WHO'S ROLE AND THE HEALTH RESPONSE TO VIOLENCE AGAINST WOMEN AND GIRLS IN EMERGENCIES - 9 May 2019, Brazzaville, Congo Collective action for ...
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WHO’S ROLE AND THE HEALTH
RESPONSE TO VIOLENCE AGAINST
WOMEN AND GIRLS
IN EMERGENCIES
9 May 2019, Brazzaville, Congo
Collective action for better health outcomes
PRESENTATION PURPOSE
• To present an overview of the GBV in
emergencies project;
• To understand the essential elements of a
health response to VAWG;
• To share information across contexts
about the priorities for current health
responses to VAWG and related
challenges.
Collective action for better health outcomes
EXPECTED OUTCOME
Health Cluster coordinators are
equipped with information about
the components of a health
response to VAWG and what
global guidance and activities
exist to support their work in this
area.
Collective action for better health outcomes
PRESENTATION OUTLINE
• GBV in Emergencies Project
• Definitions
• Scope and magnitude of the problem
• The health consequences of VAWG
• WHO’s mandate on VAWG
• A multisectoral response and the role of the Health
Cluster
• Components of a health response to VAWG
• WHO recommendations, policies, tools and guidelines
• Draft regional framework and CO roadmaps
• Institutionalization
Collective action for better health outcomes
GBV IN EMERGENCIES PROJECT Collective action for better health outcomes
PROJECT BACKGROUND 16 May 2019
Goal
• Health sector has improved capacity to deliver services to GBV
survivors and to enhance prevention.
Rationale
• As the United Nations lead agency for health and the IASC
designated cluster lead agency for health in humanitarian settings,
WHO is well placed to institutionalize the health sector response to
GBV in crises, within a gender equality and human rights
perspective.
Outcome
• Health sector/health care providers’ capacity to prevent and
adequately respond to GBV is enhanced.
• Coordination between the health cluster and the GBV AoR is
strengthened.
Collective action for better health outcomes
PROJECT BACKGROUND 16 May 2019
Activities
• GBV strengthened within health cluster responses
• In the following countries/sites: Afghanistan, Bangladesh
(Cox’Bazar), DRC (Kasais), Iraq, Nigeria (Northeast), Whole of Syria
• Updated technical and normative guidelines and tools
• In particular the Clinical Management of Rape Survivors and Training
materials on mental health, first line support and IPV
• Strengthened WHO participation in relevant interagency initiatives
Cluster Coordination Health providers training
webinars and workshops • Technical support,
Timeline mentoring
April - July - October- • Deployment of a
2019 GBV advisor to a
June September December
new, acute
emergency
Country Supplies and technical Monitoring • QAT research
missions guidance development
Collective action for better health outcomes
PROJECT UPDATES 16 May 2019
Technical
Scoping missions Trainings
Guidance
• Iraq • Updated Clinical • Trainings and
• Syria Management of workshops in all
Rape Manual of the 6 target
• Bangladesh countries
• Nigeria • Mental health
and GBV between
• DRC October and
training
curriculum December
• Self care
module
Collective action for better health outcomes
VAWG/GBV DEFINITIONS
Collective action for better health outcomes
GBV: DEFINITIONS
• Gender-based violence (GBV)
is an umbrella term for any
harmful act that is perpetrated
against a person’s will and that
is based on socially ascribed
(i.e. gender) differences
between males and females.
• GBV against women is a life-
threatening global health and
human rights issue.
• While men may experience
GBV, in general women
experience more sexual
violence, more severe physical
violence, and more control
from male partners.
Collective action for better health outcomesIT’S ABOUT POWER AND CONTROL
Collective action for better health outcomesVAWG TAKES MANY FORMS
The most common:
Intimate Partner
Violence, i.e. experience
of one or more acts of
physical and/or sexual
violence
and/or emotional/
psychological abuse by a
current or former
partner
Collective action for better health outcomes16 May 2019
COMMON TYPES OF VAWG/GBV
Sexual Violence by someone a woman knows or by a stranger.
