The training began at 9.30 AM. It is now 6 PM. Yet one doesn’t see any rush among the trainees to hurry home. Instead, the trainees wait eagerly to share their learning experiences. The trainees are health workers from Ch. Sambhajinagar’s Gangapur and Paithan Talukas and from among the 278 health staff who had previously attended MASUM Udaan’s training on domestic violence (DV), prior to the launch of the project in June 2025. Now, in April 2026, these health workers are attending the refresher training on domestic violence. These health workers are from among 13 PHCs, 2 Rural Hospitals, 1 Sub-District Hospital, or the Health Unit Paithan.

These health workers are vocal about how much they learned from the training and how they enjoyed being part of it. They eagerly click photos as memories of their participation in the exercise. Not rushing home after work is by itself a certificate of how much they value being part of this training and project.

They share that the training has provided practical information that will help them in their work to help address and respond to domestic violence and to effectively aid women survivors of such violence. Trainees also share how they understood concepts like patriarchy and gender discrimination which they were not familiar with before.

Udaan’s activities to address and prevent domestic violence against women have commenced since the last 10 months. In the initial training, the health workers were oriented with aspects like how to identify a DV survivor and how to provide survivors with counselling using the LIVES protocol (Listen, Inquire, Validate, Ensure Safety and provide Support). The health facilities participating in Udaan have, till the end of March 2026, provided assistance to 538 DV survivors through the efforts of these health workers and others like them from the participating facilities.

The refresher training held in April aims at improving the effectiveness of health workers in addressing and preventing issues of domestic violence against women. Rather than conducting the refresher training in the form of revision of previously explained concepts, the training focused on hearing and understanding the experiences of these health workers, the challenges they faced, and how they overcame such challenges. Group discussions were held and health workers were able to share issues like the stress related to assisting DV survivors, managing to maintain confidentiality of the survivors, legal issues that can crop up, and other such concerns. Not just limited to Group Discussions, the training led to self-introspection and arrival at solutions that can strengthen systems for effectively tacking the DV issue. 

The DV survivor identification numbers for the various participating health-care facilities are depicted in the following bar graph:

Udaan trainings are characterized by the informal and playful environment created to put the participants at ease. Participants feel free to share their personal and professional issues. They don’t hesitate to ask their doubts. This leads to all sessions becoming interactive with active participation of all those present. 

The session began with participants sharing their challenges and learnings.  The first training had changed their mindset about DV being a private or personal matter. Many shared that they experienced satisfaction when they were able to help DV survivors in dire situations.  But, among the challenges, they voiced the concern that DV survivors are often reluctant to leave their homes despite the violence.

To better understand why DV survivors are unable to take drastic steps and actions, the context of DV needs to be understood. The training therefore emphasized that DV takes place in the context of patriarchy, gender discrimination, social orientation on gender roles, and gender hierarchy. Thes concepts were emphasized using games, examples, group activities, and documentaries. The difference between biological and social gender was explained to demonstrate how violence against women stems from gender discrimination. 

The root cause of gender discrimination is patriarchy. Patriarchal societies tend to link a woman’s identity and stature in society with her marital status and motherhood. Being a mother and mother of a son grants a woman a higher stature in patriarchal circles. Women who do not have husbands or sons are often discriminated against. Patriarchal systems negate a woman’s right to education or to be financially independent. Controls are placed on a woman in several ways. Her access to education, what she is allowed to say, how she dresses--are all controlled. Barriers are placed on her travel and freedom in general. This prevents the woman from growing as a human. These limitations placed on a woman reduce her self-confidence and ability to protect herself. This makes the women more vulnerable to becoming targets of violence.

The training also discussed the impact of patriarch on men as well. Patriarchy also places certain limitations on men. Men are often curtailed from showing their emotions or showing their sensitivity. Participating women agreed that patriarchy also conditions men to behave in a particular way.

The CEHAT-produced documentary “Marz, Mareez, Majboori” explains patriarchy through humour and satire. Modern medicine provides for treatment procedures for different ailments. The documentary shows how the experience of accessing health care and outcomes of treatment can differ for different individuals with different circumstances. For example, a woman, a disabled person, or a labourer would all have different experiences about accessing health care, receiving proper treatment, getting suitable nutrition, and getting rest. The documentary was able to portray that the same system can be experienced very differently according to gender and social circumstances.

The training also had health workers presenting information on the various DV survivor cases they handled.  Group activities were assigned with a view to help health workers understand non-obvious signs for identifying DV survivors. For example, constant visits with complaints like headache and weakness could be non-obvious signs of DV. The mechanisms to overcome challenges faced while addressing DV issues were also discussed.  For ensuring confidentiality, strategies like sending the accompanying person to fetch medicines or bringing the suspected survivor to a private space for giving injections, etc, can be adopted. It was also suggested that the survivors should not just be given the contact numbers of the services like the Sakhi One-Stop Centre or the Shakti Sadan but be directly connected these services through personal referrals through phone calls.

DV survivors disclosing the violence they face often doesn’t occur instantly. Often, it requires repeated effort by the health worker so that an environment of trust is created. Only when the survivor feels safe and trust is built, will the survivor disclose the problem. The ‘validate’ aspect of LIVES is also very important in counselling a survivor. Participants learned that telling a survivor that she is not to blame for the situation helps her emotional and mental health in a big way. 

Certain decisions were arrived at during the training with a view to improve the readiness of the health system to aid DV survivors. These relate to the following topics:

Identifying survivors and check-ups:

• The OPD and ANC forms will have an additional question: “Do you have any additional comments or remarks?”
• An in-depth medical history will be taken for women who visit repeatedly with the same complaints and health issues.
• Posters with information on DV and helpline numbers will be displayed in the health facilities such that they are easily visible to all visitors.

Confidentiality and interaction with survivor:

• During ANC visits, accompanying relatives of the women will be asked to wait outside so that there is privacy for discussing issues.
• A suspected survivor will be escorted to a private space using reasons like giving injection or doing a thorough check up.
• When a woman reveals any issue, she will be believed and no doubt or distrust will be shown towards her words. There should be an affirmation saying “we believe you.”

Documentation:

• There will be timely entry of the DV survivor details in the Udaan register which will also record the survivor’s address and follow-up date of visit clearly.
• Documentation responsibilities will be assigned to specific staff members.
• Certain code words and symbols will be used for ensuring confidentiality. 

Multi-stakeholder coordination:

• There will be a fortnightly meeting to review DV issues.
• The survivor will not just be given phone numbers of support services like the Sakhi One-Stop Centre or the Protection Officer, but will be directly connected to these services through the facility.
• For better coordination, a WhatsApp group comprising the Nodal Officer, Protection Officer and topmost officials from the various support services.

Community intervention and awareness raising:

• ASHAs will aid in connecting survivors to the facilities and will also raise awareness about DV.
• At the village level, the “Healthy Village” campaign will prioritize the topic of becoming violence free.
• Efforts will be made to network with the local Police Patil, Sarpanch, and Women’s Committees.

Apart from this, the training also took account of the mental stress experienced by the health workers through a special session on dealing with stress. This session introduced the health workers to calming techniques like “Box Breathing” and “Grounding”.

The health system is no longer operating as only a medical treatment solution for DV survivors. Rather, it is now addressing the root cause of DV and guiding women to lead their lives with dignity and self-respect. The training has aimed not just at skill building but also at sensitizing the health workers to develop a compassionate mindset. This has improved the capacity of the health workers.