Violence against women and girls (VAWG) is a societal problem with serious long-term health, social and economic repercussions. Reaching epidemic proportions, 1 in 3 women will experience violence in their lifetime. Some countries are disproportionately and significantly impacted, such as Albania and Brazil, where violence against women and girls affects 53% and 41% of women, respectively.

Health sectors are often the first point of contact of survivors or victims and can positively influence their short- and long-term life trajectories. Yet, the majority of health systems lack systematic detection and referral protocols for VAWG. Every time a woman or girl suffering from VAWG attends a health service and is not detected, treated adequately or referred, it constitutes a missed opportunity. These missed opportunities lead to longstanding health, psychological, social and economic consequences that have global implications.

The MISSOP study will apply a combination of epidemiology, ethnography, social and system sciences to understand the scale and determinants of missed opportunities to respond to violence against women and girls in primary care and emergency departments in Tirana, Albania and Belo Horizonte, Brazil.

To achieve this, the study team will answer the following questions:

• How often do missed opportunities to detect and respond to violence against women and girls happen in the health sector?
• What are the reasons behind these missed opportunities?
• How can we ensure that the health sector doesn’t miss any opportunity to respond to violence?

The study will generate policy-relevant and actionable evidence on the best strategy to address missed opportunities for responding to VAWG in the health sector. It will base its process on a robust transdisciplinary approach. The authors are convinced that the longstanding partnership with governmental and global institutions built in this consortium will contribute to the national and international policy debate for action.