R E S P E C T Preventing violence against women For more information, contact Department of Reproductive Health and Research World Health Organization 20 Avenue Appia CH 1211, Geneva 27 Switzerland Fax: +41 22 791 4171 Email: reproductivehealth@who.int www.who.int/reproductivehealth/topics/violence/en WHO/RHR/18.19 W O M E N © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. 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Printed in Switzerland RESPECT women: Preventing violence against women Know the facts Assess risk and protective factors Implement 7 strategies to prevent violence against women Assess evidence for interventions Develop a theory of change Apply the guiding principles for prevention Strengthen enabling environment for prevention Adapt and scale-up what works Monitor, evaluate and measure progress Commit to action! Introduction The primary audience for this document is policymakers. Programme implementers working on preventing and responding to violence against women will also find it useful for designing, planning, implementing, and monitoring and evaluating interventions and programmes. I II III IV V VI VII VIII IX p.4 Table of contents X p.6 p.10 p.14 p.18 p.22 p.12 p.8 p.16 p.20 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 2 3 I Know the facts Nearly 1 in 3 (35%) women worldwide have experienced physical and/or sexual violence by an intimate partner or sexual violence, not including sexual harassment, by any perpetrator. Low education, exposure to violence in childhood, unequal power in intimate relationships, and attitudes and norms accepting violence and gender inequality increase the risk of experiencing intimate partner violence and sexual violence. Violence against women and girls is preventable. To prevent violence, mitigate the risk factors and amplify the protective factors. Globally, 30% of women have experienced physical and/or sexual violence by an intimate partner in their lifetime. Violence negatively affects women’s physical and mental health and well-being. It has social and economic consequences and costs for families, communities and societies. Violence against women (VAW) is a violation of human rights, is rooted in gender inequality, is a public health problem, and an impediment to sustainable development. Low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality increase risk of perpetrating intimate partner violence. Adolescent girls, young women, women belonging to ethnic and other minorities, transwomen, and women with disabilities face a higher risk of different forms of violence. The majority (55-95%) of women survivors of violence do not disclose or seek any type of services. Humanitarian emergencies may exacerbate existing violence and lead to additional forms of violence against women and girls. Globally between 38%-50% of murders of women are committed by intimate partners.R ES PE CT : P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 4 5 II Childhood experience of violence and/ or exposure to violence in the family Mental disorders Attitudes condoning or justifying violence as normal or acceptable Discriminatory laws on property ownership, marriage, divorce and child custody Low levels of women’s employment and education Absence or lack of enforcement of laws addressing violence against women Gender discrimination in institutions (e.g. police, health) High levels of inequality in relationships/ male-controlled relationships/ dependence on partner Men's multiple sexual relationships Men's use of drugs and harmful use of alcohol Harmful gender norms that uphold male privilege and limit women’s autonomy High levels of poverty and unemployment High rates of violence and crime Availability of drugs, alcohol and weapons Assess the risk & protective factors1 Intimate relationships characterized by gender equality, including in shared decision- making and household responsibilities Laws that: • promote gender equality • promote women’s access to formal employment • address violence against women Non-exposure to violence in the family Secondary education for women and men and less disparity in education levels between women and men Both men and boys and women and girls are socialized to, and hold gender equitable attitudes Norms that support non- violence and gender equitable relationships, and promote women’s empowerment Protective Factors Risk Factors SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 6 7 III R E S P E C T Implement strategies to prevent violence against women27 Relationship skills strengthened refers to strategies aimed at individuals or groups of women, men or couples to improve skills in interpersonal communication, conflict management and shared decision-making. Environments made safe refers to efforts to create safe schools, public spaces and work environments, among others. Empowerment of women refers to both economic and social empowerment including inheritance and asset ownership, microfinance plus gender and empowerment training interventions, collective action, creating safe spaces and mentoring to build skills in self-efficacy, assertiveness, negotiation, and self-confidence. Services ensured refers to a range of services including police, legal, health, and social services provided to survivors. Poverty reduced refers to strategies targeted to women or the household whose primary aim is to alleviate poverty ranging from cash transfers, savings, microfinance loans, labour force interventions. Child and adolescent abuse prevented refers to establishing nurturing family relationships, prohibiting corporal punishment, and implementing parenting programmes as mentioned in INSPIRE - 7 strategies for preventing violence against children. Transformed attitudes, beliefs, and norms refers to strategies that challenge harmful gender attitudes, beliefs, norms and stereotypes that uphold male privilege and female subordination, that justify violence against women and that stigmatize survivors. These may range from public campaigns, group education to community mobilization efforts. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 8 9 R E S P E C T IV Group-based workshops with women and men to promote egalitarian attitudes and relationships Couples counselling and therapy Empowerment training for women and girls including life skills, safe spaces, mentoring Inheritance and asset ownership policies and interventions Micro-finance or savings and loans plus gender and empowerment training components Economic transfers, including conditional/ unconditional cash transfers plus vouchers, and in-kind transfers Labour force interventions including employment policies, livelihood and employment training Microfinance or savings interventions without any additional components Infrastructure and transport Bystander interventions Whole School interventions Empowerment counselling interventions or psychological support to support access to services (i.e. advocacy) Alcohol misuse prevention interventions Shelters Hotlines One-stop crisis centres Perpetrator interventions Women’s police stations/units Screening in health services Sensitization and training of institutional personnel without changing the institutional environment Home visitation and health worker outreach Parenting interventions Psychological support interventions for children who experience violence and who witness intimate partner violence Life skills / school-based curriculum, rape and dating violence prevention training Community mobilization Group-based workshops with women and men to promote changes in attitudes and norms Social marketing or edutainment and group education Group education with men and boys to change attitudes and norms Stand-alone awareness campaigns/single component communications campaigns Economic transfers In Northern Ecuador, a cash, vouchers and food transfer programme implemented by the World Food Programme (WFP) was targeted to women in poor urban areas, intending to reduce poverty. Participating households received monthly transfers equivalent to $40 per month for a period of 6 months. The transfer was conditional on attendance of monthly nutrition trainings. The evaluation showed reductions in women’s experience of controlling behaviours, physical and/or sexual violence by intimate partners by 19 to 30%. A plausible mechanism for this was reduced conflict within couples related to poverty- related stresses.p Microfinance plus gender and empowerment The IMAGE project (Intervention with Microfinance for Aids and Gender Equity) in South Africa empowers women through microfinance together with training on gender and power and community mobilization activities. Studies show it reduced domestic violence by 50% in the intervention group over a period of two years. At US$244 per incident case of partner violence averted during a 2-year scale up phase, the intervention is highly cost-effective.w Relationships skills strengthened Empowerment of women Services ensured Poverty reduced LL L H H H H H H L L EXAMPLE EXAMPLE H H L H L L L L L L L L L L L H H H L L L H H L H H H L H H L H H L H H H H Advocacy for survivors The Community Advocacy Project in Michigan and Illinois, United States, is an evidence-based program designed to help women survivors of intimate partner abuse re-gain control of their lives. Trained advocates provide advocacy and individually tailored assistance to survivors so that they can access community resources and social support. The intervention was found to lower recurrance of violence and depression and improve quality of life and social support. Two years after the intervention ended, the positive change continued.y Right to play - preventing violence among and against children in schools In Hyderabad (Sindh Province), Pakistan, a right to play intervention reached children in 40 public schools. Boys and girls were engaged in play-based learning providing them opportunity to develop life skills such as confidence, communication, empathy, coping with negative emotions, resilience, cooperation, leadership, critical thinking and conflict resolution that help combat conflict, intolerance, gender discrimination and peer violence. An evaluation showed decreases in peer victimization by 33% among boys and 59% among girls at 24 months post intervention; in corporal punishment by 45% in boys and 66% in girls; and in witnessing of domestic violence by 65% among boys and by 70% in girls.o Community Mobilizations SASA! is a community intervention in Uganda that prevents violence against women by shifting the power balance between men and women in relationships. Studies show that in SASA! communities 76% of women and men believe physical violence against a partner is not acceptable while only 26% of women and men in control communities believe the same. At the cost of US$ 460 per incident case of partner violence averted in trial phase, intervention is cost-effective and further economies of scale can be achieved during scale-up.v Group-based Workshops In the two-year period following the implementation of Stepping Stones in South Africa with female and male participants aged 15–26 years, men were less likely to perpetrate intimate partner violence, rape and transactional sex in the intervention group compared to the baseline.x Environments made safe Child and adolescent abuse prevented EXAMPLE EXAMPLE EXAMPLEEXAMPLE Transformed attitudes, beliefs, and norms H L L H L L H Assess the evidence on interventions3 L H LEGEND4 promising, >1 evaluations show significant reductions in violence outcomes more evidence needed, > 1 evaluations show improvements in intermediate outcomes related to violence conflicting, evaluations show conflicting results in reducing violence5 no evidence, intervention not yet rigorously evaluated ineffective, >1 evaluations show no reductions in violence outcomes World Bank Low and Middle Income Countries (LMIC) World Bank High Income Countries (HIC) L H RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 10 11 V BA RR IE R S Co m m un iti es w ith h ig h le ve ls of v io le nc e Fa m ili es a ffe ct ed b y vi ol en ce W om en fa ci ng v io le nc e IN TE R V EN TI O N S Environments made safe OUTPUTS OUTCOMES IMPACT Relationship skills strengthened Empowerment of women Services ensured Poverty reduced Child and adolescent abuse prevented Transformed attitudes, beliefs, and norms Programmes to address VAW widely implemented Increased resources and political will to address VAW Increased awareness about VAW as a public health problem and that it is preventable Sectoral outcomes related to health, economic, and social development improved (e.g. improved mental health, reduced household poverty, improved women's and child health, improved women's education and earnings, and reduced absenteeism) Families, communities and institutions believe in and uphold gender equality as a norm and no longer accept VAW Men accept and treat women as equals Women can make autonomous decisions Women have knowledge of their rights and access to programmes Improved health and development outcomes in households, community and society Women are exercising their human rights and contributing to development Violence against women is reduced or eliminated Equality and respect are practiced in intimate, family and community relationships Interpersonal conflicts are resolved peacefully Limitations on women's autonomy Children exposed to violence Social norms that perpetuate male power Inadequate services Inadequate legal and social protections for women Lack of political will and resources Under-resourced women's organizations or movements Develop a theory of change Build ing o n res ilien cy a nd k now ledg e, an d re sour cing and sup port ing c omm uniti es to find solu tions 12 13 G EN ER A TE A N D D IS SE M IN A TE K N O W LE D G E CO R E VA LU ES PR O G R A M M E D ES IG N VIApply the guiding principles for effective programming Strengthen monitoring and evaluation systems to build the evidence base on what works and facilitate knowledge sharing to inform programming Ensure confidentiality of information and anticipate and address unintended consequences Ensure that analysis of unequal gender and power relations and male privilege over women is at the center of programming Promote gender equality and women’s human rights Leave no one behind Develop a theory of change Promote evidence informed programming Put women’s safety first and do no harm Use participatory approaches Promote coordination Take a life-course approach Address the prevention continuum Implement combined interventions Elaborate how programming inputs will lead to changes in intermediate outcomes and likely impacts Address multiple and intersecting forms of discrimination based on sex, gender, class, race, ethnicity, disability, sexual orientation, gender identity Stimulate personal reflection and critical thinking, and build on the voice, agency and skills of people. Facilitate collective programming with individuals, families and communities to address the multiple risk factors underlying VAW and multiple forms of violence within families. Support partnerships across sectors and organizations, and at local and national levels Link prevention and response interventions Implement programmes that work with children, adolescents and young people for early interventions 6 7 8 9 10 1 5 2 3 4 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 14 15 VII Build political commitment from leaders and policy makers to speak out, condemning violence against women. Put in place and facilitate enforcement of laws and policies that address violence against women and that promote gender equality, including access to secondary education.6 Invest in, build on the work of, resource, and support women's organizations. Allocate resources to programmes, research, and to strengthen institutions and capacities of the health, education, law enforcement, and social services sectors to address violence against women. Strengthen enabling environment a c b d for prevention RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 16 17 VIIIAdapt and scale-up what works Violence prevention interventions that have been shown to work on a pilot basis can be scaled- up in different ways. They can be expanded by adding more beneficiaries; they can be adapted and replicated in another geographic location; and there can be expansion in coverage of the same intervention over a wider geographic area. Interventions that are being scaled-up in a new setting need to be adapted to context. This requires an understanding of the local culture, values and resources. Interventions identified as promising (pages 10- 11) can be adapted and scaled-up with attention to the guiding principles for prevention and to the adaptation and scaling-up considerations on the next page; those classified as “more evidence needed" (pages 10-11) may need to be replicated or further refined before they are scaled-up; and those identified as "conflicting" or "no evidence" need to be further evaluated. Align with national commitments (e.g. a national plan, policy, strategy) to end violence against women, or to promote gender equality or women’s health.7 Invest in capacity among implementers, and giving enough time to scale-up and to allow for change to occur and sustain. Programme for synergy, combining multiple strategies and interventions at the individual, interpersonal, community and societal levels for sustained impact. Identify and maintain fidelity to core principles of gender equality, rights and safety as well as to minimum “dosage”, while also adapting to context, including language and culture. Build on on-going initiatives, integrating prevention activities into existing health, development and other existing sectoral programmes. Design with “scale” in mind, investing for the long-term, keeping costs and sustainability in mind. Start small, document and evaluate the adaptation and scale-up in order to innovate and strengthen evidence-informed programming. Support a community of practice among programme developers and implementers to facilitate learning and knowledge sharing. a b c d e f g h RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 18 19 IX Progress in preventing violence against women can be measured in the short and the long-term. 1. In the long-term, the impact of prevention programmes can be measured as reductions in prevalence of different forms of violence against women. 2. At the global level, countries are required to report progress in preventing violence against women as part of SDG targets. Two indicators are proposed: • prevalence of intimate partner violence in the last 12 months among women aged 15 years and older (SDG target 5.2 - eliminate all forms of violence against women and girls); • proportion of young women and men aged 18–29 years who experienced sexual violence by age 18 (SDG target 16.2 - End abuse, exploitation, trafficking and all forms of violence against and torture of children). Monitor, evaluate and measure progress 3. In the short to medium term, interim indicators that contribute towards reductions in prevalence of violence against women will depend on the types of programmes. These can include, for example, improvements in: • gender equitable attitudes and norms • partner communication • women’s autonomy, agency and/or self- efficacy • girls' and women's education 4. It is important to specify a theory of change elaborating how the programme will likely improve interim indicators and how these in turn will contribute to reducing prevalence of violence against women. 5. It is important to evaluate before scaling-up and to monitor the scaling-up on an on-going basis to ensure that resources are invested in programmes that work, unintended or harmful outcomes are mitigated, and the scaling-up process takes into account the local context. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 20 21 X R E S P E C T ENDING VIOLENCE AGAINST WOMEN BEGINS WITH Commit to change Start today Support evidence-based approaches Join others The way forward: a call to action RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 22 23 a. CUSP (2017), On the CUSP of change: Effective scaling of social norms programming for gender equality, Community for Understanding Scale Up: http://raisingvoices.org/wp-content/ uploads/2013/02/6.CombinedCUSPcasestudies.FINAL_.pdf b. Heise L (2011), What Works to Prevent Partner Violence?: http:// strive.lshtm.ac.uk/system/files/attachments/What%20works%20 to%20prevent%20partner%20violence.pdf c. Salamander Trust (2017), ALIVE[H]E Framework: http:// salamandertrust.net/resources/alivhe-framework d. UN Women (2015), A Framework to Underpin Action to Prevent Violence Against Women: http://www.unwomen.org/-/ media/ headquarters/attachments/sections/library/publications/2015/ prevention_framework_unwomen_nov2015. pdf?la=en&vs=5223 e. WHO, LSHTM, SAMRC (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO. http://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng. pdf;jsessionid=294A291A603A7BCB4B60F588532CE53D? sequence=1 f. World Health Organization (2016), Violence against women, Intimate partner and sexual violence against women, Fact Sheet: http://www.who.int/mediacentre/factsheets/fs239/en/ g. World Health Organization and UNAIDS (2013), 16 Ideas for addressing violence against women in the context of the HIV epidemic - A programming tool: http://www.who.int/ reproductivehealth/publications/violence/vaw_hiv_epidemic/en/ h. WHO, LSHTM (2010), Preventing Intimate partner violence and sexual violence: generating evidence and taking action: http://apps.who.int/iris/bitstream/ handle/10665/44350/9789241564007_eng.pdf?sequence=1 i. What Works to Prevent Violence (2014), A global programme to prevent violence against women and girls: A Summary of the Evidence and Research Agenda: https://www.gov.uk/ government/publications/what-works-in-preventing-violenceagainst- women-and-girls-review-of-the-evidence-from-the-programme j. Ellsberg M., Arango D.J., Morton M., Gennari F., Kiplesund S., Contreras-Urbina M., Watts C (2015), Prevention of violence against women and girls: what does the evidence say? The Lancet, Volume 385, No. 9977, p1555–1566: https://www.thelancet. com/journals/lancet/article/PIIS0140-6736(14)61703-7/ fulltext?rss%3Dyes k. Contreras-Urbina M., Heilman B., Von Au A. K., Hill A., Puerto Gómez M., Zelaya J., Arango D.J (2016) Community-based approaches to intimate partner violence : a review of evidence and essential steps to adaptation (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/ en/907511467996712161/Community-based-approaches-to- intimate-partner-violence-a-review-of-evidence-and-essential-steps-to- adaptation l. World Health Organization (2016), 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: http://www.who.int/ reproductivehealth/publications/violence/global-plan-of-action/en/ m. Garcia-Moreno C., Zimmerman C., Morris-Gehring A., Heise L., Amin A., Abrahams N., Montoya O., Bhate-Deosthali P., Kilonzo N., Watts C (2015), Addressing violence against women: a call to action, The Lancet, Volume 385, No. 9978, p1685–1695: https://doi.org/10.1016/S0140-6736(14)61830-4 n. World Health Organization (2016) INSPIRE: Seven strategies for Ending Violence Against Children: http://www.who.int/violence_ injury_prevention/violence/inspire/en/ o. What works to prevent violence against women and girls global programme (2018), Right to play: preventing violence among and against children in schools in Hyderabad, Pakistan: Evidence brief. South Africa: Medical Research Council and UK: UK aid. https:// www.whatworks.co.za/documents/publications/211-right-to-play/ file p. Hidrobo M, Peterman A, Heise L (2016), The effect of cash, vouchers and food transfers on intimate partner violence: evidence from a randomized experiment in Northern Ecuador. American Economic Journal Applied Economics, Volume 8, No 3, p284-303: https://DOI:10.1257/app.20150048 q. National Resource Center on Domestic Violence (2012), Program and Practice Profiles: Community Advocacy Project, Harrisburg, PA: National Resource Center on Domestic Violence. http://www. dvevidenceproject.org r. Buller A, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L (2018). A mixed-method review of cash transfers and intimate partner violence in low- and middle-income countries. The World Bank Research Observer, Volume 22, No 2, p218-258: https:// doi.org/10.1093/wbro/lky002 s. Peterman A, Palermo TM, Ferrari G (2018). Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ global health, Volume 3, No. 6: e001143. doi:10.1136/ bmjgh-2018-001143. t. Karakurt G, Whiting K, Van Esch, Bolen S, Calabrese J (2016). Couple therapy for intimate partner violence: A systematic review and meta-analysis. J Marital Fam Ther, Volume 42, No. 4, p567- 583: doi:10.1111/jmft.12178. u. Desai CC, Reece J, Shakespear-Pellington S (2017) The prevention of violence in childhood through parenting programmes: a global review, Psychology, Health & Medicine, Volume 22, Sup1, p166- 186: DOI: 10.1080/13548506.2016.1271952. v. Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, Cundill B, Francisco L, Kaye D, Musuya T, Michau L, Watts C (2014), Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Medicine, Volume 12:122: https:// doi.org/10.1186/s12916-014-0122-5. w. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD (2006), Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. The Lancet, Volume 368, No. 9551, p1973–1983: doi: 10.1016/S0140-6736(06)69744-4. x. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N (2008), Impact of Stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Brit Med J, Volume 337, No. 7666:a506: doi: 10.1136/bmj.a506. y. Sullivan, CM, Bybee, DI (1999), Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, Volume 67, No. 1, p43-53: https://cap.vaw.msu.edu/wp-content/ uploads/2014/05/Two-year-followup-CAP-JCCP.pdf. 1 These are for both perpetration of and victimization from intimate partner violence (IPV) 2 The 7 strategies are not mutually exclusive, should not be seen as silos, and there are some overlaps across them. 3 Although specific interventions and their examples are listed under one particular strategy, it is important to note that many of them reflect combination/bundled programming with multi- component and multi-level interventions that fall across more than 1 of the 7 strategies of RESPECT. Their categorization under one strategy reflects the primary intent of the intervention. For example, some interventions under transforming norms also include relationship strengthening skills. Likewise, empowerment of women interventions may include an economic transfer component. Therefore, these strategies should not be seen as stand-alone but as approaches whose impact may be better enhanced in combination with others. 4 Evidence ratings are largely derived from systematic reviews of more than 1 evaluation of interventions that mostly use experimental designs including randomized, cluster randomized and quasi- experimental methods. It is recognized that for some strategies such as justice sector interventions, alternative evaluation methods may be more appropriate including time series, observational and cross-sectional designs despite being typically considered lower quality. This is an emerging field and hence, there is a great deal of variation in rigor of study design and evaluation. The sources for these reviews and studies are provided as part of references. 5 Refers to evaluations where some studies may show positive impacts and others may show no impacts or negative impacts, highlighting that the impact of interventions may be context specific. Hence, any replication or adaptation of the intervention must pay close attention to the contextual or implementation factors. 6 This includes laws and policies that: criminalize sexual abuse; promote equality in inheritance; ban child marriage and FGM; marriage, custody and divorce laws that guarantee equality for women; action plans that promote gender equality and address violence against women. It also includes implementing justice and law enforcement services such as arrest orders and legal aid. 7 Even where there is no national commitment to ending violence against women, there may be other commitments to empower women, to gender equality, or to women’s health that may be useful to consider. Citations and additional references Endnotes RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 24
