QUICK ESCAPE FROM SITE

Screening

  • Screening is “asking women about experiences of violence/abuse, whether or not they have any signs or symptoms” (Bott et al, 2004). Without screening, health services mainly respond when survivors take the initiative to disclose. (from Health Module).
  • When done appropriately, screening creates a record of the main violence issues for the survivor, which in turn determines what care and support she needs from the provider doing the screening, and from others in the facility or the community.  Routine screening increases the likelihood that providers can ensure appropriate care for survivors. (from Health Module).
  • In recent years, there has been an interest in developing screening capacity of health care providers working in conflict-affected settings.  By screening for violence against women and girls in humanitarian settings, health care providers have the potential to provide life saving services and counteract the negative long term affects which can minimize the long term affects on survivors (Ciampi).
  • However, there are widespread concerns about the risks of routine screening, particularly in resource-poor settings where there is limited training to prepare providers to conduct screening (Garcia Moreno, 2002b) and/or lack of support to providers who routinely screen clients. Routine screening may harm women in settings where providers are insensitive to violence issues or are otherwise not equipped to respond appropriately, where privacy and confidentiality cannot be ensured, and where adequate referral services do not exist. Poorly implemented routine screening can put women at additional risk of violence (Bott et al, 2004). (from Health Module)
  • When operating in conflict and post-conflict humanitarian settings where both financial and human resources are often overstretched, health care providers may consider screening for violence against women and girls to be an added burden and feel torn between providing quality health care services and fulfilling productivity targets (Stevens, 2004 as cited by Ciampi). 
  • Furthermore, working in conflict and post-conflict humanitarian settings often includes added pressures on health providers such as harsh living and working conditions, isolation, lack of privacy, limited communication with usual support systems, regular turnover of expatriate staff and possible threats to personal safety by perpetrators and their families or the authorities (WHO, 1998 & Women’s Commission for Refugee Women and Children, 2002 as cited by Ciampi). 
  • Any initiatives to introduce screening for violence against women and girls within the health sector requires caution and must be implemented paying special attention to safety, privacy and confidentiality (WHO, 1998 and Lapidus et al, 2002 as cited by Ciampi). And yet, it can be a challenge in conflict and post-conflict humanitarian settings to ensure safety and privacy due to lack of resources and facilities. 
  • When considering whether to implement screening, providers should first understand the four basic approaches to screening:  Universal screening, Selected integration, High risk screening and Selective screening (For more comprehensive general information on screening and screening tools, please see Health Module)

 

Additional Resources

Responding to Intimate Partner Violence and Sexual Violence against Women: WHO Clinical and Policy Guidelines (World Health Organization, 2013). Available in English (pages 17-19).

The Screening Section of the Health Module. Available in English, French and Spanish.

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