Help-Seeking Pathways and Barriers for ... - EngenderHealth

efforts might be grounded in structured advocacy, awareness-raising, and training
initiatives, as described in several of the recommendations presented in this paper.
C. Improve Quality of Care for Survivors of GBV
While few services exist that are specifically designed to respond to GBV, the research
identified an array of services that can and do provide care for the small proportion of GBV
survivors who enter channels of help-seeking. Across these available sources of formal and
informal support, however, our findings suggest that the quality of care varies greatly. This
is due in large part to a lack of training among service providers and duty bearers on the
needs and appropriate response mechanisms for women who experience violence. In order
to improve the quality of the care received by survivors across all sectors, PEPFAR
implementing partners and the Government of Tanzania should focus on improving the
training provided, and on integrating GBV screening and comprehensive care into existing
structures. Specific recommendations for improving training and care are listed below. It is
essential to note that GBV screening should be introduced only when appropriate support
and services are in place for women who are identified as survivors.
1. Improving training for duty bearers and providers
a. Utilize a training approach that promotes supportive attitudes toward survivors of
violence and strongly challenges the forms of shame and blame placed on
survivors of GBV [Example: “In Her Shoes” methodology, which has been
adapted for use in Sub-Saharan Africa and translated into Kiswahili 34 ];
b. Require training for all formal service providers (from the lowest to highest tiers)
that incorporates the elements above but also encompasses the technical aspects
of their specific services and the Tanzanian laws, regulations, and guidelines that
pertain to GBV;
c. Offer periodic refresher trainings (additional “in service” learning opportunities)
for providers at all levels and in all sectors;
d. Provide specific training to HIV/family planning/antenatal care providers (as
below) to screen for and respond appropriately to cases of GBV;
e. Expand the basic components of GBV services to include a holistic response to
the physical, psychosocial, and economic needs of survivors.
2. Improving the provision of comprehensive care for GBV survivors
a. Ensure the new National Policy and National Management Guidelines for the
Health Sector Prevention of and Response to GBV are disseminated down to the
lowest tier of healthcare providers (e.g., dispensaries) and adhered to, including
by making sure that the protocols and necessary materials (e.g., forensic kits,
reporting forms) are made available to providers in an accessible format;
b. Integrate screening for and response to GBV into HIV testing and counseling,
family planning service provision, and the standard package of antenatal care
34 http://www.preventgbvafrica.org/adaptation-her-shoes-sub-saharan-context
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