Circular No. 24/2017/TT-BYT on the procedures for receiving, providing medical care, and statistics and reporting for patients who are victims of domestic violence at healthcare facilities

CIRCULAR

REGULATIONS ON PROCEDURES FOR RECEIVING, PROVIDING HEALTH CARE AND STATISTICAL REPORTS FOR DOMESTIC VIOLENCE VICTIMS AT MEDICAL FACILITIES

FOR TREATMENT

Pursuant to the Law on Prevention of Domestic Violence dated November 21, 2007;No.Pursuant to Decree No. 63/2012/NĐ-CP dated August 31, 2012 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health; lThe Minister of Health issues this Circular prescribing procedures for receiving, providing health care for domestic violence victims and statistical reports on domestic violence victims at medical facilities.

This Circular prescribes procedures for receiving, providing health care for domestic violence victims and statistical reports on domestic violence victims at medical facilities.

The scope of professional activities of medical practitioners includes specialized techniques that they are permitted to perform as stipulated in this Circular.

AND trThis Circular applies to state-owned and private medical facilities in accordance with the Law on Medical Examination and Treatment.No.PROCEDURE FOR RECEIVING AND PROVIDING HEALTH CARE FOR DOMESTIC VIOLENCE VICTIMS AT MEDICAL FACILITIES

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

Article 3. Receiving Patients

Article 2. Applicability

1. Victims of domestic violence are received for emergency treatment, examination, and therapy at medical facilities in accordance with the laws on medical examination and treatment.

Chapter II

2. When receiving other patients for examination and treatment at medical facilities, during the examination and medical history taking process, if there is suspicion that the patient may be a victim of domestic violence, doctors and healthcare staff (collectively referred to as medical practitioners) must conduct screening interviews to identify domestic violence victims in accordance with Article 4 of this Circular.

Article 4. Screening to Identify Domestic Violence Victims

1. Patients must be screened and interviewed in a private, quiet place (a separate examination room), without family members present to ensure objectivity and safety when providing information. In cases where emergency patients cannot answer the interview questions, the interview will be conducted after the patient has been stabilized.

2. Medical practitioners must pay attention to identifying signs and symptoms of physical, mental, and sexual abuse of the patient; examining the relationship between the patient's condition and their disclosure about the cause of the injury. If the patient wishes to conceal the fact of being abused, medical practitioners and healthcare staff must encourage the patient to disclose.

3. Medical practitioners must adhere to confidentiality regarding the information disclosed by the patient during the screening, examination, and treatment processes.

Article 5. Recording Information Form for Domestic Violence Victims

1. If the patient discloses or confirms they are a domestic violence victim upon arrival at the medical facility or after screening, doctors and healthcare staff must record relevant information on the Recording Information Form for Domestic Violence Victims according to the model prescribed in Appendix No. 1 attached to this Circular.

2. The Recording Information Form for Domestic Violence Victims is assigned a medical record number and kept together with the inpatient medical records for patient monitoring and statistical reporting on domestic violence.

2. Physicians must pay attention to identifying signs and symptoms indicating physical, mental, and sexual abuse of patients; they should consider the relationship between the patient's condition and the disclosure of the cause of such harm by the patient. In cases where the patient wishes to conceal the fact of violence, physicians and healthcare staff must encourage the patient to disclose.

3. Physicians must adhere to confidentiality principles regarding information disclosed by patients during screening, examination, and treatment.

Article 5. Recording Information Form for Victims of Domestic Violence

1. When a patient discloses or confirms being a victim of domestic violence upon arrival at a medical facility or after screening, physicians and healthcare staff must record relevant information on the Recording Information Form for Victims of Domestic Violence according to the model specified in Appendix 1 attached to this Circular.

2. The Recording Information Form for Victims of Domestic Violence shall be assigned a medical record number and kept with the inpatient's medical file for monitoring the patient and statistical reporting on domestic violence.

Article 6. Medical care and support for victims of domestic violence at healthcare facilities with inpatient beds

1. Victims of domestic violence shall be examined and treated according to general regulations applicable to all patients and the following specific provisions:

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

b) Patients must undergo a comprehensive examination to avoid overlooking physical, mental, and sexual injuries related to domestic violence and ensure that all physical and mental injuries of the patient are properly treated.

c) Patients shall be evaluated comprehensively based on signs of physical, mental, and sexual injuries and other relevant signs. In this regard, physicians need to pay attention to recognizable symptoms and signs of violence, thereby adopting appropriate treatment methods.

d) The results of the examination must be recorded fully, ensuring that no necessary information is omitted.

e) In cases where the patient's injuries exceed the scope of expertise of the facility, the patient must be referred to another healthcare facility in accordance with Circular No. 14/2014/TT-BYT on the referral process between healthcare facilities.

