Table 2 Policy guidance and other OSCC key elements

Policy support

1996 directive of Ministry of Health to develop a specific directive to manage abuse cases in general.

Aim: to have a place where all services could converge so that the woman would not need to go to different places.

Types of GBV: OSCC should provide services to women and children for any type of violence they experienced.

Main role of the hospital: to provide a place for the OSCC within the Emergency Department where victims could be referred to when they didn’t need emergency medical treatment.

Available clinical guidelines

MOH developed a protocol on the management of rape that was disseminated to all hospitals.

Guidelines for the hospital management of child abuse and neglect were published by the Ministry of Health Malaysia in 2009. Clinical practice guidelines (management of child abuse and neglect) are also available.

A flow chart for child abuse is also available in public hospitals. No specific protocol or procedures have been developed specifically for IPV cases.

Specific guidelines on the management of GBV cases - coming through OSCCs - were developed by the Kuala Lumpur Hospital (HKL) in 1994, and to be later used in all hospitals around Malaysia. However, not many hospitals are using these specific guidelines, but would use instead specific clinical protocols for rape and child abuse contained in these guidelines.

Effort is currently being made by HKL to develop Clinical Practice Guidelines (CPG) for OSCCs by the end of 2012 (Wong 2011).

At the same time, in 2011, the Malaysian Department of Social Welfare developed a document to ensure multi-sectoral cooperation when handling cases of domestic violence (Siti Hawa Ali - direct communication).

Training

Besides a national training course offered annually by the hospital Kuala Lumpur, very few specific courses are available in other States (e.g. Kelantan, Kuantan, Pahang), which focus primarily on forensic evidence and medical intervention. With the exception of Kelantan’s main tertiary hospital, the training courses do not run annually, have a limited number of participants, are often offered by specialised hospitals, and only few providers can attend them.

Services provided

Based on a multi-sectoral approach, OSCC provides comprehensive services such as counselling, medical care, support services, police and collection of forensic evidence, legal aid and temporary shelter, all in one site. Counselling is often offered on site by medical social workers at specialised hospitals, and upon referral by women’s NGOs or social workers from the Department of Social Welfare. Internal referral systems are created to refer cases from OSCCs to other specialised services on-site; while an interagency network including police and social workers is crucial for external referrals.