R E S P E C T Preventing violence against women For more information, contact Department of Reproductive Health and Research World Health Organization 20 Avenue Appia CH 1211, Geneva 27 Switzerland Fax: +41 22 791 4171 Email: reproductivehealth@who.int www.who.int/reproductivehealth/topics/violence/en WHO/RHR/18.19 W O M E N WHO/RHR/18.19 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. 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Printed in Switzerland RESPECT women: Preventing violence against women Know the facts Assess risk and protective factors Implement 7 strategies to prevent violence against women Assess evidence for interventions Develop a theory of change Apply the guiding principles for prevention Strengthen enabling environment for prevention Adapt and scale-up what works Monitor, evaluate and measure progress Commit to action! Introduction The primary audience for this document is policymakers. Programme implementers working on preventing and responding to violence against women will also find it useful for designing, planning, implementing, and monitoring and evaluating interventions and programmes. I II III IV V VI VII VIII IX p.4 Table of contents X p.6 p.10 p.14 p.18 p.22 p.12 p.8 p.16 p.20 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 2 3 I Know the facts Nearly 1 in 3 (35%) women worldwide have experienced physical and/or sexual violence by an intimate partner or sexual violence, not including sexual harassment, by any perpetrator. Low education, exposure to violence in childhood, unequal power in intimate relationships, and attitudes and norms accepting violence and gender inequality increase the risk of experiencing intimate partner violence and sexual violence. Violence against women and girls is preventable. To prevent violence, mitigate the risk factors and amplify the protective factors. Globally, 30% of women have experienced physical and/or sexual violence by an intimate partner in their lifetime. Violence negatively affects women’s physical and mental health and well-being. It has social and economic consequences and costs for families, communities and societies. Violence against women (VAW) is a violation of human rights, is rooted in gender inequality, is a public health problem, and an impediment to sustainable development. Low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality increase risk of perpetrating intimate partner violence. Adolescent girls, young women, women belonging to ethnic and other minorities, transwomen, and women with disabilities face a higher risk of different forms of violence. The majority (55-95%) of women survivors of violence do not disclose or seek any type of services. Humanitarian emergencies may exacerbate existing violence and lead to additional forms of violence against women and girls. Globally between 38%-50% of murders of women are committed by intimate partners.R ES PE CT : P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 4 5 II Childhood experience of violence and/ or exposure to violence in the family Mental disorders Attitudes condoning or justifying violence as normal or acceptable Discriminatory laws on property ownership, marriage, divorce and child custody Low levels of women’s employment and education Absence or lack of enforcement of laws addressing violence against women Gender discrimination in institutions (e.g. police, health) High levels of inequality in relationships/ male-controlled relationships/ dependence on partner Men's multiple sexual relationships Men's use of drugs and harmful use of alcohol Harmful gender norms that uphold male privilege and limit women’s autonomy High levels of poverty and unemployment High rates of violence and crime Availability of drugs, alcohol and weapons Assess the risk & protective factors1 Intimate relationships characterized by gender equality, including in shared decision- making and household responsibilities Laws that: • promote gender equality • promote women’s access to formal employment • address violence against women Non-exposure to violence in the family Secondary education for women and men and less disparity in education levels between women and men Both men and boys and women and girls are socialized to, and hold gender equitable attitudes Norms that support non- violence and gender equitable relationships, and promote women’s empowerment Protective Factors Risk Factors SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 6 7 III R E S P E C T Implement strategies to prevent violence against women27 Relationship skills strengthened refers to strategies aimed at individuals or groups of women, men or couples to improve skills in interpersonal communication, conflict management and shared decision-making. Environments made safe refers to efforts to create safe schools, public spaces and work environments, among others. Empowerment of women refers to both economic and social empowerment including inheritance and asset ownership, microfinance plus gender and empowerment training interventions, collective action, creating safe spaces and mentoring to build skills in self-efficacy, assertiveness, negotiation, and self-confidence. Services ensured refers to a range of services including police, legal, health, and social services provided to survivors. Poverty reduced refers to strategies targeted to women or the household whose primary aim is to alleviate poverty ranging from cash transfers, savings, microfinance loans, labour force interventions. Child and adolescent abuse prevented refers to establishing nurturing family relationships, prohibiting corporal punishment, and implementing parenting programmes as mentioned in INSPIRE - 7 strategies for preventing violence against children. Transformed attitudes, beliefs, and norms refers to strategies that challenge harmful gender attitudes, beliefs, norms and stereotypes that uphold male privilege and female subordination, that justify violence against women and that stigmatize survivors. These may range from public campaigns, group education to community mobilization efforts. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 8 9 R E S P E C T IV Group-based workshops with women and men to promote egalitarian attitudes and relationships Couples counselling and therapy Empowerment training for women and girls including life skills, safe spaces, mentoring Inheritance and asset ownership policies and interventions Micro-finance or savings and loans plus gender and empowerment training components Economic transfers, including conditional/ unconditional cash transfers plus vouchers, and in-kind transfers Labour force interventions including employment policies, livelihood and employment training Microfinance or savings interventions without any additional components Infrastructure and transport Bystander interventions Whole School interventions Empowerment counselling interventions or psychological support to support access to services (i.e. advocacy) Alcohol misuse prevention interventions Shelters Hotlines One-stop crisis centres Perpetrator interventions Women’s police stations/units Screening in health services Sensitization and training of institutional personnel without changing the institutional environment Home visitation and health worker outreach Parenting interventions Psychological support interventions for children who experience violence and who witness intimate partner violence Life skills / school-based curriculum, rape and dating violence prevention training Community mobilization Group-based workshops with women and men to promote changes in attitudes and norms Social marketing or edutainment and group education Group education with men and boys to change attitudes and norms Stand-alone awareness campaigns/single component communications campaigns Economic transfers In Northern Ecuador, a cash, vouchers and food transfer programme implemented by the World Food Programme (WFP) was targeted to women in poor urban areas, intending to reduce poverty. Participating households received monthly transfers equivalent to $40 per month for a period of 6 months. The transfer was conditional on attendance of monthly nutrition trainings. The evaluation showed reductions in women’s experience of controlling behaviours, physical and/or sexual violence by intimate partners by 19 to 30%. A plausible mechanism for this was reduced conflict within couples related to poverty- related stresses.p Microfinance plus gender and empowerment The IMAGE project (Intervention with Microfinance for Aids and Gender Equity) in South Africa empowers women through microfinance together with training on gender and power and community mobilization activities. Studies show it reduced domestic violence by 50% in the intervention group over a period of two years. At US$244 per incident case of partner violence averted during a 2-year scale up phase, the intervention is highly cost-effective.w Relationships skills strengthened Empowerment of women Services ensured Poverty reduced LL L H H H H H H L L EXAMPLE EXAMPLE H H L H L L L L L L L L L L L H H H L L L H H L H H H L H H L H H L H H H H Advocacy for survivors The Community Advocacy Project in Michigan and Illinois, United States, is an evidence-based program designed to help women survivors of intimate partner abuse re-gain control of their lives. Trained advocates provide advocacy and individually tailored assistance to survivors so that they can access community resources and social support. The intervention was found to lower recurrance of violence and depression and improve quality of life and social support. Two years after the intervention ended, the positive change continued.y Right to play - preventing violence among and against children in schools In Hyderabad (Sindh Province), Pakistan, a right to play intervention reached children in 40 public schools. Boys and girls were engaged in play-based learning providing them opportunity to develop life skills such as confidence, communication, empathy, coping with negative emotions, resilience, cooperation, leadership, critical thinking and conflict resolution that help combat conflict, intolerance, gender discrimination and peer violence. An evaluation showed decreases in peer victimization by 33% among boys and 59% among girls at 24 months post intervention; in corporal punishment by 45% in boys and 66% in girls; and in witnessing of domestic violence by 65% among boys and by 70% in girls.o Community Mobilizations SASA! is a community intervention in Uganda that prevents violence against women by shifting the power balance between men and women in relationships. Studies show that in SASA! communities 76% of women and men believe physical violence against a partner is not acceptable while only 26% of women and men in control communities believe the same. At the cost of US$ 460 per incident case of partner violence averted in trial phase, intervention is cost-effective and further economies of scale can be achieved during scale-up.v Group-based Workshops In the two-year period following the implementation of Stepping Stones in South Africa with female and male participants aged 15–26 years, men were less likely to perpetrate intimate partner violence, rape and transactional sex in the intervention group compared to the baseline.x Environments made safe Child and adolescent abuse prevented EXAMPLE EXAMPLE EXAMPLEEXAMPLE Transformed attitudes, beliefs, and norms H L L H L L H Assess the evidence on interventions3 L H LEGEND4 promising, >1 evaluations show significant reductions in violence outcomes more evidence needed, > 1 evaluations show improvements in intermediate outcomes related to violence conflicting, evaluations show conflicting results in reducing violence5 no evidence, intervention not yet rigorously evaluated ineffective, >1 evaluations show no reductions in violence outcomes World Bank Low and Middle Income Countries (LMIC) World Bank High Income Countries (HIC) L H RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 10 11 V BA RR IE R S Co m m un iti es w ith h ig h le ve ls of v io le nc e Fa m ili es a ffe ct ed b y vi ol en ce W om en fa ci ng v io le nc e IN TE R V EN TI O N S Environments made safe OUTPUTS OUTCOMES IMPACT Relationship skills strengthened Empowerment of women Services ensured Poverty reduced Child and adolescent abuse prevented Transformed attitudes, beliefs, and norms Programmes to address VAW widely implemented Increased resources and political will to address VAW Increased awareness about VAW as a public health problem and that it is preventable Sectoral outcomes related to health, economic, and social development improved (e.g. improved mental health, reduced household poverty, improved women's and child health, improved women's education and earnings, and reduced absenteeism) Families, communities and institutions believe in and uphold gender equality as a norm and no longer accept VAW Men accept and treat women as equals Women can make autonomous decisions Women have knowledge of their rights and access to programmes Improved health and development outcomes in households, community and society Women are exercising their human rights and contributing to development Violence against women is reduced or eliminated Equality and respect are practiced in intimate, family and community relationships Interpersonal conflicts are resolved peacefully Limitations on women's autonomy Children exposed to violence Social norms that perpetuate male power Inadequate services Inadequate legal and social protections for women Lack of political will and resources Under-resourced women's organizations or movements Develop a theory of change Build ing o n res ilien cy a nd k now ledg e, an d re sour cing and sup port ing c omm uniti es to find solu tions 12 13 G EN ER A TE A N D D IS SE M IN A TE K N O W LE D G E CO R E VA LU ES PR O G R A M M E D ES IG N VIApply the guiding principles for effective programming Strengthen monitoring and evaluation systems to build the evidence base on what works and facilitate knowledge sharing to inform programming Ensure confidentiality of information and anticipate and address unintended consequences Ensure that analysis of unequal gender and power relations and male privilege over women is at the center of programming Promote gender equality and women’s human rights Leave no one behind Develop a theory of change Promote evidence informed programming Put women’s safety first and do no harm Use participatory approaches Promote coordination Take a life-course approach Address the prevention continuum Implement combined interventions Elaborate how programming inputs will lead to changes in intermediate outcomes and likely impacts Address multiple and intersecting forms of discrimination based on sex, gender, class, race, ethnicity, disability, sexual orientation, gender identity Stimulate personal reflection and critical thinking, and build on the voice, agency and skills of people. Facilitate collective programming with individuals, families and communities to address the multiple risk factors underlying VAW and multiple forms of violence within families. Support partnerships across sectors and organizations, and at local and national levels Link prevention and response interventions Implement programmes that work with children, adolescents and young people for early interventions 6 7 8 9 10 1 5 2 3 4 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 14 15 VII Build political commitment from leaders and policy makers to speak out, condemning violence against women. Put in place and facilitate enforcement of laws and policies that address violence against women and that promote gender equality, including access to secondary education.6 Invest in, build on the work of, resource, and support women's organizations. Allocate resources to programmes, research, and to strengthen institutions and capacities of the health, education, law enforcement, and social services sectors to address violence against women. Strengthen enabling environment a c b d for prevention RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 16 17 VIIIAdapt and scale-up what works Violence prevention interventions that have been shown to work on a pilot basis can be scaled- up in different ways. They can be expanded by adding more beneficiaries; they can be adapted and replicated in another geographic location; and there can be expansion in coverage of the same intervention over a wider geographic area. Interventions that are being scaled-up in a new setting need to be adapted to context. This requires an understanding of the local culture, values and resources. Interventions identified as promising (pages 10- 11) can be adapted and scaled-up with attention to the guiding principles for prevention and to the adaptation and scaling-up considerations on the next page; those classified as “more evidence needed" (pages 10-11) may need to be replicated or further refined before they are scaled-up; and those identified as "conflicting" or "no evidence" need to be further evaluated. Align with national commitments (e.g. a national plan, policy, strategy) to end violence against women, or to promote gender equality or women’s health.7 Invest in capacity among implementers, and giving enough time to scale-up and to allow for change to occur and sustain. Programme for synergy, combining multiple strategies and interventions at the individual, interpersonal, community and societal levels for sustained impact. Identify and maintain fidelity to core principles of gender equality, rights and safety as well as to minimum “dosage”, while also adapting to context, including language and culture. Build on on-going initiatives, integrating prevention activities into existing health, development and other existing sectoral programmes. Design with “scale” in mind, investing for the long-term, keeping costs and sustainability in mind. Start small, document and evaluate the adaptation and scale-up in order to innovate and strengthen evidence-informed programming. Support a community of practice among programme developers and implementers to facilitate learning and knowledge sharing. a b c d e f g h RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 18 19 IX Progress in preventing violence against women can be measured in the short and the long-term. 1. In the long-term, the impact of prevention programmes can be measured as reductions in prevalence of different forms of violence against women. 2. At the global level, countries are required to report progress in preventing violence against women as part of SDG targets. Two indicators are proposed: • prevalence of intimate partner violence in the last 12 months among women aged 15 years and older (SDG target 5.2 - eliminate all forms of violence against women and girls); • proportion of young women and men aged 18–29 years who experienced sexual violence by age 18 (SDG target 16.2 - End abuse, exploitation, trafficking and all forms of violence against and torture of children). Monitor, evaluate and measure progress 3. In the short to medium term, interim indicators that contribute towards reductions in prevalence of violence against women will depend on the types of programmes. These can include, for example, improvements in: • gender equitable attitudes and norms • partner communication • women’s autonomy, agency and/or self- efficacy • girls' and women's education 4. It is important to specify a theory of change elaborating how the programme will likely improve interim indicators and how these in turn will contribute to reducing prevalence of violence against women. 5. It is important to evaluate before scaling-up and to monitor the scaling-up on an on-going basis to ensure that resources are invested in programmes that work, unintended or harmful outcomes are mitigated, and the scaling-up process takes into account the local context. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 20 21 X R E S P E C T ENDING VIOLENCE AGAINST WOMEN BEGINS WITH Commit to change Start today Support evidence-based approaches Join others The way forward: a call to action RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 22 23 a. CUSP (2017), On the CUSP of change: Effective scaling of social norms programming for gender equality, Community for Understanding Scale Up: http://raisingvoices.org/wp-content/ uploads/2013/02/6.CombinedCUSPcasestudies.FINAL_.pdf b. Heise L (2011), What Works to Prevent Partner Violence?: http:// strive.lshtm.ac.uk/system/files/attachments/What%20works%20 to%20prevent%20partner%20violence.pdf c. Salamander Trust (2017), ALIVE[H]E Framework: http:// salamandertrust.net/resources/alivhe-framework d. UN Women (2015), A Framework to Underpin Action to Prevent Violence Against Women: http://www.unwomen.org/-/ media/ headquarters/attachments/sections/library/publications/2015/ prevention_framework_unwomen_nov2015. pdf?la=en&vs=5223 e. WHO, LSHTM, SAMRC (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO. http://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng. pdf;jsessionid=294A291A603A7BCB4B60F588532CE53D? sequence=1 f. World Health Organization (2016), Violence against women, Intimate partner and sexual violence against women, Fact Sheet: http://www.who.int/mediacentre/factsheets/fs239/en/ g. World Health Organization and UNAIDS (2013), 16 Ideas for addressing violence against women in the context of the HIV epidemic - A programming tool: http://www.who.int/ reproductivehealth/publications/violence/vaw_hiv_epidemic/en/ h. WHO, LSHTM (2010), Preventing Intimate partner violence and sexual violence: generating evidence and taking action: http://apps.who.int/iris/bitstream/ handle/10665/44350/9789241564007_eng.pdf?sequence=1 i. What Works to Prevent Violence (2014), A global programme to prevent violence against women and girls: A Summary of the Evidence and Research Agenda: https://www.gov.uk/ government/publications/what-works-in-preventing-violenceagainst- women-and-girls-review-of-the-evidence-from-the-programme j. Ellsberg M., Arango D.J., Morton M., Gennari F., Kiplesund S., Contreras-Urbina M., Watts C (2015), Prevention of violence against women and girls: what does the evidence say? The Lancet, Volume 385, No. 9977, p1555–1566: https://www.thelancet. com/journals/lancet/article/PIIS0140-6736(14)61703-7/ fulltext?rss%3Dyes k. Contreras-Urbina M., Heilman B., Von Au A. K., Hill A., Puerto Gómez M., Zelaya J., Arango D.J (2016) Community-based approaches to intimate partner violence : a review of evidence and essential steps to adaptation (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/ en/907511467996712161/Community-based-approaches-to- intimate-partner-violence-a-review-of-evidence-and-essential-steps-to- adaptation l. World Health Organization (2016), 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: http://www.who.int/ reproductivehealth/publications/violence/global-plan-of-action/en/ m. Garcia-Moreno C., Zimmerman C., Morris-Gehring A., Heise L., Amin A., Abrahams N., Montoya O., Bhate-Deosthali P., Kilonzo N., Watts C (2015), Addressing violence against women: a call to action, The Lancet, Volume 385, No. 9978, p1685–1695: https://doi.org/10.1016/S0140-6736(14)61830-4 n. World Health Organization (2016) INSPIRE: Seven strategies for Ending Violence Against Children: http://www.who.int/violence_ injury_prevention/violence/inspire/en/ o. What works to prevent violence against women and girls global programme (2018), Right to play: preventing violence among and against children in schools in Hyderabad, Pakistan: Evidence brief. South Africa: Medical Research Council and UK: UK aid. https:// www.whatworks.co.za/documents/publications/211-right-to-play/ file p. Hidrobo M, Peterman A, Heise L (2016), The effect of cash, vouchers and food transfers on intimate partner violence: evidence from a randomized experiment in Northern Ecuador. American Economic Journal Applied Economics, Volume 8, No 3, p284-303: https://DOI:10.1257/app.20150048 q. National Resource Center on Domestic Violence (2012), Program and Practice Profiles: Community Advocacy Project, Harrisburg, PA: National Resource Center on Domestic Violence. http://www. dvevidenceproject.org r. Buller A, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L (2018). A mixed-method review of cash transfers and intimate partner violence in low- and middle-income countries. The World Bank Research Observer, Volume 22, No 2, p218-258: https:// doi.org/10.1093/wbro/lky002 s. Peterman A, Palermo TM, Ferrari G (2018). Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ global health, Volume 3, No. 6: e001143. doi:10.1136/ bmjgh-2018-001143. t. Karakurt G, Whiting K, Van Esch, Bolen S, Calabrese J (2016). Couple therapy for intimate partner violence: A systematic review and meta-analysis. J Marital Fam Ther, Volume 42, No. 4, p567- 583: doi:10.1111/jmft.12178. u. Desai CC, Reece J, Shakespear-Pellington S (2017) The prevention of violence in childhood through parenting programmes: a global review, Psychology, Health & Medicine, Volume 22, Sup1, p166- 186: DOI: 10.1080/13548506.2016.1271952. v. Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, Cundill B, Francisco L, Kaye D, Musuya T, Michau L, Watts C (2014), Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Medicine, Volume 12:122: https:// doi.org/10.1186/s12916-014-0122-5. w. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD (2006), Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. The Lancet, Volume 368, No. 9551, p1973–1983: doi: 10.1016/S0140-6736(06)69744-4. x. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N (2008), Impact of Stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Brit Med J, Volume 337, No. 7666:a506: doi: 10.1136/bmj.a506. y. Sullivan, CM, Bybee, DI (1999), Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, Volume 67, No. 1, p43-53: https://cap.vaw.msu.edu/wp-content/ uploads/2014/05/Two-year-followup-CAP-JCCP.pdf. 1 These are for both perpetration of and victimization from intimate partner violence (IPV) 2 The 7 strategies are not mutually exclusive, should not be seen as silos, and there are some overlaps across them. 3 Although specific interventions and their examples are listed under one particular strategy, it is important to note that many of them reflect combination/bundled programming with multi- component and multi-level interventions that fall across more than 1 of the 7 strategies of RESPECT. Their categorization under one strategy reflects the primary intent of the intervention. For example, some interventions under transforming norms also include relationship strengthening skills. Likewise, empowerment of women interventions may include an economic transfer component. Therefore, these strategies should not be seen as stand-alone but as approaches whose impact may be better enhanced in combination with others. 4 Evidence ratings are largely derived from systematic reviews of more than 1 evaluation of interventions that mostly use experimental designs including randomized, cluster randomized and quasi- experimental methods. It is recognized that for some strategies such as justice sector interventions, alternative evaluation methods may be more appropriate including time series, observational and cross-sectional designs despite being typically considered lower quality. This is an emerging field and hence, there is a great deal of variation in rigor of study design and evaluation. The sources for these reviews and studies are provided as part of references. 5 Refers to evaluations where some studies may show positive impacts and others may show no impacts or negative impacts, highlighting that the impact of interventions may be context specific. Hence, any replication or adaptation of the intervention must pay close attention to the contextual or implementation factors. 6 This includes laws and policies that: criminalize sexual abuse; promote equality in inheritance; ban child marriage and FGM; marriage, custody and divorce laws that guarantee equality for women; action plans that promote gender equality and address violence against women. It also includes implementing justice and law enforcement services such as arrest orders and legal aid. 7 Even where there is no national commitment to ending violence against women, there may be other commitments to empower women, to gender equality, or to women’s health that may be useful to consider. Citations and additional references Endnotes RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 24