3. When identifying a patient as a victim of domestic violence, physicians and healthcare staff must cooperate with the social work department, team, or social worker of the hospital to provide counseling to the patient in accordance with Article 8, Chapter II of this Circular and the guidance provided in Circular No. 43/2015/TT-BYT on the tasks and organizational forms of social work in hospitals.

4. Arranging temporary shelter:

a) Hospitals and clinics with inpatient beds, depending on their capacity and actual conditions, shall arrange temporary shelter for victims of domestic violence at the facility for up to 24 hours upon the request of the victim. If a commune health station has sufficient conditions to ensure safety for both the patient and healthcare staff, it may arrange temporary shelter for up to 24 hours or transfer the patient to community temporary shelters or accommodations.

b) Provide beds, clothing, and bedding for victims as if they were inpatients under observation.

c) During the period of temporary shelter, if the victim does not have family members to support them and cannot take care of themselves, the healthcare facility shall assist with meals according to its capacity and actual conditions.

d) Notify the nearest police authority to develop a plan to ensure safety and security for the victim, physicians, and healthcare staff.

e) If the temporary shelter period has expired but the victim still requires assistance with temporary shelter, depending on the facility's capacity and actual conditions, the healthcare facility shall consider one of the following options:

- Continue to arrange temporary shelter for the victim at the healthcare facility.

- Contact and request assistance from organizations providing support to victims of domestic violence to accept and arrange temporary shelter for the victim at an appropriate location.

Article 7. Medical care for patients who visit healthcare facilities without inpatient beds

1. Victims of domestic violence shall be examined and treated according to general regulations applicable to all patients.

2. Implement examinations and treatments for victims of domestic violence in accordance with the guidelines set out in Clause 2 and Clause 3 of Article 6 of this Circular.

3. Healthcare facilities shall be responsible for notifying and coordinating with the police, People's Committee of the commune or ward where the facility operates or where the domestic violence occurred, to ensure safety for healthcare staff and victims during treatment at the healthcare facility; notify and coordinate with the People's Committee of the commune where the domestic violence occurred to provide urgent assistance to meet the essential needs of victims in accordance with the law on preventing and combating domestic violence.

4. Contact and request organizations providing support to victims of domestic violence to accept and arrange temporary shelter for the victim at an appropriate location when requested by the victim.

Article 8. Discovery of Domestic Violence Acts with Criminal Indicators

1. During the process of receiving, screening, and providing medical care to patients, if acts of domestic violence with criminal indicators as defined in Articles 2 and 8 of the Law on Prevention and Control of Domestic Violence are discovered, medical doctors and healthcare staff shall report to the head of the medical examination and treatment facility.

2. The head of the medical examination and treatment facility shall be responsible for reporting in writing, by telephone, or by sending someone directly to report to the nearest police station or the police station where the patient resides regarding acts of domestic violence with criminal indicators and requesting the police to take measures to support and ensure safety for victims of domestic violence.

Article 9. Counseling Necessary Services for Patients Who Are Victims of Domestic Violence

1. Medical doctors and healthcare staff shall directly counsel patients about their rights and legitimate benefits available from the medical examination and treatment facility, such as providing temporary shelter; reducing or waiving medical examination and treatment fees (if applicable); health insurance benefits; issuing certificates confirming the examination and treatment of victims of domestic violence.

2. Providing informational materials, promotional materials in the form of short files, pamphlets, small books, posters, short films about domestic violence; prevention and control of domestic violence; rights, legitimate benefits, and other supportive information for patients.

3. Medical doctors and healthcare staff shall present treatment options and preventive measures, assist patients in making choices, and allow patients to make their own decisions with a friendly attitude and without judgment.

4. Introducing and referring patients to assistance facilities for victims of domestic violence or related agencies and organizations such as the police, local authorities, associations, and mass organizations for assistance.

Article 10. 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. The medical examination and treatment facility that has received and provided medical care to victims of domestic violence shall issue a certificate confirming the examination and treatment of the patient according to the model specified in Appendix 2 issued together with this Circular.

Article 11. Costs of Examination and Treatment for 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 of examination and treatment at medical examination and treatment facilities for victims of domestic violence without health insurance shall be borne by the victim or their family. Medical examination and treatment facilities are encouraged to consider reducing or waiving costs for victims of domestic violence in difficult circumstances who are unable to pay.

