Since the start of the war in Ukraine, WHO/Europe has scaled up services to tackle gender-based violence (GBV) among refugees fleeing Ukraine into neighbouring countries. In the Republic of Moldova, where over 580 000 Ukrainians have fled since February 2022 and where 77 000 still remain, WHO has focused on support for women, older people and children, who make up the vast majority of refugees.
Women and girls fleeing Ukraine lack access to quality GBV services, reproductive and sexual health care and psychosocial support. Marginalized groups, including Roma and LGBTQI+ communities, face additional discrimination and protection concerns. Ensuring that health-care providers in the Republic of Moldova are prepared and equipped to provide effective and survivor-centred care to people experiencing GBV is critical.
Strengthening survivor-centred care
The prevalence of GBV, including intimate partner violence, was high in the Republic of Moldova and Ukraine prior to the onset of the refugee crisis. According to WHO estimates, 27% of ever-married/partnered women aged 15–49 in the Republic of Moldova and 18% in Ukraine have experienced intimate partner violence in their lifetime.
WHO, with support from the Government of Canada, plans to train emergency medical team members on GBV response in the Republic of Moldova’s border regions. Building on a WHO online training completed by the teams earlier this year, the in-person training aims to strengthen the capacity of health workers to offer first-line support and quality care to GBV survivors in the context of the refugee crisis, in line with WHO guidelines and standards.
Health-care providers will be trained to identify signs of GBV, communicate with survivors with empathy, offer effective first-line psychosocial support and information on referral pathways, and provide quality clinical care for rape survivors.
“The training will provide practical guidance for health workers on their critical role in supporting people who have suffered different forms of GBV, with a focus on survivor-centred approaches,” said Valeriu Sava, Focal Point for Gender, Equity and Human Rights in the WHO Country Office in the Republic of Moldova. “Since health workers are often the first points of contact for GBV survivors, it’s vital that they can respond safely and appropriately.”
Scaling up health sector response to GBV
The health sector plays an essential role in responding to different forms of GBV, including physical, sexual and emotional violence that can all have severe consequences for physical, psychological and reproductive health.
WHO recently supported the development of the Ministry of Health’s contingency plan on emergency and refugee response in the Republic of Moldova, with a focus on strengthening GBV case management and ensuring that health facilities and health-care providers are prepared to deliver quality services for survivors.
The Republic of Moldova’s ratification of the Council of Europe Convention on Combating Violence against Women and Domestic Violence (the Istanbul Convention) and its entry into force in May 2022 provides a renewed opportunity for strengthening the health sector’s role and capacity to address GBV.
“WHO works with the government to adapt training curricula in medical universities for future doctors and health professionals, focusing also on building the capacity of health facility managers on effective GBV response. Strengthening the legal framework, including removing mandatory reporting requirements from health-care providers to the police, needs to happen simultaneously as this poses a barrier for survivors disclosing violence and accessing services,” added Mr Sava.
GBV needs to be elevated to the top of public health priorities, with long-term planning and commitment required for scaling up and sustaining interventions.
“Facilitating coordination across sectors is key for an effective response. WHO plays an active role in the Republic of Moldova’s GBV Taskforce and various interagency coordination mechanisms and, together with the United Nations Population Fund and other partners, we support the Ministry of Health to further institutionalize the health sector response to gender-based violence,” said Stela Gheorghita, Emergencies Coordinator at the WHO Country Office in the Republic of Moldova.
“We need continuous and coordinated efforts, backed by adequate funding and resources, to move towards concrete actions on the ground to ensure GBV survivors are supported and no one is left behind.”