Intimate partner violence can include physical violence, sexual
violence, emotional/psychological abuse, and controlling
behaviors.
Collective action for better health outcomes✓ being physically forced to
have sexual intercourse
when you didn't want to
✓ having sexual intercourse
because you were afraid
of what your partner
might do
✓ being forced to do
something sexual that
you found humiliating or
degrading
Sexual Violence HEALTH
EMERGENCIES
programmeInvolvement of a child in
sexual activity that he or
she does not fully
comprehend, is unable to
give informed consent to, or
for which the child is not
developmentally prepared
and cannot give consent, or
that violates the laws or
social taboos of society.
Child sexual abuse
HEALTH
EMERGENCIES
programmeSESSION 1: DÉFINITIONS, MANDATS ET
INFORMATIONS CONTEXTUELLES
Collective action for better health outcomesSCOPE AND MAGNITUDE OF THE PROBLEM
Collective action for better health outcomesThe prevalence of lifetime physical and/or sexual by intimate partner
violence by WHO region (2013)
Collective action for better health outcomes7% of ♀ globally:
have experienced sexual violence by a non-partner
Collective action for better health outcomesViolence starts early in lives of women
Lifetime prevalence of intimate partner violence by age group among ever-
partnered
Collective action women (WHO,
for better 2013)
health outcomesGBV IN EMERGENCIES
• Conflict and displacement exacerbate pre-existing
violence and present new forms of GBV.
• 1 in 5 women who are refugees or displaced
experience sexual violence globally.
• Reported rates of IPV are more prevalent than non-
partner sexual violence in emergency settings.
• Adolescent girls aged 10 - 19 are one of the most at-
risk groups
Collective action for better health outcomesAnalyse des données de l’Enqûete
Démographique et de Santé (EDS) de la
RDC pour évaluer les facteurs de risqué et
les facteurs de protection pour la VPI et le
rôle que joue le statut des femmes.
68.2% des répondentes avait vécu au
moins 1 des 3 types de VPI (physique,
sexuelle, émotionnelle).
Facteurs de risque - attitude d’acceptation
de la violence conjugale, utilisation de
l’alcool par le partenaire.
Facteurs de protection – unions
monogames.
Les résultats de cette étude démontre que
la VPI est fréquente et elle est justifiée
comme étant acceptable par beaucoup de
congolaises.
Collective action for better health outcomesGBV IN EMERGENCIES
• Conflict and displacement exacerbate pre-
existing violence and present new forms of GBV.
• 1 in 5 women who are refugees or displaced
experience sexual violence globally.
• Reported rates of IPV are more prevalent than
non-partner sexual violence in emergency
settings.
• Adolescent girls aged 10 - 19 are one of the most
at-risk groups
Collective action for better health outcomesHEALTH CONSEQUENCES OF VAWG
Collective action for better health outcomesHEALTH IMPACTS OF VIOLENCE
Collective action for better health outcomesPATHWAYS & HEALTH EFFECTS OF IPV
Collective action for better health outcomesHEALTH EFFECTS OF IPV
IPV 53% any contraception
IPV 52% condom use
IPV 10% child stunting
Collective action for better health outcomesINTER-GENERATIONAL & SOCIO-ECONOMIC
CONSEQUENCES
Effects on • Higher rates of infant mortality
children of • Behavior problems
• Anxiety, depression, attempted suicide
women who
• Poor school performance
experience • Experiencing or perpetrating violence as adults
abuse • Physical injury or health complaints
• Lost productivity in adulthood
Effects on • Inability to work
families • Lost wages and productivity
• Housing instability
Social and • Costs of services incurred by victims and families (health, social, justice)
economic ✓ 42% higher health care expenditure in the US
• Lost workplace productivity and costs to employers
effects
✓ 3.7% of GDP in Peru
• Perpetuation of violence
Collective action for better health outcomesSMALL GROUP DISCUSSION (15 MINUTES)
–What do you know about
VAWG/GBV in the context of the
emergency you are working in (ex.
types, reported incidents, info from
assessments re: risks) ?
