Transcript of Tough Choices in Implementing Multisectoral Reponses to Gender-Based Violence Prevention and...
- Slide 1
- Tough Choices in Implementing Multisectoral Reponses to
Gender-Based Violence Prevention and Response Sarah Eckhoff,
Technical Advisor for Gender
- Slide 2
- SESSION OVERVIEW Introduction to the session Overview of key
terms associated with multisectoral approaches to GBV prevention
and response Review of three case studies within which
multisectoral approaches to GBV prevention and response have been
employed: Kenya and Mozambique Group brainstorm and discussion
Wrap-up
- Slide 3
- GENDER-BASED VIOLENCE Gender-based violence (GBV) is defined as
an umbrella term for any act that is perpetrated against a persons
will, and that is based on socially ascribed (gender) differences
between males and females. 1 Acts constituting GBV include intimate
partner, sexual, and emotional violence, as well as harmful
traditional practices, including female genital cutting and early
marriage. GBV is correlated with myriad adverse health outcomes
including: unintended pregnancy; depression; substance abuse;
sexually transmitted infections (STIs), including HIV; and maternal
and child mortality 2 1 UN Inter-agency Standing Committee,
Guidelines for Gender-based Violence Interventions in Humanitarian
Settings: Focusing on Prevention of and Response to Sexual Violence
in Emergencies (2005). 2 Population Reference Bureau, Gender-based
Violence: Impediment to Reproductive Health (USAID/Interagency
Gender Working Group, 2010).
- Slide 4
- WHAT ARE PRIMARY AND SECONDARY PREVENTION OF GBV? Primary
prevention: Efforts to enhance the protective factors that prevent
GBV Secondary prevention: Interventions that aim to moderate the
immediate effects of GBV
- Slide 5
- PRIMARY PREVENTION OF GBV Efforts to enhance the protective
factors that prevent GBV: Deconstructing harmful gender norms
Education Promotion of gender equality Promotion of non-violent
conflict resolution Interventions may include: School-based
programs to foster greater gender equality Community-based
activities to foster collective reflection and dialogue around
gender norms through the lens of power and access
- Slide 6
- SECONDARY PREVENTION OF GBV Efforts that aim to moderate the
immediate effects of GBV: A package of clinical services (e.g.,
provision of PEP for HIV and STI prevention and provision of
emergency contraception, treatment of injuries, forensic evidence
collection, Hepatitis vaccination, abortion) Psychosocial, legal,
and police support Temporary shelter Secondary prevention
modalities: One-stop center: where clinical services are co-located
with police, legal, and psychosocial support services; and,
Integrated services model where clinical services are integrated
into existing health services, and connected through referrals to
appropriate police, psychosocial, shelter, and legal aid
support.
- Slide 7
- EXPERIENCES OF GBV IN KENYA AND MOZAMBIQUE *Data not collected
in Mozambique DHS on women aged 15-49 whose first sexual
intercourse was forced against their will.
- Slide 8
- TANZANIA: TUTUNZANE II Pathfinder supported MOH to develop 5
separate GBV clinical management training curricula for health
providers Developed through multisectoral collaboration Master
training of national trainers conducted in Dar es Salaam: cascade
training in 4 regions Facilitation of local planning within Dar es
Salaam to respond to gaps in GBV services Galvanizing community-led
responses to GBV and VAC Integration of GBV and VAC referral into
HIV counseling and testing
- Slide 9
- KENYA Government-led multisectoral prevention and response
model that operated at facility and community levels Implementation
began with the WJEI pilot in Kibera and Kenyatta National Hospital
from 2009-2011 and continued with APHIAplus Key interventions :
Community-based interventions to increase knowledge of
intersections between HIV/AIDS and GBV and galvanize community
responses to GBV Capacity building of health providers Integrated
package of services at health facilities OSCs Strengthening of
multisectoral coordination Male engagement through male champions
network
- Slide 10
- MOZAMBIQUE Multisectoral approaches to primary and secondary
prevention of GBV within 2 projects and 2 provinces UNTF-funded
project in Gaza Province Norwegian Ministry of Foreign Affairs in
Inhambane Province Gender norm transformation interventions:
School-based activities Community-based activities + male
involvement Bolstering community responses to GBV Building the
capacity of multisectoral providers engaged in GBV response
Establishment of services for survivors Integrated package of
services with multisectoral referrals One-stop-centers Increasing
multisectoral coordination Strengthening multisectoral
referrals
- Slide 11
- MOZAMBIQUE
- Slide 12
- OVERARCHING LESSONS LEARNED Greater investment must be made in
measuring the effects of primary prevention interventions
Government and community buy-in and participation are key in
implementing sustainable multisectoral approaches to secondary
prevention of GBV Need to go beyond provider training to ensure
that services are integrated and of quality Human resources must be
sufficient to staff stand-alone OSCs Uptake of services at health
facilities is not consistent across contexts A participatory
development process is key in fostering multisectoral coordination
at all levels Indicator consistency will facilitate greater
cross-program and cross- context learning
- Slide 13
- RECOMMENDATIONS FOR FUTURE CONSIDERATION Many OSCs are often
well-marked and located in larger provincial hospitals; this can
pose a significant access barrier for survivors The maturity and
strength of the health system must be considered when selecting a
secondary prevention modality In contexts where uptake of services
at health facilities is more limited among GBV survivors policy
barriers must be overcome to increase access to EC and PEP (e.g.,
via police) Multisectoral referral linkages must be strengthened to
ensure that survivors are reaching essential services The unique
needs of male survivors of GBV must be considered in project
design
- Slide 14
- COUNTRY X BRAINSTORM GBV is pervasive throughout this country;
among even the highly educated physical violence is acceptable
while GBV refers mostly to cases of sexual violence Post-conflict
state where there is little faith in the justice system including
police Many actors in GBV prevention and response efforts; although
provider turnover challenges capacity building One comprehensive
one-stop-center (rural) and one center for GBV survivors excluding
police services (urban) EC and ARVs are available at lower level
facilities; providers are apprehensive to provide ARVs for PEP to
GBV survivors Medical certificate must be signed by government
doctor (provincial hospitals) in order for legal redress to be
pursued Understood that many GBV survivors do not seek
services
- Slide 15
- GROUP BRAINSTORMING Based on the lessons-learned put forward as
well as any of your experiences, what recommendations would you
make to employing these multisectoral approaches to primary and
secondary prevention of GBV? Is there one secondary prevention
modality that seems most feasible in certain contexts or health
systems? What are the limiting factors in terms of one secondary
prevention modality over the other? When we think about primary
prevention and the behavior and norm change necessary, what are the
strategic choices that we face as implementers when
scaling-up?
- Slide 16
- twitter.com/PathfinderInt facebook.com/PathfinderInternational
Youtube/user/PathfinderInt Thank you!