R E S P E C T Preventing violence against women For more information, contact Department of Reproductive Health and Research World Health Organization 20 Avenue Appia CH 1211, Geneva 27 Switzerland Fax: +41 22 791 4171 Email: reproductivehealth@who.int www.who.int/reproductivehealth/topics/violence/en WHO/RHR/18.19 W O M E N WHO/RHR/18.19 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. 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Printed in Switzerland RESPECT women: Preventing violence against women Know the facts Assess risk and protective factors Implement 7 strategies to prevent violence against women Assess evidence for interventions Develop a theory of change Apply the guiding principles for prevention Strengthen enabling environment for prevention Adapt and scale-up what works Monitor, evaluate and measure progress Commit to action! Introduction The primary audience for this document is policymakers. Programme implementers working on preventing and responding to violence against women will also find it useful for designing, planning, implementing, and monitoring and evaluating interventions and programmes. I II III IV V VI VII VIII IX p.4 Table of contents X p.6 p.10 p.14 p.18 p.22 p.12 p.8 p.16 p.20 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 2 3 I Know the facts Nearly 1 in 3 (35%) women worldwide have experienced physical and/or sexual violence by an intimate partner or sexual violence, not including sexual harassment, by any perpetrator. Low education, exposure to violence in childhood, unequal power in intimate relationships, and attitudes and norms accepting violence and gender inequality increase the risk of experiencing intimate partner violence and sexual violence. Violence against women and girls is preventable. To prevent violence, mitigate the risk factors and amplify the protective factors. Globally, 30% of women have experienced physical and/or sexual violence by an intimate partner in their lifetime. Violence negatively affects women’s physical and mental health and well-being. It has social and economic consequences and costs for families, communities and societies. Violence against women (VAW) is a violation of human rights, is rooted in gender inequality, is a public health problem, and an impediment to sustainable development. Low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality increase risk of perpetrating intimate partner violence. Adolescent girls, young women, women belonging to ethnic and other minorities, transwomen, and women with disabilities face a higher risk of different forms of violence. The majority (55-95%) of women survivors of violence do not disclose or seek any type of services. Humanitarian emergencies may exacerbate existing violence and lead to additional forms of violence against women and girls. Globally between 38%-50% of murders of women are committed by intimate partners.R ES PE CT : P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 4 5 II Childhood experience of violence and/ or exposure to violence in the family Mental disorders Attitudes condoning or justifying violence as normal or acceptable Discriminatory laws on property ownership, marriage, divorce and child custody Low levels of women’s employment and education Absence or lack of enforcement of laws addressing violence against women Gender discrimination in institutions (e.g. police, health) High levels of inequality in relationships/ male-controlled relationships/ dependence on partner Men's multiple sexual relationships Men's use of drugs and harmful use of alcohol Harmful gender norms that uphold male privilege and limit women’s autonomy High levels of poverty and unemployment High rates of violence and crime Availability of drugs, alcohol and weapons Assess the risk & protective factors1 Intimate relationships characterized by gender equality, including in shared decision- making and household responsibilities Laws that: • promote gender equality • promote women’s access to formal employment • address violence against women Non-exposure to violence in the family Secondary education for women and men and less disparity in education levels between women and men Both men and boys and women and girls are socialized to, and hold gender equitable attitudes Norms that support non- violence and gender equitable relationships, and promote women’s empowerment Protective Factors Risk Factors SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 6 7 III R E S P E C T Implement strategies to prevent violence against women27 Relationship skills strengthened refers to strategies aimed at individuals or groups of women, men or couples to improve skills in interpersonal communication, conflict management and shared decision-making. Environments made safe refers to efforts to create safe schools, public spaces and work environments, among others. Empowerment of women refers to both economic and social empowerment including inheritance and asset ownership, microfinance plus gender and empowerment training interventions, collective action, creating safe spaces and mentoring to build skills in self-efficacy, assertiveness, negotiation, and self-confidence. Services ensured refers to a range of services including police, legal, health, and social services provided to survivors. Poverty reduced refers to strategies targeted to women or the household whose primary aim is to alleviate poverty ranging from cash transfers, savings, microfinance loans, labour force interventions. Child and adolescent abuse prevented refers to establishing nurturing family relationships, prohibiting corporal punishment, and implementing parenting programmes as mentioned in INSPIRE - 7 strategies for preventing violence against children. Transformed attitudes, beliefs, and norms refers to strategies that challenge harmful gender attitudes, beliefs, norms and stereotypes that uphold male privilege and female subordination, that justify violence against women and that stigmatize survivors. These may range from public campaigns, group education to community mobilization efforts. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 8 9 R E S P E C T IV Group-based workshops with women and men to promote egalitarian attitudes and relationships Couples counselling and therapy Empowerment training for women and girls including life skills, safe spaces, mentoring Inheritance and asset ownership policies and interventions Micro-finance or savings and loans plus gender and empowerment training components Economic transfers, including conditional/ unconditional cash transfers plus vouchers, and in-kind transfers Labour force interventions including employment policies, livelihood and employment training Microfinance or savings interventions without any additional components Infrastructure and transport Bystander interventions Whole School interventions Empowerment counselling interventions or psychological support to support access to services (i.e. advocacy) Alcohol misuse prevention interventions Shelters Hotlines One-stop crisis centres Perpetrator interventions Women’s police stations/units Screening in health services Sensitization and training of institutional personnel without changing the institutional environment Home visitation and health worker outreach Parenting interventions Psychological support interventions for children who experience violence and who witness intimate partner violence Life skills / school-based curriculum, rape and dating violence prevention training Community mobilization Group-based workshops with women and men to promote changes in attitudes and norms Social marketing or edutainment and group education Group education with men and boys to change attitudes and norms Stand-alone awareness campaigns/single component communications campaigns Economic transfers In Northern Ecuador, a cash, vouchers and food transfer programme implemented by the World Food Programme (WFP) was targeted to women in poor urban areas, intending to reduce poverty. Participating households received monthly transfers equivalent to $40 per month for a period of 6 months. The transfer was conditional on attendance of monthly nutrition trainings. The evaluation showed reductions in women’s experience of controlling behaviours, physical and/or sexual violence by intimate partners by 19 to 30%. A plausible mechanism for this was reduced conflict within couples related to poverty- related stresses.p Microfinance plus gender and empowerment The IMAGE project (Intervention with Microfinance for Aids and Gender Equity) in South Africa empowers women through microfinance together with training on gender and power and community mobilization activities. Studies show it reduced domestic violence by 50% in the intervention group over a period of two years. At US$244 per incident case of partner violence averted during a 2-year scale up phase, the intervention is highly cost-effective.w Relationships skills strengthened Empowerment of women Services ensured Poverty reduced LL L H H H H H H L L EXAMPLE EXAMPLE H H L H L L L L L L L L L L L H H H L L L H H L H H H L H H L H H L H H H H Advocacy for survivors The Community Advocacy Project in Michigan and Illinois, United States, is an evidence-based program designed to help women survivors of intimate partner abuse re-gain control of their lives. Trained advocates provide advocacy and individually tailored assistance to survivors so that they can access community resources and social support. The intervention was found to lower recurrance of violence and depression and improve quality of life and social support. Two years after the intervention ended, the positive change continued.y Right to play - preventing violence among and against children in schools In Hyderabad (Sindh Province), Pakistan, a right to play intervention reached children in 40 public schools. Boys and girls were engaged in play-based learning providing them opportunity to develop life skills such as confidence, communication, empathy, coping with negative emotions, resilience, cooperation, leadership, critical thinking and conflict resolution that help combat conflict, intolerance, gender discrimination and peer violence. An evaluation showed decreases in peer victimization by 33% among boys and 59% among girls at 24 months post intervention; in corporal punishment by 45% in boys and 66% in girls; and in witnessing of domestic violence by 65% among boys and by 70% in girls.o Community Mobilizations SASA! is a community intervention in Uganda that prevents violence against women by shifting the power balance between men and women in relationships. Studies show that in SASA! communities 76% of women and men believe physical violence against a partner is not acceptable while only 26% of women and men in control communities believe the same. At the cost of US$ 460 per incident case of partner violence averted in trial phase, intervention is cost-effective and further economies of scale can be achieved during scale-up.v Group-based Workshops In the two-year period following the implementation of Stepping Stones in South Africa with female and male participants aged 15–26 years, men were less likely to perpetrate intimate partner violence, rape and transactional sex in the intervention group compared to the baseline.x Environments made safe Child and adolescent abuse prevented EXAMPLE EXAMPLE EXAMPLEEXAMPLE Transformed attitudes, beliefs, and norms H L L H L L H Assess the evidence on interventions3 L H LEGEND4 promising, >1 evaluations show significant reductions in violence outcomes more evidence needed, > 1 evaluations show improvements in intermediate outcomes related to violence conflicting, evaluations show conflicting results in reducing violence5 no evidence, intervention not yet rigorously evaluated ineffective, >1 evaluations show no reductions in violence outcomes World Bank Low and Middle Income Countries (LMIC) World Bank High Income Countries (HIC) L H RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 10 11 V BA RR IE R S Co m m un iti es w ith h ig h le ve ls of v io le nc e Fa m ili es a ffe ct ed b y vi ol en ce W om en fa ci ng v io le nc e IN TE R V EN TI O N S Environments made safe OUTPUTS OUTCOMES IMPACT Relationship skills strengthened Empowerment of women Services ensured Poverty reduced Child and adolescent abuse prevented Transformed attitudes, beliefs, and norms Programmes to address VAW widely implemented Increased resources and political will to address VAW Increased awareness about VAW as a public health problem and that it is preventable Sectoral outcomes related to health, economic, and social development improved (e.g. improved mental health, reduced household poverty, improved women's and child health, improved women's education and earnings, and reduced absenteeism) Families, communities and institutions believe in and uphold gender equality as a norm and no longer accept VAW Men accept and treat women as equals Women can make autonomous decisions Women have knowledge of their rights and access to programmes Improved health and development outcomes in households, community and society Women are exercising their human rights and contributing to development Violence against women is reduced or eliminated Equality and respect are practiced in intimate, family and community relationships Interpersonal conflicts are resolved peacefully Limitations on women's autonomy Children exposed to violence Social norms that perpetuate male power Inadequate services Inadequate legal and social protections for women Lack of political will and resources Under-resourced women's organizations or movements Develop a theory of change Build ing o n res ilien cy a nd k now ledg e, an d re sour cing and sup port ing c omm uniti es to find solu tions 12 13 G EN ER A TE A N D D IS SE M IN A TE K N O W LE D G E CO R E VA LU ES PR O G R A M M E D ES IG N VIApply the guiding principles for effective programming Strengthen monitoring and evaluation systems to build the evidence base on what works and facilitate knowledge sharing to inform programming Ensure confidentiality of information and anticipate and address unintended consequences Ensure that analysis of unequal gender and power relations and male privilege over women is at the center of programming Promote gender equality and women’s human rights Leave no one behind Develop a theory of change Promote evidence informed programming Put women’s safety first and do no harm Use participatory approaches Promote coordination Take a life-course approach Address the prevention continuum Implement combined interventions Elaborate how programming inputs will lead to changes in intermediate outcomes and likely impacts Address multiple and intersecting forms of discrimination based on sex, gender, class, race, ethnicity, disability, sexual orientation, gender identity Stimulate personal reflection and critical thinking, and build on the voice, agency and skills of people. Facilitate collective programming with individuals, families and communities to address the multiple risk factors underlying VAW and multiple forms of violence within families. Support partnerships across sectors and organizations, and at local and national levels Link prevention and response interventions Implement programmes that work with children, adolescents and young people for early interventions 6 7 8 9 10 1 5 2 3 4 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 14 15 VII Build political commitment from leaders and policy makers to speak out, condemning violence against women. Put in place and facilitate enforcement of laws and policies that address violence against women and that promote gender equality, including access to secondary education.6 Invest in, build on the work of, resource, and support women's organizations. Allocate resources to programmes, research, and to strengthen institutions and capacities of the health, education, law enforcement, and social services sectors to address violence against women. Strengthen enabling environment a c b d for prevention RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 16 17 VIIIAdapt and scale-up what works Violence prevention interventions that have been shown to work on a pilot basis can be scaled- up in different ways. They can be expanded by adding more beneficiaries; they can be adapted and replicated in another geographic location; and there can be expansion in coverage of the same intervention over a wider geographic area. Interventions that are being scaled-up in a new setting need to be adapted to context. This requires an understanding of the local culture, values and resources. Interventions identified as promising (pages 10- 11) can be adapted and scaled-up with attention to the guiding principles for prevention and to the adaptation and scaling-up considerations on the next page; those classified as “more evidence needed" (pages 10-11) may need to be replicated or further refined before they are scaled-up; and those identified as "conflicting" or "no evidence" need to be further evaluated. Align with national commitments (e.g. a national plan, policy, strategy) to end violence against women, or to promote gender equality or women’s health.7 Invest in capacity among implementers, and giving enough time to scale-up and to allow for change to occur and sustain. Programme for synergy, combining multiple strategies and interventions at the individual, interpersonal, community and societal levels for sustained impact. Identify and maintain fidelity to core principles of gender equality, rights and safety as well as to minimum “dosage”, while also adapting to context, including language and culture. Build on on-going initiatives, integrating prevention activities into existing health, development and other existing sectoral programmes. Design with “scale” in mind, investing for the long-term, keeping costs and sustainability in mind. Start small, document and evaluate the adaptation and scale-up in order to innovate and strengthen evidence-informed programming. Support a community of practice among programme developers and implementers to facilitate learning and knowledge sharing. a b c d e f g h RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 18 19 IX Progress in preventing violence against women can be measured in the short and the long-term. 1. In the long-term, the impact of prevention programmes can be measured as reductions in prevalence of different forms of violence against women. 2. At the global level, countries are required to report progress in preventing violence against women as part of SDG targets. Two indicators are proposed: • prevalence of intimate partner violence in the last 12 months among women aged 15 years and older (SDG target 5.2 - eliminate all forms of violence against women and girls); • proportion of young women and men aged 18–29 years who experienced sexual violence by age 18 (SDG target 16.2 - End abuse, exploitation, trafficking and all forms of violence against and torture of children). Monitor, evaluate and measure progress 3. In the short to medium term, interim indicators that contribute towards reductions in prevalence of violence against women will depend on the types of programmes. These can include, for example, improvements in: • gender equitable attitudes and norms • partner communication • women’s autonomy, agency and/or self- efficacy • girls' and women's education 4. It is important to specify a theory of change elaborating how the programme will likely improve interim indicators and how these in turn will contribute to reducing prevalence of violence against women. 5. It is important to evaluate before scaling-up and to monitor the scaling-up on an on-going basis to ensure that resources are invested in programmes that work, unintended or harmful outcomes are mitigated, and the scaling-up process takes into account the local context. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 20 21 X R E S P E C T ENDING VIOLENCE AGAINST WOMEN BEGINS WITH Commit to change Start today Support evidence-based approaches Join others The way forward: a call to action RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 22 23 a. CUSP (2017), On the CUSP of change: Effective scaling of social norms programming for gender equality, Community for Understanding Scale Up: http://raisingvoices.org/wp-content/ uploads/2013/02/6.CombinedCUSPcasestudies.FINAL_.pdf b. Heise L (2011), What Works to Prevent Partner Violence?: http:// strive.lshtm.ac.uk/system/files/attachments/What%20works%20 to%20prevent%20partner%20violence.pdf c. Salamander Trust (2017), ALIVE[H]E Framework: http:// salamandertrust.net/resources/alivhe-framework d. UN Women (2015), A Framework to Underpin Action to Prevent Violence Against Women: http://www.unwomen.org/-/ media/ headquarters/attachments/sections/library/publications/2015/ prevention_framework_unwomen_nov2015. pdf?la=en&vs=5223 e. WHO, LSHTM, SAMRC (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO. http://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng. pdf;jsessionid=294A291A603A7BCB4B60F588532CE53D? sequence=1 f. World Health Organization (2016), Violence against women, Intimate partner and sexual violence against women, Fact Sheet: http://www.who.int/mediacentre/factsheets/fs239/en/ g. World Health Organization and UNAIDS (2013), 16 Ideas for addressing violence against women in the context of the HIV epidemic - A programming tool: http://www.who.int/ reproductivehealth/publications/violence/vaw_hiv_epidemic/en/ h. WHO, LSHTM (2010), Preventing Intimate partner violence and sexual violence: generating evidence and taking action: http://apps.who.int/iris/bitstream/ handle/10665/44350/9789241564007_eng.pdf?sequence=1 i. What Works to Prevent Violence (2014), A global programme to prevent violence against women and girls: A Summary of the Evidence and Research Agenda: https://www.gov.uk/ government/publications/what-works-in-preventing-violenceagainst- women-and-girls-review-of-the-evidence-from-the-programme j. Ellsberg M., Arango D.J., Morton M., Gennari F., Kiplesund S., Contreras-Urbina M., Watts C (2015), Prevention of violence against women and girls: what does the evidence say? The Lancet, Volume 385, No. 9977, p1555–1566: https://www.thelancet. com/journals/lancet/article/PIIS0140-6736(14)61703-7/ fulltext?rss%3Dyes k. Contreras-Urbina M., Heilman B., Von Au A. K., Hill A., Puerto Gómez M., Zelaya J., Arango D.J (2016) Community-based approaches to intimate partner violence : a review of evidence and essential steps to adaptation (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/ en/907511467996712161/Community-based-approaches-to- intimate-partner-violence-a-review-of-evidence-and-essential-steps-to- adaptation l. World Health Organization (2016), 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: http://www.who.int/ reproductivehealth/publications/violence/global-plan-of-action/en/ m. Garcia-Moreno C., Zimmerman C., Morris-Gehring A., Heise L., Amin A., Abrahams N., Montoya O., Bhate-Deosthali P., Kilonzo N., Watts C (2015), Addressing violence against women: a call to action, The Lancet, Volume 385, No. 9978, p1685–1695: https://doi.org/10.1016/S0140-6736(14)61830-4 n. World Health Organization (2016) INSPIRE: Seven strategies for Ending Violence Against Children: http://www.who.int/violence_ injury_prevention/violence/inspire/en/ o. What works to prevent violence against women and girls global programme (2018), Right to play: preventing violence among and against children in schools in Hyderabad, Pakistan: Evidence brief. South Africa: Medical Research Council and UK: UK aid. https:// www.whatworks.co.za/documents/publications/211-right-to-play/ file p. Hidrobo M, Peterman A, Heise L (2016), The effect of cash, vouchers and food transfers on intimate partner violence: evidence from a randomized experiment in Northern Ecuador. American Economic Journal Applied Economics, Volume 8, No 3, p284-303: https://DOI:10.1257/app.20150048 q. National Resource Center on Domestic Violence (2012), Program and Practice Profiles: Community Advocacy Project, Harrisburg, PA: National Resource Center on Domestic Violence. http://www. dvevidenceproject.org r. Buller A, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L (2018). A mixed-method review of cash transfers and intimate partner violence in low- and middle-income countries. The World Bank Research Observer, Volume 22, No 2, p218-258: https:// doi.org/10.1093/wbro/lky002 s. Peterman A, Palermo TM, Ferrari G (2018). Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ global health, Volume 3, No. 6: e001143. doi:10.1136/ bmjgh-2018-001143. t. Karakurt G, Whiting K, Van Esch, Bolen S, Calabrese J (2016). Couple therapy for intimate partner violence: A systematic review and meta-analysis. J Marital Fam Ther, Volume 42, No. 4, p567- 583: doi:10.1111/jmft.12178. u. Desai CC, Reece J, Shakespear-Pellington S (2017) The prevention of violence in childhood through parenting programmes: a global review, Psychology, Health & Medicine, Volume 22, Sup1, p166- 186: DOI: 10.1080/13548506.2016.1271952. v. Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, Cundill B, Francisco L, Kaye D, Musuya T, Michau L, Watts C (2014), Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Medicine, Volume 12:122: https:// doi.org/10.1186/s12916-014-0122-5. w. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD (2006), Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. The Lancet, Volume 368, No. 9551, p1973–1983: doi: 10.1016/S0140-6736(06)69744-4. x. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N (2008), Impact of Stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Brit Med J, Volume 337, No. 7666:a506: doi: 10.1136/bmj.a506. y. Sullivan, CM, Bybee, DI (1999), Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, Volume 67, No. 1, p43-53: https://cap.vaw.msu.edu/wp-content/ uploads/2014/05/Two-year-followup-CAP-JCCP.pdf. 1 These are for both perpetration of and victimization from intimate partner violence (IPV) 2 The 7 strategies are not mutually exclusive, should not be seen as silos, and there are some overlaps across them. 3 Although specific interventions and their examples are listed under one particular strategy, it is important to note that many of them reflect combination/bundled programming with multi- component and multi-level interventions that fall across more than 1 of the 7 strategies of RESPECT. Their categorization under one strategy reflects the primary intent of the intervention. For example, some interventions under transforming norms also include relationship strengthening skills. Likewise, empowerment of women interventions may include an economic transfer component. Therefore, these strategies should not be seen as stand-alone but as approaches whose impact may be better enhanced in combination with others. 4 Evidence ratings are largely derived from systematic reviews of more than 1 evaluation of interventions that mostly use experimental designs including randomized, cluster randomized and quasi- experimental methods. It is recognized that for some strategies such as justice sector interventions, alternative evaluation methods may be more appropriate including time series, observational and cross-sectional designs despite being typically considered lower quality. This is an emerging field and hence, there is a great deal of variation in rigor of study design and evaluation. The sources for these reviews and studies are provided as part of references. 5 Refers to evaluations where some studies may show positive impacts and others may show no impacts or negative impacts, highlighting that the impact of interventions may be context specific. Hence, any replication or adaptation of the intervention must pay close attention to the contextual or implementation factors. 6 This includes laws and policies that: criminalize sexual abuse; promote equality in inheritance; ban child marriage and FGM; marriage, custody and divorce laws that guarantee equality for women; action plans that promote gender equality and address violence against women. It also includes implementing justice and law enforcement services such as arrest orders and legal aid. 7 Even where there is no national commitment to ending violence against women, there may be other commitments to empower women, to gender equality, or to women’s health that may be useful to consider. Citations and additional references Endnotes RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 24
R E S P E C T Preventing violence against women For more information, contact Department of Reproductive Health and Research World Health Organization 20 Avenue Appia CH 1211, Geneva 27 Switzerland Fax: +41 22 791 4171 Email: reproductivehealth@who.int www.who.int/reproductivehealth/topics/violence/en WHO/RHR/18.19 W O M E N WHO/RHR/18.19 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. 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Printed in Switzerland RESPECT women: Preventing violence against women Know the facts Assess risk and protective factors Implement 7 strategies to prevent violence against women Assess evidence for interventions Develop a theory of change Apply the guiding principles for prevention Strengthen enabling environment for prevention Adapt and scale-up what works Monitor, evaluate and measure progress Commit to action! Introduction The primary audience for this document is policymakers. Programme implementers working on preventing and responding to violence against women will also find it useful for designing, planning, implementing, and monitoring and evaluating interventions and programmes. I II III IV V VI VII VIII IX p.4 Table of contents X p.6 p.10 p.14 p.18 p.22 p.12 p.8 p.16 p.20 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 2 3 I Know the facts Nearly 1 in 3 (35%) women worldwide have experienced physical and/or sexual violence by an intimate partner or sexual violence, not including sexual harassment, by any perpetrator. Low education, exposure to violence in childhood, unequal power in intimate relationships, and attitudes and norms accepting violence and gender inequality increase the risk of experiencing intimate partner violence and sexual violence. Violence against women and girls is preventable. To prevent violence, mitigate the risk factors and amplify the protective factors. Globally, 30% of women have experienced physical and/or sexual violence by an intimate partner in their lifetime. Violence negatively affects women’s physical and mental health and well-being. It has social and economic consequences and costs for families, communities and societies. Violence against women (VAW) is a violation of human rights, is rooted in gender inequality, is a public health problem, and an impediment to sustainable development. Low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality increase risk of perpetrating intimate partner violence. Adolescent girls, young women, women belonging to ethnic and other minorities, transwomen, and women with disabilities face a higher risk of different forms of violence. The majority (55-95%) of women survivors of violence do not disclose or seek any type of services. Humanitarian emergencies may exacerbate existing violence and lead to additional forms of violence against women and girls. Globally between 38%-50% of murders of women are committed by intimate partners.R ES PE CT : P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 4 5 II Childhood experience of violence and/ or exposure to violence in the family Mental disorders Attitudes condoning or justifying violence as normal or acceptable Discriminatory laws on property ownership, marriage, divorce and child custody Low levels of women’s employment and education Absence or lack of enforcement of laws addressing violence against women Gender discrimination in institutions (e.g. police, health) High levels of inequality in relationships/ male-controlled relationships/ dependence on partner Men's multiple sexual relationships Men's use of drugs and harmful use of alcohol Harmful gender norms that uphold male privilege and limit women’s autonomy High levels of poverty and unemployment High rates of violence and crime Availability of drugs, alcohol and weapons Assess the risk & protective factors1 Intimate relationships characterized by gender equality, including in shared decision- making and household responsibilities Laws that: • promote gender equality • promote women’s access to formal employment • address violence against women Non-exposure to violence in the family Secondary education for women and men and less disparity in education levels between women and men Both men and boys and women and girls are socialized to, and hold gender equitable attitudes Norms that support non- violence and gender equitable relationships, and promote women’s empowerment Protective Factors Risk Factors SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 6 7 III R E S P E C T Implement strategies to prevent violence against women27 Relationship skills strengthened refers to strategies aimed at individuals or groups of women, men or couples to improve skills in interpersonal communication, conflict management and shared decision-making. Environments made safe refers to efforts to create safe schools, public spaces and work environments, among others. Empowerment of women refers to both economic and social empowerment including inheritance and asset ownership, microfinance plus gender and empowerment training interventions, collective action, creating safe spaces and mentoring to build skills in self-efficacy, assertiveness, negotiation, and self-confidence. Services ensured refers to a range of services including police, legal, health, and social services provided to survivors. Poverty reduced refers to strategies targeted to women or the household whose primary aim is to alleviate poverty ranging from cash transfers, savings, microfinance loans, labour force interventions. Child and adolescent abuse prevented refers to establishing nurturing family relationships, prohibiting corporal punishment, and implementing parenting programmes as mentioned in INSPIRE - 7 strategies for preventing violence against children. Transformed attitudes, beliefs, and norms refers to strategies that challenge harmful gender attitudes, beliefs, norms and stereotypes that uphold male privilege and female subordination, that justify violence against women and that stigmatize survivors. These may range from public campaigns, group education to community mobilization efforts. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 8 9 R E S P E C T IV Group-based workshops with women and men to promote egalitarian attitudes and relationships Couples counselling and therapy Empowerment training for women and girls including life skills, safe spaces, mentoring Inheritance and asset ownership policies and interventions Micro-finance or savings and loans plus gender and empowerment training components Economic transfers, including conditional/ unconditional cash transfers plus vouchers, and in-kind transfers Labour force interventions including employment policies, livelihood and employment training Microfinance or savings interventions without any additional components Infrastructure and transport Bystander interventions Whole School interventions Empowerment counselling interventions or psychological support to support access to services (i.e. advocacy) Alcohol misuse prevention interventions Shelters Hotlines One-stop crisis centres Perpetrator interventions Women’s police stations/units Screening in health services Sensitization and training of institutional personnel without changing the institutional environment Home visitation and health worker outreach Parenting interventions Psychological support interventions for children who experience violence and who witness intimate partner violence Life skills / school-based curriculum, rape and dating violence prevention training Community mobilization Group-based workshops with women and men to promote changes in attitudes and norms Social marketing or edutainment and group education Group education with men and boys to change attitudes and norms Stand-alone awareness campaigns/single component communications campaigns Economic transfers In Northern Ecuador, a cash, vouchers and food transfer programme implemented by the World Food Programme (WFP) was targeted to women in poor urban areas, intending to reduce poverty. Participating households received monthly transfers equivalent to $40 per month for a period of 6 months. The transfer was conditional on attendance of monthly nutrition trainings. The evaluation showed reductions in women’s experience of controlling behaviours, physical and/or sexual violence by intimate partners by 19 to 30%. A plausible mechanism for this was reduced conflict within couples related to poverty- related stresses.p Microfinance plus gender and empowerment The IMAGE project (Intervention with Microfinance for Aids and Gender Equity) in South Africa empowers women through microfinance together with training on gender and power and community mobilization activities. Studies show it reduced domestic violence by 50% in the intervention group over a period of two years. At US$244 per incident case of partner violence averted during a 2-year scale up phase, the intervention is highly cost-effective.w Relationships skills strengthened Empowerment of women Services ensured Poverty reduced LL L H H H H H H L L EXAMPLE EXAMPLE H H L H L L L L L L L L L L L H H H L L L H H L H H H L H H L H H L H H H H Advocacy for survivors The Community Advocacy Project in Michigan and Illinois, United States, is an evidence-based program designed to help women survivors of intimate partner abuse re-gain control of their lives. Trained advocates provide advocacy and individually tailored assistance to survivors so that they can access community resources and social support. The intervention was found to lower recurrance of violence and depression and improve quality of life and social support. Two years after the intervention ended, the positive change continued.y Right to play - preventing violence among and against children in schools In Hyderabad (Sindh Province), Pakistan, a right to play intervention reached children in 40 public schools. Boys and girls were engaged in play-based learning providing them opportunity to develop life skills such as confidence, communication, empathy, coping with negative emotions, resilience, cooperation, leadership, critical thinking and conflict resolution that help combat conflict, intolerance, gender discrimination and peer violence. An evaluation showed decreases in peer victimization by 33% among boys and 59% among girls at 24 months post intervention; in corporal punishment by 45% in boys and 66% in girls; and in witnessing of domestic violence by 65% among boys and by 70% in girls.o Community Mobilizations SASA! is a community intervention in Uganda that prevents violence against women by shifting the power balance between men and women in relationships. Studies show that in SASA! communities 76% of women and men believe physical violence against a partner is not acceptable while only 26% of women and men in control communities believe the same. At the cost of US$ 460 per incident case of partner violence averted in trial phase, intervention is cost-effective and further economies of scale can be achieved during scale-up.v Group-based Workshops In the two-year period following the implementation of Stepping Stones in South Africa with female and male participants aged 15–26 years, men were less likely to perpetrate intimate partner violence, rape and transactional sex in the intervention group compared to the baseline.x Environments made safe Child and adolescent abuse prevented EXAMPLE EXAMPLE EXAMPLEEXAMPLE Transformed attitudes, beliefs, and norms H L L H L L H Assess the evidence on interventions3 L H LEGEND4 promising, >1 evaluations show significant reductions in violence outcomes more evidence needed, > 1 evaluations show improvements in intermediate outcomes related to violence conflicting, evaluations show conflicting results in reducing violence5 no evidence, intervention not yet rigorously evaluated ineffective, >1 evaluations show no reductions in violence outcomes World Bank Low and Middle Income Countries (LMIC) World Bank High Income Countries (HIC) L H RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 10 11 V BA RR IE R S Co m m un iti es w ith h ig h le ve ls of v io le nc e Fa m ili es a ffe ct ed b y vi ol en ce W om en fa ci ng v io le nc e IN TE R V EN TI O N S Environments made safe OUTPUTS OUTCOMES IMPACT Relationship skills strengthened Empowerment of women Services ensured Poverty reduced Child and adolescent abuse prevented Transformed attitudes, beliefs, and norms Programmes to address VAW widely implemented Increased resources and political will to address VAW Increased awareness about VAW as a public health problem and that it is preventable Sectoral outcomes related to health, economic, and social development improved (e.g. improved mental health, reduced household poverty, improved women's and child health, improved women's education and earnings, and reduced absenteeism) Families, communities and institutions believe in and uphold gender equality as a norm and no longer accept VAW Men accept and treat women as equals Women can make autonomous decisions Women have knowledge of their rights and access to programmes Improved health and development outcomes in households, community and society Women are exercising their human rights and contributing to development Violence against women is reduced or eliminated Equality and respect are practiced in intimate, family and community relationships Interpersonal conflicts are resolved peacefully Limitations on women's autonomy Children exposed to violence Social norms that perpetuate male power Inadequate services Inadequate legal and social protections for women Lack of political will and resources Under-resourced women's organizations or movements Develop a theory of change Build ing o n res ilien cy a nd k now ledg e, an d re sour cing and sup port ing c omm uniti es to find solu tions 12 13 G EN ER A TE A N D D IS SE M IN A TE K N O W LE D G E CO R E VA LU ES PR O G R A M M E D ES IG N VIApply the guiding principles for effective programming Strengthen monitoring and evaluation systems to build the evidence base on what works and facilitate knowledge sharing to inform programming Ensure confidentiality of information and anticipate and address unintended consequences Ensure that analysis of unequal gender and power relations and male privilege over women is at the center of programming Promote gender equality and women’s human rights Leave no one behind Develop a theory of change Promote evidence informed programming Put women’s safety first and do no harm Use participatory approaches Promote coordination Take a life-course approach Address the prevention continuum Implement combined interventions Elaborate how programming inputs will lead to changes in intermediate outcomes and likely impacts Address multiple and intersecting forms of discrimination based on sex, gender, class, race, ethnicity, disability, sexual orientation, gender identity Stimulate personal reflection and critical thinking, and build on the voice, agency and skills of people. Facilitate collective programming with individuals, families and communities to address the multiple risk factors underlying VAW and multiple forms of violence within families. Support partnerships across sectors and organizations, and at local and national levels Link prevention and response interventions Implement programmes that work with children, adolescents and young people for early interventions 6 7 8 9 10 1 5 2 3 4 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 14 15 VII Build political commitment from leaders and policy makers to speak out, condemning violence against women. Put in place and facilitate enforcement of laws and policies that address violence against women and that promote gender equality, including access to secondary education.6 Invest in, build on the work of, resource, and support women's organizations. Allocate resources to programmes, research, and to strengthen institutions and capacities of the health, education, law enforcement, and social services sectors to address violence against women. Strengthen enabling environment a c b d for prevention RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 16 17 VIIIAdapt and scale-up what works Violence prevention interventions that have been shown to work on a pilot basis can be scaled- up in different ways. They can be expanded by adding more beneficiaries; they can be adapted and replicated in another geographic location; and there can be expansion in coverage of the same intervention over a wider geographic area. Interventions that are being scaled-up in a new setting need to be adapted to context. This requires an understanding of the local culture, values and resources. Interventions identified as promising (pages 10- 11) can be adapted and scaled-up with attention to the guiding principles for prevention and to the adaptation and scaling-up considerations on the next page; those classified as “more evidence needed" (pages 10-11) may need to be replicated or further refined before they are scaled-up; and those identified as "conflicting" or "no evidence" need to be further evaluated. Align with national commitments (e.g. a national plan, policy, strategy) to end violence against women, or to promote gender equality or women’s health.7 Invest in capacity among implementers, and giving enough time to scale-up and to allow for change to occur and sustain. Programme for synergy, combining multiple strategies and interventions at the individual, interpersonal, community and societal levels for sustained impact. Identify and maintain fidelity to core principles of gender equality, rights and safety as well as to minimum “dosage”, while also adapting to context, including language and culture. Build on on-going initiatives, integrating prevention activities into existing health, development and other existing sectoral programmes. Design with “scale” in mind, investing for the long-term, keeping costs and sustainability in mind. Start small, document and evaluate the adaptation and scale-up in order to innovate and strengthen evidence-informed programming. Support a community of practice among programme developers and implementers to facilitate learning and knowledge sharing. a b c d e f g h RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 18 19 IX Progress in preventing violence against women can be measured in the short and the long-term. 1. In the long-term, the impact of prevention programmes can be measured as reductions in prevalence of different forms of violence against women. 2. At the global level, countries are required to report progress in preventing violence against women as part of SDG targets. Two indicators are proposed: • prevalence of intimate partner violence in the last 12 months among women aged 15 years and older (SDG target 5.2 - eliminate all forms of violence against women and girls); • proportion of young women and men aged 18–29 years who experienced sexual violence by age 18 (SDG target 16.2 - End abuse, exploitation, trafficking and all forms of violence against and torture of children). Monitor, evaluate and measure progress 3. In the short to medium term, interim indicators that contribute towards reductions in prevalence of violence against women will depend on the types of programmes. These can include, for example, improvements in: • gender equitable attitudes and norms • partner communication • women’s autonomy, agency and/or self- efficacy • girls' and women's education 4. It is important to specify a theory of change elaborating how the programme will likely improve interim indicators and how these in turn will contribute to reducing prevalence of violence against women. 5. It is important to evaluate before scaling-up and to monitor the scaling-up on an on-going basis to ensure that resources are invested in programmes that work, unintended or harmful outcomes are mitigated, and the scaling-up process takes into account the local context. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 20 21 X R E S P E C T ENDING VIOLENCE AGAINST WOMEN BEGINS WITH Commit to change Start today Support evidence-based approaches Join others The way forward: a call to action RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 22 23 a. CUSP (2017), On the CUSP of change: Effective scaling of social norms programming for gender equality, Community for Understanding Scale Up: http://raisingvoices.org/wp-content/ uploads/2013/02/6.CombinedCUSPcasestudies.FINAL_.pdf b. Heise L (2011), What Works to Prevent Partner Violence?: http:// strive.lshtm.ac.uk/system/files/attachments/What%20works%20 to%20prevent%20partner%20violence.pdf c. Salamander Trust (2017), ALIVE[H]E Framework: http:// salamandertrust.net/resources/alivhe-framework d. UN Women (2015), A Framework to Underpin Action to Prevent Violence Against Women: http://www.unwomen.org/-/ media/ headquarters/attachments/sections/library/publications/2015/ prevention_framework_unwomen_nov2015. pdf?la=en&vs=5223 e. WHO, LSHTM, SAMRC (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO. http://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng. pdf;jsessionid=294A291A603A7BCB4B60F588532CE53D? sequence=1 f. World Health Organization (2016), Violence against women, Intimate partner and sexual violence against women, Fact Sheet: http://www.who.int/mediacentre/factsheets/fs239/en/ g. World Health Organization and UNAIDS (2013), 16 Ideas for addressing violence against women in the context of the HIV epidemic - A programming tool: http://www.who.int/ reproductivehealth/publications/violence/vaw_hiv_epidemic/en/ h. WHO, LSHTM (2010), Preventing Intimate partner violence and sexual violence: generating evidence and taking action: http://apps.who.int/iris/bitstream/ handle/10665/44350/9789241564007_eng.pdf?sequence=1 i. What Works to Prevent Violence (2014), A global programme to prevent violence against women and girls: A Summary of the Evidence and Research Agenda: https://www.gov.uk/ government/publications/what-works-in-preventing-violenceagainst- women-and-girls-review-of-the-evidence-from-the-programme j. Ellsberg M., Arango D.J., Morton M., Gennari F., Kiplesund S., Contreras-Urbina M., Watts C (2015), Prevention of violence against women and girls: what does the evidence say? The Lancet, Volume 385, No. 9977, p1555–1566: https://www.thelancet. com/journals/lancet/article/PIIS0140-6736(14)61703-7/ fulltext?rss%3Dyes k. Contreras-Urbina M., Heilman B., Von Au A. K., Hill A., Puerto Gómez M., Zelaya J., Arango D.J (2016) Community-based approaches to intimate partner violence : a review of evidence and essential steps to adaptation (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/ en/907511467996712161/Community-based-approaches-to- intimate-partner-violence-a-review-of-evidence-and-essential-steps-to- adaptation l. World Health Organization (2016), 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: http://www.who.int/ reproductivehealth/publications/violence/global-plan-of-action/en/ m. Garcia-Moreno C., Zimmerman C., Morris-Gehring A., Heise L., Amin A., Abrahams N., Montoya O., Bhate-Deosthali P., Kilonzo N., Watts C (2015), Addressing violence against women: a call to action, The Lancet, Volume 385, No. 9978, p1685–1695: https://doi.org/10.1016/S0140-6736(14)61830-4 n. World Health Organization (2016) INSPIRE: Seven strategies for Ending Violence Against Children: http://www.who.int/violence_ injury_prevention/violence/inspire/en/ o. What works to prevent violence against women and girls global programme (2018), Right to play: preventing violence among and against children in schools in Hyderabad, Pakistan: Evidence brief. South Africa: Medical Research Council and UK: UK aid. https:// www.whatworks.co.za/documents/publications/211-right-to-play/ file p. Hidrobo M, Peterman A, Heise L (2016), The effect of cash, vouchers and food transfers on intimate partner violence: evidence from a randomized experiment in Northern Ecuador. American Economic Journal Applied Economics, Volume 8, No 3, p284-303: https://DOI:10.1257/app.20150048 q. National Resource Center on Domestic Violence (2012), Program and Practice Profiles: Community Advocacy Project, Harrisburg, PA: National Resource Center on Domestic Violence. http://www. dvevidenceproject.org r. Buller A, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L (2018). A mixed-method review of cash transfers and intimate partner violence in low- and middle-income countries. The World Bank Research Observer, Volume 22, No 2, p218-258: https:// doi.org/10.1093/wbro/lky002 s. Peterman A, Palermo TM, Ferrari G (2018). Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ global health, Volume 3, No. 6: e001143. doi:10.1136/ bmjgh-2018-001143. t. Karakurt G, Whiting K, Van Esch, Bolen S, Calabrese J (2016). Couple therapy for intimate partner violence: A systematic review and meta-analysis. J Marital Fam Ther, Volume 42, No. 4, p567- 583: doi:10.1111/jmft.12178. u. Desai CC, Reece J, Shakespear-Pellington S (2017) The prevention of violence in childhood through parenting programmes: a global review, Psychology, Health & Medicine, Volume 22, Sup1, p166- 186: DOI: 10.1080/13548506.2016.1271952. v. Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, Cundill B, Francisco L, Kaye D, Musuya T, Michau L, Watts C (2014), Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Medicine, Volume 12:122: https:// doi.org/10.1186/s12916-014-0122-5. w. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD (2006), Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. The Lancet, Volume 368, No. 9551, p1973–1983: doi: 10.1016/S0140-6736(06)69744-4. x. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N (2008), Impact of Stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Brit Med J, Volume 337, No. 7666:a506: doi: 10.1136/bmj.a506. y. Sullivan, CM, Bybee, DI (1999), Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, Volume 67, No. 1, p43-53: https://cap.vaw.msu.edu/wp-content/ uploads/2014/05/Two-year-followup-CAP-JCCP.pdf. 1 These are for both perpetration of and victimization from intimate partner violence (IPV) 2 The 7 strategies are not mutually exclusive, should not be seen as silos, and there are some overlaps across them. 3 Although specific interventions and their examples are listed under one particular strategy, it is important to note that many of them reflect combination/bundled programming with multi- component and multi-level interventions that fall across more than 1 of the 7 strategies of RESPECT. Their categorization under one strategy reflects the primary intent of the intervention. For example, some interventions under transforming norms also include relationship strengthening skills. Likewise, empowerment of women interventions may include an economic transfer component. Therefore, these strategies should not be seen as stand-alone but as approaches whose impact may be better enhanced in combination with others. 4 Evidence ratings are largely derived from systematic reviews of more than 1 evaluation of interventions that mostly use experimental designs including randomized, cluster randomized and quasi- experimental methods. It is recognized that for some strategies such as justice sector interventions, alternative evaluation methods may be more appropriate including time series, observational and cross-sectional designs despite being typically considered lower quality. This is an emerging field and hence, there is a great deal of variation in rigor of study design and evaluation. The sources for these reviews and studies are provided as part of references. 5 Refers to evaluations where some studies may show positive impacts and others may show no impacts or negative impacts, highlighting that the impact of interventions may be context specific. Hence, any replication or adaptation of the intervention must pay close attention to the contextual or implementation factors. 6 This includes laws and policies that: criminalize sexual abuse; promote equality in inheritance; ban child marriage and FGM; marriage, custody and divorce laws that guarantee equality for women; action plans that promote gender equality and address violence against women. It also includes implementing justice and law enforcement services such as arrest orders and legal aid. 7 Even where there is no national commitment to ending violence against women, there may be other commitments to empower women, to gender equality, or to women’s health that may be useful to consider. Citations and additional references Endnotes RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 24
R E S P E C T Preventing violence against women For more information, contact Department of Reproductive Health and Research World Health Organization 20 Avenue Appia CH 1211, Geneva 27 Switzerland Fax: +41 22 791 4171 Email: reproductivehealth@who.int www.who.int/reproductivehealth/topics/violence/en WHO/RHR/18.19 W O M E N WHO/RHR/18.19 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. 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Printed in Switzerland RESPECT women: Preventing violence against women Know the facts Assess risk and protective factors Implement 7 strategies to prevent violence against women Assess evidence for interventions Develop a theory of change Apply the guiding principles for prevention Strengthen enabling environment for prevention Adapt and scale-up what works Monitor, evaluate and measure progress Commit to action! Introduction The primary audience for this document is policymakers. Programme implementers working on preventing and responding to violence against women will also find it useful for designing, planning, implementing, and monitoring and evaluating interventions and programmes. I II III IV V VI VII VIII IX p.4 Table of contents X p.6 p.10 p.14 p.18 p.22 p.12 p.8 p.16 p.20 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 2 3 I Know the facts Nearly 1 in 3 (35%) women worldwide have experienced physical and/or sexual violence by an intimate partner or sexual violence, not including sexual harassment, by any perpetrator. Low education, exposure to violence in childhood, unequal power in intimate relationships, and attitudes and norms accepting violence and gender inequality increase the risk of experiencing intimate partner violence and sexual violence. Violence against women and girls is preventable. To prevent violence, mitigate the risk factors and amplify the protective factors. Globally, 30% of women have experienced physical and/or sexual violence by an intimate partner in their lifetime. Violence negatively affects women’s physical and mental health and well-being. It has social and economic consequences and costs for families, communities and societies. Violence against women (VAW) is a violation of human rights, is rooted in gender inequality, is a public health problem, and an impediment to sustainable development. Low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality increase risk of perpetrating intimate partner violence. Adolescent girls, young women, women belonging to ethnic and other minorities, transwomen, and women with disabilities face a higher risk of different forms of violence. The majority (55-95%) of women survivors of violence do not disclose or seek any type of services. Humanitarian emergencies may exacerbate existing violence and lead to additional forms of violence against women and girls. Globally between 38%-50% of murders of women are committed by intimate partners.R ES PE CT : P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 4 5 II Childhood experience of violence and/ or exposure to violence in the family Mental disorders Attitudes condoning or justifying violence as normal or acceptable Discriminatory laws on property ownership, marriage, divorce and child custody Low levels of women’s employment and education Absence or lack of enforcement of laws addressing violence against women Gender discrimination in institutions (e.g. police, health) High levels of inequality in relationships/ male-controlled relationships/ dependence on partner Men's multiple sexual relationships Men's use of drugs and harmful use of alcohol Harmful gender norms that uphold male privilege and limit women’s autonomy High levels of poverty and unemployment High rates of violence and crime Availability of drugs, alcohol and weapons Assess the risk & protective factors1 Intimate relationships characterized by gender equality, including in shared decision- making and household responsibilities Laws that: • promote gender equality • promote women’s access to formal employment • address violence against women Non-exposure to violence in the family Secondary education for women and men and less disparity in education levels between women and men Both men and boys and women and girls are socialized to, and hold gender equitable attitudes Norms that support non- violence and gender equitable relationships, and promote women’s empowerment Protective Factors Risk Factors SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 6 7 III R E S P E C T Implement strategies to prevent violence against women27 Relationship skills strengthened refers to strategies aimed at individuals or groups of women, men or couples to improve skills in interpersonal communication, conflict management and shared decision-making. Environments made safe refers to efforts to create safe schools, public spaces and work environments, among others. Empowerment of women refers to both economic and social empowerment including inheritance and asset ownership, microfinance plus gender and empowerment training interventions, collective action, creating safe spaces and mentoring to build skills in self-efficacy, assertiveness, negotiation, and self-confidence. Services ensured refers to a range of services including police, legal, health, and social services provided to survivors. Poverty reduced refers to strategies targeted to women or the household whose primary aim is to alleviate poverty ranging from cash transfers, savings, microfinance loans, labour force interventions. Child and adolescent abuse prevented refers to establishing nurturing family relationships, prohibiting corporal punishment, and implementing parenting programmes as mentioned in INSPIRE - 7 strategies for preventing violence against children. Transformed attitudes, beliefs, and norms refers to strategies that challenge harmful gender attitudes, beliefs, norms and stereotypes that uphold male privilege and female subordination, that justify violence against women and that stigmatize survivors. These may range from public campaigns, group education to community mobilization efforts. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 8 9 R E S P E C T IV Group-based workshops with women and men to promote egalitarian attitudes and relationships Couples counselling and therapy Empowerment training for women and girls including life skills, safe spaces, mentoring Inheritance and asset ownership policies and interventions Micro-finance or savings and loans plus gender and empowerment training components Economic transfers, including conditional/ unconditional cash transfers plus vouchers, and in-kind transfers Labour force interventions including employment policies, livelihood and employment training Microfinance or savings interventions without any additional components Infrastructure and transport Bystander interventions Whole School interventions Empowerment counselling interventions or psychological support to support access to services (i.e. advocacy) Alcohol misuse prevention interventions Shelters Hotlines One-stop crisis centres Perpetrator interventions Women’s police stations/units Screening in health services Sensitization and training of institutional personnel without changing the institutional environment Home visitation and health worker outreach Parenting interventions Psychological support interventions for children who experience violence and who witness intimate partner violence Life skills / school-based curriculum, rape and dating violence prevention training Community mobilization Group-based workshops with women and men to promote changes in attitudes and norms Social marketing or edutainment and group education Group education with men and boys to change attitudes and norms Stand-alone awareness campaigns/single component communications campaigns Economic transfers In Northern Ecuador, a cash, vouchers and food transfer programme implemented by the World Food Programme (WFP) was targeted to women in poor urban areas, intending to reduce poverty. Participating households received monthly transfers equivalent to $40 per month for a period of 6 months. The transfer was conditional on attendance of monthly nutrition trainings. The evaluation showed reductions in women’s experience of controlling behaviours, physical and/or sexual violence by intimate partners by 19 to 30%. A plausible mechanism for this was reduced conflict within couples related to poverty- related stresses.p Microfinance plus gender and empowerment The IMAGE project (Intervention with Microfinance for Aids and Gender Equity) in South Africa empowers women through microfinance together with training on gender and power and community mobilization activities. Studies show it reduced domestic violence by 50% in the intervention group over a period of two years. At US$244 per incident case of partner violence averted during a 2-year scale up phase, the intervention is highly cost-effective.w Relationships skills strengthened Empowerment of women Services ensured Poverty reduced LL L H H H H H H L L EXAMPLE EXAMPLE H H L H L L L L L L L L L L L H H H L L L H H L H H H L H H L H H L H H H H Advocacy for survivors The Community Advocacy Project in Michigan and Illinois, United States, is an evidence-based program designed to help women survivors of intimate partner abuse re-gain control of their lives. Trained advocates provide advocacy and individually tailored assistance to survivors so that they can access community resources and social support. The intervention was found to lower recurrance of violence and depression and improve quality of life and social support. Two years after the intervention ended, the positive change continued.y Right to play - preventing violence among and against children in schools In Hyderabad (Sindh Province), Pakistan, a right to play intervention reached children in 40 public schools. Boys and girls were engaged in play-based learning providing them opportunity to develop life skills such as confidence, communication, empathy, coping with negative emotions, resilience, cooperation, leadership, critical thinking and conflict resolution that help combat conflict, intolerance, gender discrimination and peer violence. An evaluation showed decreases in peer victimization by 33% among boys and 59% among girls at 24 months post intervention; in corporal punishment by 45% in boys and 66% in girls; and in witnessing of domestic violence by 65% among boys and by 70% in girls.o Community Mobilizations SASA! is a community intervention in Uganda that prevents violence against women by shifting the power balance between men and women in relationships. Studies show that in SASA! communities 76% of women and men believe physical violence against a partner is not acceptable while only 26% of women and men in control communities believe the same. At the cost of US$ 460 per incident case of partner violence averted in trial phase, intervention is cost-effective and further economies of scale can be achieved during scale-up.v Group-based Workshops In the two-year period following the implementation of Stepping Stones in South Africa with female and male participants aged 15–26 years, men were less likely to perpetrate intimate partner violence, rape and transactional sex in the intervention group compared to the baseline.x Environments made safe Child and adolescent abuse prevented EXAMPLE EXAMPLE EXAMPLEEXAMPLE Transformed attitudes, beliefs, and norms H L L H L L H Assess the evidence on interventions3 L H LEGEND4 promising, >1 evaluations show significant reductions in violence outcomes more evidence needed, > 1 evaluations show improvements in intermediate outcomes related to violence conflicting, evaluations show conflicting results in reducing violence5 no evidence, intervention not yet rigorously evaluated ineffective, >1 evaluations show no reductions in violence outcomes World Bank Low and Middle Income Countries (LMIC) World Bank High Income Countries (HIC) L H RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 10 11 V BA RR IE R S Co m m un iti es w ith h ig h le ve ls of v io le nc e Fa m ili es a ffe ct ed b y vi ol en ce W om en fa ci ng v io le nc e IN TE R V EN TI O N S Environments made safe OUTPUTS OUTCOMES IMPACT Relationship skills strengthened Empowerment of women Services ensured Poverty reduced Child and adolescent abuse prevented Transformed attitudes, beliefs, and norms Programmes to address VAW widely implemented Increased resources and political will to address VAW Increased awareness about VAW as a public health problem and that it is preventable Sectoral outcomes related to health, economic, and social development improved (e.g. improved mental health, reduced household poverty, improved women's and child health, improved women's education and earnings, and reduced absenteeism) Families, communities and institutions believe in and uphold gender equality as a norm and no longer accept VAW Men accept and treat women as equals Women can make autonomous decisions Women have knowledge of their rights and access to programmes Improved health and development outcomes in households, community and society Women are exercising their human rights and contributing to development Violence against women is reduced or eliminated Equality and respect are practiced in intimate, family and community relationships Interpersonal conflicts are resolved peacefully Limitations on women's autonomy Children exposed to violence Social norms that perpetuate male power Inadequate services Inadequate legal and social protections for women Lack of political will and resources Under-resourced women's organizations or movements Develop a theory of change Build ing o n res ilien cy a nd k now ledg e, an d re sour cing and sup port ing c omm uniti es to find solu tions 12 13 G EN ER A TE A N D D IS SE M IN A TE K N O W LE D G E CO R E VA LU ES PR O G R A M M E D ES IG N VIApply the guiding principles for effective programming Strengthen monitoring and evaluation systems to build the evidence base on what works and facilitate knowledge sharing to inform programming Ensure confidentiality of information and anticipate and address unintended consequences Ensure that analysis of unequal gender and power relations and male privilege over women is at the center of programming Promote gender equality and women’s human rights Leave no one behind Develop a theory of change Promote evidence informed programming Put women’s safety first and do no harm Use participatory approaches Promote coordination Take a life-course approach Address the prevention continuum Implement combined interventions Elaborate how programming inputs will lead to changes in intermediate outcomes and likely impacts Address multiple and intersecting forms of discrimination based on sex, gender, class, race, ethnicity, disability, sexual orientation, gender identity Stimulate personal reflection and critical thinking, and build on the voice, agency and skills of people. Facilitate collective programming with individuals, families and communities to address the multiple risk factors underlying VAW and multiple forms of violence within families. Support partnerships across sectors and organizations, and at local and national levels Link prevention and response interventions Implement programmes that work with children, adolescents and young people for early interventions 6 7 8 9 10 1 5 2 3 4 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 14 15 VII Build political commitment from leaders and policy makers to speak out, condemning violence against women. Put in place and facilitate enforcement of laws and policies that address violence against women and that promote gender equality, including access to secondary education.6 Invest in, build on the work of, resource, and support women's organizations. Allocate resources to programmes, research, and to strengthen institutions and capacities of the health, education, law enforcement, and social services sectors to address violence against women. Strengthen enabling environment a c b d for prevention RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 16 17 VIIIAdapt and scale-up what works Violence prevention interventions that have been shown to work on a pilot basis can be scaled- up in different ways. They can be expanded by adding more beneficiaries; they can be adapted and replicated in another geographic location; and there can be expansion in coverage of the same intervention over a wider geographic area. Interventions that are being scaled-up in a new setting need to be adapted to context. This requires an understanding of the local culture, values and resources. Interventions identified as promising (pages 10- 11) can be adapted and scaled-up with attention to the guiding principles for prevention and to the adaptation and scaling-up considerations on the next page; those classified as “more evidence needed" (pages 10-11) may need to be replicated or further refined before they are scaled-up; and those identified as "conflicting" or "no evidence" need to be further evaluated. Align with national commitments (e.g. a national plan, policy, strategy) to end violence against women, or to promote gender equality or women’s health.7 Invest in capacity among implementers, and giving enough time to scale-up and to allow for change to occur and sustain. Programme for synergy, combining multiple strategies and interventions at the individual, interpersonal, community and societal levels for sustained impact. Identify and maintain fidelity to core principles of gender equality, rights and safety as well as to minimum “dosage”, while also adapting to context, including language and culture. Build on on-going initiatives, integrating prevention activities into existing health, development and other existing sectoral programmes. Design with “scale” in mind, investing for the long-term, keeping costs and sustainability in mind. Start small, document and evaluate the adaptation and scale-up in order to innovate and strengthen evidence-informed programming. Support a community of practice among programme developers and implementers to facilitate learning and knowledge sharing. a b c d e f g h RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 18 19 IX Progress in preventing violence against women can be measured in the short and the long-term. 1. In the long-term, the impact of prevention programmes can be measured as reductions in prevalence of different forms of violence against women. 2. At the global level, countries are required to report progress in preventing violence against women as part of SDG targets. Two indicators are proposed: • prevalence of intimate partner violence in the last 12 months among women aged 15 years and older (SDG target 5.2 - eliminate all forms of violence against women and girls); • proportion of young women and men aged 18–29 years who experienced sexual violence by age 18 (SDG target 16.2 - End abuse, exploitation, trafficking and all forms of violence against and torture of children). Monitor, evaluate and measure progress 3. In the short to medium term, interim indicators that contribute towards reductions in prevalence of violence against women will depend on the types of programmes. These can include, for example, improvements in: • gender equitable attitudes and norms • partner communication • women’s autonomy, agency and/or self- efficacy • girls' and women's education 4. It is important to specify a theory of change elaborating how the programme will likely improve interim indicators and how these in turn will contribute to reducing prevalence of violence against women. 5. It is important to evaluate before scaling-up and to monitor the scaling-up on an on-going basis to ensure that resources are invested in programmes that work, unintended or harmful outcomes are mitigated, and the scaling-up process takes into account the local context. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 20 21 X R E S P E C T ENDING VIOLENCE AGAINST WOMEN BEGINS WITH Commit to change Start today Support evidence-based approaches Join others The way forward: a call to action RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 22 23 a. CUSP (2017), On the CUSP of change: Effective scaling of social norms programming for gender equality, Community for Understanding Scale Up: http://raisingvoices.org/wp-content/ uploads/2013/02/6.CombinedCUSPcasestudies.FINAL_.pdf b. Heise L (2011), What Works to Prevent Partner Violence?: http:// strive.lshtm.ac.uk/system/files/attachments/What%20works%20 to%20prevent%20partner%20violence.pdf c. Salamander Trust (2017), ALIVE[H]E Framework: http:// salamandertrust.net/resources/alivhe-framework d. UN Women (2015), A Framework to Underpin Action to Prevent Violence Against Women: http://www.unwomen.org/-/ media/ headquarters/attachments/sections/library/publications/2015/ prevention_framework_unwomen_nov2015. pdf?la=en&vs=5223 e. WHO, LSHTM, SAMRC (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO. http://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng. pdf;jsessionid=294A291A603A7BCB4B60F588532CE53D? sequence=1 f. World Health Organization (2016), Violence against women, Intimate partner and sexual violence against women, Fact Sheet: http://www.who.int/mediacentre/factsheets/fs239/en/ g. World Health Organization and UNAIDS (2013), 16 Ideas for addressing violence against women in the context of the HIV epidemic - A programming tool: http://www.who.int/ reproductivehealth/publications/violence/vaw_hiv_epidemic/en/ h. WHO, LSHTM (2010), Preventing Intimate partner violence and sexual violence: generating evidence and taking action: http://apps.who.int/iris/bitstream/ handle/10665/44350/9789241564007_eng.pdf?sequence=1 i. What Works to Prevent Violence (2014), A global programme to prevent violence against women and girls: A Summary of the Evidence and Research Agenda: https://www.gov.uk/ government/publications/what-works-in-preventing-violenceagainst- women-and-girls-review-of-the-evidence-from-the-programme j. Ellsberg M., Arango D.J., Morton M., Gennari F., Kiplesund S., Contreras-Urbina M., Watts C (2015), Prevention of violence against women and girls: what does the evidence say? The Lancet, Volume 385, No. 9977, p1555–1566: https://www.thelancet. com/journals/lancet/article/PIIS0140-6736(14)61703-7/ fulltext?rss%3Dyes k. Contreras-Urbina M., Heilman B., Von Au A. K., Hill A., Puerto Gómez M., Zelaya J., Arango D.J (2016) Community-based approaches to intimate partner violence : a review of evidence and essential steps to adaptation (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/ en/907511467996712161/Community-based-approaches-to- intimate-partner-violence-a-review-of-evidence-and-essential-steps-to- adaptation l. World Health Organization (2016), 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: http://www.who.int/ reproductivehealth/publications/violence/global-plan-of-action/en/ m. Garcia-Moreno C., Zimmerman C., Morris-Gehring A., Heise L., Amin A., Abrahams N., Montoya O., Bhate-Deosthali P., Kilonzo N., Watts C (2015), Addressing violence against women: a call to action, The Lancet, Volume 385, No. 9978, p1685–1695: https://doi.org/10.1016/S0140-6736(14)61830-4 n. World Health Organization (2016) INSPIRE: Seven strategies for Ending Violence Against Children: http://www.who.int/violence_ injury_prevention/violence/inspire/en/ o. What works to prevent violence against women and girls global programme (2018), Right to play: preventing violence among and against children in schools in Hyderabad, Pakistan: Evidence brief. South Africa: Medical Research Council and UK: UK aid. https:// www.whatworks.co.za/documents/publications/211-right-to-play/ file p. Hidrobo M, Peterman A, Heise L (2016), The effect of cash, vouchers and food transfers on intimate partner violence: evidence from a randomized experiment in Northern Ecuador. American Economic Journal Applied Economics, Volume 8, No 3, p284-303: https://DOI:10.1257/app.20150048 q. National Resource Center on Domestic Violence (2012), Program and Practice Profiles: Community Advocacy Project, Harrisburg, PA: National Resource Center on Domestic Violence. http://www. dvevidenceproject.org r. Buller A, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L (2018). A mixed-method review of cash transfers and intimate partner violence in low- and middle-income countries. The World Bank Research Observer, Volume 22, No 2, p218-258: https:// doi.org/10.1093/wbro/lky002 s. Peterman A, Palermo TM, Ferrari G (2018). Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ global health, Volume 3, No. 6: e001143. doi:10.1136/ bmjgh-2018-001143. t. Karakurt G, Whiting K, Van Esch, Bolen S, Calabrese J (2016). Couple therapy for intimate partner violence: A systematic review and meta-analysis. J Marital Fam Ther, Volume 42, No. 4, p567- 583: doi:10.1111/jmft.12178. u. Desai CC, Reece J, Shakespear-Pellington S (2017) The prevention of violence in childhood through parenting programmes: a global review, Psychology, Health & Medicine, Volume 22, Sup1, p166- 186: DOI: 10.1080/13548506.2016.1271952. v. Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, Cundill B, Francisco L, Kaye D, Musuya T, Michau L, Watts C (2014), Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Medicine, Volume 12:122: https:// doi.org/10.1186/s12916-014-0122-5. w. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD (2006), Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. The Lancet, Volume 368, No. 9551, p1973–1983: doi: 10.1016/S0140-6736(06)69744-4. x. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N (2008), Impact of Stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Brit Med J, Volume 337, No. 7666:a506: doi: 10.1136/bmj.a506. y. Sullivan, CM, Bybee, DI (1999), Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, Volume 67, No. 1, p43-53: https://cap.vaw.msu.edu/wp-content/ uploads/2014/05/Two-year-followup-CAP-JCCP.pdf. 1 These are for both perpetration of and victimization from intimate partner violence (IPV) 2 The 7 strategies are not mutually exclusive, should not be seen as silos, and there are some overlaps across them. 3 Although specific interventions and their examples are listed under one particular strategy, it is important to note that many of them reflect combination/bundled programming with multi- component and multi-level interventions that fall across more than 1 of the 7 strategies of RESPECT. Their categorization under one strategy reflects the primary intent of the intervention. For example, some interventions under transforming norms also include relationship strengthening skills. Likewise, empowerment of women interventions may include an economic transfer component. Therefore, these strategies should not be seen as stand-alone but as approaches whose impact may be better enhanced in combination with others. 4 Evidence ratings are largely derived from systematic reviews of more than 1 evaluation of interventions that mostly use experimental designs including randomized, cluster randomized and quasi- experimental methods. It is recognized that for some strategies such as justice sector interventions, alternative evaluation methods may be more appropriate including time series, observational and cross-sectional designs despite being typically considered lower quality. This is an emerging field and hence, there is a great deal of variation in rigor of study design and evaluation. The sources for these reviews and studies are provided as part of references. 5 Refers to evaluations where some studies may show positive impacts and others may show no impacts or negative impacts, highlighting that the impact of interventions may be context specific. Hence, any replication or adaptation of the intervention must pay close attention to the contextual or implementation factors. 6 This includes laws and policies that: criminalize sexual abuse; promote equality in inheritance; ban child marriage and FGM; marriage, custody and divorce laws that guarantee equality for women; action plans that promote gender equality and address violence against women. It also includes implementing justice and law enforcement services such as arrest orders and legal aid. 7 Even where there is no national commitment to ending violence against women, there may be other commitments to empower women, to gender equality, or to women’s health that may be useful to consider. Citations and additional references Endnotes RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 24
R E S P E C T Preventing violence against women For more information, contact Department of Reproductive Health and Research World Health Organization 20 Avenue Appia CH 1211, Geneva 27 Switzerland Fax: +41 22 791 4171 Email: reproductivehealth@who.int www.who.int/reproductivehealth/topics/violence/en WHO/RHR/18.19 W O M E N WHO/RHR/18.19 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. 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Printed in Switzerland RESPECT women: Preventing violence against women Know the facts Assess risk and protective factors Implement 7 strategies to prevent violence against women Assess evidence for interventions Develop a theory of change Apply the guiding principles for prevention Strengthen enabling environment for prevention Adapt and scale-up what works Monitor, evaluate and measure progress Commit to action! Introduction The primary audience for this document is policymakers. Programme implementers working on preventing and responding to violence against women will also find it useful for designing, planning, implementing, and monitoring and evaluating interventions and programmes. I II III IV V VI VII VIII IX p.4 Table of contents X p.6 p.10 p.14 p.18 p.22 p.12 p.8 p.16 p.20 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 2 3 I Know the facts Nearly 1 in 3 (35%) women worldwide have experienced physical and/or sexual violence by an intimate partner or sexual violence, not including sexual harassment, by any perpetrator. Low education, exposure to violence in childhood, unequal power in intimate relationships, and attitudes and norms accepting violence and gender inequality increase the risk of experiencing intimate partner violence and sexual violence. Violence against women and girls is preventable. To prevent violence, mitigate the risk factors and amplify the protective factors. Globally, 30% of women have experienced physical and/or sexual violence by an intimate partner in their lifetime. Violence negatively affects women’s physical and mental health and well-being. It has social and economic consequences and costs for families, communities and societies. Violence against women (VAW) is a violation of human rights, is rooted in gender inequality, is a public health problem, and an impediment to sustainable development. Low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality increase risk of perpetrating intimate partner violence. Adolescent girls, young women, women belonging to ethnic and other minorities, transwomen, and women with disabilities face a higher risk of different forms of violence. The majority (55-95%) of women survivors of violence do not disclose or seek any type of services. Humanitarian emergencies may exacerbate existing violence and lead to additional forms of violence against women and girls. Globally between 38%-50% of murders of women are committed by intimate partners.R ES PE CT : P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 4 5 II Childhood experience of violence and/ or exposure to violence in the family Mental disorders Attitudes condoning or justifying violence as normal or acceptable Discriminatory laws on property ownership, marriage, divorce and child custody Low levels of women’s employment and education Absence or lack of enforcement of laws addressing violence against women Gender discrimination in institutions (e.g. police, health) High levels of inequality in relationships/ male-controlled relationships/ dependence on partner Men's multiple sexual relationships Men's use of drugs and harmful use of alcohol Harmful gender norms that uphold male privilege and limit women’s autonomy High levels of poverty and unemployment High rates of violence and crime Availability of drugs, alcohol and weapons Assess the risk & protective factors1 Intimate relationships characterized by gender equality, including in shared decision- making and household responsibilities Laws that: • promote gender equality • promote women’s access to formal employment • address violence against women Non-exposure to violence in the family Secondary education for women and men and less disparity in education levels between women and men Both men and boys and women and girls are socialized to, and hold gender equitable attitudes Norms that support non- violence and gender equitable relationships, and promote women’s empowerment Protective Factors Risk Factors SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL SOCIETAL COMMUNITY INTERPERSONAL INDIVIDUAL RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 6 7 III R E S P E C T Implement strategies to prevent violence against women27 Relationship skills strengthened refers to strategies aimed at individuals or groups of women, men or couples to improve skills in interpersonal communication, conflict management and shared decision-making. Environments made safe refers to efforts to create safe schools, public spaces and work environments, among others. Empowerment of women refers to both economic and social empowerment including inheritance and asset ownership, microfinance plus gender and empowerment training interventions, collective action, creating safe spaces and mentoring to build skills in self-efficacy, assertiveness, negotiation, and self-confidence. Services ensured refers to a range of services including police, legal, health, and social services provided to survivors. Poverty reduced refers to strategies targeted to women or the household whose primary aim is to alleviate poverty ranging from cash transfers, savings, microfinance loans, labour force interventions. Child and adolescent abuse prevented refers to establishing nurturing family relationships, prohibiting corporal punishment, and implementing parenting programmes as mentioned in INSPIRE - 7 strategies for preventing violence against children. Transformed attitudes, beliefs, and norms refers to strategies that challenge harmful gender attitudes, beliefs, norms and stereotypes that uphold male privilege and female subordination, that justify violence against women and that stigmatize survivors. These may range from public campaigns, group education to community mobilization efforts. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 8 9 R E S P E C T IV Group-based workshops with women and men to promote egalitarian attitudes and relationships Couples counselling and therapy Empowerment training for women and girls including life skills, safe spaces, mentoring Inheritance and asset ownership policies and interventions Micro-finance or savings and loans plus gender and empowerment training components Economic transfers, including conditional/ unconditional cash transfers plus vouchers, and in-kind transfers Labour force interventions including employment policies, livelihood and employment training Microfinance or savings interventions without any additional components Infrastructure and transport Bystander interventions Whole School interventions Empowerment counselling interventions or psychological support to support access to services (i.e. advocacy) Alcohol misuse prevention interventions Shelters Hotlines One-stop crisis centres Perpetrator interventions Women’s police stations/units Screening in health services Sensitization and training of institutional personnel without changing the institutional environment Home visitation and health worker outreach Parenting interventions Psychological support interventions for children who experience violence and who witness intimate partner violence Life skills / school-based curriculum, rape and dating violence prevention training Community mobilization Group-based workshops with women and men to promote changes in attitudes and norms Social marketing or edutainment and group education Group education with men and boys to change attitudes and norms Stand-alone awareness campaigns/single component communications campaigns Economic transfers In Northern Ecuador, a cash, vouchers and food transfer programme implemented by the World Food Programme (WFP) was targeted to women in poor urban areas, intending to reduce poverty. Participating households received monthly transfers equivalent to $40 per month for a period of 6 months. The transfer was conditional on attendance of monthly nutrition trainings. The evaluation showed reductions in women’s experience of controlling behaviours, physical and/or sexual violence by intimate partners by 19 to 30%. A plausible mechanism for this was reduced conflict within couples related to poverty- related stresses.p Microfinance plus gender and empowerment The IMAGE project (Intervention with Microfinance for Aids and Gender Equity) in South Africa empowers women through microfinance together with training on gender and power and community mobilization activities. Studies show it reduced domestic violence by 50% in the intervention group over a period of two years. At US$244 per incident case of partner violence averted during a 2-year scale up phase, the intervention is highly cost-effective.w Relationships skills strengthened Empowerment of women Services ensured Poverty reduced LL L H H H H H H L L EXAMPLE EXAMPLE H H L H L L L L L L L L L L L H H H L L L H H L H H H L H H L H H L H H H H Advocacy for survivors The Community Advocacy Project in Michigan and Illinois, United States, is an evidence-based program designed to help women survivors of intimate partner abuse re-gain control of their lives. Trained advocates provide advocacy and individually tailored assistance to survivors so that they can access community resources and social support. The intervention was found to lower recurrance of violence and depression and improve quality of life and social support. Two years after the intervention ended, the positive change continued.y Right to play - preventing violence among and against children in schools In Hyderabad (Sindh Province), Pakistan, a right to play intervention reached children in 40 public schools. Boys and girls were engaged in play-based learning providing them opportunity to develop life skills such as confidence, communication, empathy, coping with negative emotions, resilience, cooperation, leadership, critical thinking and conflict resolution that help combat conflict, intolerance, gender discrimination and peer violence. An evaluation showed decreases in peer victimization by 33% among boys and 59% among girls at 24 months post intervention; in corporal punishment by 45% in boys and 66% in girls; and in witnessing of domestic violence by 65% among boys and by 70% in girls.o Community Mobilizations SASA! is a community intervention in Uganda that prevents violence against women by shifting the power balance between men and women in relationships. Studies show that in SASA! communities 76% of women and men believe physical violence against a partner is not acceptable while only 26% of women and men in control communities believe the same. At the cost of US$ 460 per incident case of partner violence averted in trial phase, intervention is cost-effective and further economies of scale can be achieved during scale-up.v Group-based Workshops In the two-year period following the implementation of Stepping Stones in South Africa with female and male participants aged 15–26 years, men were less likely to perpetrate intimate partner violence, rape and transactional sex in the intervention group compared to the baseline.x Environments made safe Child and adolescent abuse prevented EXAMPLE EXAMPLE EXAMPLEEXAMPLE Transformed attitudes, beliefs, and norms H L L H L L H Assess the evidence on interventions3 L H LEGEND4 promising, >1 evaluations show significant reductions in violence outcomes more evidence needed, > 1 evaluations show improvements in intermediate outcomes related to violence conflicting, evaluations show conflicting results in reducing violence5 no evidence, intervention not yet rigorously evaluated ineffective, >1 evaluations show no reductions in violence outcomes World Bank Low and Middle Income Countries (LMIC) World Bank High Income Countries (HIC) L H RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 10 11 V BA RR IE R S Co m m un iti es w ith h ig h le ve ls of v io le nc e Fa m ili es a ffe ct ed b y vi ol en ce W om en fa ci ng v io le nc e IN TE R V EN TI O N S Environments made safe OUTPUTS OUTCOMES IMPACT Relationship skills strengthened Empowerment of women Services ensured Poverty reduced Child and adolescent abuse prevented Transformed attitudes, beliefs, and norms Programmes to address VAW widely implemented Increased resources and political will to address VAW Increased awareness about VAW as a public health problem and that it is preventable Sectoral outcomes related to health, economic, and social development improved (e.g. improved mental health, reduced household poverty, improved women's and child health, improved women's education and earnings, and reduced absenteeism) Families, communities and institutions believe in and uphold gender equality as a norm and no longer accept VAW Men accept and treat women as equals Women can make autonomous decisions Women have knowledge of their rights and access to programmes Improved health and development outcomes in households, community and society Women are exercising their human rights and contributing to development Violence against women is reduced or eliminated Equality and respect are practiced in intimate, family and community relationships Interpersonal conflicts are resolved peacefully Limitations on women's autonomy Children exposed to violence Social norms that perpetuate male power Inadequate services Inadequate legal and social protections for women Lack of political will and resources Under-resourced women's organizations or movements Develop a theory of change Build ing o n res ilien cy a nd k now ledg e, an d re sour cing and sup port ing c omm uniti es to find solu tions 12 13 G EN ER A TE A N D D IS SE M IN A TE K N O W LE D G E CO R E VA LU ES PR O G R A M M E D ES IG N VIApply the guiding principles for effective programming Strengthen monitoring and evaluation systems to build the evidence base on what works and facilitate knowledge sharing to inform programming Ensure confidentiality of information and anticipate and address unintended consequences Ensure that analysis of unequal gender and power relations and male privilege over women is at the center of programming Promote gender equality and women’s human rights Leave no one behind Develop a theory of change Promote evidence informed programming Put women’s safety first and do no harm Use participatory approaches Promote coordination Take a life-course approach Address the prevention continuum Implement combined interventions Elaborate how programming inputs will lead to changes in intermediate outcomes and likely impacts Address multiple and intersecting forms of discrimination based on sex, gender, class, race, ethnicity, disability, sexual orientation, gender identity Stimulate personal reflection and critical thinking, and build on the voice, agency and skills of people. Facilitate collective programming with individuals, families and communities to address the multiple risk factors underlying VAW and multiple forms of violence within families. Support partnerships across sectors and organizations, and at local and national levels Link prevention and response interventions Implement programmes that work with children, adolescents and young people for early interventions 6 7 8 9 10 1 5 2 3 4 RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 14 15 VII Build political commitment from leaders and policy makers to speak out, condemning violence against women. Put in place and facilitate enforcement of laws and policies that address violence against women and that promote gender equality, including access to secondary education.6 Invest in, build on the work of, resource, and support women's organizations. Allocate resources to programmes, research, and to strengthen institutions and capacities of the health, education, law enforcement, and social services sectors to address violence against women. Strengthen enabling environment a c b d for prevention RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 16 17 VIIIAdapt and scale-up what works Violence prevention interventions that have been shown to work on a pilot basis can be scaled- up in different ways. They can be expanded by adding more beneficiaries; they can be adapted and replicated in another geographic location; and there can be expansion in coverage of the same intervention over a wider geographic area. Interventions that are being scaled-up in a new setting need to be adapted to context. This requires an understanding of the local culture, values and resources. Interventions identified as promising (pages 10- 11) can be adapted and scaled-up with attention to the guiding principles for prevention and to the adaptation and scaling-up considerations on the next page; those classified as “more evidence needed" (pages 10-11) may need to be replicated or further refined before they are scaled-up; and those identified as "conflicting" or "no evidence" need to be further evaluated. Align with national commitments (e.g. a national plan, policy, strategy) to end violence against women, or to promote gender equality or women’s health.7 Invest in capacity among implementers, and giving enough time to scale-up and to allow for change to occur and sustain. Programme for synergy, combining multiple strategies and interventions at the individual, interpersonal, community and societal levels for sustained impact. Identify and maintain fidelity to core principles of gender equality, rights and safety as well as to minimum “dosage”, while also adapting to context, including language and culture. Build on on-going initiatives, integrating prevention activities into existing health, development and other existing sectoral programmes. Design with “scale” in mind, investing for the long-term, keeping costs and sustainability in mind. Start small, document and evaluate the adaptation and scale-up in order to innovate and strengthen evidence-informed programming. Support a community of practice among programme developers and implementers to facilitate learning and knowledge sharing. a b c d e f g h RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 18 19 IX Progress in preventing violence against women can be measured in the short and the long-term. 1. In the long-term, the impact of prevention programmes can be measured as reductions in prevalence of different forms of violence against women. 2. At the global level, countries are required to report progress in preventing violence against women as part of SDG targets. Two indicators are proposed: • prevalence of intimate partner violence in the last 12 months among women aged 15 years and older (SDG target 5.2 - eliminate all forms of violence against women and girls); • proportion of young women and men aged 18–29 years who experienced sexual violence by age 18 (SDG target 16.2 - End abuse, exploitation, trafficking and all forms of violence against and torture of children). Monitor, evaluate and measure progress 3. In the short to medium term, interim indicators that contribute towards reductions in prevalence of violence against women will depend on the types of programmes. These can include, for example, improvements in: • gender equitable attitudes and norms • partner communication • women’s autonomy, agency and/or self- efficacy • girls' and women's education 4. It is important to specify a theory of change elaborating how the programme will likely improve interim indicators and how these in turn will contribute to reducing prevalence of violence against women. 5. It is important to evaluate before scaling-up and to monitor the scaling-up on an on-going basis to ensure that resources are invested in programmes that work, unintended or harmful outcomes are mitigated, and the scaling-up process takes into account the local context. RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 20 21 X R E S P E C T ENDING VIOLENCE AGAINST WOMEN BEGINS WITH Commit to change Start today Support evidence-based approaches Join others The way forward: a call to action RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS RESPECT: PREV EN TIN G V IO LEN CE A G A IN ST W O M EN A FRA M EW O RK FO R PO LIC YM A KERS 22 23 a. CUSP (2017), On the CUSP of change: Effective scaling of social norms programming for gender equality, Community for Understanding Scale Up: http://raisingvoices.org/wp-content/ uploads/2013/02/6.CombinedCUSPcasestudies.FINAL_.pdf b. Heise L (2011), What Works to Prevent Partner Violence?: http:// strive.lshtm.ac.uk/system/files/attachments/What%20works%20 to%20prevent%20partner%20violence.pdf c. Salamander Trust (2017), ALIVE[H]E Framework: http:// salamandertrust.net/resources/alivhe-framework d. UN Women (2015), A Framework to Underpin Action to Prevent Violence Against Women: http://www.unwomen.org/-/ media/ headquarters/attachments/sections/library/publications/2015/ prevention_framework_unwomen_nov2015. pdf?la=en&vs=5223 e. WHO, LSHTM, SAMRC (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO. http://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng. pdf;jsessionid=294A291A603A7BCB4B60F588532CE53D? sequence=1 f. World Health Organization (2016), Violence against women, Intimate partner and sexual violence against women, Fact Sheet: http://www.who.int/mediacentre/factsheets/fs239/en/ g. World Health Organization and UNAIDS (2013), 16 Ideas for addressing violence against women in the context of the HIV epidemic - A programming tool: http://www.who.int/ reproductivehealth/publications/violence/vaw_hiv_epidemic/en/ h. WHO, LSHTM (2010), Preventing Intimate partner violence and sexual violence: generating evidence and taking action: http://apps.who.int/iris/bitstream/ handle/10665/44350/9789241564007_eng.pdf?sequence=1 i. What Works to Prevent Violence (2014), A global programme to prevent violence against women and girls: A Summary of the Evidence and Research Agenda: https://www.gov.uk/ government/publications/what-works-in-preventing-violenceagainst- women-and-girls-review-of-the-evidence-from-the-programme j. Ellsberg M., Arango D.J., Morton M., Gennari F., Kiplesund S., Contreras-Urbina M., Watts C (2015), Prevention of violence against women and girls: what does the evidence say? The Lancet, Volume 385, No. 9977, p1555–1566: https://www.thelancet. com/journals/lancet/article/PIIS0140-6736(14)61703-7/ fulltext?rss%3Dyes k. Contreras-Urbina M., Heilman B., Von Au A. K., Hill A., Puerto Gómez M., Zelaya J., Arango D.J (2016) Community-based approaches to intimate partner violence : a review of evidence and essential steps to adaptation (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/ en/907511467996712161/Community-based-approaches-to- intimate-partner-violence-a-review-of-evidence-and-essential-steps-to- adaptation l. World Health Organization (2016), 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: http://www.who.int/ reproductivehealth/publications/violence/global-plan-of-action/en/ m. Garcia-Moreno C., Zimmerman C., Morris-Gehring A., Heise L., Amin A., Abrahams N., Montoya O., Bhate-Deosthali P., Kilonzo N., Watts C (2015), Addressing violence against women: a call to action, The Lancet, Volume 385, No. 9978, p1685–1695: https://doi.org/10.1016/S0140-6736(14)61830-4 n. World Health Organization (2016) INSPIRE: Seven strategies for Ending Violence Against Children: http://www.who.int/violence_ injury_prevention/violence/inspire/en/ o. What works to prevent violence against women and girls global programme (2018), Right to play: preventing violence among and against children in schools in Hyderabad, Pakistan: Evidence brief. South Africa: Medical Research Council and UK: UK aid. https:// www.whatworks.co.za/documents/publications/211-right-to-play/ file p. Hidrobo M, Peterman A, Heise L (2016), The effect of cash, vouchers and food transfers on intimate partner violence: evidence from a randomized experiment in Northern Ecuador. American Economic Journal Applied Economics, Volume 8, No 3, p284-303: https://DOI:10.1257/app.20150048 q. National Resource Center on Domestic Violence (2012), Program and Practice Profiles: Community Advocacy Project, Harrisburg, PA: National Resource Center on Domestic Violence. http://www. dvevidenceproject.org r. Buller A, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L (2018). A mixed-method review of cash transfers and intimate partner violence in low- and middle-income countries. The World Bank Research Observer, Volume 22, No 2, p218-258: https:// doi.org/10.1093/wbro/lky002 s. Peterman A, Palermo TM, Ferrari G (2018). Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ global health, Volume 3, No. 6: e001143. doi:10.1136/ bmjgh-2018-001143. t. Karakurt G, Whiting K, Van Esch, Bolen S, Calabrese J (2016). Couple therapy for intimate partner violence: A systematic review and meta-analysis. J Marital Fam Ther, Volume 42, No. 4, p567- 583: doi:10.1111/jmft.12178. u. Desai CC, Reece J, Shakespear-Pellington S (2017) The prevention of violence in childhood through parenting programmes: a global review, Psychology, Health & Medicine, Volume 22, Sup1, p166- 186: DOI: 10.1080/13548506.2016.1271952. v. Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, Cundill B, Francisco L, Kaye D, Musuya T, Michau L, Watts C (2014), Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Medicine, Volume 12:122: https:// doi.org/10.1186/s12916-014-0122-5. w. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD (2006), Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. The Lancet, Volume 368, No. 9551, p1973–1983: doi: 10.1016/S0140-6736(06)69744-4. x. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N (2008), Impact of Stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Brit Med J, Volume 337, No. 7666:a506: doi: 10.1136/bmj.a506. y. Sullivan, CM, Bybee, DI (1999), Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, Volume 67, No. 1, p43-53: https://cap.vaw.msu.edu/wp-content/ uploads/2014/05/Two-year-followup-CAP-JCCP.pdf. 1 These are for both perpetration of and victimization from intimate partner violence (IPV) 2 The 7 strategies are not mutually exclusive, should not be seen as silos, and there are some overlaps across them. 3 Although specific interventions and their examples are listed under one particular strategy, it is important to note that many of them reflect combination/bundled programming with multi- component and multi-level interventions that fall across more than 1 of the 7 strategies of RESPECT. Their categorization under one strategy reflects the primary intent of the intervention. For example, some interventions under transforming norms also include relationship strengthening skills. Likewise, empowerment of women interventions may include an economic transfer component. Therefore, these strategies should not be seen as stand-alone but as approaches whose impact may be better enhanced in combination with others. 4 Evidence ratings are largely derived from systematic reviews of more than 1 evaluation of interventions that mostly use experimental designs including randomized, cluster randomized and quasi- experimental methods. It is recognized that for some strategies such as justice sector interventions, alternative evaluation methods may be more appropriate including time series, observational and cross-sectional designs despite being typically considered lower quality. This is an emerging field and hence, there is a great deal of variation in rigor of study design and evaluation. The sources for these reviews and studies are provided as part of references. 5 Refers to evaluations where some studies may show positive impacts and others may show no impacts or negative impacts, highlighting that the impact of interventions may be context specific. Hence, any replication or adaptation of the intervention must pay close attention to the contextual or implementation factors. 6 This includes laws and policies that: criminalize sexual abuse; promote equality in inheritance; ban child marriage and FGM; marriage, custody and divorce laws that guarantee equality for women; action plans that promote gender equality and address violence against women. It also includes implementing justice and law enforcement services such as arrest orders and legal aid. 7 Even where there is no national commitment to ending violence against women, there may be other commitments to empower women, to gender equality, or to women’s health that may be useful to consider. Citations and additional references Endnotes RE SP EC T: P RE V EN TI N G V IO LE N CE A G A IN ST W O M EN A F RA M EW O RK F O R PO LIC YM A KE RS 24
R E S P E C T Предупреждение насилия в отношении женщин М Е Х А Н И З М З А Щ И Т Ы Ж Е Н Щ И Н RESPECT: предупреждение насилия в отношении женщин. Механизм для представителей директивных органов [RESPECT: preventing violence against women. A framework for policymakers] © Всемирная организация здравоохранения, 2019 Некоторые права защищены. Настоящая публикация распространяется на условиях лицензии Creative Commons 3.0 IGO «С указанием авторства – Некоммерческая – Распространение на тех же условиях» (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Лицензией допускается копирование, распространение и адаптация публикации в некоммерческих целях с указанием библиографической ссылки согласно нижеприведенному образцу. Никакое использование публикации не означает одобрения ВОЗ какой-либо организации, товара или услуги. Использование логотипа ВОЗ не допускается. Распространение адаптированных вариантов публикации допускается на условиях указанной или эквивалентной лицензии Creative Commons. При переводе публикации на другие языки приводится библиографическая ссылка согласно нижеприведенному образцу и следующая оговорка: «Настоящий перевод не был выполнен Всемирной организацией здравоохранения (ВОЗ). ВОЗ не несет ответственности за его содержание и точность. Аутентичным подлинным текстом является оригинальное издание на английском языке». Урегулирование споров, связанных с условиями лицензии, производится в соответствии с согласительным регламентом Всемирной организации интеллектуальной собственности. Образец библиографической ссылки: RESPECT: предупреждение насилия в отношении женщин. Механизм для представителей директивных органов. [RESPECT: preventing violence against women. A framework for policymakers]. Женева: Всемирная организация здравоохранения; 2020. Лицензия: CC BY- NC-SA 3.0 IGO. Данные каталогизации перед публикацией (CIP). Данные CIP доступны по ссылке: http://apps. who.int/iris/. Приобретение, авторские права и лицензирование. По вопросам приобретения публикаций ВОЗ см. http://apps.who.int/bookorders. По вопросам оформления заявок на коммерческое использование и направления запросов, касающихся права пользования и лицензирования, см. http://www.who.int/about/ licensing/. Материалы третьих сторон. Пользователь, желающий использовать в своих целях содержащиеся в настоящей публикации материалы, принадлежащие третьим сторонам, например таблицы, рисунки или изображения, должен установить, требуется ли для этого разрешение обладателя авторского права, и при необходимости получить такое разрешение. Ответственность за нарушение прав на содержащиеся в публикации материалы третьих сторон несет пользователь. Оговорки общего характера. Используемые в настоящей публикации обозначения и приводимые в ней материалы не означают выражения мнения ВОЗ относительно правового статуса любой страны, территории, города или района или их органов власти или относительно делимитации границ. Штрихпунктирные линии на картах обозначают приблизительные границы, которые могут быть не полностью согласованы. Упоминание определенных компаний или продукции определенных производителей не означает, что они одобрены или рекомендованы ВОЗ в отличие от аналогичных компаний или продукции, не названных в тексте. Названия патентованных изделий, исключая ошибки и пропуски в тексте, выделяются начальными прописными буквами. ВОЗ приняты все разумные меры для проверки точности информации, содержащейся в настоящей публикации. Однако данные материалы публикуются без каких-либо прямых или косвенных гарантий. Ответственность за интерпретацию и использование материалов несет пользователь. ВОЗ не несет никакой ответственности за ущерб, связанный с использованием материалов. Отпечатано в Швейцарии RESPECT: механизм защиты женщин Предупреждение насилия в отношении женщин Введение Данный документ предназначен главным образом для представителей директивных органов. Он будет также полезен для лиц, занимающихся разработкой, планированием, реализацией, мониторингом и оценкой программ и мероприятий по предупреждению насилия в отношении женщин и борьбе с ним. Содержание R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 2 Ознакомление с фактами Оценка факторов риска и факторов защиты Реализация семи стратегий по предупреждению насилия в отношении женщин Оценка фактических данных в качестве основы для реализации мероприятий Разработка теории изменений Применение руководящих принципов для предупреждения насилия Создание благоприятных условий для предупреждения насилия Адаптация и массовое проведение эффективных мероприятий Мониторинг, оценка и определение показателей прогресса Решимость действовать! I II III IV V VI VII VIII IX c. 4 X c. 6 c. 10 c. 14 c. 18 c. 22 c. 12 c. 8 c. 16 c. 20 R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 3 I Ознакомление с фактами Почти каждая третья (35%) женщина в мире подвергается физическому и/или сексуальному насилию со стороны интимного партнера, помимо сексуальных домогательств со стороны других лиц. Во всем мире 30% женщин в течение жизни подвергаются физическому и/или сексуальному насилию со стороны интимного партнера. Насилие в отношении женщин уходит корнями в гендерное неравенство и является нарушением прав человека и проблемой общественного здравоохранения, которая препятствует устойчивому развитию. Девочки-подростки, молодые женщины, представительницы этнических и национальных меньшинств, женщины-транссексуалы и женщины с ограниченными возможностям больше других рискуют стать жертвами различных форм насилия. R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 4 Низкий уровень образования, пережитое в детстве насилие, неравноправие в интимных отношениях, а также убеждения и нормы, способствующие насилию и гендерному неравенству, повышают риск стать жертвой сексуального насилия и насилия со стороны интимного партнера. Насилие в отношении женщин можно предотвращать. Для предотвращения насилия необходимо противодействовать факторам риска и усиливать факторы, способствующие защите женщин. Насилие пагубно сказывается на физическом и психологическом здоровье и благополучии женщин. Оно влечет за собой социальные и экономические последствия и ложится тяжелым бременем на семьи, местные сообщества и общество в целом. Низкий уровень образования, жестокое обращение с детьми и угроза насилия в семье, злоупотребление алкоголем, а также терпимость к насилию и гендерному неравенству повышают риск насилия со стороны интимных партнеров. Большинство (55–95%) женщин, переживших насилие, не рассказывают об этом и не обращаются за помощью. Чрезвычайные ситуации гуманитарного характера могут усугублять существующее насилие и приводить к возникновению дополнительных форм насилия, направленного против женщин и девочек. От 38 до 50% убийств женщин в мире совершается их интимными партнерами. R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 5 II Дискриминационные законы об имущественных правах, браке, разводах и опеке/ попечительстве над детьми Низкий уровень образования и занятости среди женщин Отсутствие или недостаточный контроль за соблюдением законов о противодействии насилию в отношении женщин Гендерная дискриминация в общественных институтах (например, правоохранительных органах, учреждениях здравоохранения) Пагубные гендерные нормы, закрепляющие привилегированное положение мужчин и ограничивающие самостоятельность женщин Высокий уровень бедности и безработицы Широкая распространенность насилия и преступности Доступность наркотиков, алкоголя и оружия Значительное неравенство в отношениях, доминирование мужчин в отношениях, зависимость от партнера-мужчины Наличие у мужчин нескольких сексуальных партнеров Наркомания и алкоголизм среди мужчин Пережитое в детстве насилие и/или подверженность насилию в семье Психические расстройства Убеждения, оправдывающие насилие или признающие его допустимым или приемлемым Факторы риска ОБЩЕСТВО В ЦЕЛОМ МЕСТНОЕ СООБЩЕСТВО БЛИЗКОЕ ОКРУЖЕНИЕ ИНДИВИДУУМ Оценка факторов риска и факторов защиты1 R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 6 Недопущение насилия в семье Доступность среднего образования для женщин и мужчин и сокращение диспропорций между женщинами и мужчинами по уровню образования Традиции равноправного общения между мужчинами/ мальчиками и женщинами/ девочками и формирование ценностей гендерного равенства Личные отношения, предусматривающие равенство мужчины и женщины, в том числе совместное принятие решений и несение обязанностей по дому Законы, которые: • способствуют достижению гендерного равенства; • расширяют доступ женщин к официальной занятости; • запрещают насилие в отношении женщин Нормы, которые поддерживают ненасильственные и гендерно равноправные отношения и помогают расширять права и возможности женщин Факторы защиты ОБЩЕСТВО В ЦЕЛОМ МЕСТНОЕ СООБЩЕСТВО БЛИЗКОЕ ОКРУЖЕНИЕ ИНДИВИДУУМ R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 7 III R E S P E C T Реализация стратегий по предупреждению насилия в отношении женщин27 R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 8 стратегий по предупреждению насилия в отношении женщин2 Relationship – развитие навыков межличностного общения Стратегии, направленные на формирование у отдельных лиц или групп мужчин, женщин или пар навыков межличностного общения, разрешения конфликтов и совместного принятия решений. Empowerment – расширение прав и возможностей женщин Расширение экономических и социальных прав и возможностей женщин, в том числе в вопросах наследования имущества и имущественных прав, доступ женщин к микрокредитованию и обучению, укрепляющему их потенциал, возможность участвовать в коллективном урегулировании споров, создание «зон безопасности», а также кураторство для формирования у женщин уверенности в себе, воспитания навыков самостоятельности, умения отстаивать свои права и вести переговоры. Poverty – сокращение бедности Стратегии помощи женщинам или семьям, направленные прежде всего на искоренение нищеты, в том числе путем выплаты денежных пособий, накопления сбережений, микрокредитования и мер трудовой политики. Services – предоставление необходимых услуг Различные услуги для женщин, переживших насилие, в том числе услуги, предоставляемые правоохранительными органами, юридическими службами, учреждениями здравоохранения и органами социального обеспечения. Environments – создание безопасной среды Меры по созданию безопасных условий в школах, общественных местах, в трудовой и других сферах. Child – профилактика жестокого обращения с детьми и подростками Формирование благоприятных семейных отношений, запрет на телесные наказания и реализация программ родительского воспитания в соответствии с документом «INSPIRE: семь стратегий по ликвидации насилия в отношении детей». Transformed – изменение установок, убеждений и норм Стратегии, направленные на борьбу с пагубными гендерными представлениями, убеждениями, нормами и стереотипами, которые закрепляют доминирующее положение мужчин и подчинение женщин, оправдывают насилие в отношении женщин и возлагают вину на женщин, переживших насилие. Это самые различные стратегии, включающие в себя публичные кампании, массовую просветительскую работу и меры по воспитанию активной позиции населения на местах. 