–To what extent are VAWG/GBV
concerns and interventions
integrated into the HPC/HNO/HRP?
Collective action for better health outcomesWHO’S MANDATE ON VAWG
Collective action for better health outcomesViolence against women on the development agenda
5. GENDER EQUALITY
SDG Target 5.2
Eliminate all forms of violence against women and
girls
SDG Target 5.3
No MDG Eliminate all harmful practices, such as child, early
and forced marriage, and female genital mutilation
targets
related to 16. PEACE, JUSTICE
violence SDG Target 16.1
Significantly reduce all forms of violence and related
death rates everywhere
SDG Target 16.2
End abuse, exploitation, trafficking and all forms of
Collective action for betteragainst
violence health outcomes
childrenVAW ON THE GLOBAL PUBLIC HEALTH AGENDA
69th World Health Assembly, May 2016
The Ministries of Health of the 193
Member States of WHO, endorsed the
Global Plan of Action on strengthening
the health system’s response to violence
against women and girls and against
children.
Collective action for better health outcomesA call to action! Collective action for better health outcomes
A MULTISECTORAL RESPONSE TO GBV AND
THE ROLE OF THE HEALTH CLUSTER
Collective action for better health outcomesLA RÉPONSE MULTISECTORIELLE ET LE
RÔLE DU CLUSTER SANTÉ ET DES
PARTENAIRES DE LA SANTÉ
Collective action for better health outcomesINTRODUCTION A L’APPROCHE CLUSTER
• Les acteurs humanitaires sont variés et pluriels:
– Le Système des Nations Unies (OCHA, UNHCR, UNICEF,
OMS, UNFPA, FAO, PAM, PNUD, UNHABITAT);
– Les ONG/I (Save The Children, Care International,
MSF, ALIMA, ADRA, WAR CHILD, etc.);
– Le CICR, Croissant Rouge, Conseil International des
agences volontaires, Conseil américain de l’Action,
Volontaire, etc.;
– La BM, l’OIM; et
– Au niveau des pays, il faut ajouter les acteurs
nationaux (gouvernements, ONG/N, autres).
Collective action for better health outcomesINTRODUCTION A L’APPROCHE CLUSTER
• L’approche « CLUSTER » est l’un des quatre piliers de
la réforme humanitaire intervenue en 2005
(leadership, financement, partenariats et cluster) en
vue de renforcer la réponse humanitaire face aux
crises de plus en plus complexes, fréquentes et
meurtrières.
• Le but de l’approche « Cluster » est de renforcer la
préparation de tous les intervenants du secteur et
leur capacités techniques à faire face aux
urgences humanitaires en garantissant un
leadership et une redevabilité prévisibles dans tous
les secteurs de la réponse humanitaire.
Collective action for better health outcomesINTRODUCTION A L’APPROCHE CLUSTER
• L’IASC a désigné un leader mondial de chaque
cluster. Celui-ci a la responsabilité d’assurer une
réponse cohérente et efficace, mobiliser et
inclure tous les acteurs du secteur dans le
respect de leurs mandats et avantages
comparatifs. Pour une meilleure coordination et
efficacité de la réponse, un cluster peut être
subdivisé en sous-clusters et ou en groupe de
travail.
• Lead du Cluster Santé: OMS
Collective action for better health outcomes16 May 2019
CLUSTER SANTÉ
Santé
Santé de la Santé mentale et
Reproduction soutien
(SR) psychosocial
Comme Lead, l’OMS a pour rôle
de veiller à ce que les principaux
partenaires humanitaires du secteurs
respectent les priorités des différents
programme respectives
Collective action for better health outcomesLa réponse multisectorielle en matière
de prévention et réponse aux VBG
Réinsertion
socioéconomique
Education Communications
Coordination
Principes Directeurs
Réseaux de Référence
Psychosocial Santé
LA SURVIVANTE
Familles Communauté
Autorites locales
Ministères
Comités de Refugiés et Déplacés
Organisations du SNU
Juridique/Judiciaire Sécurité
CollectiveONG nationales
action et internationales
for better health outcomes
Leaders et groupes religieuxLES PARTENARIATS
• La communauté humanitaire reconnait
qu’aucune agence humanitaire ne peut
à elle seule couvrir tous les besoins
humanitaires et que la collaboration n’est
pas une option mais une nécessité.
