Circular No. 16/2009/TT-BYT guiding the reception, medical care, and statistics reporting for patients who are victims of domestic violence at healthcare facilities.

CIRCULAR

Guidelines for receiving, providing medical care, and statistics reporting for patients who are victims of domestic violence at healthcare facilities

at healthcare facilities

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Pursuant to the Domestic Violence Prevention and Control Law enacted on November 21, 2007;

Pursuant to the Government Decree No. 08/2009/NĐ-CP dated February 4, 2009 detailing and guiding the implementation of certain provisions of the Law on Prevention and Control of Domestic Violence;

Pursuant to Decree No. 188/2007/NĐ-CP dated December 27, 2007 of the Government on the functions, tasks, powers, and organizational structure of the Ministry of Health;

The Ministry of Health provides guidelines for receiving, providing medical care, and statistics reporting for patients who are victims of domestic violence at state and private healthcare facilities as follows:

PART I

RECEIVING PATIENTS WHO ARE VICTIMS OF DOMESTIC VIOLENCE

Article 1. Receiving Patients

Patients who are victims of domestic violence shall be received for emergency treatment, examination, and treatment at healthcare facilities in accordance with the provisions of the Law on Medical Examination and Treatment.

Article 2. Screening to Identify Victims of Domestic Violence

Clause 1. Screening:

Point a. When patients come to healthcare facilities for medical examination and treatment, during the examination process and when collecting medical history, doctors and healthcare staff must ask additional questions about domestic violence related to the patient's health condition to identify victims of domestic violence.

Point b. Doctors and healthcare staff must conduct screening for domestic violence in cases of patients with accidental injuries, household accidents; patients showing signs of domestic violence; female patients aged 15 years and above.

Clause 2. Principles of Screening:

Point a. Ensuring confidentiality and privacy of personal information of patients.

Point b. Conducting thorough and comprehensive examinations to avoid missing physical, sexual, and psychological injuries caused by acts of domestic violence.

Point c. Doctors and healthcare staff must have a considerate, supportive, friendly attitude, refrain from judgment, and frequently encourage patients.

Point d. Ensuring the safety of patients at healthcare facilities.

Clause 3. Pay attention to identifying signs and symptoms of physical, mental, and sexual abuse of patients; examine the relationship between the injury status and the patient's disclosure of the cause of the injury. In cases where patients want to conceal being subjected to violence, doctors and healthcare staff must encourage patients to disclose.

Clause 4. Patients should be interviewed without family members present to ensure privacy, objectivity, and safety when providing information. If patients are accompanied by family members, doctors and healthcare staff must separate the patient from the accompanying family member during screening to prevent interference with the screening process. In cases where emergency patients cannot answer the interview, the interview will be conducted after the patient has been stabilized.

Clause 5. Completing the Domestic Violence Victim Screening Form and Recording Information Form:

Point a. Doctors and healthcare staff must record the results on the Domestic Violence Victim Screening Form according to the model specified in Appendix 1 issued together with this Circular.

Point b. In cases where patients disclose or confirm that they are victims of domestic violence, after completing the Screening Form, doctors and healthcare staff must record relevant information on the Domestic Violence Victim Information Recording Form according to the model specified in Appendix 2 issued together with this Circular.

Point c. The Domestic Violence Victim Screening Form and Information Recording Form must be stored separately from the medical records but marked with a code number and recorded in the medical records to facilitate patient monitoring and statistics reporting on domestic violence.

Clause 6. Doctors and healthcare staff must provide counseling to patients in accordance with Article 5 of Chapter II of this Circular and explain to patients about the screening process to identify victims of domestic violence and their rights to protection when subjected to domestic violence to encourage cooperation with doctors and healthcare staff during the screening process.

Article 3. Discovery of domestic violence acts with criminal signs

1. During the process of receiving and providing medical care to patients, if domestic violence acts with criminal signs are discovered, upon discovery, medical doctors and healthcare staff have the responsibility to report to the head of the medical examination and treatment facility.

2. The head of the medical examination and treatment facility has the responsibility to report in writing, by telephone, or by sending someone directly to report to the nearest police agency about the domestic violence acts with criminal signs and request the police agency to take measures to support and ensure safety for victims of domestic violence.

Chapter II

MEDICAL CARE FOR PATIENTS WHO ARE VICTIMS OF DOMESTIC VIOLENCE

Article 4. Medical examination and treatment for patients who are victims of domestic violence

1. Patients who are victims of domestic violence shall be examined and treated according to general regulations applicable to all patients at medical examination and treatment facilities.

2. Requirements when examining patients who are victims of domestic violence:

a) Physicians must inquire thoroughly about the patient's history of domestic violence.

b) Conduct a comprehensive examination of the patient to avoid missing physical, mental, and sexual injuries related to domestic violence.

c) Evaluate the patient thoroughly based on signs of physical, mental, and sexual injuries and other related signs. In this regard, medical doctors need to pay attention to symptoms that can be identified and signs of violence, from which appropriate treatment methods can be determined.

d) Record the results of the examination comprehensively, ensuring that no necessary information is omitted.

