Gender-based violence (GBV) undermines physical and mental health, including the dignity of anyone subjected to it. Its consequences can last a lifetime, depriving the right of survivors to lead a healthy life. Health providers are often first responders to violence, and their response is critical to the recovery of survivors. To strengthen the capacity of health providers to respond and serve women and girls subjected to violence, the Ministry of Health (MoH) conducted a four-day Training of Trainer, with support from United Nations Population Fund (UNFPA).
In Lao PDR, the National Survey on Women’s Health and Life Experiences - A Study on Violence Against Women 2014, conducted by LSB and NCAW, with the support of UNFPA and others, found that one in three women have experienced physical, sexual or emotional violence from their partners at least once in their lifetime. However, the National Study also reveals that half of the women who encountered violence did not report or seek help due to “embarrassment and fear of social stigma”
In her 30 years as a health provider at the Mother and Child Hospital, Dr. Khamphiew Ngamsena has received many patients who experienced violence seeking support and healthcare. She says she provides “immediate health care including psychosocial support and essential treatment to the women survivors of violence”.
Providing healthcare services to GBV survivors in Lao PDR has been challenging because until recently, there were no national guidelines on how to manage patients presenting with signs of violence. As Dr. Khamphiew explains, “it is difficult to identify a woman who experiences violence, or a woman suspected of having encountered violence because we do not have a standard guideline that helps guide us in identifying and managing such cases.”
To fill this gap, UNFPA recently supported MoH to adapt the WHO Clinical Handbook for Health Care for Women Subjected to Intimate Partner Violence or Sexual Violence. This UNFPA supported Handbook is the first of its kind to provide national guidance on clinical management of survivors. The four-day Training of Trainer at the Ministry of Health in July 2021 had trained 13 masters trainers, including five male health care providers using this Handbook.
Dr. Khamphiew participated in the training, stated that "this Handbook is comprehensive, and helps us to better identify and manage cases, and provides guidance on the diagnosis and treatment including mental health and psychosocial support, and recording of information, which will be used as evidence to guide women's access to law and justice and ensure that they can claim their rights.”
Dr. Daodouangchanh Boulommavong, Director of the Department of Advancement of Women and Children, Cabinet of Ministry of Health, also welcomed the Handbook, stating that it is “essential for health providers to understand the process of the treatment and care for women subjected to violence.”
Ms. Mariam A. Khan, Representative of UNFPA, congratulated MoH on such a significant milestone. She said that “health providers are critical first-line support to women subjected to violence. The training will equip health providers with knowledge and skills to manage GBV cases confidently, quickly, and systematically based on international standards.”
Whilst the Handbook is a critical step forward, barriers remain for survivors of violence to receive necessary assistance. Limited coordination between the sectors means that survivors often do not receive holistic and quality support. Dr. Khamphiew explains that “after completing the treatment for the survivors, I want to make sure that they can access justice and claim their rights. However, a well-coordinated referral system is not yet in place.”
To set up the multisectoral coordination, NCAWMC and LWU, supported by UNFPA, are establishing a national coordination mechanism and referral pathway for GBV that will link the health sector with social, justice and police sectors. Falling under UNFPA’s overarching work in implementing the Essential Services Package for Women and Girls Subject to Violence (ESP), the project is funded by Australia DFAT, and the broader ESP implementation is supported by development partners including DFAT, KOICA, UK and SDC.
For the health sector's role, Dr. Daodouangchanh said that health providers must know what to do before, during, and after caring for the survivors: "Based on the Handbook, we have drawn a network of support and referral systems, connecting the Ministry of Health, the Lao Women Union, the Ministry of Labor and Social Welfare, and the People's Supreme Court. So, we can ensure women have access to a full range of support systems and their rights are claimed and protected," she said.
Moving forward, Dr. Daoduangchanh emphasizes that “after completing this training, we will be conducting a pilot in Savannakhet provincial hospital as there is a protection center run by the Lao Women Union there, so we will see how it goes in practice.” In addition, her department plans to provide training to health providers in all health facilities at the central, provincial, and district levels using this Handbook.
For more information please contact:
Oulayvanh Sayarath
National Program Analyst
UNFPA Laos
Vanly Lorkuangming
Communications and Partnerships Analyst
UNFPA Laos