• Parmi les partenaires humanitaires, il y a des
agences et fonds du SNU, les ONG/I/N, les
gouvernements, les privés, les fondations,
les communautés, les survivants de VBG,
etc.
Collective action for better health outcomesLES PARTENARIATS (SUITE)
• Les partenaires qui ont des interventions
directes ou indirectes sur la santé doivent
être impliqués dans la réponse holistique
(multisectorielle).
• Les principes de partenariats sont l’égalité, la
transparence, la redevabilité, la
complémentarité et l’orientation vers les
résultats.
• Le cluster Santé doit veiller à la réduction de
la surmortalité et de la surmorbidité face à
une crise humanitaire et à la restauration de
la dignité.
Collective action for better health outcomes16 May 2019
GBV AREA OF RESPONSIBILITY
Logement,
Protection Action des
VBG terres et
de l’enfant mines
propriété
Collective action
Gender-Based Violence Areafor
of better health outcomes
ResponsibilityCYCLE DE PROGRAMME HUMANITAIRE
Collective action for better health outcomesLE RÔLE DU CLUSTER SANTÉ ET DES
PARTENAIRES DE LA SANTÉ
Intégrer des actions
essentielles en matière de
VBG tout au long du cycle
de programme humanitaire
Collective action for better health outcomesLE RÔLE DU CLUSTER SANTÉ ET DES
PARTENAIRES DE LA SANTÉ – ÉVALUATION DES
BESOINS
✓ Incorporer des questions
reliées aux VBG au sein des
évaluations sanitaires
✓ Assurer que les VBG sont pris
en compte dans la Revue
des Besoins Humanitaires
(Humanitarian Needs
Overview)
Exemple: Combien de centres de santé
offrent des soins cliniques pour les
survivantes de viol et d’autres formes de
VBG?
Exemple : Existe-il des protocoles ou
procédures opérationnelles standards
pour la prestation de services de santé à
l’intention des survivantes?
Collective action for better health outcomesQUELLES INFORMATIONS SONT
NÉCESSAIRES?
Message Clé: Considérez la violence basée Sources d’information
sur le genre comme un état de fait • Services de santé existants
Les actions sont pertinentes dès les premiers
stades d’une intervention humanitaire et • Statistiques sur l’accès aux services de
dans toutes les situations d’urgence, quelle santé
que soit la prévalence ou l’incidence connue • Enquêtes démographiques et de la
et vérifiée des différentes formes de VBG…
Dans les situations d’urgence, l’attente ou la santé
recherche de données démographiques sur • Informations sur les obstacles à l’accès
l’ampleur réelle de la question ne doit pas aux services par les femmes
être une priorité, compte tenu des problèmes
de sécurité et d’éthique que soulève la • Études spécialisées sur l’inégalité du
collecte de telles données. Dans ce contexte, genre et VBG
tous les membres du personnel humanitaire
ont le devoir de considérer les VBG comme • Informations sur les lois, politiques et
un état de fait et une menace pour les protocoles
populations touchées, de traiter cette
question comme un problème grave qui met
la vie des personnes en danger et Suggestions:
d’appliquer les mesures sectorielles ✓ Interroger les lead “VBG”. Se servir des
recommandées indépendamment de la
présence ou de l’absence de preuves évaluations genre/VBG pour comprend
concrètes. le contexte.
