Published: August 2024 | Contact: Theo Lorenc
What do we want to know?
Violence against women and girls (VAWG) takes many forms and can often have serious, lasting effects on both physical and mental health. A range of approaches in the healthcare sector may aim to reduce VAWG, to mitigate its effects, or to improve how organisations deal with VAWG (for example by improving the identification of victims). We aimed to identify all interventions relevant to healthcare which address VAWG in any of these ways, and to summarise the evidence base for each one in a user-friendly ‘toolkit’ giving an overview of what is known for each type of programme.
Who wants to know?
This independent research report was commissioned by the National Institute for Health Research Policy Research Programme for the Department of Health and Social Care. The findings may be of interest to national and local policymakers and commissioners, clinicians and other professionals (for example, people working in shelters or refuges for victims of violence), and to people experiencing or at risk of violence.
What did we find?
The toolkit identified 18 types of intervention, including a range of approaches: psychological therapies for victims of VAWG; interventions for perpetrators to reduce reoccurence of violence; and a range of organisational interventions, such as training of professionals, to improve the response to VAWG. Most of the evidence concerns violence committed by intimate partners, with a smaller number concerning sexual abuse of children.
Some interventions have reasonable evidence of positive impacts on mental health and wellbeing for victims of VAWG, including psychological therapies and digital interventions. There is less evidence that interventions can help to reduce or prevent violence. Organisational interventions, such as professional training or screening programmes, show some evidence of effect on intermediate outcomes (for example, knowledge), but it is unclear whether they improve outcomes for victims. The evidence suggests that other interventions, including advocacy and interventions for perpetrators, are not effective. There is a lack of robust evidence on several interventions, including specialist victim support services (such as Sexual Assault Referral Centres) and sexual health services.
What are the conclusions?
Healthcare organisations can address VAWG in several ways, and there is evidence that several interventions can improve outcomes for victims of violence. Many interventions are fairly intensive, and can be challenging to implement; for example, there are often barriers for victims in accessing appropriate support. Ensuring safety, and maintaining trust between victims and service providers, are fundamental for successful interventions.
Organisational interventions are promising but may have limited value in isolation. Integrated approaches which aim to improve responses to VAWG across the care pathway may be needed. Specialist service models may play an important role, but there is limited evidence on their effectiveness.
How did we get these results?
We used a systematic best evidence review-of-reviews approach, to identify evidence from existing high-quality systematic reviews as far as possible, combined with pragmatic searches for data on costs and implementation. The toolkit summarises information on effectiveness, cost and evidence quality in a standardised format. Our methods guide provides a detailed account of our approach for developing the toolkit.
