Strengthening Health System Responses to Gender-based Violence in Eastern Europe and Central Asia

A resource package

5. Identifying gender-based violence

5.1        Outline of the module

Duration of the module

2 hours

Aim of the module

To provide participants with knowledge and skills to

  • recognize clinical conditions and behaviours that may indicate a patient’s exposure to GBV,
  • understand the minimum requirements for enquiring about GBV, in particular whether it is safe to ask,
  • communicate with survivors in a non-judgemental and supportive manner, and
  • formulate questions about GBV.

Key learning messages

  • When health care professionals sensitively enquire about GBV, this can increase the chances of disclosure. 
  • Clinical enquiry (i.e. asking about GBV based on clinical conditions) is preferred over routine enquiry (i.e. routinely asking all women presenting in a health are setting about GBV).
  • Certain clinical conditions and behaviours should raise suspicion and prompt health care professionals to ask about GBV.
  • Before asking about GBV, health care professionals need to establish that it is safe to ask.
  • Health care professionals should observe the following recommendations for communicating with survivors:
  1.  show a non-judgemental and supportive attitude,
  2. be patient, listen carefully and validate what the patient is saying,
  3. when asking about GBV, start with a more general introductory question, before continuing with more specific, direct questions,
  4. do not pressure the patient to disclose and, if she does not disclose, offer her to come back for further support, and
  5.  emphasize that there is help available.

Background readings for trainer

UNFPA-WAVE Resource Package, Part I, chapter 3.1

Further readings:

WHO 2013

Methods

  • Presentation by trainer (PPT slides 1-6)
  • Group discussion: How to recognize gender-based violence
  • Presentation by trainer (PPT slides 7-16, distribution of handouts 19-22)
  • Role play: Asking about gender-based violence – the case of Natasa (handout 23)
  • Presentation by trainer (PPT slides 17-19)

Notes for trainers

Group discussion: How to recognize gender-based violence (duration: 15 minutes)

Before the presentation on clinical indicators of GBV, ask participants to think about situations from their professional experience when they suspected a case of GBV. What were the signs that made them think of GBV? Facilitate a group discussion and wrap up the results, using PPT slide 8 and handout 19.

 

Role play – Asking about gender-based violence (handout 23; duration: 30-45 minutes):

Disseminate handout 23 with the instructions. Ask for volunteers for the following four roles: patient, her little son, doctor/nurse, observer. A bigger training group can be divided into small groups (factor in more time for the discussion). Allow 10-15 minutes for the role play. Parties can change roles, if there is enough time. After the role play, facilitate a discussion (15-20 minutes):

  • Questions to the person playing the survivor: How did you feel in your role? Which questions were helpful and encouraged me to talk more? Which questions were not that helpful? What could the doctor have done differently?
  •  Questions to the person playing the doctor/nurse: How did you feel in your role? What did I handle well? What was the most difficult for me? How could I have done it differently?
  • Ask the observer to share her/his observations and feedback.
  • Open the discussion to the group.  

Materials for training session

Presentation: PowerPointpresentation Module 5 (download it at the buttom of the page)

Handouts:

Handout 19: Understanding the signs of gender-based violence

Handout 20: Is it safe to ask about gender-based violence?

Handout 21: Asking about gender-based violence - examples of questions

Handout 22: Tips for communicating with survivors – do’s and don’ts

Handout 23: Role play – Asking about gender-based violence – the case of Natasa