Training Program Enhances Health Sector Response to Gender-Based Violence

Longstanding Communication Barriers to be addressed

Communication barriers have long been a challenge for health professionals worldwide to effectively help women facing intimate partner violence (IPV) and sexual violence (SV). To address the significant health impact of these conditions, the World Health Organization (WHO) recently developed guidelines for the health care response to IPV and SV against women, with an accompanying clinical handbook. To translate these guidelines and clinical recommendations into effective practice, a Johns Hopkins team has created a training program for health service providers to respond to violence against women.

The training is an active, participant-centered learning program for health care providers to understand the perspectives of violence survivors as well as to build skills and confidence to assess and respond to IPV and SV. The program emphasizes effective communication skills and the first-line support using WHO’s LIVES approach: Listen, Inquire, Validate, Enhance Safety, and Support. The curriculum embeds interactive activities, such as roleplaying, for participants to build skills in a supported environment. It is also adaptable to local contexts including referral pathways to foster engagement within the local systems a survivor may navigate. 

The Johns Hopkins team has piloted this training program in four countries, including the Bahamas, Guyana, Liberia, and Trinidad and Tobago, reaching over 100 doctors, nurses, midwives, and other healthcare providers across specialties ranging from emergency medicine to psychiatry. An abridged curriculum for pre-service providers including medical students, was tested in Ghana. The pilot evaluations show that providers see a boost in their confidence and preparation for implementing first-line support for IPV/SV survivors, as well as their ability to provide appropriate care. 

The training program was developed by Johns Hopkins Bloomberg School of Public Health Associate Professor Dr. Michele Decker, together with Johns Hopkins School of Nursing Professor Dr. Nancy Glass, and colleagues at Johns Hopkins Center for Clinical Global Health Education, JHPIEGO and University of Michigan, in partnership with the World Health Organization and Pan American Health Organization. To learn more about the program, contact Dr. Decker at

Further Information

For more information on enhancing the health response to gender-based violence, see selected publications as well as publicly available training via Coursera.

Decker MR, Miller E, Glass N.  Rapid response to: "Screening women for intimate partner violence in healthcare settings: abridged Cochrane systematic review and meta analysis."  BMJ. [epub 16 May 2014]. 

Decker MR, Miller E, Glass N.  "Gender-based violence assessment in the health sector and beyond."  In CM Renzetti, D Follingstad, A Coker (Eds.), Preventing intimate partner violence: Interdisciplinary perspectives.  (pp101-128).  2017 Bristol, United Kingdom: Policy Press.

Miller E., Decker MR, Glass N.  "Innovative health care responses to violence against women."  In CM Renzetti, JL Edelson, RK Bergen (Eds.), Sourcebook on violence against women (3rd ed., pp299-313).  2017 Thousand Oaks, CA: Sage.

Decker MR, Frattaroli S, McCaw B, Coker AL, Miller E, Sharps P, Lane W, Mandal M, Hirsch K, Strobino D, Bennett WL, Campbell J, Gielen A.  "Transforming the health care response to intimate partner violence and taking best practices to scale."  J Women’s Health.  2012; 21(12)1222-9. 

Decker MR, Flessa S, Pillai RV, Dick RN, Quam J, Cheng D, McDonald-Mosley R, Alexander KA, Holliday CN, Miller E. "Implementing trauma-informed partner violence assessment in family planning clinics." J Womens Health (Larchmt). 2017;26(9):957-965. 

Decker MR, Latimore AD, Yasutake S, Haviland M, Ahmed S, Blum RW, Sonenstein F, Astone NM.  "Gender-based violence against adolescent and young adult women in low and middle income countries." J Adol Health. 2015;56(2):188-96. PMID: 25620301.

Decker MR, Peitzmeier S, Olumide A, Acharya R, Ojengbede O, Covarrubias L, Gao E, Cheng Y, Delany-Moretlwe S, Brahmbhatt H. "Prevalence and health impact of intimate partner violence and non-partner sexual violence among female adolescents aged 15-19 years in vulnerable urban environments: A multi-country study." J Adol Health. 2014. 6S(55):S6-12. PMID: 25454004.

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Michele Decker co-leads the AHW Gender Equity & Justice theme, is the AHW Theme Co-Leader for Gender Equity & Justice, and Associate Professor Associate Professor in the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. She directs the Women's Health & Rights Program at the Johns Hopkins Center for Public Health & Human Rights.