Caring for women subjected to violence: A WHO curriculum for training health-care providers

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16/12/2019 12:00 am


Violence against women, including intimate partner violence and sexual violence, is pervasive globally and leads to significant physical and mental health problems. Thus, it is a public health issue that emands a concerted response from health-care providers and health systems worldwide. The World Health Organization (WHO) has developed guidelines for the health-care sector: Responding to intimate partner violence and sexual violence against women:
WHO clinical and policy guidelines (2013) and an accompanying clinical handbook Health care for women subjected to intimate partner violence or sexual violence: clinical handbook (2014). This in-service curriculum, based on these documents, aims to provide healthcare providers with the knowledge and basic skills to implement the WHO recommendations in their clinical practice. Training providers is key to improving the health system’s response to violence against women.

This curriculum is designed to provide health-care providers, particularly in low- and middle-income countries,
with a foundation for esponding to domestic/intimate partner violence and sexual violence against women. The curriculum seeks to build skills and to address providers’ attitudes towards survivors of violence. Participants will learn how to provide women-centred clinical care, including identifying women experiencing violence, providing first-line
support though the LIVES approach (Listen, Inquire, Validate, Enhance safety and Support), providing essential clinical care for survivors, and identifying loca support resources. They will learn to reflect on their own attitudes and understand survivors’ experience.

The curriculum emphasizes compassionate, empathic provider–patient communication. This curriculum is based on WHO’s clinical handbook. Participants and facilitators are advised to keep the handbook handy for reference throughout the training. Training is an important component of an overarching health system response to violence against women. Health services managers and health policy-makers also have responsibility for strengthening planning, coordination and human resource management; establishing policies and protocols; and monitoring
and evaluating the provision of care to survivors of violence. Managers and policy-makers are advised o consult Strengthening health systems to respond to women subjected to intimate partner violence or sexual violence: a manual for health managers (WHO, 2017) or comprehensive guidance on improving health system readiness.

The clinical guidelines on which this training is based do not specifically address children, adolescent girls (under age 18) or men. Nonetheless, actions described may also be valuable for these population. They also apply to domestic violence more broadly – that is, violence by family members other than an intimate partner. Facilitators are encouraged to review Responding to children and adolescents who have been sexually abused: WHO clinical guidelines
(WHO, 2017) for recommendations for a child- and adolescent-centred response.

Who is this training for?

This training curriculum is primarily designed for practising health-care providers, particularly doctors, nurses and midwives. Parts of it may also be useful to other cadres of health-care providers, including psychologists, social workers, nurse assistants, community health workers and lay counsellors.

Participant-centred learning

This curriculum uses a participant-centred approach to learning – an active, collaborative, inquiry-based approach to teaching and training. Also known as learner-centred education, participant-centred learning emphasizes that the trainee is an active participant. Participant-centred learning actively engages the trainee wherever possible, rather than
relying only on facilitators. Learners actively participate in knowledge and skills development through case studies, guided discussions, participatory reflection exercises, videos and readings. This process supports critical reflection, emotional engagement, skills development and the ability to put knowledge into practice.

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