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 medical examination and treatment facilities.

Chapter III

STATISTICS AND REPORTING OF CASES WHERE PATIENTS ARE

VICTIMS OF DOMESTIC VIOLENCE AT FACILITIES

MEDICAL EXAMINATION AND TREATMENT

Article 12. General Provisions on Statistics and Reporting

1. Medical examination and treatment establishments shall record information about patients who are victims of domestic violence according to the model prescribed in Appendix 1 of this Circular for use as input data for statistics and reporting.

2. The statistical and reporting forms for cases where patients are victims of domestic violence applicable to medical examination and treatment establishments nationwide shall be implemented according to the model prescribed in Appendix 3 issued with this Circular.

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

4. Forms of Reporting:

a) Annual periodic reports.

b) Ad hoc reports upon request of competent state agencies.

5. 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, District Health Centers, and District Health Departments.

d) Regional multi-specialty clinics, Commune Health Stations, Ward Health Stations.

đ) Private medical examination and treatment establishments nationwide.

Article 13. 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. Health Departments of Ministries and Sectors are responsible for compiling, collecting, and processing statistical data and reports on cases where patients are victims of domestic violence at medical examination and treatment establishments under their respective Ministries and Sectors.

4. District Hospitals (District Health Centers with medical examination and treatment functions) are responsible for collecting, processing, compiling, and managing all statistical data and reports on cases where patients are victims of domestic violence at district-level medical examination and treatment establishments.

5. Commune Health Stations and Ward Health Stations are responsible for organizing the implementation of initial recording and statistics and reporting of cases where patients are victims of domestic violence at their stations.

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

ORGANIZATION AND IMPLEMENTATION

Article 14. Responsibilities of Heads of Medical Examination and Treatment Establishments

1. To implement procedures for receiving and providing healthcare to patients who are victims of domestic violence as stipulated in this Circular.

2. To establish communication corners (materials, information, images) about domestic violence and available services to assist and provide healthcare to patients who are victims of domestic violence at the medical examination and treatment establishment they oversee, in consultation rooms or other suitable locations within the establishment.

3. To organize training and capacity building for staff on receiving, providing healthcare, and counseling for patients who are victims of domestic violence for all doctors and healthcare personnel under their supervision.

4. To establish and maintain connections with competent state agencies, victim assistance establishments, and organizations and associations in the locality to promptly coordinate support and protect patients who are victims of domestic violence.

5. To store patient information and records of victims of domestic violence appropriately, ensuring accessibility when needed; to organize statistics and reporting of cases where patients are victims of domestic violence in accordance with regulations.

Article 15. Funding for the implementation of family violence prevention and control work

Annually, based on the programs and plans for family violence prevention and control issued by the competent state authorities at higher levels, medical examination and treatment facilities shall prepare budgets for their own family violence prevention and control activities in accordance with the provisions of the law.

Article 16. Responsibility for Organization and Implementation

1. The Department of Medical Examination and Treatment shall be responsible for:

a) Take the lead and coordinate with the Department of Maternal and Child Health and related Departments and Bureaus to direct, guide, and inspect medical examination and treatment facilities regarding the reception and healthcare services provided to patients who are victims of domestic violence at such facilities; take the lead and coordinate with the Department of Planning and Finance to compile and guide medical examination and treatment facilities in implementing statistics and reports on cases of patients who are victims of domestic violence.

b) Take the lead in developing materials, guidelines, and organizing training sessions on the procedures for receiving and providing healthcare services to patients who are victims of domestic violence at medical examination and treatment facilities.

2. The Health Departments of provinces and centrally governed cities, and health departments of ministries and sectors shall be responsible for:

a) Directing medical examination and treatment facilities under their jurisdiction to comply with the provisions of this Circular.

b) Organizing training and training sessions on the procedures for receiving and providing healthcare services to patients who are victims of domestic violence at medical examination and treatment facilities within their jurisdictions.

Chapter V

IMPLEMENTING PROVISIONS

Article 16. Effective Date

This Circular shall take effect from July 7, 2017.

Circular No. 16/2009/TT-BYT dated September 22, 2009, guiding the reception, healthcare services, and statistical reporting for patients who are victims of domestic violence at medical examination and treatment facilities shall cease to be effective from the date this Circular takes effect.

Article 17. Responsibility for Implementation

Heads of relevant agencies, organizations, and units are responsible for organizing the dissemination, promulgation, and implementation of this Circular. Any difficulties encountered during the implementation should be promptly reported to the Ministry of Health (Department of Medical Examination and Treatment) for research and resolution./.