This also includes enforcing laws on child marriage, female genital mutilation, and human trafficking—practices that are all forms of gender-based violence.

Supporting Survivors of Gender-Based Violence

Survivors of GBV face numerous health challenges, including physical injuries, sexual and reproductive health issues, and mental health conditions. WHO emphasizes that healthcare professionals should be at the forefront of providing support.

Mental Health Support

Survivors often suffer from post-traumatic stress disorder (PTSD), depression, anxiety, and suicidal thoughts. WHO supports the integration of mental health services into primary care, ensuring that survivors have access to psychological counseling and therapy.

Sexual and Reproductive Health

Women who experience GBV are at higher risk for unintended pregnancies, unsafe abortions, STIs, and gynecological complications. WHO's strategy includes ensuring that healthcare facilities provide emergency contraception, STI testing and treatment, and safe abortion services where legal.

Data Collection and Research on Gender-Based Violence

Reliable data is essential for understanding the scope of GBV and designing interventions that work. WHO collaborates with national governments and NGOs to collect data on the prevalence of GBV and its impact on health systems. This data informs policy development, resource allocation, and program implementation.

Ethical Considerations

Collecting data on GBV presents significant ethical challenges, particularly around the safety and confidentiality of survivors. WHO's Ethical and Safety Recommendations for Research on Domestic Violence Against Women provide guidelines to ensure that data collection does not harm participants (https://www.who.int/publications/i/item/9789241546472).

The Role of Healthcare Providers in Addressing GBV

Healthcare providers play a critical role in both preventing and responding to gender-based violence. They are often the first professionals that survivors encounter after experiencing violence, making their intervention crucial for the well-being of the survivor.

Identifying GBV Cases

Many survivors of GBV do not disclose their experiences unless asked. Healthcare providers need to develop the skills to identify signs of GBV and conduct screenings sensitively. Routine questioning in reproductive health services, for example, can reveal cases of intimate partner violence that may otherwise go unnoticed.

Providing Holistic Care

A holistic approach to care means addressing not only the physical injuries but also the emotional, psychological, and social needs of survivors. WHO recommends that healthcare providers use trauma-informed care principles to ensure that survivors feel safe, respected, and supported.

Conclusion: A Global Call to Action

Gender-based violence is not just a women's issue—it is a public health crisis that affects the entire world. WHO’s multi-faceted approach, which combines health system strengthening, prevention, survivor support, and data-driven policies, provides a comprehensive framework for tackling GBV.

Healthcare professionals, especially doctors, can make a difference by being vigilant, compassionate, and informed. Medical students and practitioners must be equipped with the knowledge and skills to address GBV in their communities and clinical practices.