Strategies for primary healthcare in Ukraine: An integrated response to gender-based violence

Abstract Issue/problem Survivors of gender-based violence (GBV) and conflict-related sexual violence (CRSV) in Ukraine face significant challenges in accessing appropriate healthcare services. Despite governmental commitment, acknowledgment and regulatory frameworks, including the ratification of the Istanbul Convention, gaps persist in integrating comprehensive GBV/CRSV services into primary healthcare (PHC) settings, exacerbated by the ongoing conflict with Russia. Description of the problem An analysis of healthcare providers’ knowledge has revealed deficiencies in effectively supporting GBV/CRSV survivors. Barriers include workload pressures, lack of inter-sectoral cooperation and case-management protocols, and insufficient training opportunities on survivor support. In collaboration with the World Health Organization, the global Clinical Management of Rape (CMR) guidelines was adapted for Ukrainian context. Among findings from CMR trainings attended by 443 PHC providers in 2022-2023 (213 participants in 2022 and 230 participants in 2023), the results underscore gaps in PHC workers’ basic knowledge and readiness to effectively support survivors during the war. Results Data from WHO training sessions underscored significant gaps in knowledge among healthcare professionals regarding legal protocols, available resources, and best practices in PHC service delivery. Identified barriers emphasized the urgent need for targeted interventions to enhance PHC workers’ capacity in GBV/CRSV response. Lessons Recommendations focus on systemic enhancements including revising regulatory frameworks, developing standardized protocols, and institutionalizing and providing comprehensive training programs. Innovative approaches like online courses, mentoring programs, and integrated service models are crucial for addressing multifaceted challenges. Key messages • A holistic GBV/CRSV response is an essential component in PHC. • This intersectoral survivor-centered approach provides safe spaces that can be adapted to other contexts in Europe.