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

A resource package

9. Referrals to other service providers

9.1        Outline of the module

Duration of the module

1 hr 45 minutes hours

Aim of the module

To provide participants with knowledge and skills to

  • understand the importance of referral systems in facilitating access of survivors of GBV to multi-sectoral services,
  • learn about the actors involved, the requirements for effective referrals, and the steps for developing and implementing referral systems, and
  • learn about practical resources for health care professionals and patients to facilitate referrals.

Key learning messages

  • A referral system or mechanism provides a comprehensive institutional framework for multi-sectoral cooperation that connects various governmental, non-governmental and, as appropriate, international organizations, with the overall aim of ensuring the protection and assistance of survivors, the prevention of GBV and the prosecution of perpetrators (“3 p’s”). 
  • Referral mechanisms benefit both the patient who experienced GBV and the health care professional:
  1. Women who have experienced GBV have multiple and complex needs. Therefore, referrals to other services – medical and non-medical - are key to ensure that survivors of GBV have access to comprehensive care, support and protection. As health care professionals are often the first point of contact for survivors, they provide an important entry point for referrals.
  2. Health care professionals are relieved from their work load as they can benefit from support from other partner organizations; they may feel more confident to ask about GBV, knowing that other needed services exist; they are in a position to adequately act upon the identification of a survivor.
  • In order to ensure sustainability and effectiveness, the operation of referral mechanisms should be grounded in legislation or standardized protocols that define the roles and responsibilities or all organizations involved.
  • Effective referrals require that health care professionals are able to identify and facilitate the disclosure of GBV; are able to assess the situation and needs of the individual patient as well as the risk of further violence; are knowledgeable about the existing referral system and services and support the patient in identifying the best options; are knowledgeable about national laws on GBV and obtain the consent of the patient before sharing her case with other organizations.
  • Key actors involved in referral systems besides the health sector typically include specialized women’s services (such as shelters or helplines), general support services (such as housing; financial support and other social services; employment services, public education or child welfare), police and judiciary.
  • In the absence of a formal referral system, health care professionals may use follow-up appointments to check the wellbeing of the patient, consider establishing basic services in-house, and refer to the patient to other known service providers, possibly using a referral directory.

Background readings for trainer

UNFPA-WAVE Resource Package, part I, chapter 4

Further readings:

Istanbul Convention and Explanatory Report, UNFPA 2010, IPPF 2010

Methods

  • Presentation by trainer (PPT slides 1-4)
  • Brainstorming: Defining Referrals
  • Presentation by trainer (PPT slides 5-9, handout 35)
  • Presentation by trainer (PPT slides 10-15, handout 36)
  • Presentation by trainer (PPT slides 16-17, Annexes 6-7)
  • Presentation by trainer (PPT slides 18-27)

Notes for trainers

Brainstorming: Defining Referral Systems – duration: 10 minutes

Ask participants to do a brainstorm in which they try to come up with a definition of a referral system. Write the answers on a flipchart. After the brainstorm, discuss the results before introducing the definition provided on GBV (PPT slides 5-6)

 

The trainer may want to prepare a handout listing existing key providers of services to women survivors of GBV in the country, region or town of training participants, as appropriate. This should include in particular women’s shelters, women’s helplines and women’s centres.

Before presenting slide 27, the trainer may want to collect suggestions from participants on what health care professionals can do in the absence of formal referral mechanisms.

Materials for training session

Presentation: PowerPointpresentation Module 9 (download it at the buttom of the page

Handouts:

Handout 35: Establishing a referral mechanism to prevent and respond to domestic violence at the local level – an example from Kyrgyzstan

Handout 36: The role of specialized women support services in the multi-sectoral response to GBV

Annex 6: Template for identifying and mapping potential referral partners

Annex 7: Template for compiling a directory of referral organizations