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Health service delivery points: anonymous, round-the-clock and free of charge

29 May 2019

Where can a woman who suffered of gender-based violence receive emergency help? How could she be assured to remain anonymous? What doctor can she trust? Health service delivery points, opened with support of the United Nations Population Fund, have become an ultimate answer to all these questions.

 

Health service delivery points (HSDP) is a cabinet, based in a multi-profile hospital, with a qualified medical staff and equipment. There are essential medicaments and means for reproductive health protection, HIV prevention, treatment of sexually transmitted infections, prevention of unwanted pregnancy and emergency care for victims of rape. There are fourteen such HSDP s in total in Ukraine. The first ten opened with support of UNFPA along the contact line in the east of Ukraine in 2016. A number of risks multiplies in a military conflict zone, thus HSDPs were founded to provide maximum support – both medical and psychological to the victims of violence. In 2018 four more HSDPs were opened in Kharkiv, Vinnytsia, Kryvyi Rih and Mariupol. Only last year alone, three thousand women who became victims of physical and/or sexual violence received emergency aid in HSDPs.

 

Multifaceted care

One of such emergency points is based in perinatal center in Pokrovsk, Donetsk oblast. “There are a plenty of internally displaced people here, the front line is only 30 kilometers from here. Thanks to our center, victims of violence can receive help confidentially and free of charge, which is especially important for population affected by war,” says Ivan Tsyganok, the head of this HSDP. Moreover, help is provided “expertly and without unnecessary chats”. All personnel of cabinets were trained by UNFPA to identify and assist victims of gender-based and domestic violence.

 

Competency of physicians, availability of necessary means for reproductive health protection, modern equipment are the key advantages of HSDPs in comparison with an ordinary gynecological cabinet. “One can receive universal and multifaceted care from personnel that has obtained appropriate training. That’s why these cabinets are so popular among vulnerable population groups,” says Galina Maistruk, the head of Charity Foundation “Woman Health and Family Planning”, an implementing partner of UNFPA in this project.

Another advantage of these cabinets is their accessibility for people with disabilities. An ordinary gynecological examination chair is not suitable for them. “There was an issue how to lift a woman in a wheelchair to examine her. We solved it by equipping HSDP s in accordance with the needs of women with disabilities. Therefore, those who hadn’t access to medical examination now got it,” Galina Maistruk comments.

 

The question of trust

When coming to an ordinary medical institution, one has to undergo a registration process. In fact, it often scares victims of gender-based and domestic violence away, since their situation might be revealed to others. According to UNFPA’s statistics, only 32% of victims of physical and/or sexual violence ask for help. Only 1% of them come to see a physician. Therefore, provision of confidentiality is pivotal for affected women. HSDPs do not demand any registration. Moreover, there is a separate entrance to these cabinets. It helps to build trust and make HSDPs more popular. Every year more and more patients come. “To make people trust you, it is vitally important not to deceive their expectations once they come, but to provide help on the highest level and in a patient- friendly atmosphere. That’s what we do,” explains the growing number of patients Ivan Tsyganok. HSDPs have also got clients who aren’t necessarily victims of violence. Galina Maistruk gives an example, when a young person that had an unprotected sexual contact, comes to an HSDP to seek advice on how to protect herself from HIV and sexually transmitted infections.

 

Besides medical help, psychological one is available in HSDPs as well. After the initial consultation, a patient can receive a referral to the Centers of social and psychological assistance for further support. Ivan Tsyganok tells about a case when a woman came to the HSDP after continuous emotional violence and pressure from her partner. She was allowed to stay in the center and obtained necessary help. Eventually, a family’s situation normalized.

 

Fourteen HSDP’s altogether make a unique project. Before their foundation there was no service in Ukraine that would provide anonymous and free of charge help to victims of physical and sexual violence. Now victims know that they have a place to come to round-the-clock and receive both medical and psychological support.

 

Health service delivery points were opened within the UNFPA, the United Nations Population Fund program "Integrated response to end gender-based violence against vulnerable women and adolescent girls in Ukraine”, implemented in cooperation with the Ministry of Social Policy of Ukraine with the support of the Governments of the United Kingdom, Canada and Estonia.