Why Primary Healthcare is Important for Survivors
At least one out of six women worldwide has experienced a form of physical or sexual assault. These lead to both physical and psychological pain. Thus making it both a health and human rights emergency. Our fieldwork revealed a need for health service providers to do more to care for survivors and carry out preventive programs.
The impact of sexual and gender-based violence (SGBV) on women’s health is enormous. It is a major cause of disability, and many women are killed via this means worldwide. The health impact ranges from physical injury, chronic pain, and anxiety, post-traumatic stress disorder (PTSD) and depression to fatal outcomes such as suicide and homicide. It also results in many physical, mental, sexual and reproductive health problems.
It also severely affects women’s sexual and reproductive health. SGBV usually impedes women’s reproductive rights and access to contraceptives. As a result, it increases women’s risks to sexually transmitted diseases (STDs) such as HIV/AIDS, unwanted pregnancies, and unsafe abortions.
SGBV also results in gynaecological disorders and pregnancy complications such as pelvic inflammatory disease and miscarriage. 10 Violence during pregnancy can cause serious harm to both the mother and fetus. Domestic violence during pregnancy has also been linked to fetal or infant mortality, developmental abnormalities, low birth weight infants, and maternal mortality.
Care for sexual and gender-based violence is relegated by healthcare professionals in countries such as Nigeria, where health services are subpar. Some do not even recognise the impact of violence on women’s health and see it as a domestic dispute that should be settled privately without involving them, the police or the courts. They are also not adequately trained to deal with SGBV cases as it is not seen as a major health concern.
Why are healthcare professionals central to the response to SGBV?
Violence against women is not seen as a healthcare emergency by many in Nigeria. Victims and survivors usually suffer in silence. Healthcare professionals are essential to helping break the silence and providing critical care to them.
Health professionals are often the earliest point of contact for survivors. They are also essential workers and respected members of society. As such, they are key to influencing people’s attitudes by reframing violence as a health problem. If untrained, healthcare professionals may only tend to physical wounds for instance and miss an opportunity to provide more comprehensive care to survivors.
In some cases, they may even be condescending and dismissive toward survivors. This is fueled by the negative patriarchal belief that they must have done something to trigger the abuse. Key things like patient-provider confidentiality were also taught.
What can be done?
The role of health services is to provide immediate medical and psychological care to survivors of sexual and gender-based violence and to help them avoid additional exposure to violence.
After identifying a knowledge gap, the Stand to End Rape Initiative, in partnership with the Federal Ministry of Health and with support from Ford Foundation, organised a 2-week intensive training for healthcare professionals at all levels in Kwara State, North-Central, Nigeria.
For the training, we employed the systems approach, which influences every aspect of health services, from private consultation rooms to staff support, supervision, training, and referrals to SARCs, the police, and so on. We taught them about local and national laws and policies related to SGBV, such as the VAPP law.
We also developed a training manual and distributed it to participants as well as the Ministry of Health, so they will always have something to guide them and serve as documentation that can be used to access the legal system and support legal proceedings.
We have also set aside adequate monitoring and evaluation of services provided to survivors of violence in the state.
The Primary Healthcare Project will be followed by the SGBV Accountability Project to show where each state ranks in providing support and justice for survivors as well as preventative efforts. The report will be out on December 10.
Watch this space.