----- Directives pour l’intégration d’interventions ciblant la VBG de l’IASC
✓ Profiter de la calculatrice DMU pour
faire une projection des intrants
Collective action for betternécessaires. health outcomesLE RÔLE DU CLUSTER SANTÉ ET DES
PARTENAIRES DE LA SANTÉ – PLANIFICATION
STRATÉGIQUE
✓ Comprendre l’impact des
différentes formes de VBG sur les
résultats de santé
✓ S’assurer que l’apport des VBG aux
autres problématiques de santé soit
pris en compte dans le cadre des
objectifs sanitaires (ou du
Cluster/Secteur Santé) du Plan de
Réponse Humanitaire
(Humanitarian Response Plan)
✓ Produire les 3W et 5W
Exemple : Inclure des services destines aux
survivantes dans la définition de “services qui
sauvent les vies” (“life-saving services”).
Exemple : Inclure de l’information sur la disponibilités
des services de santé VBG dans le résumé des
besoins.
Exemple : Inclure au moins 1 cible ou objectif dédié
aux VBG dans le plan de secteurde la santé, ex.
90% des centres de santé offre des soins cliniques
aux survivantes de VBG.
Collective action for better health outcomesLE RÔLE DU CLUSTER SANTÉ ET DES
PARTENAIRES DE LA SANTÉ – MISE EN ŒUVRE
ET MONITORING
✓ Inclure les services VBG dans le
paquet de servies de santé
essentiels
✓ Assurer la disponibilité des PPE,
traitements IST, contraception
d’urgence et le vaccine pour
l’hépatite B.
✓ Inclure indicateurs pour mesurer les
résultats des interventions VBG.
Exemple : # de centres de santé avec un système de
référence fonctionnel.
Exemple : Assurer que le staff médical ont les
aptitudes en gestion clinque des survivantes de VBG.
Exemple : Inclure des espaces privées et
confidentielles dans le design de centres de santé.
Exemple : Mettre les survivantes en rapport avec
d’autres services nécessaires.
Collective action for better health outcomesLA COORDINATION INTER-SECTORIELLE
CLUSTER SANTÉ CLUSTER PROTECTION
Santé mentale et
Prestataires
soutien VBG
de services Cluster Santé psychosocial
Coordination Santé de la Protection de
inter- Reproduction RH l’enfance
sectorielle
✓ Cartographie et analyse des lacunes dans les services
✓ Plaidoyer and sensibilisation sur les domaines
Réponse intégrant conjointes
les VBG dans les ✓ Développement de circuits de référencement et POS
urgences
Collective action for better health outcomesSMALL GROUP DISCUSSION (15 MINUTES)
–What actions do you currently
prioritize to address VAWG/GBV
within the Health Cluster/Sector?
–What are challenges do you face in
coordinating the health response to
VAWG/GBV?
Collective action for better health outcomesLES COMPOSANTS D’UNE RÉPONSE
SANITAIRE EN MATIÈRE DE VIOLENCES
À L’ÉGARD DES FEMMES ET DES FILLES
Collective action for better health outcomesVIDEO: LA VIOLENCE À L’ÉGARD DES FEMMES :
INTERVENTION DANS LE SECTEUR DE LA SANTÉ
Collective action for better health outcomesCollective action for better health outcomes
LA SANTÉ: UN SERVICE INDISPENSABLE POUR
LES SURVIVANTES
Les prestataires de services de santé
et les systèmes de santé jouent un
rôle primordial en termes de fournir
un soutien aux femmes afin de
minimiser l'impact de la violence et
de prévenir que ça se produit.
Pourquoi les systèmes de santé?
• Il est plus probable que les femmes et les filles qui vivent des
violences utilisent des services de santé.
• Les prestataires de services de santé sont souvent le premier
point de contact professionnel pour les femmes.
• Il est probable que toute femme consulte des services de santé
à un certain moment de sa vie.
Collective action for better health outcomesPOURQUOI LES SYSTÈME DE SANTÉ?
