Healthcare for women following domestic or sexual violence using the example of the State of Hesse

Abstract

Background: Domestic and sexual violence pose a threat to the health of women. There has been a requirement to provide adequate healthcare to women affected by violence since the Istanbul Convention came into effect in Germany in 2018. So far, in the area of postviolence healthcare, neither the current regional care structures nor the existing care situations have been systematically assessed. Objective: An overview of the services and situations in the healthcare sector in Hesse, Germany, and their related framework conditions are provided and identified gaps are outlined. Methods: A total of 34 expert interviews were conducted with healthcare professionals in clinics and other healthcare facilities, with staff members of coordination or counselling centers, and with women’s representatives. The interviews were examined using qualitative content analysis. This was supplemented by internet research on healthcare services that specialize in violence. Results: The results show that services for healthcare following domestic or sexual violence do not exist in every county in Hesse. Rural areas in particular do not receive adequate healthcare coverage, which results in uneven treatment options for those affected. Differences could be found between services specialized in addressing violent abuse and other healthcare facilities. While guideline programs and procedures exist in specialized services, the care in other healthcare facilities depends on the respective staff member’s personal commitment. Conclusion: In Hesse, adequate healthcare following sexual or domestic violence, as laid out in the Istanbul Convention, cannot be ensured and there remains a need for further action.