Madrid, 20 November 2025
The health sector’s response to violence against women and girls is critically inadequate, leaving millions of survivors without access to life-saving and time-sensitive medical and psychological care. This is the stark finding of a landmark new report from WHO/Europe.
Launched at a high-level event hosted by Spain’s Ministry of Health in Madrid, the report “Care, courage, change: health sector leadership in ending violence against women and girls” highlights that a staggering 28.6% of women and girls in the WHO European Region 15 years and older will experience physical and/or sexual violence in their lifetime. Despite this widespread public health crisis, health systems in most countries are failing to mandate the full, essential package of care recommended by WHO.
“Violence against women and girls is at crisis levels, and our health systems are often the first, and only, point of contact for survivors,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.
“Our data show that political commitments to protect the health and well-being of women and girls and end gender-based violence are not translating into safe and accessible care. Health systems are letting survivors down at their most vulnerable moment. Politicians need to move beyond lip service and fully implement the WHO-recommended package of care, especially time-sensitive post-rape services and access to safe abortion,” Dr Kluge added.
Key findings
The report highlights significant policy gaps in essential health services that should immediately be made available to survivors of sexual assault and/or intimate partner violence.
Of the 53 Member States in the Region:
- only 7 (13%) offer safe abortion services
- only 17 (32%) offer emergency contraception
- only 17 (32%) offer HIV post-exposure prophylaxis
- only 20 (38%) offer prophylaxis for sexually transmitted infections
- only 20 (38%) offer mental health assessment
- only 23 (43%) offer mental health referrals.
In addition, nearly one third of countries (32%) still require health-care workers to report domestic or intimate partner violence to police without the consent of adult survivors. WHO strongly advises against this practice because it violates survivor autonomy, breaches confidentiality and has been known to deter women from seeking help.
The report also notes some areas of progress and hope. For example, 75% of countries in the Region have policies supporting the training of health professionals on violence against women and girls. This reflects a growing recognition of the health sector’s role in identification, response and referral.
In addition, more than two thirds (68%) of countries now include first-line support for survivors – a minimum standard of compassionate, nonjudgmental care. However, the lack of clinical resources and political will to mandate the full package of essential services undermines this progress.
“As someone who has worked closely with survivors for many years, and as a survivor myself, I know how critical it is that every part of the health system responds with compassion and competence,” said Ms Melanie Hyde, the report’s author and WHO/Europe’s Gender, Equality and Human Rights Technical Officer.
She continued, “We know that survivors will use health services for conditions related to violence, even if they do not disclose that to health providers. That is why it is so important for health workers across all levels of the health system to learn about the different forms of violence, their health impacts and how to respond in a nonjudgmental way. Simply hearing ‘I believe you and I am here to help’ from a trusted health worker can go a long way in the healing process.”
Immediate action needed
WHO/Europe is calling on Member States to immediately take the following 3 actions.
- Mandate the full package of essential services: Ensure national health policies explicitly require the provision of the full WHO-recommended package of care, especially time-sensitive post-rape services.
- Remove barriers to care: Eliminate policies that undermine survivor-centred care, most urgently by removing blanket mandatory reporting requirements that require health workers to report adult survivors to police without their consent.
- Invest in implementation: Mobilize resources to ensure that more than half of countries that currently lack the full package of essential health services adopt them immediately.
Dr Mónica García, Health Minister of Spain, explained, “In Spain, we have sought to make primary health-care one of the key pathways to identify violence against women and girls and offer appropriate treatment and support. This is because primary health care is where many women come into contact with the health system for the first time.”
She added, “We are strengthening systematic screening, specialized training for professionals, and coordination with judicial, forensic and social resources. In this way, we guarantee a consistent, empathetic health response focused on their safety and recovery.”
A survivor from the United Kingdom attending the launch event in Madrid shared, “A health system that is built around our rights and needs as women and girls is a health system that will enable us all to thrive. I believe I have the right to be safe, to not to be harmed by telling you what has happened to me, to be valued as the person who knows most about my experience, to have a voice, and choice, to be at the heart of your response, to be treated justly and fairly, with compassion and respect, and to expect accountability for your decision-making.”
Dr Kluge concluded, “My message to every health worker is clear: we can no longer be bystanders to the public health crisis of gender-based violence. People in power must now translate commitments into funded action and ensure that every woman and girl is met with essential life-saving care, dignity and choice. We have the knowledge; now let’s summon the courage to make the health sector the first responder that every survivor deserves.”
About the report
The new report analyses 241 policies across the 53 Member States in the Region, providing a roadmap for the health sector to strengthen its role within the multisectoral system of prevention and response to violence against women and girls.