Supporting health system responses to violence against women and children in Timor-Leste

Our aim is to support a sustainable health system response to violence against women and children in Timor-Leste, through collaborative partnerships and rigorous research.

Our team have developed, piloted and refined a set of training material and learning resources based on the WHO in-service curriculum on responding to violence against women, as well as formative research in Timor-Leste with women survivors of violence, midwives and community leaders.

These learning materials, videos and reports can be used by Governments, Universities, NGOs and anyone striving to transform health systems to be safer, more empathic and supportive places for people who have been subjected to domestic violence, sexual assault or child abuse.

The pre-service training course is available in English and Tetum, and is suitable for a variety of health professionals and country settings, but is particularly targeted to nurses, midwives and doctors in Timor-Leste. Upon completion of the course, health providers will be competent in:

  • Understanding domestic violence, sexual assault and child abuse as public health issues
  • Identifying signs of abuse and knowing when and how to ask about violence in a sensitive way
  • Practising women-centred care and being able to communicate with empathy
  • Enhancing women and children’s safety and providing referral and ongoing support
  • Practising self-care and collaboration with colleagues

Pre-service training course

The pre-service training course is designed for teaching within nursing, midwifery, medical and other health-related University degrees. It is delivered over 9 x 2 hour modules, which can be taught as a subject over a semester or condensed over a week of intensive training.

  • PowerPoint slides
  • Facilitators’ manual
  • Students’ guide
  • Literature to read

Videos

These videos are in Tetum with English subtitles. They have been developed as part of the training course, for use within group activities. They could also be used as learning resources or to generate discussion in other training or awareness programs.


Begin a good relationship

A video role play demonstrating how health providers can identify signs of violence, ask about problems, respond with empathy, protect confidentiality, enhance safety and provide referral and ongoing support.


Women’s stories of trauma and resilience

Based on the real stories from research with 28 survivors of violence, these three videos enhance students’ understanding of the effects of trauma, barriers to getting help, and what care women value. Please note: some viewers may find the content upsetting.


Midwives against violence

Midwives talk about why their role is so important when helping survivors of violence, their responsibility under the law and important aspect of care.


Health system strengthening

This animation, developed by the World Health Organisation and dubbed in Tetum, illustrates the global health burden of violence against women, and how and why the health system is so important in addressing this issue.


Research

Support

Development

An inter-agency working group led the curriculum development, pilot and evaluation. The project team included:

  • Kayli Wild, Judith Lumley Centre and Institute for Human Security and Social Change, La Trobe University, Darwin
  • Lidia Gomes, Department of Midwifery, Universidade Nacional Timor Lorosa’e, Dili
  • Angelina Fernandes, Department of Midwifery, Instituto Superior Cristal, Dili
  • Luisa Marcal, Psychosocial Recovery & Development in East Timor (PRADET), Dili
  • Guilhermina de Araujo, Judith Lumley Centre and Institute for Human Security and Social Change, La Trobe University, Dili
  • Angela Taft, Judith Lumley Centre, La Trobe University, Melbourne

Funding

The curriculum development and evaluation was funded by WHO Department of Reproductive Health and Research and a Rotary Global Grant (GG1867745).

The research was led by Kayli Wild under an Australian Research Council Discovery Early Career Research Award (DE17010454), with support from La Trobe University’s Transforming Human Society’s RFA grant and a La Trobe Asia grant.

Acknowledgements

Thank you to the many people and organisations in Timor-Leste who supported us in this work, including National Institute for Health (INS), Ministry of Health, Marie Stopes, The Asia Foundation Nabilan Program, Uma Pas, ALFeLa, Alola Foundation, FOKUPERS, MSSI, SEM/SEII, WHO, UNFPA, UNICEF, University lecturers and faculty leaders, and the women and midwives who shared their stories.

We are grateful to Leesa Hooker, La Trobe University, who assisted with pre-post test data analysis.

Support and referral

Learning about and working in the area of domestic and sexual violence can be difficult and it is normal to find some of the learning material upsetting. Please feel free to take a break or stop at any time and encourage your students or colleagues to do the same. If you or someone close to you has experienced or witnessed abuse in the past, this material may trigger trauma. If you feel distressed or want further support please consider contacting: