By: Janna Oberdorf, Women Deliver
For too many women around the world, broken arms and bruised eyes are a part of daily life. Whether they are abused verbally or physically, by their husbands or even their mother-in-laws, these women live in constant fear and feel unable to escape.
In Vietnam, where domestic violence is reportedly present in all areas of the country and across the social spectrum, the Improving Health Care Response to Gender-based Violence project was launched by the Center for Studies and Applied Sciences in Gender, Family, Women and Adolescents and the Population Council, and financial support from the Ford Foundation. Though gender-based violence (GBV) is under-reported and under-researched in Vietnam, several small-scale studies have revealed that its country-wide prevalence ranges widely from 16 to 37 percent for physical violence, and 19 to 55 percent for emotional violence. For many people, verbal abuse, slapping, and coerced or forced sex are often not considered violence in Vietnam.
At the launch of the Improving Health Care Response to Gender-based Violence project, clinics and hospitals did not routinely screen clients for gender-based violence (GBV). When health care providers did identify cases of GBV, there was no legal obligation to record the violence, give advice to survivors, or notify the police or community officials. There were no standard service protocols or guidelines for providers who wanted to give specialized care to GBV victims, and no referral networks for services after survivors of violence were discharged.
To develop guidelines for improving service delivery, Hanoi Department of Health (HDH) staff visited GBV service sites in Thailand and the United States to observe approaches that they then used to develop an appropriate model for Vietnam. A major project goal was to establish routine screening of female patients for GBV and to shift providers’ perspectives so that they would see screening not as a one-time project activity, but as part of their daily routine and ongoing professional duty. The project model had three components: screening, referrals, and community outreach and support.
• Screening: To integrate GBV screening into health services, all medical and nursing staff in emergency rooms, obstetrics/gynecology and surgery departments, maternal and child health and family planning, mobile teams, and other professional staff and managers were trained to recognize and talk with clients who exhibited signs of GBV.
• Referrals: Women who experienced GBV would receive emergency treatment if needed and a referral to the Women’s Counseling Center for Health. The counselors provided one-on-one counseling and referred women for reproductive health services, voluntary HIV and STI counseling and testing, the counseling hotline or shelter in Hanoi, and community-based organizations that provided support.
• Support: The program trained hospital and counseling center staff as master trainers. These trainers then visited communities monthly to provide communication sessions on GBV and gender equality to members of larger organizations or interested community members.
By the project’s end, providers’ perceptions of GBV had changed; they saw violence as not a purely medical issue, but also a social and public health issue. Many staff members said that the GBV project transformed their lives.
Community awareness about counseling services also increased significantly during phase II of the project. Between January 2007 and May 2009, the majority (60 percent) of women who visited the counseling center were referred by other organizations or came on their own to one of the participating hospitals. This suggests that the GBV services met a significant need within the community and that word quickly spread, allowing women to access these services without having to go through the hospital.
The project, which concluded in September 2009, is now the responsibility of the respective hospitals, commune authorities, and HDH. In 2010, the Ministry of Health endorsed the project model for all health facilities in Vietnam.
To learn more about The Improving Health Care Response to Gender-based Violence project, please click here.
Flickr photo via United Nations Photo.
Celebrate Solutions: Stopping Gender-Based Violence in Vietnam
December 17th, 2012
By: Janna Oberdorf, Women Deliver