Burke Eva, Watson Katherine, Eva Gillian, Gold Judy, Garcia-Moreno Claudia, Amin Avni
Freelance Consultant, Bath, United Kingdom.
Freelance Consultant, Torchlight Collective, Nashville, Tennessee, United States of America.
PLOS Glob Public Health. 2024 Feb 16;4(2):e0002504. doi: 10.1371/journal.pgph.0002504. eCollection 2024.
Violence against women (VAW) affects almost 1 in 3 women and can lead to short and long-term adverse health outcomes. The health sector is an important entry point to respond to VAW. Globally, countries have committed to eliminating VAW through the SDGs and WHO Member States have endorsed a Global Plan of Action on Violence, which asks countries to provide comprehensive health services to VAW survivors. To track progress and establish a baseline for the Global Plan of Action on Violence, WHO developed a VAW Policies Database to assess how countries are addressing VAW in health and multisectoral policies. This paper presents findings from 15 select indicators related to the existence of VAW-related policies and the inclusion of health services for survivors in policies in line with WHO recommendations. Results show that while 80% of countries have multisectoral VAW policies in place, only 34% have national health policies that include VAW response and/or prevention as a strategic priority, and 48% have clinical guidelines for the health sector response. Policies were analysed to identify inclusion of WHO-recommended VAW health services: 75% of countries' policies mention provision of first-line support; while 50% or fewer of countries mention clinical enquiry to identify intimate partner violence, post-rape care services, or mental health assessment, referral and treatment. The high-income countries group had the lowest proportion of countries that specified each of the above-mentioned health services in policies. Findings show that more efforts are needed to raise the awareness of ministries of health about the public health impact of VAW and the importance of including VAW in health policies. Where policies exist, many are not aligned with WHO-recommendations. Policy dialogues should be conducted with governments on how to better align their VAW policies with internationally-agreed, evidence-based standards, and to implement them through programmes and services.
针对妇女的暴力行为（VAW）影响着近三分之一的女性，并可能导致短期和长期的不良健康后果。卫生部门是应对针对妇女暴力行为的重要切入点。在全球范围内，各国已承诺通过可持续发展目标消除针对妇女的暴力行为，世界卫生组织成员国也认可了一项《暴力问题全球行动计划》，该计划要求各国为针对妇女暴力行为的幸存者提供全面的卫生服务。为了跟踪进展情况并为《暴力问题全球行动计划》建立基线，世界卫生组织开发了一个针对妇女暴力行为政策数据库，以评估各国在卫生政策和多部门政策中如何应对针对妇女的暴力行为。本文介绍了与针对妇女暴力行为相关政策的存在情况以及符合世界卫生组织建议的政策中为幸存者提供卫生服务的情况有关的15项选定指标的调查结果。结果显示，虽然80%的国家制定了多部门针对妇女暴力行为政策，但只有34%的国家制定了将应对和/或预防针对妇女暴力行为作为战略重点的国家卫生政策，48%的国家有针对卫生部门应对措施的临床指南。对政策进行了分析，以确定是否纳入了世界卫生组织建议的针对妇女暴力行为卫生服务：75%的国家政策提到提供一线支持；而只有50%或更少的国家提到进行临床询问以识别亲密伴侣暴力、强奸后护理服务或心理健康评估、转诊和治疗。高收入国家组在政策中规定上述各项卫生服务的国家比例最低。调查结果表明，需要做出更多努力，提高卫生部对针对妇女暴力行为的公共卫生影响以及将针对妇女暴力行为纳入卫生政策的重要性的认识。在存在相关政策的地方，许多政策并不符合世界卫生组织的建议。应与各国政府进行政策对话，讨论如何使其针对妇女暴力行为政策更好地符合国际商定的、基于证据的标准，并通过方案和服务加以实施。
