A review of the Sri Lankan health-sector response to intimate partner violence: looking back, moving forward

Abstract

Intimate partner violence (IPV) is a major health concern for women worldwide. Prevalence rates for IPV are high in the World Health Organization South-East Asia Region, but little is known about health-sector responses in this area. Health-care professionals can play an important role in supporting women who are seeking recourse from IPV. A comprehensive search was conducted to identify relevant published and grey literature over the last 35 years that focused on IPV, partner/ spousal violence, wife beating/abuse/battering, domestic violence, and Sri Lanka. Much of the information about current health-sector response to IPV in Sri Lanka was not reported in published and grey literature. Therefore, key personnel from the Ministry of Health, hospitals, universities and nongovernmental organizations were also interviewed to gain additional, accurate and timely information. It was found that the health-sector response to IPV in Sri Lanka is evolving, and consists of two models of service provision: (i) gender based violence desks, which integrate selective services at the provider/facility level; and (ii) Mithuru Piyasa (Friendly Abode) service points, which integrate comprehensive services at the provider/facility level and some at the system level. This paper presents each model's strengths and limitations in providing comprehensive and integrated health services for women who experience IPV in the Sri Lankan context.

Factors shaping political priorities for violence against women-mitigation policies in Sri Lanka

“…The Family Health Bureau of the MOH’s Directorate of Maternal and Child Health is the national focal point for maternal and child health programmes, and – recently through its Gender and Women’s Health Unit – also oversees all formal VAW training and establishment of VAW services provided through the national hospital system [ 30 ]. In 2012, the Maternal and Child Health (MCH) Policy was adopted, recognizing the role of the health sector in preventing and responding to VAW, including domestic violence.…”

“…For example, international agencies and donors were able to support NGO services for abused women, especially during the civil war and the tsunami in 2004 [ 16 ]. UNFPA and other international donors have also supported the MOH’s comprehensive VAW services and the Ministry of Women’s VAW activities [ 30 ].…”

“…Besides the initial NGO response through GBV health desks in public hospitals, MOH, in collaboration with UNFPA, developed a comprehensive response to VAW in the form of One-Stop Crisis Centres (OSCCs), called Mithuru Piyasa or ‘Friendly Havens’, offering on-site medical care and basic counselling and external referral for in-depth counselling and legal aid [ 33 , 59 ]. To date 33 hospitals across Sri Lanka have a Mithuru Piyasa centre [ 30 ]. A more recent model was to have medical officers (trained in mental health) offering mental health clinics for women who experienced abuse in hospitals with no on-site psychiatrists [ 60 ].…”

Searching for evidence or approval? A commentary on database search in systematic reviews and alternative information retrieval methodologies

“…Taking the field of international development as an example, most research does not get published in indexed peer‐reviewed journals. SRs in these domains find a large proportion of their relevant literature from nondatabase sources . Reasons for this include but are not limited to donors directly funding research to support their own programming.…”

“…SRs in these domains find a large proportion of their relevant literature from nondatabase sources. 20,31,32 Reasons for this include but are not limited to donors directly funding research to support their own programming. This directly commissioned research is infrequently publicly registered, and results are reported to funders, disseminated through peer networks, and inconsistently filed in funders' libraries.…”