VIA-H - Violence against health care workers: understanding context through citizen science and measuring a de-escalation training intervention effectiveness in Eastern DRC and Iraq

This study investigates the effectiveness of a tailored violence de-escalation training for health professionals in combination with a set of publicly displayed violence-prevention rules at the health facility (e.g. posters with Code of Conduct for both health professionals and clients) on the incidence and severity of episodes of violence against healthcare workers. More specifically, with a transdisciplinary approach we will

  • Identify, triggers, causes and types of (non-military) violence against healthcare workers and to understand the underlying motivations of violence;

  •  Tailor a violence de-escalating training developed by ICRC to the local context and combine it with a structural intervention (code of conduct) at the facility level;

  • Implement and evaluate the effectiveness of the tailored intervention.

The study will include three phases to meet these objectives. Phase 1 is a formative study exploring triggers and underlying causes of violence by means of qualitative methods and through citizen science. Using a transdisciplinary approach involving community and health system stakeholders the proposed interventions will be tailored to the respective context. Phase 2 comprises a stepped-wedge randomized-cluster trial (SW-RCT) to assess the effectiveness of the de-escalation violence training in combination with the code of conduct on performance and health of healthcare workers; Phase 3 will estimate the financial and economic cost of implementing the intervention and its cost-effectiveness compared to no intervention. The study will be conducted in a rural site in Eastern DRC and in an urban site In Iraq. This study will provide guidance to further Interventions conducted in humanitarian settings aiming at reducing non-military violence in the healthcare system. More information on the study can be found under this link.

Involved Regions: Africa, Middle East and North Africa
Involved Countries: Iraq, Congo (the Democratic Republic of the)


Sonja Merten

Prof. Sonja Merten, MD, PD, PhD, MPH
Head of Unit


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