A Harden framework evaluation of gender-based violence and trauma in German public health curricula

Background

European Institute for Gender Equality (EIGE) data shows 26% of women in Germany experience gender-based violence (GBV), with survivors facing serious physical, mental and reproductive health consequences (WHO, 2024). Addressing this burden requires an integrated understanding of four correlated pillars: Health Inequity (structural driver), Violence (mechanism), Injuries (clinical manifestation), and Trauma (requiring trauma-informed care). This study evaluates whether current German public health curricula equip graduates to address these pillars as a unified health priority, and to identify curricular reforms needed to close the existing competency gap.

Methods

Using the Harden 10-Question Framework, a systematic comparative analysis of 2025/2026 module handbooks across 18 German Public, Global, and International Health master’s program was conducted. Primary metrics including needs, content, strategy, and assessment, along with six additional curricular dimensions, were evaluated to assess curricular integration of the four-pillar GBV continuum.

Results

Health inequity features across all 18 programs: as a core module in 9 (50%) and a secondary theme in 9. Yet 12 (67%) have no violence or trauma as a core pillar. Violence appears in 4 (22%), addressing global or conflict health — not domestic GBV. Injury competencies in 3 (17%) are limited to occupational or patient safety contexts. Trauma-informed pedagogy is absent in 16 (89%); no program integrates all four pillars into a unified GBV-response continuum.

Conclusions

German public health universities have an opportunity to build structured, integrated curricula that equip graduates to respond to GBV across the full continuum from structural inequity to clinical trauma. To realise this, education systems should: embed GBV-specific competencies within existing modules, adopt trauma-informed pedagogical strategies and integrate GBV prevention and standardised injury data assessment across programs.

Key messages

• Evaluation of different master in public health programs in Germany for components of health inequities, violence, injuries and trauma-informed care, highlighting the need for an integrated approach.

• Assess curricula-based need in German public health to create a unified workforce with interdisciplinary continuity for tackling the complexities of gender-based violence and trauma-informed care.