9 R E S IV Групповые семинары с участием женщин и мужчин, способствующие формированию равноправных и гармоничных взаимоотношений Консультирование семейных пар и оказание им психологической помощи Обучение женщин и девочек по вопросам расширения их прав и возможностей, включая формирование жизненных навыков, создание «зон безопасности» и кураторство Меры политики и стратегии по обеспечению наследственных и имущественных прав Схемы микрокредитования, стимулирования сбережений и выдачи займов наряду с обучением по вопросам гендерного равенства и расширения прав и возможностей Программы консультирования и оказания психологической поддержки по вопросам расширения прав и возможностей женщин для расширения доступа к услугам (т. е. информационно- разъяснительная работа) Меры профилактики злоупотребления алкоголем Предоставление убежища Горячие линии Центры комплексной кризисной помощи Мероприятия по работе с виновниками насилия Отделения и отряды полиции по работе с женщинами Скрининг в учреждениях здравоохранения Информационно-разъяснительная работа и обучение сотрудников учреждений (без принятия масштабных экономико-правовых мер) Выдача микрокредитов наряду с обучением по вопросам гендерного равенства и расширения прав и возможностей женщин В ЮАР был реализован проект по расширению прав и возможностей женщин IMAGE («Противодействие распространению СПИДа и преодоление гендерного неравенства посредством микрокредитования»), предусматривавший выдачу микрокредитов с одновременным обучением по вопросу о влиянии гендерного фактора на возможности мужчин и женщин и проведением мероприятий по мобилизации местных сообществ. Как показали исследования, осуществление проекта в течение двух лет привело к снижению на 50% числа случаев домашнего насилия среди охваченных им групп населения. Проект также продемонстрировал эффективность с экономической точки зрения: за двухлетний период массового внедрения проекта затраты на предупреждение насилия в одной паре партнеров составили всего 244 долл. СШАw. Relationship – развитие навыков межличностного общения Empowerment – расширение прав и возможностей женщин Services – предоставление необходимых услуг В В Н Н Н Н Н Н Н В В В Н Н Н В В Н Н ВВ В В Информационно-разъяснительная работа с пострадавшими Информационно-просветительский проект на уровне местных сообществ в штатах Мичиган и Иллинойс (США) – научно обоснованная программа социально- психологической реабилитации женщин, переживших жестокое обращение со стороны интимных партнеров. Специально подготовленные защитники оказывают пострадавшим информационную помощь и индивидуальное содействие в получении доступа к услугам местных организаций и системы социального обеспечения. Было установлено, что программа позволяет снизить число рецидивов насилия и эпизодов депрессии и повысить качество жизни и социальной поддержки. Эти положительные тенденции сохранились спустя два года после окончания программыy. Групповые семинары Спустя два года после реализации в ЮАР программы «Шаг вперед» с участием мужчин и женщин в возрасте 15–26 лет среди мужчин, которые участвовали в программе, снизилась распространенность насилия, изнасилований и использования сексуальных услуг по сравнению с исходными показателямиx. ПРИМЕР ПРИМЕРПРИМЕР В Н В Оценка фактических данных в качестве основы для реализации мероприятий3 Н В R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 10 P E C TПредоставление доступа к экономическим ресурсам, включая условные и безусловные выплаты денежных пособий, а также выдачу талонов и выплаты в натуральной форме Мероприятия в сфере трудовой занятости, включая меры трудовой политики и обучение по вопросам трудоустройства и улучшения экономического положения Программы микрокредитования или стимулирования сбережений без дополнительных компонентов Инфраструктура и транспорт Активная позиция сограждан Комплексные школьные мероприятия Посещение семей и медико-санитарная работа с населением Мероприятия по улучшению методов родительского воспитания Программы психологической поддержки детей, подверженных насилию или являющихся свидетелями насилия со стороны интимных партнеров женщин Формирование жизненных навыков, адаптация учебных программ и обучение предупреждению изнасилований и насилия на свиданиях Мобилизация местных сообществ Групповые семинары с участием мужчин и женщин, способствующие изменению убеждений и норм Социальный маркетинг или информационное просветительство, а также групповая информационная работа Групповое обучение с участием мужчин и мальчиков, способствующее изменению убеждений и норм Тематические кампании по повышению осведомленности и информированию общественности Предоставление доступа к экономическим ресурсам Реализованная Всемирной продовольственной программой (ВПП) инициатива по оказанию экономической помощи, распределению продовольственных карточек и продуктов питания в Северном Эквадоре была предназначена для малоимущих женщин из сельских районов и направлена на сокращение масштабов бедности. В течение шести месяцев участвующие в инициативе домохозяйства ежемесячно получали материальную помощь на сумму около 40 долларов. Условием получения помощи было посещение ежемесячных учебных мероприятий по вопросам питания. В ходе оценки инициативы было зарегистрировано снижение на 19–30% доли женщин, сталкивающихся с проявлениями контролирующего поведения, физическим и/или сексуальным насилием со стороны интимных партнеров. Это может объясняться тем, что в отношениях между мужчинами и женщинами в паре снизился уровень конфликтности, порождаемой сопровождающими бедность факторами стрессаp. Poverty – сокращение бедности Н Н Н В В В В В В Н В Н Н Н Н Н Н В В Н В В В Н В В Право на игры: профилактика насилия среди детей и в отношении детей в школах Учащиеся 40 государственных школ Хайдарабада (провинция Синд, Пакистан) были охвачены инициативой по социальной адаптации с использованием игровых методик. Мальчики и девочки участвовали в игровых учебных занятиях, направленных на формирование жизненно важных навыков, помогающих противостоять конфликтам, нетерпимости, гендерной дискриминации и насилию со стороны сверстников, таких как уверенность в себе, умение общаться и проявлять эмпатию, способы контроля негативных эмоций, психологическая устойчивость, взаимодействие, лидерство, критическое мышление и урегулирование конфликтов. По итогам оценки было установлено, что спустя 24 месяца после проведения инициативы уровень виктимизации сверстников уменьшился на 33% среди мальчиков и на 59% среди девочек, частота применения телесных наказаний снизилась на 45% среди мальчиков и на 66% среди девочек, а количество детей, которые стали свидетелями домашнего насилия, сократилось на 65% среди мальчиков и на 70% среди девочекo. Мобилизация местных сообществ Реализуемая в Уганде кампания по мобилизации общин SASA! направлена на профилактику насилия в отношении женщин за счет изменения баланса сил в отношениях между мужчинами и женщинами. Согласно проведенным исследованиям, 76% женщин и мужчин в охваченных инициативой SASA! общинах считают физическое насилие в отношении партнера неприемлемым, тогда как в общинах, где кампания не проводилась, такое мнение разделяют лишь 26% женщин и мужчин. Данная инициатива является экономически оправданной, поскольку расходы на предупреждение одного эпизода насилия в отношении партнера на этапе апробации кампании составили 460 долл. США, а в ходе ее массового проведения этот показатель может быть сокращен еще больше за счет эффекта масштабаv. Environments – создание безопасной среды Child – профилактика жестокого обращения с детьми и подростками ПРИМЕР ПРИМЕР ПРИМЕР Transformed – изменение установок, убеждений и норм В Н Н Н УСЛОВНЫЕ ОБОЗНАЧЕНИЯ4 Перспективная мера: значительное сокращение показателей насилия по данным как минимум двух оценок Требуется больше фактических данных: положительная динамика промежуточных показателей сокращения насилия по данным как минимум двух оценок Неоднозначные выводы: противоречивые выводы об эффективности меры для сокращения насилия по данным различным оценок5 Нет фактических данных: данная мера еще не подвергалась тщательной оценке Неэффективная мера: результаты как минимум двух оценок свидетельствуют об отсутствии эффекта сокращения насилия Страны с низким и средним уровнем дохода по классификации Всемирного банка Страны с высоким уровнем дохода по классификации Всемирного банка Н В R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 11 V П РЕ П Я ТС ТВ И Я Со об щ ес тв а с в ыс ок им у ро вн ем н ас ил ия Се мь и, с тр ад аю щ ие о т на си ли я Ж ен щ ин ы , с та лк ив аю щ ие ся с н ас ил ие м М ЕР О П Р И Я ТИ Я Environments – создание безопасной среды Relationship – развитие навыков межличностного общения Empowerment – расширение прав и возможностей женщин Services – предоставление необходимых услуг Poverty – сокращение бедности Child – профилактика жестокого обращения с детьми и подростками Transform – изменение установок, убеждений и норм Факторы, ограничивающие самостоятельность женщин Присутствие насилия в жизни детей Социальные нормы, закрепляющие доминирование мужчин Несоответствие услуг потребностям Недостаточная правовая и социальная защита женщин Нехватка политической воли и ресурсов Недостаточное финансирование женских организаций и движений Разработка теории изменений Укр епл ени е по тен циа ла, нак опл ени е зн ани й и обе спе чен ие м естн ых соо бще ств рес урс ами и по дде ржк ой д ля п оис ка р еше ний 12 ПРОМЕЖУТОЧНЫЕ РЕЗУЛЬТАТЫ ИТОГОВЫЕ РЕЗУЛЬТАТЫ ДОЛГОСРОЧНЫЙ ЭФФЕКТ Широкое внедрение программ по борьбе с насилием в отношении женщин Увеличение объема ресурсов и укрепление политической воли для борьбы с насилием в отношении женщин Повышение осведомленности о том, что насилие в отношении женщин пагубно сказывается на здоровье населения и его можно предотвращать Улучшение показателей, связанных со здоровьем, экономическим и социальным развитием (например, улучшение психического здоровья населения, снижение доли бедных домохозяйств, улучшение здоровья женщин и детей, повышение уровня образования и дохода женщин и сокращение частоты случаев неявки на работу или учебу) в различных секторах Утверждение норм гендерного равенства в семье, обществе и институтах и искоренение терпимости к насилию в отношении женщин Признание мужчинами равноправия с женщинами и соответствующее обращение с женщинами Самостоятельное принятие решений женщинами Осведомленность женщин о своих правах и наличие у них доступа к программам Улучшение показателей в области здоровья и развития на уровне семьи, местного сообщества и общества в целом Осуществление женщинами прав человека и участие в процессах развития Сокращение или ликвидация насилия в отношении женщин Соблюдение равноправия и уважения в интимных, семейных и общественных отношениях Мирное разрешение межличностных конфликтов Разработка теории изменений 13 Н А К О П Л ЕН И Е И Р А С П Р О С ТР А Н ЕН И Е З Н А Н И Й К Л Ю Ч ЕВ Ы Е Ц ЕН Н О С ТИ Применение руководящих принципов Укрепление систем мониторинга и оценки для накопления доказательной базы по наиболее эффективным решениям и содействие обмену знаниями, которые должны учитываться при разработке программ Сохранение конфиденциальности информации, а также прогнозирование и устранение непреднамеренных последствий Проведение анализа проявлений неравенства в гендерных и властных отношениях, а также доминирующего положения мужчин по сравнению с женщинами – это важнейший этап планирования программ Поощрение гендерного равенства и прав человека женщин Никто не должен быть оставлен без внимания Разработка теории изменений Развитие научно обоснованной программной деятельности Главное – безопасность женщин и соблюдение принципа «не навреди» Подробное описание того, как ресурсы программы обеспечат изменения на уровне промежуточных результатов и долгосрочного эффекта Борьба с многочисленными и взаимосвязанными формами дискриминации по половому и гендерному признакам, классовой, расовой и этнической принадлежности, трудоспособности, сексуальной ориентации и гендерной идентичности 1 5 2 3 4 R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 14 РА З РА Б О ТК А П Р О ГР А М М для эффективной программной деятельности Обеспечение активного участия заинтересованных сторон Содействие координации Охват всех возрастных групп Согласование различных мер по предупреждению насилия Внедрение комплексных программ Развитие самоанализа и критического мышления, а также учет мнений, личного потенциала и навыков людей Содействие разработке и проведению коллективных программ с участием отдельных лиц, семей и местных сообществ для противодействия многочисленным факторам риска, порождающим насилие в отношении женщин и разнообразные формы насилия в семье Поддержка партнерских отношений между различными секторами и организациями и отношений на местном и национальном уровнях Координация мер профилактики и пресечения насилия Внедрение программ раннего вмешательства по работе с детьми, подростками и молодежью 6 7 8 9 10 R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 15 VII Укрепление политической воли лидеров и директивных органов к открытому диалогу о проблеме насилия в отношении женщин и осуждению этого явления. Финансирование, развитие деятельности, обеспечение ресурсами и поддержка женских организаций. Создание благоприятных условий a b R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 16 VII Принятие и контроль за соблюдением законов и стратегий по борьбе с насилием в отношении женщин и поощрению гендерного равенства, включая равный доступ к среднему образованию6. Выделение ресурсов на проведение программ и научных исследований, а также укрепление структур и потенциала в сфере здравоохранения, образования, поддержания правопорядка и социального обеспечения в интересах борьбы с насилием в отношении женщин. для предупреждения насилия c d R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 17 VIIIАдаптация и массовое проведение эффективных мероприятий Существует несколько способов обеспечить массовый характер мероприятий по профилактике насилия, доказавших свою эффективность на экспериментальной основе. К ним относятся: расширение круга получателей помощи; адаптация и воспроизведение в другой географической области; увеличение географических границ охвата одних и тех же мероприятий. При внедрении мероприятий в новых условиях их необходимо адаптировать к местной специфике. Для этого требуется понимание местных культурных обычаев, ценностей и ресурсов. Мероприятия, отнесенные к перспективным (см. раздел об оценке фактических данных), могут быть адаптированы и внедрены в широких масштабах с учетом руководящих принципов профилактики насилия, а также рекомендаций, представленных на следующей странице; мероприятия категории «требуется больше фактических данных» (см. в разделе об оценке выше) могут потребовать сначала воспроизведения и дополнительной оптимизации и лишь затем масштабирования; мероприятия, отнесенные к категориям «неоднозначные выводы» или «нет фактических данных», требуют дальнейшей оценки. R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 18 Согласование с обязательствами по ликвидации насилия в отношении женщин или поощрению гендерного равенства и укреплению здоровья женщин, заявленными на национальном уровне (например, в рамках общенационального плана, политики или стратегии)7. Выделение ресурсов на укрепление потенциала исполнителей и установление реалистичных сроков для массовой реализации мероприятий, осуществления и закрепления изменений. Разработка синергетически ориентированных программ за счет сочетания различных стратегий и мероприятий на уровне отдельных лиц, межличностных отношений, местного сообщества и общества в целом в интересах достижения долгосрочного эффекта. Определение и тщательное соблюдение основных принципов обеспечения гендерного равенства, прав и безопасности, а также минимально необходимого объема мероприятий; их адаптация к новым условиям, включая язык и культурные особенности. Использование возможностей уже существующих инициатив за счет интеграции профилактических мероприятий в программы, уже реализуемые в сфере здравоохранения, развития и других секторах. Разработка программ с расчетом на масштабирование путем формирования долгосрочного притока ресурсов, планирования затрат и учета принципов устойчивости. Соблюдение принципа «начинать с малого», документальное оформление и оценка процесса адаптации и массовой реализации для совершенствования и укрепления программной деятельности с опорой на фактические данные. Содействие формированию сообщества практиков в сфере разработки и осуществления программ в интересах накопления и распространения знаний. a b c d e f g h R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 19 IX Прогресс в области предупреждения насилия в отношении женщин можно оценивать в краткосрочной и долгосрочной перспективах. 1. В долгосрочной перспективе эффект профилактических программ можно оценивать по сокращению распространенности различных форм насилия в отношении женщин. 2. На глобальном уровне страны обязаны докладывать о достигнутом прогрессе в области предупреждения насилия в отношении женщин в рамках деятельности по достижению задач ЦУР. Предлагается два показателя: • распространенность насилия со стороны интимных партнеров женщин в возрасте от 15 лет и старше за последние 12 месяцев (задача 5.2 ЦУР: «Ликвидировать все формы насилия в отношении всех женщин и девочек»); • доля молодых женщин и мужчин в возрасте от 18 до 29 лет, подвергшихся сексуальному насилию до достижения ими 18-летнего возраста (задача 16.2 ЦУР: «Положить конец надругательствам, эксплуатации, торговле и всем формам насилия и пыток в отношении детей»). Мониторинг, оценка и определение показателей прогресса R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 20 3. В краткосрочной и среднесрочной перспективе промежуточные показатели, свидетельствующие о сокращении распространенности насилия в отношении женщин, будут зависеть от типа программы. Они могут свидетельствовать о положительных изменениях в таких областях, как: • убеждения и нормы, касающиеся гендерного равенства; • взаимодействие между партнерами; • самостоятельность, правомочность женщин и/или их уверенность в собственных силах; • образование девочек и женщин. 4. При формулировании теории изменений важно подробно описать, каким образом программа может улучшить промежуточные показатели и как эти показатели будут в свою очередь способствовать сокращению распространенности насилия в отношении женщин. 5. До начала массовой работы важно провести оценку планируемых мер и впоследствии непрерывно отслеживать их широкомасштабное внедрение в интересах распределения ресурсов в пользу наиболее эффективных программ, уменьшения непреднамеренных или негативных последствий и учета местных условий в рамках этого процесса. R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 21 R E S P E C T ЛИКВИДАЦИЯ НАСИЛИЯ В ОТНОШЕНИИ ЖЕНЩИН НАЧИНАЕТСЯ С УВАЖЕНИЯ R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 22 X Твердый курс на перемены Готовность начать уже сегодня Опора на фактические данные Объединение усилий Дальнейшие шаги: призыв к действию R ESPEC T: П РЕД У П РЕЖ Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХА Н И З М Д Л Я П РЕД С ТА ВИ ТЕЛ ЕЙ Д И РЕКТИ ВН Ы Х О РГА Н О В 23 a. CUSP (2017), On the CUSP of change: Effective scaling of social norms programming for gender equality, Community for Understanding Scale Up: http://raisingvoices.org/wp-content/ uploads/2013/02/6.CombinedCUSPcasestudies.FINAL_.pdf. b. Heise L (2011), What Works to Prevent Partner Violence?: http:// strive.lshtm.ac.uk/system/files/attachments/What%20works%20 to%20prevent%20partner%20violence.pdf. c. Salamander Trust (2017), ALIVE[H]E Framework: http:// salamandertrust.net/resources/alivhe-framework. d. UN Women (2015), A Framework to Underpin Action to Prevent Violence Against Women: http://www.unwomen.org/-/media/ headquarters/attachments/sections/library/publications/2015/ prevention_framework_unwomen_nov2015. pdf?la=en&vs=5223. e. WHO, LSHTM, SAMRC (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO. http://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng. pdf;jsessionid=294A291A603A7BCB4B60F588532CE53D? sequence=1. f. Всемирная организация здравоохранения (2016 г.). Насилие в отношении женщин, насилие со стороны интимного партнера и сексуальное насилие, информационный бюллетень: https:// www.who.int/ru/news-room/fact-sheets/detail/violence-against- women. g. World Health Organization and UNAIDS (2013), 16 Ideas for addressing violence against women in the context of the HIV epidemic – A programming tool: http://www.who.int/ reproductivehealth/publications/violence/vaw_hiv_epidemic/en/. h. WHO, LSHTM (2010), Preventing Intimate partner violence and sexual violence: generating evidence and taking action: http://apps. who.int/iris/bitstream/handle/10665/44350/9789241564007_ eng.pdf?sequence=1. i. What Works to Prevent Violence (2014), A global programme to prevent violence against women and girls: A Summary of the Evidence and Research Agenda: https://www.gov.uk/government/ publications/what-works-in-preventing-violenceagainst-women-and- girls-review-of-the-evidence-from-the-programme. j. Ellsberg M., Arango D.J., Morton M., Gennari F., Kiplesund S., Contreras-Urbina M., Watts C (2015), Prevention of violence against women and girls: what does the evidence say? The Lancet, Volume 385, No. 9977, p1555–1566: https://www.thelancet. com/journals/lancet/article/PIIS0140-6736(14)61703-7/ fulltext?rss%3Dyes. k. Contreras-Urbina M., Heilman B., Von Au A. K., Hill A., Puerto Gómez M., Zelaya J., Arango D.J (2016) Community-based approaches to intimate partner violence : a review of evidence and essential steps to adaptation (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/ en/907511467996712161/Community-based-approaches-to- intimate-partner-violence-a-review-of-evidence-and-essential-steps- to-adaptation. l. World Health Organization (2016), 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: http://www.who.int/reproductivehealth/ publications/violence/global-plan-of-action/en/. m. Garcia-Moreno C., Zimmerman C., Morris-Gehring A., Heise L., Amin A., Abrahams N., Montoya O., Bhate-Deosthali P., Kilonzo N., Watts C (2015), Addressing violence against women: a call to action, The Lancet, Volume 385, No. 9978, p1685–1695: https://doi. org/10.1016/S0140-6736(14)61830-4. n. World Health Organization (2016) INSPIRE: Seven strategies for Ending Violence Against Children: http://www.who.int/violence_ injury_prevention/violence/inspire/en/. o. What works to prevent violence against women and girls global programme (2018), Right to play: preventing violence among and against children in schools in Hyderabad, Pakistan: Evidence brief. South Africa: Medical Research Council and UK: UK aid. https:// www.whatworks.co.za/documents/publications/211-right-to- play/file. p. Hidrobo M, Peterman A, Heise L (2016), The effect of cash, vouchers and food transfers on intimate partner violence: evidence from a randomized experiment in Northern Ecuador. American Economic Journal Applied Economics, Volume 8, No 3, p284-303: https:// DOI:10.1257/app.20150048. q. National Resource Center on Domestic Violence (2012), Program and Practice Profiles: Community Advocacy Project, Harrisburg, PA: National Resource Center on Domestic Violence. http://www. dvevidenceproject.org. r. Buller A, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L (2018). A mixed-method review of cash transfers and intimate partner violence in low- and middle-income countries. The World Bank Research Observer, Volume 22, No 2, p218-258: https://doi. org/10.1093/wbro/lky002. s. Peterman A, Palermo TM, Ferrari G (2018). Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ global health, Volume 3, No. 6: e001143. doi:10.1136/bmjgh-2018-001143. t. Karakurt G, Whiting K, Van Esch, Bolen S, Calabrese J (2016). Couple therapy for intimate partner violence: A systematic review and meta-analysis. J Marital Fam Ther, Volume 42, No. 4, p567-583: doi:10.1111/jmft.12178. u. Desai CC, Reece J, Shakespear-Pellington S (2017) The prevention of violence in childhood through parenting programmes: a global review, Psychology, Health & Medicine, Volume 22, Sup1, p166- 186: DOI: 10.1080/13548506.2016.1271952. v. Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, Cundill B, Francisco L, Kaye D, Musuya T, Michau L, Watts C (2014), Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Medicine, Volume 12:122: https://doi.org/10.1186/s12916- 014-0122-5. w. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD (2006), Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. The Lancet, Volume 368, No. 9551, p1973–1983: doi: 10.1016/S0140-6736(06)69744-4. x. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N (2008), Impact of Stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Brit Med J, Volume 337, No. 7666:a506: doi: 10.1136/bmj.a506. y. Sullivan, CM, Bybee, DI (1999), Reducing violence using community- based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, Volume 67, No. 1, p43-53: https://cap.vaw.msu.edu/wp-content/uploads/2014/05/Two- year-followup-CAP-JCCP.pdf. Список литературы и дополнительные материалы R ES PE C T: П РЕ Д У П РЕ Ж Д ЕН И Е Н А С И Л И Я В О ТН О Ш ЕН И И Ж ЕН Щ И Н М ЕХ А Н И З М Д Л Я П РЕ Д С ТА ВИ ТЕ Л ЕЙ Д И РЕ КТ И ВН Ы Х О РГ А Н О В 24 1 Относятся как к совершению насилия, так и к виктимизации со стороны совершившего насилие интимного партнера. 2 Данные семь стратегий не являются взаимоисключающими, должны рассматриваться в комплексе и содержат некоторые дублирующие элементы. 3 Хотя отдельные мероприятия и примеры отнесены лишь к одной стратегии, многие из них представляют собой совокупные или комплексные программы с многокомпонентными и многоуровневыми вмешательствами, которые соответствуют двум и более из семи стратегий RESPECT. Распределение по стратегиям представлено в целях демонстрации основной цели этих мероприятий. Так, ряд мероприятий по изменению общественных норм также включает в себя укрепление навыков межличностных отношений. Аналогичным образом, мероприятия по расширению прав и возможностей женщин могут содержать компонент передачи экономических ресурсов. Таким образом, эти стратегии следует рассматривать не по отдельности, а в качестве подходов, обеспечивающих гораздо бо́льшую эффективность при совместном применении. 4 Иерархия фактических данных основана главным образом на систематических обзорах не менее чем двух оценок вмешательств, которые в основном являются экспериментальными исследованиями, включая рандомизированные, кластерные рандомизированные и квазиэкспериментальные исследования. Нельзя не отметить, что для некоторых стратегий, таких как программы в сфере правосудия, могут лучше подойти альтернативные методы оценки, включая исследования временных рядов и наблюдательные и межсекторальные исследования, несмотря на то, что эти методы обычно считаются низкокачественными. Эта область активно формируется и поэтому обладает гораздо большей вариативностью с точки зрения строгости дизайна и оценки исследований. Первоисточники обзоров и исследований приведены в списке дополнительных материалов. 5 Относится к оценкам, согласно которым некоторые исследования могут продемонстрировать положительное воздействие, а другие – отсутствие негативного воздействия, причем такое воздействие может зависеть от условий реализации мероприятий. Таким образом, при любом воспроизведении или адаптации мероприятий следует уделять особое внимание таким факторам, как местные условия или условия реализации. 6 Включает законы и меры политики, которые: устанавливают уголовную ответственность за сексуальное насилие; направлены на поощрение равноправия в наследовании имущества; устанавливают запрет на детские браки и калечащие операции на половых органах девочек; законы о браке, разводах и опеке/попечительстве над детьми, гарантирующие равные права для женщин; планы действий, направленные на укрепление гендерного равноправия и борьбу с насилием в отношении женщин. Также включает такие меры правосудия и правопорядка, как арест агрессора и юридическая помощь. 7 Даже при отсутствии национальных обязательств по ликвидации насилия в отношении женщин в стране могут существовать другие полезные для изучения обязательства, направленные на расширение прав и возможностей женщин, обеспечение гендерного равноправия или улучшение здоровья женщин. Ссылки WHO/RHR/18.19 Для получения дополнительной информации просьба обращаться в Департамент репродуктивного здоровья и научных исследований Всемирной организации здравоохранения 20 Avenue Appia CH 1211, Geneva 27 Switzerland Факс: +41 22 791 4171 Эл. почта: reproductivehealth@who.int www.who.int/reproductivehealth/topics/violence/en