• Les violences sont souvent responsables de blessures et de
maladies physiques
• Les prestataires de santé peuvent offrir de meilleurs soins dans les
conditions de violence en:
– Identifiant les femmes victimes de violence avant l’aggravation
de leur condition
– Fournissant des soins appropriés
– Réduisant les impacts négatifs sur la santé des VBG
– Assistant les survivantes dans l’accès à la protection
– Améliorant les services de santé sexuelle et
reproductive/IST/VIH/SIDA
• Obligations en matière de droits de la personne de respecter les
normes les plus élevées en matière de soins de santé.
Collective action for better health outcomesLe rôle du secteur
de la santé
dans le cadre d’une
réponse holistique
(multisectorielle)
Collective action for better health outcomesLa réponse sanitaire en matière de VBG
DISPENSER UN APPUI DE PREMIÈRE LIGNE EN CAS DE VIOLENCE EXERCÉE PAR UN PARTENAIRE INTIME ET D’AGRESSION
SEXUELLE Écouter. S’informer des besoins et des préoccupations. Valider. Améliorer la sécurité. Soutenir.
IDENTIFICATION ET SOINS DES VICTIMES DE VIOLENCE EXERCÉE PAR UN PARTENAIRE INTIME
SOINS CLINIQUES POUR LES VICTIMES D’UNE AGRESSION SEXUELLE
FORMATION DES PRESTATAIRES DE SOINS DE SANTÉ
INTÉGRATION DES VIOLENCES COMMIS PAR UN PARTENAIRE INTIME ET VIOLENCES SEXUELLES
LA DÉCLARATION OBLIGATOIRE N’EST PAS RECOMMANDEÉ
COLLECTER DES DONNÉES AFIN DE GÉNÉRER UNE BASE D’EVIDENCE ET COORDONNER AVEC LES AUTRES
SECTUERS
HEALTH 16 May 2019
EMERGENCIES
programmeSOUTIEN DE PREMIÈRE LIGNE
Collective action for better health outcomesGESTION CLINIQUE DU VIOL:
PRINCIPALES MISES À JOUR
• Preuves médico-légales
✓ Reconnaissance que la collecte de preuves judiciaires n’est
souvent pas possible/disponible;
✓ Informations complètes en annexe mais ne constitue plus
une étape;
✓ Accent sur l’importance d’une bonne documentation
• Traitement et suivi
✓ Traitement mis à jour selon les derniers protocoles
✓ Suivi à 2 semaines; 1mois, 3mois et 6mois
✓ Plus d’accent sur les références, soutien psychosocial et
sécurité
Collective action for better health outcomesSANTÉ MENTALE ET ASSISTANCE
PSYCHOSOCIALE
• Rôle du prestataire de santé
• Information sur les réactions
normales aux événements
traumatiques
• Soutien psychosocial de base
• Évaluation des problèmes de
santé mentale : dépression,
suicide et automutilation,
SPT, troubles somatiques
Collective action for better health outcomesWHO RECOMMENDATIONS, POLICIES,
TOOLS AND GUIDELINES
Collective action for better health outcomesIMPLEMENTATION TOOLS
"What" "How”
Collective action for better health outcomesCLINICAL HANDBOOK FOR HEALTH PROVIDERS
Objective
• Tool/Job aid to strengthen the capacity
of health-care providers.
What does it do?
• Provides operational guidance (the ‘how
to’) based on WHO guidelines (the ‘what’)
• It is an easy-to-use, helpful guide
including practical tips and job aids
• While it does not directly address young
women (under 18) or men directly, many
of the suggestions are applicable them.
Collective action for better health outcomesCONTENTS OF THE CLINICAL HANDBOOK
Guiding principles for
Introduction providing women –
centered care
Awareness &
Part 1 Identification
Part 2 First-line support
Additional care after
Part 3 sexual assault
Additional care for
Part 4 mental health
Collective action for better health outcomesIPV & SV AGAINST
WOMEN GUIDELINES
Objectives
• Guidance for clinicians on
responding to IPV and SV
• Guidance to policy makers on
training and models of health
care provision
• Inform educators designing
medical, nursing and public
health curricula regarding
training
Collective action for better health outcomesHEALTH MANAGER'S MANUAL
Objective
To strengthen health systems to
provide women-centred services
to survivors of violence.
