Responding to violence against women in Rwanda: An issue of health equity

A 2007 Rwandan government study showed that:

• More than 25% of Rwandan women had experienced sexual violence during the five years prior to the study.

• More than 12% had been victims of at least one act of physical violence.

• More than 13% had been victims of psychological violence.

In 2008, IntraHealth's Twubakane Program assessed the readiness of health facilities, the politico-legal environment, and the community to respond to violence against women (VAW) in three districts.

Assessment results showed:

• Positive health provider attitudes about caring for victims but weak knowledge about VAW and lack of service delivery protocols and client education materials

• The politico-legal environment offers opportunities to integrate a response to VAW into antenatal care (ANC), but policy gaps must be addressed to make services more victim-friendly.

• A culture of silence and impunity perpetuates violence. Collaboration between health facilities, police and community organizations can improve response to VAW.

VAW prevents women from achieving psychological and physical security and healthy pregnancies. Follow-on activities at policy, health facility and community levels that promote health equity by eliminating obstacles to service access and better health will include:

• Policy reform, training health care providers to respond to VAW and developing clinic protocols and materials for screening ,counseling and referral

• Promoting community/health facility partnerships for improved victim support and referral

• Sensitizing police officers and assisting with VAW training for improved police VAW response and referral

• Mobilizing communities to prevent VAW and promoting women's financial independence.