Global Plan of Action:
Health systems address violence against women and girls A
This is a popular version of the violence against women and girls section of The global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children. World Health Assembly, Resolution 69.5, May 2016 Online at: http://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_9-en.pdf WHO Department of Reproductive Health and Research WHO/RHR/16.13 © World Health Organization 2016 All rights reserved. Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial distribution – should be addressed to WHO Press through the WHO website (www.who.int/ about/licensing/copyright_form/en/index.html). All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. For more information, please contact: Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland E-mail: reproductivehealth@who.int Website: www.who.int/reproductivehealth Design by Samson Mwaka and Lori Michau, Raising Voices Printed in Switzerland
The Global Plan of Action compels us to use our health systems to respond to, prevent and lead efforts to address violence against women and girls.
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It is up to all of us to take action . . . now. 2
Intimate partner violence and sexual violence are the most common forms of violence experienced by women and girls globally. They happen in ALL countries across the world.
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Violence and harmful practices affect women and girls
at every stage of life. 4
child abuse and neglect | female dating violence | genital mutilation | | acid throwing | early and child marriage forced marriage | sexual violence | sexual harassment at school, work in public, online | trafficking | intimate partner violence | femicide
elder abuse (sexual violence, violence by intimate partner, violence by family members, carers)
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The violence experienced by women and girls is rooted in gender inequality.
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= Gender Equality is essential to prevent violence against women. 7
Consequences of VAWG are dire. Women and girls suffer • physical injury and disability • mental health problems • reproductive health problems • sexual health problems 8
Families suffer • children of abused women experience anxiety and behavior problems • loss of home, search for safe space • loss of wages and income
Communities and societies suffer • high cost of providing services • lost productivity • loss of women’s and girls’ participation in public life 9
Women and girls experiencing violence need support and services, but feel shame | face stigma | lack support from families and communities
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Primary Health Care
health services often are slow to recognize violence | lack staff trained on violence | have limited resources | do not consider violence a health problem | are reluctant to talk about it | do not know how to help 11
We can change this. With the Sustainable Development Goals, there is strong political momentum: now’s the time to ensure that no woman or girl is left behind.
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Health providers and health systems have a critical role in supporting women, minimizing the impact and preventing violence from happening.
Why health systems?
• women and girls experiencing violence are more likely to use health services • health care providers are often women’s first point of professional contact • all women are likely to seek health services at some point in their lives 13
But the violence stays hidden, so providers need training and skills so that women and girls get the support and care they deserve. 14
The Global Plan of Action Vision a world in which women and girls are free from all forms of violence and discrimination, their health and well-being are protected and promoted, their human rights and fundamental freedoms are fully achieved, and gender equality and the empowerment of women and girls are the norm.
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You can make this vision a reality government officials health care providers
policy makers
clinic and hospital administrators
funders 16
non-governmental agencies
YOU CAN implement 4 strategic Strengthen:
priorities to change the lives of women and girls.
1. health system leadership and governance
Primary Health Care
2. health service delivery and health providers’ capacity to respond
3. programming to prevent violence against women and girls
4. information collection and evidence
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1. YOU CAN
Strengthen health system leadership and governance
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1. Publicly commit to address and condemn all forms of violence against women and girls 2. Allocate budgets/resources to prevent and respond to violence against women and girls 3. Integrate violence against women prevention and response in health policies, plans, programmes and budgets 4. Advocate to adopt or reform laws and policies promoting sexual and reproductive health and rights and gender equality 5. Designate a unit or focal point in ministries of health to address violence against women 6. Improve coordination within health and with other sectors 19
2. YOU CAN
Primary Health Care
Strengthen health service delivery and health providers’ capacity to respond to violence against women and girls 20
1. Implement protocols for providing quality care, using WHO guidelines/tools 2. Provide comprehensive health care services to all women and girls who have experienced violence, including in humanitarian settings 3. Improve access to services by integrating care for women experiencing violence into existing programmes and services 4. Provide quality care to survivors which is womancentered and gender-sensitive 5. Eliminate mistreatment and abuse of women in health care settings 6. Train health care providers and integrate training on violence against women and girls in pre- and in-service curriculum for all health professionals 21
3. YOU CAN
Strengthen programming to prevent violence against women and girls 22
1. Address the needs of children witnessing intimate partner violence in their homes 2. Promote messages about consent and respect in intimate and sexual relationships in schools and in health education and promotion activities 3. Support prevention programmes that challenge norms that perpetuate male dominance or female subordination, stigmatize survivors or normalize violence 4. Address harmful alcohol and substance use and maternal depression as risk factors and consequences of intimate partner violence 5. Inform policies and programmes in other sectors about evidence-based prevention interventions, including comprehensive sexuality education and economic livelihood programmes for women 23
4.
YOU CAN
Strengthen information collection and evidence 24
1. Strengthen routine reporting of violence against women and girls statistics by including indicators and collection of data in health information and surveillance systems 2. Establish baselines for prevalence through population-based surveys and integrate violence against women and girls modules in recurring population-based surveys 3. Conduct or support analysis and use of disaggregated data on violence against women and girls 4. Conduct research to develop, evaluate and scale up health systems interventions to prevent or reduce violence against women and girls 5. Facilitate efforts by others to research violence against women and girls knowledge gaps and evaluate interventions 25
Your efforts should be guided by the following principles: Life-Course Approach: address risk factors and needs at all stages of life Gender Equality: address gender inequality and gender-based discrimination Human Rights: respect, protect and fulfill women’s human rights
Evidence-Based: be informed by best available scientific evidence
Ecological Approach: address individual, relationship, community and society level risks
Universal Health Coverage: ensure that all receive quality services without exacerbating financial hardships
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Health Equity: pay attention to the needs of those facing multiple forms of discrimination
Woman-Centered Care: provide respectful care, support women’s autonomy, and enhance their safety
Community Participation: support participation and voices of women and adolescents, and partner with women’s organizations
Multisectoral Response: Strengthen partnerships and coordination between health and other sectors and with NGOs, professional associations and private sector providers
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How will we know we’ve brought the vision to life? By the number of countries that: 1. include health care services to address intimate partner violence and comprehensive post-rape care in line, with WHO guidelines, in national health or sexual and reproductive health plans or policies. 2. develop or update their national guidelines or protocols for the health system response to women experiencing violence, consistent with international human rights standards and WHO guidelines. 3. provide comprehensive post-rape care in a medical facility in every territorial and/or administrative unit, consistent with WHO guidelines. 4. have a national multisectoral plan which includes the health system and which proposes at least one strategy to prevent violence against women and girls. 5. have carried out a population-based, nationally representative study/ survey on VAW or that have included a module on violence against women in other population-based demographic or health surveys within the past five years, disaggregated by age, ethnicity, socioeconomic status, other. 28
In line with the Sustainable Development Goals, we have 15 years, until 2030, to make this change happen.
It can be done. It is up to us. start today | get organized | work with others | be clear and strategic | focus on what you do best | stay informed | call on everyone to commit 29
Tools to help you implement the Global Plan of Action http://www.who.int/reproductivehealth/topics/violence/en/ http://www.who.int/reproductivehealth/publications/violence/en/
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