What does it do?
• Provides operational guidance
(the ‘how to’) for health
managers & policy makers
• Easy-to-use guide with practical
tips and job aids to plan,
manage, monitor & evaluate
services
Collective action for better health outcomesTOOLS AND GUIDELINES
Collective action for better health outcomesSMALL GROUP DISCUSSION (15 MINUTES)
• Which of the WHO guidelines, tools,
and technical resources are already
being used in your country?
• Which ones are the most relevant
and useful to your emergency
operation?
• What other GBV guidelines,
information systems and/or processes
are being implemented
Collective in your
action for better health outcomesUPDATE ON WHO’S GBV IN EMERGENCIES
PROJECT
Collective action for better health outcomesFINDINGS IN DRC AND NIGERIA 16 May 2019
• GBV is under-reported due to fear and/or stigma;
• The level of access to health services by GBV survivors is low due to
poor coverage and other barriers to access;
• The capacity of health staff to identify signs and symptoms of
various forms of GBV and respond appropriately is limited;
• The infrastructure and/or set-up of health facilities is inadequate to
provide quality care to GBV survivors;
• Medications, supplies and equipment to provide CMR (HIV PEP,
ECP, dignity kits) are insufficient; and,
• Information, communication and referrals between health service
providers and other GBV services (e.g., psychosocial, livelihoods,
legal, etc.) is lacking.
Collective action for better health outcomesPROGRESS IN AFRO Collective action for better health outcomes
1. GBV STRENGTHENED WITHIN HEALTH
CLUSTER RESPONSES
Nigeria workshop on health DRC workshop on GBV
cluster/sector response to integration in the health
GBV response
• Over 40 health managers • A two-day workshop will be
attended in Dec 2018 in organized in Tshikapa (Kasai
province) for participants from
Maiduguri and in April 2019 in the Health Clusters and/or
Yola, representing members of Reproductive Health Working
the Health Sector and the Groups from Mbuyi-Mayi,
Reproductive Health Working Kananga and Tshikapa.
Group, State MoH planners, • After the two-day workshop,
these participants led a one-
managers of government, day workshops with Tshikapa-
INGO and NGO medical based health partners to
facilities and development practice facilitating such a
partners operating in workshop, then replicated in
Kananga and Mbuyi-Mayi.
Northeastern Nigeria.
Collective action for better health outcomes2. STRENGTHENED CAPACITY OF HEALTH
PROVIDERS ON GBV RESPONSE
Nigeria DRC
• WHO focused on mobile • WHO will review and
health teams to see how to update national modules
integrate GBV in non-facility on GBV based on new WHO
based, rapid responses that guidance (updated CMR)
access some of the most and explore options for a
hard-to-reach areas in the ToT for a pool of master
Northeast. trainers on clinical
• 91 health providers from management of rape and
WHO’s mobile health teams IPV survivors.
trained on First-Line Support
in Dec 2018 (Borno State)
• 60 more trained in April 2019
(Adamawa and Yobe
States)
Collective action for better health outcomesHEALTH FACILITY READINESS EXERCISE – 16 May 2019
MAIDUGURI, NIGERIA
• 18 managers of state-run health facilities in Maiduguri assessed the
readiness of specific facilities to provide care to GBV survivors (e.g.
availability of private space, protocols for care, trained staff, drugs
and supplies for post-rape care, etc) using components of the
Minimum Care Version of the GBV Quality Assurance (QA) Tool.
• None of the facilities met any of the 4 standards for GBV quality of
care assessed through site visits.
• Findings shared with State Ministry of Health in order to develop
plans to address these gaps.
• The approach taken over the two-day workshop gave participants
hands-on experience to identify service delivery gaps and built
ownership around ensuring that health facilities meet quality
standards of care for women and girls subjected to intimate partner
violence and/or sexual violence.