3. Requirements when treating patients who are victims of domestic violence:

a) Ensure that both physical and mental injuries of the patient are treated correctly.

b) In cases where the patient is forced into sexual relations, the patient needs to be advised and provided emergency contraception as soon as possible. Under feasible conditions, female victims should be treated by female medical doctors. If the patient is pregnant unintentionally, the medical doctor needs to advise the patient to seek appropriate medical facilities for counseling and safe abortion services.

Article 5. Counseling on health care

1. Content of counseling:

a) Provide basic information to enhance the patient's awareness of domestic violence.

b) Advise the patient on how to care for, recover their health, and prevent illness.

c) Provide psychological counseling to the patient.

d) Introduce the patient to assistance facilities for victims of domestic violence or relevant agencies and organizations such as the police, local authorities, associations, and mass organizations for assistance.

đ) Inform the patient about their rights and legitimate benefits available from the medical examination and treatment facility, such as temporary shelter provision; exemption or reduction of medical examination and treatment costs (if applicable); health insurance policies; issuance of certificates confirming the examination and treatment of domestic violence victims.

2. Methods of counseling:

a) Medical doctors and healthcare staff provide direct counseling to the patient.

b) Provide informational materials, promotional materials in the form of short files, leaflets, small books, posters, short films about domestic violence; prevention and control of domestic violence; rights, legitimate benefits, and other supportive information for the patient.

c) Medical doctors and healthcare staff present options, assist the patient in making choices, and allow the patient to make decisions independently with a friendly attitude, without judgment.

Article 6. Arrangement of Temporary Shelter Locations

1. State medical examination and treatment facilities, depending on their capacity and actual conditions, shall arrange temporary shelter locations for patients who are victims of domestic violence at their facilities for a period not exceeding 01 day upon the request of the victim. Private medical examination and treatment facilities are encouraged to arrange temporary shelter locations for patients who are victims of domestic violence.

2. Bedding, clothing, and bedding covers shall be provided for victims as if they were inpatients receiving treatment.

3. During the temporary shelter period, if the victim has no relatives to support them and cannot provide for their own meals, the medical examination and treatment facility shall assist with meals according to the facility's capacity and actual conditions.

4. Medical examination and treatment facilities shall have the responsibility to notify and coordinate with public security agencies and People's Committees of communes where the facility operates or where domestic violence occurred to ensure the safety of doctors, healthcare staff, and victims of domestic violence during treatment at the facility; to notify and coordinate with the People's Committee of the commune where domestic violence occurred to provide urgent assistance to meet essential needs of victims of domestic violence when necessary, in accordance with laws on prevention and control of domestic violence.

5. In cases where the temporary shelter period has expired but the victim of domestic violence still requires support for a temporary shelter location, depending on the facility's capacity and actual conditions, the medical examination and treatment facility may consider and choose one of the following options:

a) Continue to arrange temporary shelter for the victim of domestic violence at the medical examination and treatment facility.

b) Issue a document requesting the People's Committee of the commune where the facility operates or where domestic violence occurred to accept and organize the arrangement of temporary shelter locations for the victim at appropriate victim assistance facilities in accordance with laws on prevention and control of domestic violence.

c) Contact and request appropriate victim assistance facilities to accept and arrange temporary shelter locations for the victim at suitable facilities.

Article 7. Costs for Examination and Treatment of Patients Who Are Victims of Domestic Violence

1. The costs of examination and treatment for victims of domestic violence shall be covered by the Health Insurance Fund for those who have health insurance in accordance with the laws on health insurance.

2. The costs for examination and treatment at medical examination and treatment facilities for victims of domestic violence without health insurance shall be borne by the victim themselves. Medical examination and treatment facilities are encouraged to consider waiving or reducing examination and treatment costs for victims of domestic violence in difficult circumstances who are unable to bear such costs themselves.

3. Medical examination and treatment facilities may accept financial support from individuals and organizations in accordance with the law to assist victims of domestic violence at these facilities.

Article 8. Confirmation of Examination and Treatment for Patients Who Are Victims of Domestic Violence

1. Victims of domestic violence may request confirmation of their examination and treatment from the medical examination and treatment facility if they submit a written request.

2. Medical examination and treatment facilities that have received and provided medical care to victims of domestic violence shall issue a Certificate confirming the examination and treatment of patients who are victims of domestic violence in accordance with the model prescribed in Appendix 3 issued together with this Circular.

Chapter III

STATISTICS AND REPORTING OF CASES OF PATIENTS WHO ARE VICTIMS OF DOMESTIC VIOLENCE AT MEDICAL EXAMINATION AND TREATMENT FACILITIES

Article 9. General Provisions on Statistics and Reporting

1. Statistical forms and reports on cases of patients who are victims of domestic violence applicable to all medical examination and treatment facilities nationwide shall be implemented according to the model prescribed in Appendix 4 issued together with this Circular.

2. The publication and storage of statistical data on cases of patients who are victims of domestic violence shall be carried out in accordance with current legal regulations.

