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Background <p>Addressing violence against women (VAW) has been identified as a global health priority, and healthcare providers (HCPs) have an important role in supporting survivors of violence. Despite global advocacy for change, VAW has historically received less attention than infectious or chronic diseases, particularly when health system resources are scarce. To help address these challenges, the World Health Organization (WHO) curriculum on responding to VAW in LMICs was adapted as in-service training in Timor-Leste in 2020–2021, with the goal of training HCPs in two municipalities. We evaluated the impact of the curriculum on HCP knowledge, attitudes, and preparedness using a pre- and post- study design.</p> Methods <p>HCPs were recruited from all health facilities in Liquica and Ermera and trained over five days. An adapted version of the WHO curriculum questionnaire was administered pre- and post-training. Using the Wilcoxon signed-rank test, we compared HCPs’ pre- and post-training scores in each domain (<i>n</i> = 193). Individual and training-level factors associated with improvement were investigated via regression modeling.</p> Results <p>Only 4.7% of HCPs had previously received training on responding to VAW. Median total scores for knowledge of the clinical signs of violence (6.67 vs. 8.89), attitudes towards the unacceptability of violence (6.43 vs. 8.57), individual preparedness (5.67 vs. 8.67), and perceived system support (8.33 vs. 10.0) significantly increased post-training. Attitudes were less likely to improve for older participants (Odds Ratio = 0.42, 95% UI = 0.18–0.95).</p> Conclusions <p>This evaluation supports existing evidence that in-service training for HCPs on responding to VAW is effective. The model of engaging all health staff – including medical doctors, nurses, midwives, and other positions – has the potential to shift the culture of care within municipal health systems. Ongoing phases of implementation, including regular follow-up support, present the opportunity to collectively address system barriers to providing survivor-centred care and should be further evaluated.</p>

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Knowledge, attitudes, and preparedness of healthcare providers trained to respond to violence against women: evaluation of the adapted World Health Organization curriculum in two municipalities in Timor-Leste

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月29日

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  • Cory N. Spencer,
  • Xylia Ingham,
  • Guilhermina de Araujo,
  • Laurensius Amir,
  • Kayli Wild

摘要

Background

Addressing violence against women (VAW) has been identified as a global health priority, and healthcare providers (HCPs) have an important role in supporting survivors of violence. Despite global advocacy for change, VAW has historically received less attention than infectious or chronic diseases, particularly when health system resources are scarce. To help address these challenges, the World Health Organization (WHO) curriculum on responding to VAW in LMICs was adapted as in-service training in Timor-Leste in 2020–2021, with the goal of training HCPs in two municipalities. We evaluated the impact of the curriculum on HCP knowledge, attitudes, and preparedness using a pre- and post- study design.

Methods

HCPs were recruited from all health facilities in Liquica and Ermera and trained over five days. An adapted version of the WHO curriculum questionnaire was administered pre- and post-training. Using the Wilcoxon signed-rank test, we compared HCPs’ pre- and post-training scores in each domain (n = 193). Individual and training-level factors associated with improvement were investigated via regression modeling.

Results

Only 4.7% of HCPs had previously received training on responding to VAW. Median total scores for knowledge of the clinical signs of violence (6.67 vs. 8.89), attitudes towards the unacceptability of violence (6.43 vs. 8.57), individual preparedness (5.67 vs. 8.67), and perceived system support (8.33 vs. 10.0) significantly increased post-training. Attitudes were less likely to improve for older participants (Odds Ratio = 0.42, 95% UI = 0.18–0.95).

Conclusions

This evaluation supports existing evidence that in-service training for HCPs on responding to VAW is effective. The model of engaging all health staff – including medical doctors, nurses, midwives, and other positions – has the potential to shift the culture of care within municipal health systems. Ongoing phases of implementation, including regular follow-up support, present the opportunity to collectively address system barriers to providing survivor-centred care and should be further evaluated.