On 30 January 2026, the BRAVE-WOW team finished one of the deliverables of Work Package 2: Understanding Gender-Based Violence in the World of Work. This deliverable synthesised three complementary reviews: (1) a review of reviews on workplace violence and gender-related violence and harassment in healthcare, (2) a comparative legal and epidemiological analysis across nine European countries, and (3) a scoping review of artificial intelligence (AI) related to violence and harassment in this sector.
This deliverable unveils the urgent need to shift how we protect our healthcare workforce. Here are the main findings of this work.
1 – The “hidden” gender gap
Violence in healthcare is not random; it is deeply gendered. While the male staff are more frequently targets of physical aggression, women, who compose the vast majority of the healthcare workforce, disproportionately suffer from psychological violence, sexual harassment, and bullying. Crucially, much of this is “normalised”. Many nurses and junior staff report that abuse is often brushed off as “just part of the job” or solely attributed to a patient’s condition, ignoring the power dynamics at play and the crucial role of cultural differences between those involved in violent incidents within more and more interculturally-intensive workplaces.
2 – Good laws, poor reality
Europe has a robust legal framework. From the International Labour Organisation (ILO) Convention No. 190 to various EU directives, there are laws to protect workers. However, our comparative analysis revealed a significant “implementation gap”. Whether countries follow an Occupational Safety and Health (OSH) model (like Portugal and Italy) or an Equality-centred model (like Spain and Sweden), the result is often the same: high compliance on paper, but low protection on the ground. Enforcement is uneven, resources in smaller organisations are scarce, and reporting mechanisms are often ineffective.
Furthermore, legislation is struggling to keep pace with technology. As healthcare moves to the online world, “technology-facilitated violence”—such as cyber-harassment and online threats against staff—is rising. Yet, most national surveillance systems and legal instruments fail to explicitly capture or regulate these digital forms of abuse, leaving victims without adequate recourse.
3 – A double-edged sword
AI is increasingly heralded as the solution to workplace safety, with tools designed to predict and detect aggression before it escalates. The report’s scoping review acknowledged the technical promise of AI, particularly the use of Natural Language Processing (NLP) to flag risks in clinical notes. However, there is a critical blind spot: current AI models are largely gender-blind. Most AI research operationalises violence as a neutral, countable “event” to be predicted, ignoring the complex social and gendered context in which it occurs. By failing to disaggregate data by gender, these algorithms risk depoliticising violence, treating it as a mere operational risk rather than a structural issue. If we rely solely on these tools without ethical, gender-sensitive oversight, we risk building safety systems that protect the institution but fail the individuals most at risk.
Why does this work matter, and where do we go from here?
This work equips healthcare organisations with the knowledge needed to take real action, exposing a critical blind spot in how we protect the people who protect us.
– Provides clear evidence on who is affected by Gender Based Violence and Harassment in healthcare and under what conditions;
– Informs the development of practical tools, including a questionnaire, for measuring and monitoring GBVH;
– Highlights that investment must shift from reactive measures (like security personnel and post-incident counselling) to primary prevention. This means tackling the organisational root causes of aggression before they escalate into violence;
– Developers and healthcare managers must demand gender-sensitive AI. Algorithms used for risk prediction must be trained to recognise subtle, gendered forms of harassment, rather than just flagging physical outbursts;
– Practically, this calls for merging Occupational Health & Safety (OSH) protocols with Equality & Diversity strategies. Violence and discrimination are two sides of the same coin and can no longer be managed in isolation.
Ultimately, the goal is to achieve Decent Work criteria in their multiple dimensions, a fundamental requirement for a sustainable health system that attracts and cares for its best talent.