Thinking laterally: screening for gender-based violence through existing health services in Papua New Guinea

As part of its six year Strengthening HIV/AIDS Services for Key Populations in Papua New Guinea project, FHI 360 has developed a set of practical resources to integrate gender-based violence services with HIV services and health services more generally.

The project aimed to reduce the incidence of HIV and mitigate its impact on those most at risk of contracting the virus, their sexual partners and their families. This target aligns with the Government of Papua New Guinea’s National AIDS Strategy 2011–2015 and the National Department of Health’s Gender Strategy. The project drew to a close in September 2018.

One of the innovative approaches taken in the project was to integrate gender-based violence services with HIV clinical services.  FHI 360 has produced checklists, protocols, training agendas and operating procedures to support ongoing work on this topic, including developing screening and medical services for gender-based violence, which can be applied in all health services.

The project found that the relationship between gender-based violence and HIV in Papua New Guinea echoes global findings.  There is direct transmission of HIV via forced sex and reduced ability to negotiate for safer sex due to gender-based violence in intimate relationships.  There are sexual relationships at earlier ages and increased sexual risk-taking and vulnerability to sex work among victims of child sexual abuse.

The project trialled gender-based violence screening at HIV clinics.  Existing services for people who experience gender-based violence, such as those provided by Family Support Centres, provide five essential services (treatment for injuries, psychological first aid, prevention of HIV/STI, pregnancy, Hepatitis B and Tetanus) after a person has experienced gender-based violence.  By conducting gender-based violence screening at HIV clinics, the health worker is proactively seeking to provide intervention on gender-based violence. This enables earlier interventions and support for those at risk of experiencing gender-based violence. The project demonstrated that it is possible to integrate gender-based violence screening into all health services and can lead to earlier interventions for prevention and support.

Sebastian Robert, Technical Advisor Gender & Men’s Health Program for the National Department of Health said “integrating GBV prevention, response and support strategies into existing health programming provides strategic opportunities for equitable access to quality health care and services where needs, preferences and interests of individuals can be conveniently met.”

FHI 360 found that integrating gender-based violence screening into health services accomplished five important objectives:

  • It increased the number of service points available to survivors of gender-based violence in a country with extremely high levels of violence and where travel in, around and between neighbourhoods can be dangerous and difficult for survivors.
  • It developed the first gender-based violence service sites that were friendly to key populations that are at risk of HIV, while benefiting women and girls more generally.
  • It resulted in the prevention of gender-based violence, as well as improving responses to it.
  • It offered an opportunity for people in key populations at risk of HIV, and women and girls more generally, to be educated about what gender-based violence is, how it impacts their health and where they can find services.
  • It assisted survivors to take the first, crucial steps toward safety planning.

The FHI 360 experience also showed that it is possible to integrate gender-based violence services into health services at both government and faith-based facilities using the current workforce and without the need to hire more staff.

The project was funded by the US Government.  To download the report and tools, please see FHI 360’s publication ‘Integrating GBV Services in Health Facilities’ here:

https://www.fhi360.org/sites/default/files/media/documents/resource-png-gbv-integration-sept-2018.pdf