Healthcare Responses to Gender-Based Violence in Timor-Leste: Women Want Empathy, Information and Safety From an Integrated Support System.

Healthcare providers are one of the first professionals women are likely to come into contact with after experiencing violence as they seek care for injuries and associated health problems or in routine care such as reproductive health services. Systematic reviews of women's experiences and expectations when disclosing abuse in health settings reveal a dearth of research with women in low-income countries and from rural areas. The aim of this study was to understand the information and interventions women who have experienced domestic violence or sexual assault want from their health providers in Timor-Leste, a country with a largely rural population and very high rates of violence against women. The mixed-methods study consisted of in-depth qualitative interviews with 28 women survivors of violence, followed by a 'pile-sort' activity in which they rated their preference for different types of interventions they wanted from their healthcare provider. The pile-sort activity showed the highest-ranked interventions centred around emotional support, information and safety, the middle-ranked interventions centred around empowering women and playing an advocacy role, and the lowestranked interventions were around intervening at the relationship level and mandatory reporting to the police. The qualitative interviews provided rich insights that affirmed women value empathy and kindness from service providers, they want to be supported to make their own decisions and the importance of formal as well as informal sources of support such as community leaders and family. There are significant implications for the content of existing training programmes on gender-based violence in Timor-Leste and similar contexts, particularly the need to build capacity on how to respond in an empathic and empowering way and how to balance mandatory reporting obligations, while also practising woman-centred care and providing the kind of support women value.Abstratu TetunFornesedór kuidadu saúde nuudar profisionál dahuluk ida ne'ebé iha posibilidade atu halo kontaktu ho feto sira depoiz de hetan violénsia tanba sira buka tratamentu ba kanek no problema saúde ne'ebe iha ligasaun ka iha kuidadu rutina sira hanesan servisu saúde reprodutiva nian. Estudu sistemátiku kona-ba feto sira nia esperiénsia no espetativa bainhira fósai abuzu iha kontestu saúde nian dehan katak ladun barak peskiza ho feto sira iha nasaun ho rendimentu kiik no husi área rurál sira. Estudu ida nee ezamina informasaun no intervensaun feto sira neebé hetan violénsia doméstika ka asaltu seksuál sira nia hakarak hosi fornesedor saúde iha Timor-Leste, nasaun ida neebé ho populasaun rurál barak no númeru ne'ebe mak aas tebes hosi violénsia hasoru feto. Métodu estudu mistura ne'ebé kompostu hosi entrevista kualitativa profundu ho sobrevivente feto na'in 28 ne'ebé sofre violénsia, tuir fali ho atividade 'pile sort' iha ne'ebé sira klasifika sira nia preferénsia ba tipu intervensaun ne'ebé diferente. Atividade pile sort hatudu intervensaun sira ne'ebé hetan klasifikasaun boot liu mak iha apoiu emosionál, informasaun no seguransa, intervensaun ho klasifikasaun médiu foka liu ba empoderamentu feto no hala'o papél advokasia, no intervensaun ho klasifikasaun kik liu mak iha intervensaun iha nivel relasaun, no keixa obrigatóriu (mandatory reporting) ba iha polisia. Entrevista kualitativu fórnese persepsaun barak ne'ebe feto sira koalia sai kona-ba sira nia valor empatia no laran-di'ak hosi prestadór servisu, sira hakarak atu hetan apoia atu halo desizaun rasik, no importánsia husi fonte formal no mos informál sira nia apoiu, hanesan lider komunitáriu no família. Iha implikasaun signifikativu ba konteúdu programa formasaun ne'ebé eziste kona-ba violénsia bazeia ba jéneru iha Timor-Leste no kontextu ne'ebe mak hanesan, liu-liu presiza atu hasa'e kapasidade kona-ba oinsá atu responde ho maneira empatia no empodera feto sira no oinsa halo balansu obrigasaun relatóriu mandatóriu (mandatory reporting) enkuantu mós prátika kuidadu feto sira no fornese apoiu ne'ebe mak iha valor ba feto sira.DisclaimerReaders should be aware that this article contains stories of trauma and abuse that some people may find difficult to read. If you experience any distress or something similar has happened or is happening to you, there are support services available in most countries. If you are in Timor-Leste, where this research was conducted, the following website has a list of services and contact details to get further assistance www.hamahon.tl.Nota: Le nain sira tenke hatene katak artigu ida ne'e kontein istória trauma no abuzu ne'ebé ema balun dalaruma sente defisil atu lee. Karik ita boot esperiensia difikuldade ruma ka iha esperiensia ruma neebé hanesan akontese ona ka akontese hela ba ita boot, iha servisu apoiu neebé mka disponivel iha nasaun barak. Karik ita boot hela iha Timor-Leste, iha nasaun ne'ebé hala'o peskiza ida ne'e, website tuir mai ne'e iha lista servisu no kontaktu detallu hodi hetan liu tan asisténsia www.hamahon.tl.