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Health care Responding to violence and Abuse 2 (HERA 2)

Violence against women (VAW) is recognized as public health and a human rights violation. Domestic violence (DV) and Intimate partner violence (IPV) are the pervasive forms of VAW. IPV is the second most common risk of DALY globally among women aged 20-24 years causing detrimental health outcomes. Women who have been abused by their partner are twice as likely to have abortion, twice as likely to suffer from depression and 1.5 times more likely to acquire HIV. It is an obstacle in reaching the United Nations Sustainable Development Goals (SDGs), particularly SDG 5 related to gender equality and empowerment of women and SDG 3 relating to good health and well-being. The health impact of VAW combined with the social and economic damage it causes at individual, family and community makes health care response a global priority especially low- and middle-income countries. In 2016, the World Health Organization (WHO) adopted a global plan of action to strengthen the role of health systems in multi-sector responses to VAW and children. Primary health care may provide a ‘window of opportunity’ to identify and assist women who experience VAW. Appropriately trained primary health and SRH care providers create a safe environment for disclosure, care for associated health problems and link survivors of abuse to relevant services, enhancing the safety and well-being of women and their children.

The overall aim of this study in Nepal is to develop and evaluate training provided to health care providers at the outreach centers established by DH in order to improve health system responses to violence against women. To achieve this broader aim, we will explore the perception, attitudes, practices,s, and needs of the primary health care providers at the outreach centers run by DH, women survivors, and focus group discussion with female community health volunteers (FCHVs) and women’s groups. We will also interview the health managers and administrators at DH, as well as the officials at different organizations and ministries to explore their views on VAW and health system readiness, factors that help build linkages between different women-centered care. The purpose of the project is also to develop and assess the impact of the training tailored to the needs of antenatal and SRH care providers at DH and outreach centers to provide a ‘first line response’ to the survivors of VAW.

This is collaborative research between Dhulikhel Hospital, Kathmandu University Hospital and University at Bristol (UK), London School of Hygiene and Tropical Medicine (LSHTM, UK, University of Peradeniya, Sri Lanka, University of Sao Paolo, Brazil and An Najah University, the Occupied Palestine Territories which is funded by the National Institute for Health Research (NIHR)

Local PI: Prof. Dr Kunta Devi Pun; Prof. Dr. Rajendra Koju

Co-Investigator: Dr. Poonam Rishal

Ph.D. fellow: Ms. Satya Shrestha

Senior RA: Mr. Pusp Raj Bhatt

Research Assistants: Ms. Smriti Luitel and Ms. Samita K.C