The Health System and Women Experiencing Violence. The Dedicated Pathway in Emergency Departments in Italy and the Experience in the City of Rome

Abstract

Violence against women (VAW) is a global public health problem and the health sector has an especially important role to play, considering the serious health risks faced by women (WHO, 2013, 2021). Women who experience violence are, more than others, at risk of acute and chronic health problems, as well as premature death. Medical services - especially Emergency Departments (EDs) - play a crucial role in a system that aims to intercept VAW at an early stage (Walby 2014) and guarantee women's fundamental rights (Re, 2019). In 2017, Italy approved National Guidelines for healthcare and Hospital Organizations on emergency and socio-healthcare assistance for women experiencing violence World Health Organisation (WHO) and national policy guidelines state that healthcare providers must develop integrated and multidimensional responses to intervene in cases of violence. The study aims to draw attention to the implementation of the guidelines because of two reasons. The first one is that no systematic assessment has yet been conducted to determine how effectively they are being applied. The second one is about how an integrated and multidimensional response can be developed in a complex setting such as an EDs to support women experiencing violence. The ongoing research makes use of desk and field research. Regarding the desk analysis, the study used technical reports and scientific literature to reconstruct the origins, characteristics and goals of national guidelines. The field research was conducted in Rome, because of its historical significance as one of the longest-running experiences of this kind in Italy. The case was studied by analysing documentation and conducting field interviews with three anti-violence association referees present in the EDs and by visiting their EDs workplaces. This contribution presents selected findings. Specifically, it: outlines the objectives of the National Guidelines; reconstructs the heterogeneity of organisations operating in the city of Rome; examines three experiences of healthcare services that host anti-violence practitioners; highlights critical issues in the implementation of integrated and sustainable measures; emphasises the need for stronger engagement by regional and hospital authorities to ensure that the Guidelines can fulfil their potential within broader policies to combat male violence against women.