Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, VIC, Australia.
Lancet. 2015 Apr 18;385(9977):1567-79. doi: 10.1016/S0140-6736(14)61837-7. Epub 2014 Nov 21.
Health systems have a crucial role in a multisector response to violence against women. Some countries have guidelines or protocols articulating this role and health-care workers are trained in some settings, but generally system development and implementation have been slow to progress. Substantial system and behavioural barriers exist, especially in low-income and middle-income countries. Violence against women was identified as a health priority in 2013 guidelines published by WHO and the 67th World Health Assembly resolution on strengthening the role of the health system in addressing violence, particularly against women and girls. In this Series paper, we review the evidence for clinical interventions and discuss components of a comprehensive health-system approach that helps health-care providers to identify and support women subjected to intimate partner or sexual violence. Five country case studies show the diversity of contexts and pathways for development of a health system response to violence against women. Although additional research is needed, strengthening of health systems can enable providers to address violence against women, including protocols, capacity building, effective coordination between agencies, and referral networks.
卫生系统在多部门应对暴力侵害妇女行为方面发挥着关键作用。一些国家制定了阐明这一作用的准则或方案，在某些情况下还对卫生保健工作者进行了培训，但总的来说，系统的制定和实施进展缓慢。在低收入和中等收入国家，存在着大量的系统和行为障碍。2013 年，世卫组织发布了相关指导原则，第 67 届世界卫生大会通过了关于加强卫生系统在处理暴力行为，特别是暴力侵害妇女和女孩行为方面作用的决议，都将暴力侵害妇女行为确定为一项卫生重点。在本系列论文中，我们审查了临床干预措施的证据，并讨论了有助于卫生保健提供者识别和支持受亲密伴侣或性暴力侵害的妇女的综合卫生系统方法的组成部分。五个国家的案例研究显示了针对暴力侵害妇女行为制定卫生系统应对措施的背景和途径的多样性。尽管需要开展更多的研究，但加强卫生系统可以使提供者能够处理暴力侵害妇女行为，包括制定相关方案、能力建设、机构间的有效协调以及转介网络。
