Assessing the Nepalese health system’s readiness to manage gender-based violence and deliver psychosocial counselling.

Publication date: Jan 31, 2024

Violence against women (VAW), particularly intimate partner violence (IPV) or domestic violence, is a major public health issue, garnering more attention globally post-COVID-19 lockdowns. Health providers often represent the first point of contact for IPV victims. Thus, health systems and health providers must be equipped to address survivors’ physical, sexual, and mental healthcare needs. However, there is a notable lack of evidence regarding such readiness in Nepal. This study, utilizing a concurrent triangulation design, evaluated the readiness of public health facilities in Nepal’s Madhesh Province in managing VAW, focusing on providers’ motivation to offer psychosocial counselling to survivors. A cross-sectional study was conducted across 11 hospitals and 17 primary health care centres, where 46 health care providers were interviewed in February-April 2022. The study employed the WHO’s tools for policy readiness and the Physician Readiness to Manage IPV Survey for data collection. Quantitative and qualitative data were collected via face-to-face interviews and analysed using descriptive and content analysis, respectively. Only around 28% of health facilities had trained their staff in the management of VAW. Two out of 11 hospitals had a psychiatrist, and a psychosocial counsellor was available in four hospitals and two out of 17 primary health care centres. Two-thirds of all health facilities had designated rooms for physical examinations, but only a minority had separate rooms for counselling. Though a few health facilities had guidelines for violence management, the implementation of these guidelines and the referral networks were notably weak. Hospitals with One-stop Crisis Management Centres demonstrated readiness in VAW management. Health providers acknowledged the burden of IPV or domestic violence and expressed motivation to deliver psychosocial counselling, but many had limited knowledge. This barrier can only be resolved through appropriate training and investment in violence management skills at all tiers of the health system.

Concepts Keywords
Healthcare concurrent triangulation design
Nepalese health facility readiness
Psychosocial intimate partner violence
Women mental health
violence against women


Type Source Name
disease MESH gender-based violence
disease MESH Violence
disease MESH domestic violence
disease MESH COVID-19
disease VO LACK
drug DRUGBANK Etoperidone
disease IDO facility

Original Article

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