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通过基于生活技能的干预措施提高卫生人力能力:来自巴基斯坦减少性别暴力的证据。

Enhancing health workforce capacity through life skills-based interventions: evidence from Pakistan on reducing gender-based violence.

作者信息

Ali Tazeen Saeed, Merchant Ambreen, Qamar Warisha, Memon Zahid Ali, Barolia Rubina, Bhutta Zulfiqar A

机构信息

School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan.

Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.

出版信息

BMC Health Serv Res. 2025 Aug 8;25(1):1044. doi: 10.1186/s12913-025-13041-9.

Abstract

BACKGROUND

Gender-based violence is a pervasive issue in Pakistan, necessitating effective interventions to enhance the responsiveness of healthcare workers' capacity to respond effectively to Gender-based violence. This study aims to strengthen the health system's response to Gender-based violence by implementing a need-based Life Skills-Based Training program for healthcare providers in Pakistan.

METHOD

A quasi-experimental pre-post study design was employed. The intervention, i.e., Life Skills-Based Training program was implemented across four diverse districts Matiari and Shadadkot (Sindh), Chitral (Khyber Pakhtunkhwa), and Gilgit (Gilgit-Baltistan) to ensure geographic and sociocultural variation. A total of 84 healthcare providers and 78 stakeholders were purposively selected based on their roles in patient care or Gender-based violence-related policymaking. Life Skills-Based Training was delivered over six days at each site, including tailored modules for healthcare providers and stakeholders, focusing on Gender-based violence concepts, screening, counseling, referral pathways, and system-level advocacy. A pre- and post-test assessment was administered to measure changes in knowledge, competencies, and attitudes using structured questionnaires adapted from UNHCR and UNICEF tools. Quantitative analysis of score improvements and qualitative feedback were used to evaluate training effectiveness.

RESULTS

A comparative analysis of pre- and post-test assessments demonstrated significant improvements in participants' Gender-based violence knowledge, awareness, and case management skills, with high satisfaction reported in Life Skills-Based Training evaluations. Feedback highlighted themes such as the effectiveness of training, the need for competent professionals, involving community leaders, replicating sessions, government health system responses, and integrating Gender-based violence education into curricula. Follow-up results demonstrated the sustainability of interventions, with participants actively applying their knowledge and leading community education.

CONCLUSION

The study highlights the need for continuous capacity-building and integrating Gender-based violence education into healthcare and educational systems to improve support for survivors. Strengthening the health workforce with targeted training and protocols is essential for addressing Gender-based violence effectively, offering a framework for similar efforts in other regions to foster equitable and responsive healthcare.

摘要

背景

基于性别的暴力在巴基斯坦是一个普遍存在的问题,需要采取有效干预措施,以提高医护人员有效应对基于性别的暴力的能力。本研究旨在通过为巴基斯坦的医护人员实施基于需求的生活技能培训项目,加强卫生系统对基于性别的暴力的应对。

方法

采用准实验前后对照研究设计。干预措施,即基于生活技能的培训项目,在四个不同的地区实施,分别是马蒂亚里和沙达德科特(信德省)、奇特拉尔(开伯尔-普赫图赫瓦省)和吉尔吉特(吉尔吉特-巴尔蒂斯坦),以确保地理和社会文化的多样性。根据他们在患者护理或基于性别的暴力相关政策制定中的角色,共挑选了84名医护人员和78名利益相关者。基于生活技能的培训在每个地点进行为期六天的授课,包括为医护人员和利益相关者量身定制的模块,重点是基于性别的暴力概念、筛查、咨询、转诊途径和系统层面的宣传。使用改编自联合国难民署和联合国儿童基金会工具的结构化问卷进行前后测试评估,以衡量知识、能力和态度的变化。通过对分数提高的定量分析和定性反馈来评估培训效果。

结果

前后测试评估的对比分析表明,参与者在基于性别的暴力知识、意识和案例管理技能方面有显著提高,基于生活技能的培训评估中报告的满意度很高。反馈突出了一些主题,如培训的有效性、对合格专业人员的需求、让社区领袖参与、重复培训课程、政府卫生系统的应对措施以及将基于性别的暴力教育纳入课程。后续结果表明干预措施具有可持续性,参与者积极应用所学知识并开展社区教育。

结论

该研究强调需要持续进行能力建设,并将基于性别的暴力教育纳入卫生保健和教育系统,以改善对幸存者的支持。通过有针对性的培训和规程加强卫生人力对于有效应对基于性别的暴力至关重要,为其他地区开展类似工作以促进公平和积极响应的卫生保健提供了一个框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0382/12333159/a7f617871677/12913_2025_13041_Fig1_HTML.jpg

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本文引用的文献

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Strengthening health systems response to violence against women: protocol to test approaches to train health workers in India.
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