Essential Health Care Services Addressing Intimate Partner Violence (2024) / Chapter Skim
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6 Sustaining Intimate Partner Violence Services During Public Health Emergencies
6 Sustaining Intimate Partner Violence Services During Public Health Emergencies
Pages 187-204
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From page 187... ...
6) : • essential prevention measures for communicable diseases, including immunizations; • services related to reproductive health, including during pregnancy and childbirth; • care for vulnerable populations, such as infants and older adults; • provision of medications and supplies to support the ongoing man agement of chronic diseases, including mental health conditions; • uninterrupted critical inpatient care; • management of emergency health conditions and common acute presentations that require time-sensitive intervention; and • auxiliary services, such as basic diagnostic imaging, laboratory, and blood bank services.
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From page 188... ...
Essential health care services related to IPV will similarly be based on the conditions and sequelae that co-occur with IPV. A discussion of the most common health conditions related to IPV, as well as their impact on human health, can be found in Chapter 4.
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From page 189... ...
While these are not less essential for human well-being, they are less time sensitive based on immense resource constraints during PHEs. RESTORING ESSENTIAL IPV CARE IN PHASES The committee identified the essential IPV health care services related to IPV during steady-state conditions in Chapter 4.
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From page 190... ...
The committee identified these phases of restoration not only to guide prioritization of specific essential health care services, but to also identify those services that, once they have been identified as part of public health preparedness planning, can be included as part of the process of identifying necessary supplies for emergency stockpiles and can, in some cases, be provided by a variety of clinical staff. As Table 6-1 depicts, the committee identified the services that need to be prioritized and what services could be restored once response operations and stabilization are occurring according to response plans.
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From page 191... ...
During Public Health Emergencies -- A Phased Return to Steady-State PHASE WHEN SERVICE SHOULD BE RESTORED Essential Health Care Response Initial Stabilization Service operations Universal IPV screening/ inquiry and education Safety planning Forensic medical exams Emergency medical care Treatment of physical injury Gynecologic and reproductive health care Urgent Non-urgent including pregnancy termination Obstetric care Urgent Non-urgent Perinatal home visits Contraceptives Contraception and not requiring All types of emergency contraception procedures or contraceptives immediate follow-up Screening and treatment Treatment and rapid Treatment and of sexually transmitted testing all screening infections, and HIV Substance abuse Withdrawal All treatment treatment mitigation Pharmacy/medication management Primary and specialty care Mental health care Urgent/Crisis Non-urgent Urgent Urgent treatment Dental care treatment for for acute injuries acute injuries Support services including shelter, nutritional assistance, child care Restore services for all patients Selectively restore services for acute needs or restore targeted services Do not restore services during this phase PREPUBLICATION COPY -- Uncorrected Proofs
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From page 192... ...
. The committee prioritized components of essential health care services that protect life safety and can be delivered safely and effectively using the least staff and supplies.
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From page 193... ...
Universal education and screening are crucial for connecting women experiencing IPV to needed resources during PHEs, whether they seek care in traditional clinical settings or the various settings in which disaster health responders deliver care. However, the committee recognizes that during PHEs, health care delivery often occurs under substantial time constraints and levels of urgency, particularly during the initial phase of PHE response.
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From page 194... ...
Thus, a CSC approach can be applied in IPV care to prioritize the allocation of resources for IPV survivors who are at the highest risk of harm, according to such criteria as severity of injuries, likelihood of survival, and potential to prevent further harm. In the context of IPV health care, a modification of the standards of care can mean providing more focused and streamlined services, such as prioritizing emergency medical care and safety planning over longer-term counseling or therapy.
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From page 195... ...
Their objective is to establish a common understanding of what constitutes minimum prevention and response programming for GBV in emergencies. This guidance was useful to the committee during their process of identifying priorities for ensuring access to essential health care services related to IPV during PHEs in the United States.
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From page 196... ...
• Work with health care organizations through existing relationships (e.g., emergency management and health care coalitions) to ensure immediate access to essential health care services at the onset of an emergency.
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From page 197... ...
• Disseminate information and engage communities on the health consequences of IPV -- if PHE conditions allow. • Reestablish comprehensive sexual and reproductive health care services and strengthen local health systems after the immediate emergency onset and during transition phases.
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From page 198... ...
While the GBVIMS and MISP were developed specifically for use in humanitarian emergencies and provide more targeted guidance on specific issues related to GBV and reproductive health services, the ESP provides a comprehensive set of guidelines for providing essential health care services. IPV care challenges that are not well defined in the United States (e.g., the triage of survivors in resource-limited settings, IPV toolkits for field triage, communications in resource-limited environments 3 https://www.unfpa.org/resources/minimum-initial-service-package-misp-srh-crisis-situations (accessed August 25, 2023)
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From page 199... ...
This includes having well-established formal partnership agreements and protocols with health care centers in order to provide needed services, such as emergency contraception and related treatment under the direction of a licensed health professional. ADDRESSING CHALLENGES IN SUSTAINING HEALTH CARE SERVICES Training for Disaster Response Personnel During the immediate response phase of a disaster, emergency health care may be delivered by local, state, or federal response teams or volunteer organizations active in disasters (VOADs)
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From page 200... ...
Supply chains may also be disrupted, which limits access to supplies and equipment. This hampers these groups' ability to deliver care to people experiencing IPV (Garcia et al., 2022; Lauve-Moon and Ferreira, 2016; Sapire et al., 2022)
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From page 201... ...
The law's Privacy Rule requires that clinicians, health plans, and other health care clearinghouses put in place measures to ensure that patients' health information remains confidential. While the Privacy Rule cannot be suspended during a national or public health emergency, certain provisions may be waived during declared disasters that present specific safety risks to individuals experiencing IPV who are seeking health care.5 Additionally, support service providers who receive funding under the Violence Against Women Act (VAWA)
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From page 202... ...
The essential health care services related to IPV during steady state conditions remain essential during PHEs. The response to a PHE is marked by conditions such as infrastructure damage and resource restrictions that create barriers to care delivery that improve as resources are directed to the affected geographic area.
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From page 203... ...
2018. Inter-agency field manual on reproductive health in humanitarian settings.
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From page 204... ...
2020. Minimum initial service package for sexual and reproductive health.
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