Near zero healthcare seeking behaviour among gender-based violence survivors: MSF stresses for community linked, survivor centric care model after latest data in India

New Delhi, India – The Government of India’s latest National Family Health Survey (NFHS-V) data reflects a dismal state in the practice of seeking medical care post gender-based violence, including sexual violence, said Doctors Without Borders/Médecins Sans Frontières(MSF).

Current estimates reflect that healthcare-seeking behavior (HSB) among survivors is still near zero. The new survey data, which was released last in 2015-16 as NFHS-IV, only records a marginal increase in survivors of sexual violence seeking help from medical professionals (from 0 to 1.2).

“The uptake of medical care is essential as sexual violence and intimate partner violence have well-documented, long-term physical and psychological consequences. Women, exposed to sexual and physical violence, need immediate medical care to prevent pregnancy, HIV and sexually transmitted diseases, and mental health support to reduce psychological distress,” said Dr Himanshu M, Medical Coordinator for MSF.

MSF emphasized that over 98 per cent of gender-based violence survivors, as recorded in the new survey data, do not access healthcare due to the absence of comprehensive medical care available in close proximity to vulnerable groups, as well as the fear of mandatory police reporting. “Several studies in India indicate that suffering of survivors is only compounded further by lack of knowledge of health consequences, lack of social/ family support to access health services, fear of stigma and shame by society, fear of undignified treatment by health care workers, and fear of police and legal processes,” Dr Himanshu said.

Since family and friends become the first point of contact for survivors, as demonstrated by NFHS-V data, it is imperative that their capacities are built. Out of all the women surveyed, only 14% came out to seek help, but 77% never spoke about the abuse or sought help. MSF advocates for proactive sensitization of such groups in order to offer immediate support to survivors, who may be in dire need of medical and/or psychosocial care. This is crucial in ending the deep-rooted culture of silence around gender-based violence in India.

NFHS-V further shows that 45.4 per cent of women believe that a husband is justified in beating his wife, 30 per cent of women experience gender-based violence with at least 6 per cent experiencing sexual violence in their lifetime. Given the scale of the problem and its health impact, gender-based violence should be considered a public health emergency, said MSF.

MSF recommends a public-funded program to provide a comprehensive care package for gender-based violence survivors – one that is closer to the community. “Such a comprehensive care package must include confidential and quality clinical services with destigmatizing entry points and care process; community awareness of the health consequences of gender-based violence, including removal of the perception that mandatory police reporting is the first step to seeking care. It must also include a community linked, survivor-centric model of care that facilitates access and provides comprehensive medical and psychological care round the clock,” added Dr Nimrat Kaur, Project Coordinator, Umeed Ki Kiran Clinic, Jahangirpuri.

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