ArticleHealth expectations : an international journal of public participation in health care and health policy2026
Survivor Expectations and Experiences of One-Stop Crisis Centres in Bangladesh: A Qualitative Study of Health System Responsiveness to Gender-Based Violence.
Article in Health expectations : an international journal of public participation in health care and health policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGender-based violence (GBV) constitutes a significant public health concern that necessitates coordinated, survivor-centred health system responses. Health systems are essential in addressing GBV by delivering timely, respectful, and coordinated support to survivors. In Bangladesh, One-Stop Crisis Centres (OCCs) have been established within public hospitals to provide integrated medical, psychosocial, and legal services. However, there is limited research on how survivors evaluate these services and whether their expectations for survivor-centred care are fulfilled in practice. This study explored the perspectives of survivors and frontline providers regarding OCC services, with a specific focus on health system responsiveness.
methodsThis qualitative study explored the experiences and expectations of survivors and service providers regarding OCC services in Bangladesh. In-depth interviews were conducted with GBV survivors (n = 32) and frontline service providers (n = 4) at two sites. Data were analysed using reflexive thematic analysis, guided by a health system responsiveness framework lens and the gender-responsive public services framework (availability, accessibility, acceptability, quality, and accountability) to explore how institutional practices shape survivor-centred care.
resultsFive interrelated themes emerged. Survivors demonstrated limited awareness of OCC services before crisis events, with access frequently facilitated by police or emergency referrals. Institutional capacity constraints, such as staffing shortages and inadequate infrastructure, negatively impacted the timeliness of care. Experiences related to dignity and privacy were inconsistent. Some survivors reported supportive interactions, whereas others described judgmental questioning and breaches of confidentiality. Fragmented coordination among medical, legal, and social services disrupted the continuity of care. The absence of formal feedback mechanisms restricted opportunities for survivors to contribute to service improvement.
conclusionsAlthough OCCs constitute a significant institutional response to GBV care and the realities of service delivery. Enhancing awareness pathways, improving intersectoral coordination, and establishing survivor-centred accountability mechanisms could improve the responsiveness of integrated GBV services.
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