Mental health counselling for abused women women are generally subordinated and lack self- confidence, and professional mental health coun- selling services are absent, this initiative of training village-based paramedics in counselling for women exposed to violence looks sufficiently promising to warrant further testing. Further testing is needed for exploring how tangible is the achievement demon- strated here and what impact would it ultimately have on coping of women with violence. It should be noted that ICDDR,B’s paramedics are more quali- fied than the national health workforce function- ing at the village level. Thus, further research is also needed to explore the outcomes of implementing such services using the national health workforce. It is well-recognized that multiple factors at different levels (e.g. family, community, society) contribute to violence against women. Thus, counselling tar- geted towards abused women only without taking greater community and societal issues into account is bound to have limitations (20,22). Nevertheless, counselling of victims of violence against women offers an important step in managing this pervasive public health issue. This study offers some policy- relevant insights, which could be useful in initiat- ing services for the abused women, suggesting that even in the context of an absence of professional counsellors in the country, trained paramedics can serve as the first-line support in mental healthcare for women suffering mental and physical ill-health relating to violence against women. ACKNOWLEDGEMENTS The present study is a part of MINIMat study. The MINIMat research study was funded by United Na- tions Children’s Fund (UNICEF), Swedish Interna- tional Development Cooperation Agency (SIDA), UK Medical Research Council, Swedish Research Council, Department for International Develop- ment (DFID)–UK, Global Health, Research Fund- Japan, Child Health and Nutrition Research Initia- tive (CHNRI), Uppsala University, United States Agency for Internatioal Development (USAID), and ICDDR,B. The mental health counselling com- ponent of the study and its evaluation were fully funded by Swedish International Development Cooperation Agency (SIDA) abd Department of Research Cooperation (SAREC) through Interna- tional Maternal and Child Health, Uppsala Uni- versity, Uppsala, Sweden. ICDDR,B also gratefully acknowledges the following donors which provide unrestricted support to the Centre’s research efforts: Australian Agency for International Development (AusAID), Government of the People’s Republic of Bangladesh, Canadian International Development Volume 27 | Number 4 | August 2009 Naved RT et al. Agency (CIDA), Embassy of the Kingdom of the Netherlands (EKN), Swedish International Develop- ment Cooperation Agency (SIDA), Swiss Agency for Development and Cooperation (SDC), and Depart- ment for International Development (DFID), UK. REFERENCES 1. Counts DA, Brown J, Campbell J. Sanctions and sanc- tuary: cultural perspectives on the beating of wives. Boulder, CO: Westview Press, 1992. 268 p. 2. Naved RT, Azim S, Bhuiya A, Persson LA. Physical vio- lence by husbands: magnitude, disclosure and help seeking behavior of women in Bangladesh. Soc Sci Med 2006;62:2917-29. 3. García-Moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts C. WHO multi-country study on women’s health and domestic violence against women: initial results on prevalence, health outcomes and women’s responses. Geneva: World Health Organization, 2005. 206 p. 4. Ratner PA. The incidence of wife abuse and mental health status in abused wives in Edmonton, Alberta. Canadian J Public Health 1993;84:246-9. 5. McCauley J, Kern DE, Kolodner K, Dill L, Schroeder AF, DeChant HK et al. The “battering syndrome” prevalence and clinical characteristics of domestic violence in primary care internal medicine practices. Ann Intern Med 1995;123:737-46. 6. Golding JM. Intimate partner violence as a risk factor for mental disorders: a meta-analysis. J Fam Violence 1999;14:99-132. 7. Cascardi M, O’Leary KD, Schlee KA. Co-occurrence and correlates of posttraumatice stress disorder and major depression in physically abused women. J Fam Violence 1999;14:227-50. 8. Campbell JC, Kub J, Belknap RA, Templin T. Predic- tors of depression in battered women. Violence Against Women 1997;3:271-93. 9. Campbell R, Sullivan CM, Davidson WS. Women who use domestic violence shelters: changes in de- pression over time. Psych Women Q 1995;19:237-55. 10. Campbell JC, Soeken K. Women’s responses to bat- tering over time: an analysis of change. J Interpers Vio- lence 1999;14:21-40. 11. Silva C, McFarlane J, Soeken K, Parker B, Reel S. Symptoms of posttraumatic stress disorder in abused women in a primary care setting. J Women’s Health 1997;6:543-52. 12. Ellsberg M, Caldera T, Herrera A, Winkvist A, Kullgren G. Domestic violence and emotional distress among Nicaraguan women: results from a population-based study. Am Psychol 1999;54:30-6. 489