3. Forms of reporting:

a) Periodic reports every six months and annually.

b) Ad hoc reports upon the request of competent state authorities.

4. Reporting System:

a) Central level: Ministry of Health (Department of Medical Examination and Treatment Management).

b) Provincial level and equivalent: Department of Health, Health Departments of Ministries and Sectors.

c) District level: District hospitals or district health centers with functions of medical examination and treatment.

d) All medical examination and treatment facilities nationwide.

Article 10. Responsibilities for Statistics and Reporting

1. The Department of Medical Examination and Treatment:

a) To develop, direct, and guide activities related to statistics and reporting of cases where patients are victims of domestic violence nationwide.

b) To organize inspections, supervision, and evaluation of statistics and reporting activities of cases where patients are victims of domestic violence nationwide.

c) To compile, collect, process statistical data and reports on cases where patients are victims of domestic violence from medical examination and treatment establishments under the Ministry and nationwide.

2. Provincial Department of Health:

a) To guide, organize inspections, supervision, and evaluation of statistics and reporting activities of cases where patients are victims of domestic violence at local medical examination and treatment establishments.

b) To compile, collect, and process statistical data and reports on cases where patients are victims of domestic violence at local medical examination and treatment establishments.

3. Ministries and sectors shall be responsible for compiling, collecting, processing statistical data and reporting cases of patients who are victims of domestic violence at medical facilities under their ministries and sectors.

4. District hospitals (District Health Centers with functions of diagnosis and treatment) shall be responsible for collecting, processing, compiling, and managing all statistical data and reports on cases of patients who are victims of domestic violence at medical facilities within the district.

5. Commune health stations shall be responsible for organizing the implementation of initial recording systems and statistics and reporting on cases of patients who are victims of domestic violence at the station.

6. Nationwide medical examination and treatment establishments have the responsibility to conduct statistics and reporting of cases where patients are victims of domestic violence at their establishments.

Chapter IV

IMPLEMENTATION

Article 11. Responsibilities of Heads of Medical Facilities

1. Organize the implementation of receiving and providing medical care to patients who are victims of domestic violence in accordance with this Circular.

2. Arrange temporary shelters for patients who are victims of domestic violence in accordance with this Circular.

3. Organize the display and provision of materials and information about domestic violence and available services to assist and provide medical care to patients who are victims of domestic violence at the medical facility they manage.

4. Develop and guide detailed procedures for receiving, providing medical care, and appropriate behavior towards patients who are victims of domestic violence to apply at the medical facility they manage based on the guidance of this Circular.

5. Organize training and capacity building in the areas of receiving, providing medical care, and counseling for patients who are victims of domestic violence for all doctors and healthcare staff under their management.

6. Establish and maintain relationships with competent state agencies, organizations assisting victims of domestic violence, and associations and mass organizations in the locality to promptly coordinate support and protect patients who are victims of domestic violence.

7. Maintain records of each case of domestic violence; organize statistics and reporting on cases of patients who are victims of domestic violence in accordance with regulations.

Article 12. Rights and Responsibilities of Doctors and Healthcare Staff

1. Doctors and healthcare staff are protected by law during the process of providing medical care and supporting patients who are victims of domestic violence at medical facilities.

2. Doctors and healthcare staff have the responsibility:

a) To comply with the provisions of this Circular during the process of receiving and providing medical care to patients who are victims of domestic violence at medical facilities.

b) To keep personal information of patients who are victims of domestic violence confidential.

c) To interact appropriately with patients who are victims of domestic violence with empathy, friendliness, encouragement, and without judgment.

d) To participate in relevant training sessions on domestic violence.

đ) To monitor and evaluate the immediate safety of patients who are victims of domestic violence, their children, and predict related health consequences when conducting screening examinations.

Article 13. Funding for Domestic Violence Prevention and Control Work

Annually, based on the program and plan for preventing and controlling domestic violence from higher-level competent state agencies, medical facilities shall budget funds for their own domestic violence prevention and control work in accordance with the law.

Article 14. Responsibility for implementation

1. The Department of Medical Examination and Treatment shall take the lead and coordinate with the Department of Maternal and Child Health and other relevant Departments and Bureaus to direct, guide, and inspect medical facilities regarding the reception and provision of medical care to patients who are victims of domestic violence at medical facilities; take the lead and coordinate with the Department of Planning and Finance to compile and guide medical facilities in implementing statistics and reporting on cases of patients who are victims of domestic violence.

2. Provincial and municipal health departments directly under the central government, and health departments of ministries and sectors shall be responsible for directing medical facilities in their localities and sectors to implement the provisions of this Circular.

Chapter V

IMPLEMENTING PROVISIONS

Article 15. Effective Date

This Circular shall take effect 45 days from the date of issuance.

Article 16. Responsibility for Implementation

Heads of relevant agencies, organizations, and units shall be responsible for organizing the dissemination, promulgation, and implementation of this Circular to ensure that the relevant parties are aware and comply. In the course of implementation, if there are difficulties, they should promptly report to the Ministry of Health for review and amendment as necessary./.