فنعلا نم ةياقولا ةأرملا دض ةأرملا م ر ت ح اا :ةيلاتلا ةهجلاب لاصتلاا ىجرُي تامولعلما نم ديزملل Department of Reproductive Health and Research World Health Organization 20 Avenue Appia CH 1211, Geneva 27 Switzerland Fax: +41 22 791 4171 Email: reproductivehealth@who.int www.who.int/reproductivehealth/topics/violence/enWHO/RHR/18.19 احترام المرأة: الوقاية من العنف ضد المرأة © منظمة الصحة العالمية 0202 بعض الحقوق محفوظة. هذا المصنف متاح بمقت�ضى ترخيص المشاع الإبداعي "نسب المصنف – غير تجاري – المشاركة بالمثل 0.3 لفائدة المنظمات الحكومية الدولية"0.3 ecnecil OGI (ogi/0.3/as-cn-yb/sesnecil/gro.snommocevitaerc//:sptth ;OGI 0.3 AS-CN-YB CC). وبمقت�ضى هذا الترخيص يجوز أن تنسخوا المصنف وتعيدوا توزيعه وتحوروه للأغراض غير التجارية، وذلك شريطة أن يتم اقتباس المصنف على النحو الملائم. ولا ينبغي في أي استخدام لهذا المصنف الإيحاء بأن المنظمة (OHW) تعتمد أي منظمة أو منتجات أو خدمات محددة. ولا يُ سمح باستخدام شعار المنظمة (OHW). وإذا قمتم بتعديل المصنف فيجب عندئٍذ أن تحصلوا على ترخيص لمصنفكم بمقت�ضى نفس ترخيص المشاع الإبداعي (ecnecil snommoC evitaerC) أو ترخيص يعادله. وإذا قمتم بترجمة المصنف فينبغي أن تدرجوا بيان إخلاء المسؤولية التالي مع الاقتباس المقترح: "هذه الترجمة ليست من إعداد منظمة الصحة العالمية (المنظمة (OHW)). والمنظمة (OHW) غير مسؤولة عن محتوى هذه الترجمة أو دقتها. ويجب أن يكون إصدار الأصل الإنكليزي هو الإصدار الملزم وذو الحجية." لقواعد الوساطة للمنظمة العالمية للملكية الفكرية. ً ويجب أن تتم أية وساطة فيما يتعلق بالمنازعات التي تنشأ في إطار هذا الترخيص وفقا الاقتباس المقترح. احترام المرأة: الوقاية من العنف ضد المرأة. القاهرة: المكتب الإقليمي لمنظمة الصحة العالمية لشرق المتوسط؛ 0202. الترخيص OGI 0.3 AS-CM-YB CC. المبيعات والحقوق والترخيص. لشراء مطبوعات المنظمة (OHW) انظر الرابط sredrokoob/tni.ohw.sppa//:ptth. ولتقديم طلبات الاستخدام التجاري والاستفسارات الخاصة بالحقوق والترخيص انظر الرابط gnisnecil/tuoba/tni.ohw.www//:ptth. مواد الطرف الثالث. إذا كنتم ترغبون في إعادة استخدام مواد واردة في هذا المصنف ومنسوبة إلى طرف ثالث، مثل الجداول أو الأشكال أو الصور فإنكم تتحملون مسؤولية تحديد ما إذا كان يلزم الحصول على إذن لإعادة الاستخدام هذه أم لا، وعن الحصول على الإذن من صاحب حقوق المؤلف. ويتحمل المستخدم وحده أية مخاطر لحدوث مطالبات نتيجة انتهاك أي عنصر يملكه طرف ثالث في المصنف. عن أي رأي كان من ً بيانات عامة لإخلاء المسؤولية. التسميات المستعملة في هذا المطبوع، وطريقة عرض المواد الواردة فيه، لا تعبر ضمنا جانب المنظمة (OHW) بشأن الوضع القانوني لأي بلد أو أرض أو مدينة أو منطقة أو لسلطات أي منها أو بشأن تحديد حدودها أو تخومها. حدودية تقريبية قد لا يوجد بعد اتفاق كامل بشأنها. ً وتشكل الخطوط المنقوطة على الخرائط خطوطا كما أن ذكر شركات محددة أو منتجات جهات صانعة معينة لا يعني أن هذه الشركات والمنتجات معتمدة أو مو�ضى بها من جانب المنظمة لها على سواها مما يماثلها في الطابع ولم يرد ذكره. وفيما عدا الخطأ والسهو، تميز أسماء المنتجات المسجلة الملكية ً (OHW)، تفضيلا بالأحرف الاستهلالية (في النص الإنكليزي). وزع ُ وقد اتخذت المنظمة (OHW) كل الاحتياطات المعقولة للتحقق من المعلومات الواردة في هذا المطبوع. ومع ذلك فإن المواد المنشورة ت دون أي ضمان من أي نوع، سواء أكان بشكل صريح أم بشكل ضمني. والقارئ هو المسؤول عن تفسير واستعمال المواد. والمنظمة (OHW) ليست مسؤولة بأي حال عن الأضرار التي قد تترتب على استعمالها. رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ مقدمة يتمثل الجمهور الذي تستهدفه هذه الوثيقة في راسمي السياسات. ويمكن لمنفذي البرامج العاملين في مجال الوقاية من العنف ضد المرأة والاستجابة له، من هذه الوثيقة في ً الاستفادة أيضا تصميم التدخلات والبرامج وتخطيطها وتنفيذها ورصدها وتقييمها. معرفة الحقائق تقييم عوامل الخطر والعوامل الوقائية تنفيذ 7 استراتيجيات للوقاية من العنف ضد المرأة نات الخاصة بالتدخلات ّ تقييم البي وضع نظرية للتغيير تطبيق المبادئ التوجيهية الخاصة بالوقاية من العنف تهيئة البيئة المواتية للوقاية من العنف تكييف الإجراءات الناجعة وتوسيع نطاقها رصد التقدم وتقييمه وقياسه ً أولا ً ثانيا ً ثالثا ً رابعا ً خامسا ً سادسا ً سابعا ً ثامنا ً تاسعا ً عاشرا جدول المحتويات لنلتزم بالعمل! ص. 4 ص. 6 ص. 01 ص. 41 ص. 81 ص. 22 ص. 21 ص. 8 ص. 61 ص. 02 د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 32 تعرضت امرأة واحدة من كل 3 نساء (53%) في العالم للعنف البدني و/ أو الجن�ضي من ِقبل الشريك أو للعنف الجن�ضي الذي لا يشمل التحرش الجن�ضي، من ِقبل معتد ما. يؤدي تدني مستوى التعليم، والتعّرض للعنف أثناء الطفولة، وعدم تكافؤ ميزان القوة في العلاقات الحميمة، والمواقف والأعراف التي تتقبل العنف وعدم المساواة بين الجنسين، إلى زيادة مخاطر التعرض لعنف الشريك والعنف الجن�سي. على الصعيد العالمي، تتعرض نسبة 03% من النساء للعنف البدني و/ أو الجن�ضي من ِقبل الشريك خلال حياتهن. على صحة المرأة وعافيتها البدنية والنفسية، وتترتب عليه ً يؤثر العنف سلبا عواقب وتكاليف اجتماعية واقتصادية تتحملها الأسرة والمجتمع المحلي والمجتمع ككل. لحقوق الإنسان، وينبع من عدم المساواة ً عد العنف ضد المرأة انتهاكا ُ ي ل مشكلة صحية عمومية وعقبة في سبيل التنمية ّ بين الجنسين، ويشك المستدامة. تزداد مخاطر التعرض لمختلف أشكال العنف بالنسبة إلى المراهقات والشابات والنساء المنتميات إلى الأقليات العرقية و أقليات اخرى والنساء مغايرات الهوية الجنسانية والنساء ذوات الإعاقة. قد تؤدي الطوارئ الإنسانية إلى تفاقم العنف وإلى المزيد من أشكال العنف ضد النساء والفتيات. على الصعيد العالمي، 83%–05% من جرائم قتل النساء تم ارتكابها من قبل شريك حميم. معرفة الحقائق العنف ضد النساء والفتيات يمكن منعه. وللوقاية من العنف ينبغي التخفيف من حدة عوامل الخطر وتعظيم عوامل الحماية. يؤدي تدني مستوى التعليم، وسوء معاملة الطفل أو تعرضه للعنف داخل الأسرة، وتعاطي الكحول على نحو ضار، والمواقف التي تتقبل العنف وعدم المساواة بين الجنسين، إلى زيادة مخاطر ارتكاب عنف الشريك. لا تفصح غالبية النساء (55–59%) الناجيات من العنف عن تعرضهن للعنف ولا يسعين إلى الحصول على أي نوع من الخدمات. د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 54 القوانين التمييزية بشأن الملكية والزواج والطلاق وحضانة الأطفال تدني مستويات توظيف وتعليم النساء غياب القوانين التي تتصدى للعنف ضد المرأة أو عدم إنفاذها على نحو كاف. التمييز بين الجنسين في المؤسسات (مثل الشرطة والصحة) الأعراف الجنسانية الضارة التي تدعم امتيازات الرجل وتحد من استقلال المرأة ارتفاع مستويات الفقر والبطالة ارتفاع معدلات العنف والجريمة توافر المخدرات والكحول والأسلحة ارتفاع مستويات عدم المساواة في العلاقات/ سيطرة الرجل على العلاقة/ الاعتماد على الشريك تعدد العلاقات الجنسية للرجل تعاطي الرجل للمخدرات وتعاطيه للكحول على نحو ضار تقييم عوامل الخطر وعوامل الحماية1 عوامل الخطر عوامل الحماية التعرض للعنف أثناء الطفولة و/ أو التعرض للعنف داخل الأسرة الاضطرابات النفسية المواقف التي تتغا�ضى عن العنف أو تبرره أو ً طبيعيا ً بوصفه أمرا ً مقبولا عدم التعرض للعنف داخل الأسرة التعليم الثانوي للنساء والرجال والحد من عدم المساواة في مستويات التعليم بين النساء والرجال تنشئة الرجال والفتيان والنساء ً والفتيات اجتماعيا على المواقف التي تساوي بين الجنسين وتمسكهم بهذه المواقف القوانين التي تكفل ما يلي: تعزيز المساواة بين الجنسين تعزيز إمكانية حصول النساء على الوظائف الرسمية التصدي للعنف ضد المرأة الأعراف التي تدعم الابتعاد عن العنف والعلاقات المتكافئة بين الجنسين، وتعزّ ز تمكين المرأة العلاقات الحميمة التي تنطوي على المساواة بين الجنسين، بما في ذلك من حيث المشاركة في صنع القرار والمسؤوليات الأسرية الأفرادالعلاقات بين الأفرادالمجتمع المحليالمجتمع الأفرادالعلاقات بين الأفرادالمجتمع المحليالمجتمع د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 76 تنفيذ استراتيجيات للوقاية من 2 7 العنف ضد المرأة ا إرساء مهارات تعزيز العلاقات يشير ذلك إلى الاستراتيجيات التي تستهدف فرادي أو جماعات النساء أو الرجال أو الأزواج، من أجل تحسين المهارات الخاصة بالتواصل بين الأفراد، وإدارة النزاع، والمشاركة في صنع القرار. ح حماية النساء و تمكينهن عن التدخلات للتدريب ً يشير ذلك إلى التمكين الاقتصادي والاجتماعي سواًء بسواء، بما في ذلك التوريث وملكية الأصول والتمويل البالغ الصغر، فضلا في مجال المساواة بين الجنسين والتمكين، والعمل الجماعي، وتهيئة أماكن آمنة، والتوجيه من أجل بناء المهارات الخاصة بالكفاءة الذاتية وتأكيد الذات والتفاوض والثقة بالنفس. ا الأطفال والمراهقون محميون من الإساءة إليهم يشير ذلك إلى تعزيز العلاقات الأسرية، وحظر العقاب البدني، وتنفيذ برامج إعداد الآباء لرعاية الأبناء على النحو الوارد في حزمة الاستراتيجيات السبع لإنهاء العنف ضد الأطفال. ت تقديم الخدمات يشير ذلك إلى طيف مجموعة واسعة من الخدمات، بما في ذلك الخدمات الشرطية والقانونية والصحية والاجتماعية المقدمة إلى الناجيات. م المفاهيم والمعتقدات الايجابية يشير ذلك إلى الاستراتيجيات التي تتصدى للمواقف الضارة المبنية على النوع الاجتماعي، والمعتقدات والأعراف والقوالب النمطية التي تدعم امتيازات الذكر وتبعية الأنثى، والتي تبرر العنف ضد المرأة ووصم الناجيات. وقد يمتد طيف هذه الاستراتيجيات من الحملات العامة وتوعية الجماعات إلى جهود تعبئة المجتمع. ر ريادة في الحد من الفقر و ما اح ت ر ضمان بيئة مساعدة يشير ذلك إلى الاستراتيجيات التي تتوّجه إلى النساء أو الأسر والتي يتمثل هدفها الأسا�ضي في تخفيف حدة الفقر، والتي تشمل التحويلات النقدية والمدخرات والقروض البالغة الصغر والتدخلات الخاصة بالقوى العاملة. وتهيئة المدارس والأماكن العامة وبيئات العمل وغيرها من البيئات الآمنة. د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 98 المواقف والعلاقات القائمة على النساء والرجال من أجل تعزيز ورش عمل للمجموعات من مارتحا المساواة تقديم المشورة والعلاج إلى الأزواج التدريب في مجال تمكين المرأة والفتاة بما في ذلك فيما يتعلق بالمهارات الحياتية والأماكن الآمنة والتوجيه السياسات والتدخلات الخاصة بالتوريث وملكية الأصول توفير التمويل البالغ الصغر أو المدخرات والقروض إلى جانب عناصر التدريب في مجال قضايا النوع الاجتماعي والتمكين التحويلات الاقتصادية، بما في ذلك التحويلات النقدية المشروطة/ غير المشروطة إلى جانب القسائم والتحويلات العينية التدخلات الخاصة بالقوى العاملة بما في ذلك التدريب في مجال سياسات التوظيف وسبل المعيشة والتوظيف التدخلات الخاصة بالتمويل البالغ الصغر أو المدخرات دون أي عناصر إضافية البنية التحتية ووسائل النقل التدخلات الخاصة بمشاهدي العنف التدخلات الشاملة للمدرسة ككل التدخلات الخاصة بالاستشارة بشأن التمكين أو الدعم النف�ضي لزيادة إتاحة الخدمات (أي الدعوة) التدخلات الخاصة بالوقاية من تعاطي الكحول على نحو ضار المأوى الخطوط الساخنة مراكز الأزمات الجامعة للخدمات التدخلات الخاصة بمرتكبي العنف مراكز/ وحدات شرطة المرأة إجراء التحري أثناء تقديم الخدمات الصحية توعية موظفي المؤسسات بالقضايا الجنسانية وتدريبهم عليها دون تغيير البيئة المؤسسية الزيارات المنزلية وتوعية العاملين الصحيين التدخلات الخاصة بإعداد الآباء لرعاية الأبناء التدخلات الخاصة بالدعم النف�ضي للأطفال الذين يتعرضون للعنف والذين يشاهدون عنف الشريك المهارات الحياتية/ المناهج المدرسية، التدريب في مجال الوقاية من الاغتصاب والعنف المتعلق بالمواعدة تعبئة المجتمع ورش عمل للمجموعات من النساء ر المواقف ّ والرجال من أجل تعزيز تغي والأعراف التسويق الاجتماعي أو الترفيه التعليمي والتوعية الجماعية التوعية الجماعية للرجال والفتيان لتغيير المواقف والأعراف حملات التوعية القائمة بذاتها/ الحملات الإعلامية الوحيدة العنصر التحويلات الاقتصادية في شمال الإكوادور، استهدف برنامج نفذه برنامج الأغذية العالمي لتقديم المبالغ النقدية والقسائم والتحويلات الغذائية، النساء في المناطق الحضرية الفقيرة، من أجل الحد من الفقر. وتلقت الأسر المشاركة تحويلات لمدة ً شهرية تعادل 04 دولار شهريا رط للحصول على ُ 6 أشهر. واشت التحويلات حضور دورات تدريبية شهرية تتعلق بالتغذية. وأشار التقييم إلى تراجع تعرض النساء لسلوكيات التحكم وللعنف البدني و/ أو الجن�ضي من ِقبل الشريك بنسبة تتراوح بين 91 و03%. وتتمثل الآلية المحتملة التي أدت إلى ذلك في تراجع النزاع بين الزوجين الناتج عن أوجه التوتر المرتبطة بالفقر. p عن قضايا ً التمويل البالغ الصغر فضلا النوع الاجتماعي والتمكين ن مشروع "إيمادج" (التمويل البالغ ّ يمك الصغر من أجل الإيدز والعدالة بين الجنسين) في جنوب أفريقيا، النساء عن طريق التمويل البالغ الصغر إلى جانب التدريب في مجال النوع الاجتماعي والسلطة وأنشطة التعبئة المجتمعية. وتشير الدراسات إلى تراجع العنف المنزلي بنسبة 05% في مجموعة التدخل خلال عد التدخل شديد الفّعالية ُ فترة سنتين. وي إلى أنه أدى إلى ً من حيث التكلفة، نظرا تجنب إنفاق 442 دولار أمريكي لكل حالة من حالات عنف الشريك.w ا إرساء مهارات تعزيز العلاقات ر ريادة في الحد من ت تقديم الخدماتح حماية النساء و تمكينهن الفقر خ خ خ ر ر ر ر ر ر خ خ ر خر ر خ خ خ خ خ خ خ خ خ خ خ ر ر ر خ خ خ ر ر خ ر ر ر خ ر ر خ ر ر خ ر ر ر ر الدعوة لصالح الناجيات مشروع الدعوة المجتمعية في ميشيغن وإلينوي نات ّ د بالبي ّ بالولايات المتحدة، هو برنامج مسن مصمم لمساعدة الناجيات من إساءة المعاملة من ِقبل الشريك لاستعادتهن لزمام التحكم في حياتهن. ويقدم الدعاة المدربون الدعوة والمساعدة المصممة إلى الناجيات حتى يمكنهن الحصول على ً خصيصا الموارد المجتمعية والدعم الاجتماعي. وقد ُوجد أن هذا التدخل يحد من تكرار العنف والاكتئاب وتحسين نوعية الحياة والدعم الاجتماعي. وبعد ر الإيجابي.y ّ انتهاء التدخل بعامين، استمر التغي الحق في اللعب - منع العنف بين الأطفال في المدارس والعنف ضد الأطفال في حيدر أباد (مقاطعة السند)، بباكستان، شمل تدخل الحق في عي البنون والبنات إلى المشاركة ُ اللعب الأطفال في 04 مدرسة عامة. ود في التعلم عن طريق اللعب لإتاحة أمامهم الفرصة لتنمية مهاراتهم الحياتية، مثل الثقة والتواصل والمشاركة الوجدانية والتعامل مع المشاعر السلبية والتعاون والقيادة والتفكير النقدي وحل النزاعات، التي تساعد في التصدي للنزاع وعدم التسامح والتمييز بين الجنسين والعنف بين الأقران. وأشار التقييم إلى تراجع الإيذاء بين الأقران من التدخل، ً بنسبة 33% في البنين و95% في البنات بعد 42 شهرا وتراجع العقاب البدني بنسبة 54% في البنين و66% في البنات؛ وتراجع مشاهدة العنف المنزلي بنسبة 56% في البنين و07% في البنات.o تعبئة المجتمع مبادرة "ساسا!" هي مبادرة مجتمعية نفذتها أوغندا للوقاية من العنف ضد المرأة بتغيير ميزان القوة في العلاقة بين الرجل والمرأة. وتشير الدراسات إلى أن 67% من النساء والرجال في المجتمعات المحلية التي استفادت من المبادرة، يؤمنون أن العنف البدني ضد الشريك غير مقبول، في حين أن نسبة الرجال والنساء المؤمنون بذلك في المجتمعات المحلية الشاهدة لا تتجاوز 62%. وبتلافي تكلفة قدرها 064 دولار أمريكي لكل حالة من حالات عنف الشريك في عد التدخل عالي المردود ويمكن ُ مرحلة التجريب، ي تحقيق المزيد من وفورات الحجم بالتوسع في نطاق التدخل.v ورش عمل للمجموعات في فترة السنتين التي تلت تنفيذ مبادرة "المعابر" في جنوب أفريقيا بمشاركة الإناث والذكور الذين ، ً تتراوح أعمارهم بين 51 و62 عاما قلت احتمالات ارتكاب الرجال لعنف الشريك والاغتصاب والمقايضة بالجنس في مجموعة التدخل مقارنة بالبيانات الأساسية. x ا الأطفال والمراهقون وضمان بيئة مساعدة محميون من الإساءة إليهم مثال م المفاهيم والمعتقدات الإيجابية خر خ خر خ ر تقييم نات التي ّ البي تقوم عليها التدخلات3 خ ر المفتاح4 تدخل واعد، هناك أكثر من تقييم واحد يشير إلى تراجع كبير في حصائل العنف نات، هناك أكثر من تقييم واحد يشير إلى ّ تدخل يحتاج إلى المزيد من البي تحّسن في الحصائل المتوسطة المتعلقة بالعنف نات متضاربة، التقييمات تشير إلى نتائج متضاربة بشأن الحد من ّ البي العنف5 ً دقيقا ً قّيم التدخلات بعد تقييما ُ نات، لم ت ّ لا توجد بي ال، هناك أكثر من تقييم واحد يشير إلى عدم حدوث تراجع ّ تدخل غير فع كبير في حصائل العنف لتصنيف البنك الدولي ً البلدان المنخفضة والمتوسطة الدخل وفقا لتصنيف البنك الدولي ً البلدان المرتفعة الدخل وفقا خ ر مثال مثال مثال مثالمثال د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 1101 ت العقبا ف ن العن ت عالية م ستويا د م شه حلية التي ت ت الم المجتمعا ف ن العن ضرر ة م سر المت الأ ف ن العن جه لاتي يوا ساء ال الن الاستناد إلى القدرة على الصمود والمعارف، وتوفير الموارد اللازمة للمجتمعات المحلية وتزويدها بالدعم لإيجاد الحلول ت لا خــــــــــــــــــــــــــــــــــــ د وضمان بيئة مساعدة الت المخرجات الحصائل الأثر ا إرساء مهارات تعزيز العلاقات ح حماية النساء و تمكينهن ت تقديم الخدمات ر ريادة في الحد من الفقر ا الأطفال والمراهقون محميون من الإساءة إليهم تنفيذ برامج التصدي للعنف ضد المرأة على نطاق واسع زيادة الموارد والإرادة السياسية للتصدي للعنف ضد المرأة إذكاء الوعي بشأن العنف ضد المرأة بوصفه مشكلة صحية عمومية يمكن تلافيها تحسين الحصائل القطاعية المتعلقة بالصحة والاقتصاد والتنمية الاجتماعية (مثل الصحة النفسية، والحد من فقر الأسر، وتحسين صحة المرأة والطفل، وتحسين تعليم المرأة ودخلها، والحد من التغيب) إيمان الأسر والمجتمعات المحلية والمؤسسات بالمساواة بين الجنسين كعرف وبأن العنف ضد المرأة لا ً مقبولا ً عد أمرا ُ ي قبول الرجل للمرأة ومعاملتها على قدم المساواة قدرة المرأة على اتخاذ قرارات مستقلة معرفة المرأة بحقوقها وإتاحة البرامج أمامها تحسين الحصائل الصحية والإنمائية للأسرة والمجتمع المحلي والمجتمع ككل ممارسة المرأة لحقوقها الإنسانية وإسهامها في التنمية الحد من العنف ضد المرأة أو التخلص منه ممارسة المساواة والاحترام في العلاقات الحميمة والأسرة والمجتمع المحلي تسوية النزاعات بين الأشخاص بطريقة سلمية الحدود المفروضة على استقلالية المرأة تعرض الأطفال للعنف الأعراف الاجتماعية التي تكرس سلطة الذكر عدم كفاية الخدمات عدم كفاية الحماية القانونية والاجتماعية للمرأة نقص الإرادة السياسية والموارد افتقار المنظمات والحركات المعنية بالمرأة إلى الموارد وضع نظرية للتغيير م المفاهيم والمعتقدات الايجابية رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 3121 ف وبثها د المعا ر ولي ت هرية و ج م ال القي ج م البرام صمي ت تطبيق من أجل البرمجة الفّعالةالمبادئ التوجيهية نات المتعلقة ّ ظم الرصد وقّيمها لبناء قاعدة البي ُ ز ن ّ عز بالإجراءات الفّعالة ويّسير تبادل المعارف للاسترشاد بها في وضع البرامج تأكد من سرية المعلومات وتوقع العواقب غير المقصودة وعالجها تأكد من أن تحليل عدم المساواة في العلاقة وموازين القوة بين الجنسين وتمييز الرجل على المرأة، يقع في صميم البرمجة تعزيز المساواة بين الجنسين والحقوق الإنسانية للمرأة عدم ترك أي أحد خلف الركب وضع نظرية للتغيير نات ّ دة بالبي ّ تعزيز البرمجة المسن استخدام النهوج التشاركيةإعطاء الأولوية لسلامة المرأة وعدم التسبب في الإضرار بها تعزيز التنسيق اتباع النهج الشامل لمراحل الحياة معالجة سلسلة الوقاية من العنف تنفيذ توليفة من التدخلات ح الطريقة التي ستؤدي بها المدخلات إلى تغيير الحصائل ّ وض المباشرة والآثار المحتملة لأشكال التمييز المتعددة والمتداخلة والقائمة َ تَصد على الجنس ونوع الجنس والطبقة الاجتماعية والانتماء العرقي والإثني والإعاقة والميول الجنسية والهوية الجنسانية ز التفكير الشخ�ضي والتفكير النقدي، واستند إلى رأي ّ حف الأشخاص وقدرتهم على تولي زمام الأمور ومهاراتهم. يّسر البرمجة الجماعية مع الأفراد والأسر والمجتمعات المحلية من أجل التصدي لعوامل الخطر المتعددة التي ينطوي عليها العنف ضد المرأة وأشكال العنف المتعددة داخل الأسر. ادعم الشراكات على نطاق القطاعات والمنظمات، والمستويات المحلية والوطنية مثل التدخلات الرامية إلى الوقاية من العنف والاستجابة له نفذ البرامج التي تعمل مع الأطفال والمراهقين والشباب من أجل التدخل المبكر 6 7 8 9 01 1 5 2 3 4 د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 5141 ترسيخ الالتزام السيا�سي من ِقبل القادة وراسمي السياسات كي يرفعوا أصواتهم بإدانة العنف ضد المرأة. القوانين والسياسات التي تتصدى ّ سن للعنف ضد المرأة والتي تعزز المساواة بين الجنسين، بما في ذلك إتاحة التعليم الثانوي، وتيسير إنفاذها.6 الاستثمار في المنظمات النسائية والاستناد إلى عملها وتزويدها بالموارد ودعمها. تخصيص الموارد للبرامج والبحوث، وتعزيز المؤسسات والقدرات الخاصة بالصحة والتعليم وإنفاذ القوانين، وقطاعات الخدمات الاجتماعية، من أجل التصدي للعنف ضد المرأة. تعزيز البيئة المواتية جأ دب للوقاية من العنف د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 7161 تكييف الإجراءات الناجعة وتوسيع نطاقها يمكن التوّسع بطرق مختلفة في التدخلات الرامية إلى الوقاية من العنف التي ثبتت فّعاليتها على أساس تجريبي. فيمكن التوّسع فيها بإضافة المزيد من المستفيدين، ويمكن تكييفها وتكرارها في مواقع جغرافية أخرى؛ ويمكن التوّسع في تغطية التدخل نفسه في منطقة . ً جغرافية أوسع نطاقا ويلزم تكييف التدخلات التي يجري التوّسع فيها في مكان جديد بحيث تكون ملائمة للسياق. ويتطلب ذلك فهم الثقافة والقيم والموارد المحلية. ويمكن تكييف التدخلات المشار إلى أنها "واعدة" (الصفحتان 01 و11) والتوّسع فيها مع مراعاة المبادئ التوجيهية الخاصة بالوقاية من العنف والاعتبارات الواردة في الصفحة التالية والتي ينبغي مراعاتها عند تكييف التدخلات والتوّسع فيها؛ وقد يلزم نات" ّ تكرار التدخلات التي ُصنفت بوصفها "تحتاج إلى المزيد من البي (الصفحتان 01-11) أو مواصلة تنقيحها قبل التوّسع فيها؛ ويلزم نات بشأنها "متضاربة" أو ّ مواصلة تقييم التدخلات المشار إلى أن البي نات" بشأنها. ّ إلى "غياب البي مواءمة التدخلات مع الالتزامات الوطنية (مثل الخطة والسياسة والاستراتيجية الوطنية) بالقضاء على العنف ضد المرأة أو تعزيز المساواة بين الجنسين أو صحة المرأة.7 الاستثمار في قدرات المنفذين، وتخصيص الوقت الكافي للتوّسع والسماح بحدوث التغيير واستدامته. تصميم البرامج لتحقيق التآزر، بتوليف الاستراتيجيات والتدخلات المتعددة على صعيد الأفراد والعلاقات بين الأفراد والمجتمع المحلي والمجتمع ككل من أجل تحقيق أثر مستدام. تحديد المبادئ الجوهرية والتمّسك بها، فيما يتعلق بالمساواة بين الجنسين والحقوق للسياق، بما في ذلك اللغة والثقافة. ً والسلامة وبحدودها الدنيا، مع تكييفها وفقا الاستناد إلى المبادرات الجارية، بدمج أنشطة الوقاية من العنف في البرامج الصحية والإنمائية القائمة وسائر البرامج القطاعية القائمة. تصميم المبادرات مع وضع "النطاق" في الحسبان، بالاستثمار الطويل الأجل ومراعاة التكاليف والاستدامة. البدء على نطاق ضيق وتوثيق وتقييم عملية التكييف والتوّسع من أجل الابتكار وتعزيز نات. ّ البرمجة المسترشدة بالبي دعم جماعة الممارسين في أوساط واضعي البرامج ومنفذيها من أجل تيسير التعلم وتبادل المعارف. أ ب ج د هـ و ز ح د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 9181 حرز في الوقاية من العنف ضد المرأة على المدى ُ يمكن قياس التقدم الم القصير والمدى الطويل. 1- على المدى الطويل، يمكن قياس أثر البرامج المعنية بالوقاية من العنف بوصفه التراجع في معدل انتشار مختلف أشكال العنف ضد المرأة. حرز ُ 2- وعلى الصعيد العالمي، يلزم على البلدان الإبلاغ عن التقدم الم في الوقاية من العنف ضد المرأة في إطار الغايات الخاصة بأهداف التنمية المستدامة. وُيقترح استخدام مؤشرين اثنين، وهما: معدل انتشار عنف الشريك خلال الأشهر الاثني عشر الأخيرة أو أكثر (الغاية 5–2 ً بين النساء البالغات من العمر 51 عاما من أهداف التنمية المستدامة - القضاء على جميع أشكال العنف ضد النساء والفتيات)؛ نسبة الشابات والرجال الذين تتراوح أعمارهم بين 81 و92 الذين كانوا قد تعرضوا للعنف الجن�ضي ببلوغهم 81 ً عاما من العمر (الغاية 61–2 من أهداف التنمية المستدامة ً عاما - إنهاء ما يتعرض له الأطفال من سوء المعاملة والاستغلال والاتجار بالبشر وجميع أشكال العنف والتعذيب). رصد التقدم مع تقّييمه وقياسه 3- وتتوقف المؤشرات الوسطى التي تسهم في الحد من معدل انتشار العنف ضد المرأة على المدى القصير إلى المتوسط، على أنواع البرامج. ويمكن أن تشمل هذه المؤشرات على سبيل المثال تحسين ما يلي: المواقف والأعراف المنصفة للجنسين التواصل مع الشريك الحميم استقلالية المرأة و/ أو توليها لزمام أمورها و/ أو ثقتها في كفاءتها الذاتية تعليم الفتيات والنساء 4- ومن الأهمية بمكان تحديد نظرية للتغيير توضح كيف سيحسن البرنامج المؤشرات الوسطى وكيف ستسهم هذه المؤشرات بدورها في الحد من معدل انتشار العنف ضد المرأة. تقييم البرامج قبل التوّسع فيها ورصد ً 5- ومن الأهمية بمكان أيضا التوّسع على أساس مستمر لضمان استثمار الموارد في البرامج الفّعالة، والتخفيف من الحصائل الضارة غير المقصودة، ومراعاة السياق المحلي في عملية التوّسع. د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 1202 القضاء على العنف ضد المرأة يبدأ با لــــ التزم بالتغيير ابدأ اليوم نات ّ دة بالبي ّ ادعم النهوج المسن انضم إلى الآخرين : ً سبيل الم�ضي قدما دعوة إلى العمل اا ح ت ر م د المرأة ض ف ن العن وقاية م حترام المرأة: ال ا ت سا سيا ي ال ل لمقرر طار عم إ رأة لم د ا ض ف عن ال ن م ية قا و ال ة: رأ لم م ا را حت ا ت سا يا س ال ي ر ر مق ل ل عم ر طا إ 3222 a. CUSP (2017), On the CUSP of change: Effective scaling of social norms programming for gender equality, Community for Understanding Scale Up: http://raisingvoices.org/wp-content/ uploads/2013/02/6.CombinedCUSPcasestudies.FINAL_.pdf b. Heise L (2011), What Works to Prevent Partner Violence?: http:// strive.lshtm.ac.uk/system/files/attachments/What%20works%20 to%20prevent%20partner%20violence.pdf c. Salamander Trust (2017), ALIVE[H]E Framework: http:// salamandertrust.net/resources/alivhe-framework d. UN Women (2015), A Framework to Underpin Action to Prevent Violence Against Women: http://www.unwomen.org/-/ media/ headquarters/attachments/sections/library/publications/2015/ prevention_framework_unwomen_nov2015. pdf?la=en&vs=5223 e. WHO, LSHTM, SAMRC (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO. http://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng. pdf;jsessionid=294A291A603A7BCB4B60F588532CE53D? sequence=1 f. World Health Organization (2016), Violence against women, Intimate partner and sexual violence against women, Fact Sheet: http://www.who.int/mediacentre/factsheets/fs239/en/ g. World Health Organization and UNAIDS (2013), 16 Ideas for addressing violence against women in the context of the HIV epidemic - A programming tool: http://www.who.int/ reproductivehealth/publications/violence/vaw_hiv_epidemic/en/ h. WHO, LSHTM (2010), Preventing Intimate partner violence and sexual violence: generating evidence and taking action: http://apps.who.int/iris/bitstream/ handle/10665/44350/9789241564007_eng.pdf?sequence=1 i. What Works to Prevent Violence (2014), A global programme to prevent violence against women and girls: A Summary of the Evidence and Research Agenda: https://www.gov.uk/ government/publications/what-works-in-preventing-violenceagainst- women-and-girls-review-of-the-evidence-from-the-programme j. Ellsberg M., Arango D.J., Morton M., Gennari F., Kiplesund S., Contreras-Urbina M., Watts C (2015), Prevention of violence against women and girls: what does the evidence say? The Lancet, Volume 385, No. 9977, p1555–1566: https://www.thelancet. com/journals/lancet/article/PIIS0140-6736(14)61703-7/ fulltext?rss%3Dyes k. Contreras-Urbina M., Heilman B., Von Au A. K., Hill A., Puerto Gómez M., Zelaya J., Arango D.J (2016) Community-based approaches to intimate partner violence : a review of evidence and essential steps to adaptation (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/ en/907511467996712161/Community-based-approaches-to- intimate-partner-violence-a-review-of-evidence-and-essential-steps-to- adaptation l. World Health Organization (2016), 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: http://www.who.int/ reproductivehealth/publications/violence/global-plan-of-action/en/ m. Garcia-Moreno C., Zimmerman C., Morris-Gehring A., Heise L., Amin A., Abrahams N., Montoya O., Bhate-Deosthali P., Kilonzo N., Watts C (2015), Addressing violence against women: a call to action, The Lancet, Volume 385, No. 9978, p1685–1695: https://doi.org/10.1016/S0140-6736(14)61830-4 n. World Health Organization (2016) INSPIRE: Seven strategies for Ending Violence Against Children: http://www.who.int/violence_ injury_prevention/violence/inspire/en/ o. What works to prevent violence against women and girls global programme (2018), Right to play: preventing violence among and against children in schools in Hyderabad, Pakistan: Evidence brief. South Africa: Medical Research Council and UK: UK aid. https:// www.whatworks.co.za/documents/publications/211-right-to-play/ file p. Hidrobo M, Peterman A, Heise L (2016), The effect of cash, vouchers and food transfers on intimate partner violence: evidence from a randomized experiment in Northern Ecuador. American Economic Journal Applied Economics, Volume 8, No 3, p284-303: https://DOI:10.1257/app.20150048 q. National Resource Center on Domestic Violence (2012), Program and Practice Profiles: Community Advocacy Project, Harrisburg, PA: National Resource Center on Domestic Violence. http://www. dvevidenceproject.org r. Buller A, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L (2018). A mixed-method review of cash transfers and intimate partner violence in low- and middle-income countries. The World Bank Research Observer, Volume 22, No 2, p218-258: https:// doi.org/10.1093/wbro/lky002 s. Peterman A, Palermo TM, Ferrari G (2018). Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ global health, Volume 3, No. 6: e001143. doi:10.1136/ bmjgh-2018-001143. t. Karakurt G, Whiting K, Van Esch, Bolen S, Calabrese J (2016). Couple therapy for intimate partner violence: A systematic review and meta-analysis. J Marital Fam Ther, Volume 42, No. 4, p567- 583: doi:10.1111/jmft.12178. u. Desai CC, Reece J, Shakespear-Pellington S (2017) The prevention of violence in childhood through parenting programmes: a global review, Psychology, Health & Medicine, Volume 22, Sup1, p166- 186: DOI: 10.1080/13548506.2016.1271952. v. Abramsky T, Devries K, Kiss L, Nakuti J, Kyegombe N, Starmann E, Cundill B, Francisco L, Kaye D, Musuya T, Michau L, Watts C (2014), Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Medicine, Volume 12:122: https:// doi.org/10.1186/s12916-014-0122-5. w. Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD (2006), Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. The Lancet, Volume 368, No. 9551, p1973–1983: doi: 10.1016/S0140-6736(06)69744-4. x. Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N (2008), Impact of Stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Brit Med J, Volume 337, No. 7666:a506: doi: 10.1136/bmj.a506. y. Sullivan, CM, Bybee, DI (1999), Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, Volume 67, No. 1, p43-53: https://cap.vaw.msu.edu/wp-content/ uploads/2014/05/Two-year-followup-CAP-JCCP.pdf. .هاياحضو كيرشلا فنع يبكترمب لماوعلا هذه قلعتت 1 نع لزعمب اهيلإ رظنُي لاأ يغبنيو ،ضعبلا اهضعب عم ىفانتت لا عبسلا تايجيتارتسلاا 2 .اهنيب اميف لخادتلا ضعب دجويو ،ضعبلا اهضعب ةيجيتارتسا اهفصوب ةجردم اهيلع ةلثملأاو ةددحلما تلاخدتلا نأ نم مغرلا ىلع 3 ةمزح /ةفيلوت دّسجي اهنم ديدعلا نأ ةظحلام ناكمب ةيمهلأا نمف ،ةنيعم ةدحاو ةيجيتارتسا نم رثكأ لمشت تايوتسلما ةددعتم تلاخدتو رصانع ةدع لمشت جمارب ةدحاو ةيجيتارتسا نمض اهفينصت دّسجيو .عبسلا "مارتحا" تايجيتارتسا نم رييغت يف ةجردلما تلاخدتلا ضعب نأ كلذ ىلع لاثمو .لخدتلا نم يلولأا ضرغلا ةصاخلا تلاخدتلا نإف ،لثلمابو .تاقلاعلا زيزعت تاراهم ً اضيأ لمشت فارعلأا مدع يغبني اذلو .ةيداصتقلاا تلايوحتلاب ً اصاخ ً ارصنع لمشت دق ةأرلما نيكمتب ام اذإ اهرثأ نيسحت نكمي جوهن اهرابتعا لب ،ةلقتسم تايجيتارتسلاا هذه رابتعا .ضعبلا اهضعب عم تعب ُ تا دحاو مييقت نم رثكلأ ةيجهنم تاضارعتسا ىلإ ةريبك ةجردب تان ّ يبلا مييقت دنتسي 4 ةيدوقنعلاو ةاشع ُ لما بيلاسلأا لمشت ميماصت اهمظعم يف مدختست ،تلاخدتلل تايجيتارتسلاا ضعبب قلعتي اميف هنأ هب ملس ُ لما نمو .ةيبيرجت هبشلاو ةاشع ُ لما دشأ ةليدب بيلاسأ كانه نوكت دق ،ةلادعلا عاطقب ةصاخلا تلاخدتلا لثم ميماصتلاو ةبقارلما ىلع ةمئاقلا ميماصتلاو ةينمزلا لسلاسلا كلذ يف امب ،ةمءلام ناديلما اذه نأ ىلإ ً ارظنو .ةدوج لقأ دع ُ ت ام ةداع اهنأ نم مغرلا ىلع ،ةيعطقلما هذه رداصم درتو .اهمييقتو تاساردلا ميمصت ةقد يف ريبك توافت كانهف ،دجتسم .ةروكذلما عجارلما نمض تاساردلاو تاضارعتسلاا ريشي نيح يف ةيباجيإ راثآ ىلإ تاساردلا ضعب اهيف ريشت تامييقت ىلإ كلذ ريشي 5 دق تلاخدتلا رثأ نأب ديفي ام ،ةيبلس راثآ ىلإ ريشي وأ رثلأا مادعنا ىلإ رخلآا اهضعب ءلايإ بجي اهفييكت وأ تلاخدتلا راركت دنع هنإف ،مث نمو .قايسلا فلاتخاب فلتخي .ذيفنتلا وأ قايسلاب ةصاخلا لماوعلاب ريبك مامتها ةاواسلما ززعتو ،ةيسنجلا تاكاهتنلاا مّرج ُ ت يتلا تاسايسلاو نيناوقلا كلذ لمشي 6 نيناوقلاو ،ةيوثنلأا ةيلسانتلا ءاضعلأا هيوشتو لافطلأا جاوز رظحتو ،ثاريلما يف ططخو ،ةأرملل ةيواستم ً اقوقح لفكت يتلا قلاطلاو ةناضحلاو جاوزلاب ةصاخلا كلذ لمشي امك .ةأرلما دض فنعلل ىدصتتو نيسنجلا نيب ةاواسلما ز ّ زعت يتلا لمعلا .ةينوناقلا ةدعاسلماو فيقوتلا رماوأ لثم نوناقلاو ةلادعلا ذافنإ تامدخ ميدقت كانه نوكي دق ،ةأرلما دض فنعلا ىلع ءاضقلاب يض�ايسلا مازتللاا بايغ يف ىتح 7 نوكي دق ،ةأرلما ةحص وأ ،نيسنجلا نيب ةاواسلما وأ ،ةأرلما نيكمتب ىرخأ تامازتلا .اهيف رظنلا ديفلما نم ةيفاضلإا عجارلماو تاسابتقلاايس�اوحلا ةأرملا د ض ف نعلا ن م ةياقو لا :ةأرملا مارتح ا ت اس ايس لا ي ررقمل ل مع راط إ ةأر مل ا د ض ف نع لا ن م ةي اق و لا :ة أر مل ا م ار تح ا ت اس اي س لا ي ر ر قم ل ل مع ر اط إ 24