Armenia: Improving Providers’ Response to Violence against Women
Provided by PRIME II VOICES
"The violence against women program has had a great
influence on our health providers. They now understand
that many complications occur as a result of violence,
problems that cannot be treated or prevented without
addressing the issue of violence upfront."
Dr. Efrosya Nahapetyan, head of women's consultation
at Polyclinic 8 in Yerevan, Armenia, has witnessed
changes among her facility's providers as the result
of a pilot program to expand the role of the reproductive
health sector in helping Armenian women overcome violence.
Launched by the PRIME II Project in 2002, the program
in Polyclinic 8 has demonstrated a model for reproductive
health providers to effectively screen, educate and
refer women who experience violence. The program has
also influenced national health policy to recognize
violence against women (VAW) as a public health concern
and helped providers collaborate with others working
at the community level against VAW.
VAW includes the physical, sexual, psychological and
economic abuse of women and girls. Global research
suggests that one out of every three or four women
experiences violence from an intimate partner at some
point in their lives. In Armenia, national research
indicates that both men and women have attitudes of
tolerance toward "wife-beating" and smaller
qualitative studies uncover alarming levels of VAW.
Of 1457 women screened for VAW at Polyclinic 8 between
December 2003 and May 2004, 30% had suffered from VAW
at some point in their lives.
"Discrimination against women and girls in Armenia
starts practically at birth," relates one client. "A
boy-child is celebrated as the heir of the family name
and a girl-child is perceived as one who will move
to her husband's home to become a future wife and mother.
From a very early age, a girl is treated like a guest
in her own home... We need to bring up children with
a real respect toward women, not the traditional worshipping
in words but humiliation in action."
According to Dr. Nahapetyan, the VAW program has had
a positive influence on clients as well as providers. "Patients
understand the concept of violence now--its consequences,
how to prevent it, and in which institutions you can
receive relevant care."
As psychological abuse is frequently reported by the
women screened at Polyclinic 8, Dr. Nahapetyan hired
a resident psychologist, Irina Bagdasaryan, to offer
services to both women and men free of charge. "I
help people obtain a new vision of their future," says
Ms. Bagdasaryan. "I also assist them in maintaining
their families." In addition to psychological
services, providers refer women for other appropriate
services including legal counseling, social support,
hot-line services and shelter.
To gauge the effectiveness of the pilot program, PRIME
observed providers conducting VAW screening and counseling
during prenatal care in simulated cases at Polyclinic
8 and two other reproductive health clinics in Yerevan.
Observation scores show significantly higher levels
of performance for physicians who benefited from the
program. Polyclinic 8 physicians scored 88.5% in counseling
skills versus 33.5% and 17% for control facility physicians.
The average score on frequency of performing critical
tasks was 93% for Polyclinic 8 physicians as opposed
to 41% and 30% among physicians at the other clinics.
Critical tasks include such steps as ensuring privacy
and confidentiality, explaining procedures, and making
sure women are aware of laws that protect them against
violence.
While the pilot program ended in June, Dr. Nahapetyan
and her staff plan to continue screening for VAW and
providing related services. As one physician affirms, "This
has become our new style of working and cannot be changed."
The PRIME II Project, funded by USAID and implemented
by IntraHealth International and the PRIME partners,
works around the world to strengthen the performance
of primary providers as they strive to improve family
planning and reproductive health services in their
communities.
For more success stories, visit Prime II Voices
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