Collective action for better health outcomesSUB-REGIONAL MEETING ON WHO’S ROLE AND
THE HEALTH RESPONSE TO VIOLENCE AGAINST
WOMEN AND GIRLS IN EMERGENCIES IN WEST
AND CENTRAL AFRICA
BAMAKO (MALI), APRIL 30 – MAY 2, 2019
Collective action for better health outcomesWHY ARE WE HERE?
• To bring countries together from the sub-
region
• To talk about violence against women
and girls in humanitarian situations
• To gain a common understanding
• To take action to provide quality health
services to survivors
Collective action for better health outcomesDRAFT REGIONAL FRAMEWORK
AND COUNTRY ACTION PLANS/ROADMAPS
Collective action for better health outcomesPROPOSED CRITERIA TO JOIN PROJECT
MUSTS
WR has made a formal request
G2 or G3 emergency
Commitment to designate VAWG Focal Point and possibly fund a consultancy
Stable Health Cluster coordinator
Participated in Regional Meeting (Amman, Bamako)
NICE TO HAVES
PHSA completed or soon to be done
HeRams completed or soon to be done
GBV Guidelines have been rolled-out
Good collaboration with UNFPA and OCHA
GBVIMS and case management in place
MHPSS WG activated
SR WG functional
Collective action for better health outcomesINSTITUTIONALIZATION
Collective action for better health outcomesSMALL GROUP DISCUSSIONS (15 MINUTES)
• What are the entry points for VAWG/GBV in your
country?
• How can you integrate VAWG/GBV in your core
functions? (leadership, operational support &
capacity, technical excellence, programme
delivery & partnerships)
• How can you integrate VAWG/GBV in the
Humanitarian Programme Cycle?
• What resources do you need to bolster WHO’s
role in responding to survivors?
Collective action for better health outcomesERF: ENTRY POINTS TO EMBED GBV PREVENTION
& RESPONSE
• Protection:
– Protection must be at the heart of humanitarian action
– In practice, for WHO and health partners, this means ensuring the
availability of health services to prevent and alleviate human suffering,
prioritizing the safety and dignity of patients and their families, meeting the
health needs of diverse groups, and responding to the specific needs of
survivors of sexual and gender-based violence and other forms of violence.
– It also means advocating for the protection of populations, health workers
and health facilities.
• Gender, age and vulnerability sensitivity
– Certain groups are more vulnerable to the health consequences of
emergencies
– Women and girls are at special risk, particularly in settings of conflict.
– Ensuring that they have ready access to reproductive health services and
are protected from gender-based violence are humanitarian response
priorities.
– The vulnerabilities and special needs of other groups, such as children,
older people, the disabled, those living with HIV, and ethnic or religious
minorities, must also beaction
Collective addressed in thehealth
for better designoutcomes
and implementation of
emergency operations.INTEGRATION IN ALL OUR CORE FUNCTIONS
Leadership
Governance - Advocacy - Communication
Programme delivery & Operational support
partnerships 1.1 & capacity
3.3
‐ Strategy, planning & 1.2 ‐ HR/roster management
budgeting and deployments
‐ Resource mobilization & 3.2 1 billion ‐ Learning, capacity
grant management better protected 1.3 development & expert
‐ Partner engagement from health networks
‐ Allocations & work plan 3.1 emergencies ‐ Supplies, logistics & ICT
management 2.1 ‐ Duty of care
‐ Monitoring & reporting ‐ Continuous business
2.3 Improvement
‐ Lessons learning & 2.2
evaluation
Technical excellence HEALTH
Analysis - Innovation - Policy - Knowledge EMERGENCIES
programmeWHO’s Emergency Response
Framework (ERF)
87
HEALTH
EMERGENCIES
programme16 May 2019
Institutionalizing GBV: Building Bridges
Global
Emergencies
Reproductive
Health
Mental Health
Regional Country
HEALTH
EMERGENCIES
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