Addressing Gender-based
Violence through USAID’s Health
Programs: A Guide for Health
Sector Program Officers
An Overview
[SPEAKERS NAMES]
[DATE]
Overview
 Assists USAID program
officers to integrate GBV
activities into the health
sector portfolio during
Project design
Implementation
Evaluation
 Complements literature
review of promising GBV
interventions (Guedes, 2004)
Design of Guide
 Focus on health sector programs
Why should programs address GBV?
How can programs support GBV activities?
 Range of programs
Community mobilization
Communication for social and behavior change
Health service delivery
Health policy
Youth
Humanitarian
Monitoring and evaluation
Preventing and responding to GBV requires a multisectoral approach
Guiding Principles in GBV Programming
Underlying principle—“Do no harm”
Respect survivors’ safety and autonomy
Ensure relevance and appropriateness of
interventions to local setting
Guiding Principles in GBV Programming
(continued)
Employ public health and human rights
perspectives
Encourage multisectoral interventions at multiple
levels
Invest in evaluation—assess results and protect
survivors’ safety
Rationale and
Actions
Why should Community Mobilization
programs address GBV?
 Can change community norms about gender and the
acceptability of violence
 Can improve the community response to gender-based
violence
 Dispels myth that violence is a family affair
 Encourages help seeking by women
 Encourages providers to offer support
 Can promote collaboration among service-providing
organizations and the broader community
 Ensures referral networks are in place
 Improves women’s access to a range of services
How can Community Mobilization
programs address GBV?
 Support initiatives that integrate community mobilization
around GBV into existing health and development projects
 Support initiatives that reduce tolerance for GBV through
work with boys and men
 Invest in programs that mobilize all parts of the community
 Mobilize partnerships across all levels of communities
 Support efforts to improve survivors’ access to services
 Provide long-term financial support to ensure time for
change
Why should Communication for Social and
Behavior Change (CSBC) programs
address GBV?
 Raising awareness and changing attitudes and
cultural/gender norms are essential to sustainably address
GBV
 CSBC programs can be more effective by recognizing that
health focus areas are linked to GBV
 CSBC forms a key part of other strategies to address GBV,
such as:
 Advocacy with decisionmakers
 Sensitization and training of providers
 Community mobilization
How can Communication for Social and
Behavior Change programs address GBV?
Support activities that aim to change gender
norms and acceptability of violence
Integrate GBV into existing CSBC programs
Link communication and GBV activities
Work to improve norms and attitudes among boys and
men
How can Communication for Social and
Behavior Change programs address GBV?
(continued)
Use multiple media to address wide
audiences
Invest in evaluation studies of CSBC
initiatives
Why should Health Service Delivery
programs address GBV?
 GBV is a major cause of death and disability among
women.
 Health programs can be more effective if they recognize
reproductive health (RH) implications of GBV.
 Health providers who do not ask about gender-based
violence may misdiagnose survivors or offer inappropriate
care.
 Providers may be the first point of contact for women.
 Providers can assist women, rather than inadvertently
putting women at further risk.
 Healthcare organizations can raise awareness of GBV as a
public health problem.
How can Health Service Delivery
programs address GBV?
 Use a “systems approach,” which entails:
– An institutional commitment to GBV
– Sexual harassment policies
– Patient privacy and confidentiality
– Awareness of local GBV laws
– Ongoing training and support for staff
– Referral networks to link survivors to legal aid, counseling, shelters,
etc.
– Protocols for the care of survivors
– Emergency supplies such as STI prophylaxis, post-exposure
prophylaxis (PEP), and emergency contraception (EC), where
supported by the government
– Educational materials on GBV for clients
– Data collection systems
– Monitoring and evaluation of quality of care
How can Health Service Delivery
programs address GBV?
Support efforts to fully integrate attention to GBV
within existing health programs, such as
Long-term efforts to sensitize and train health
professionals about GBV;
“Routine screening” or “routine enquiry” policies ONLY
when programs have basic protections for women; and
Participation of healthcare organizations in broader
prevention efforts, referral networks, advocacy
campaigns.
How can Health Service Delivery
programs address GBV? (continued)
Consider economic sustainability before
launching specialized social services:
Do not to duplicate services that already exist.
Health programs should try to identify the most
economically feasible, cost-effective, and sustainable
social services to provide.
Why should Health Policy
programs address GBV?
 Assist in drafting policies and approaches for the health
service response to GBV.
 Reframe the policy debate about GBV as a public health
and human rights issue
 Produce and use research on magnitude of GBV to
convince policymakers that
 They should address GBV; and
 Gaps exist in the legal and civil codes.
 Standardize health sector policies/protocols and
appropriate GBV interventions at the institutional level
How can Health Policy
programs address GBV?
 Research and dissemination of GBV findings
 Public and private coalitions that design and implement
GBV public policy approaches
 Efforts to educate key groups and broader population
about GBV as a public health problem
 Advocacy efforts to change specific laws and policies
 Efforts to reform and strengthen public agencies’
institutional policies
Why should Youth Programs
address GBV?
 Substantial proportions of girls and young women
experience sexual violence around the world:
-Ranges from 7 percent in New Zealand to 46 percent in
the Caribbean
 Physical violence by intimate partners often begins within
the first years of dating and marriage.
 Sexual abuse in childhood and adolescence has been
linked to numerous poor health consequences.
 Youth sexual activity is not always voluntary or consensual.
 Youth programs are an ideal opportunity to further GBV
prevention because attitudes gender and violence are still
forming.
How can Youth Programs
address GBV?
 Require all reproductive health programming for youth to
address sexual coercion and abuse
 Support initiatives that improve family, peer, and
community environments, such as
 Efforts to promote gender-equitable norms and nonviolence
among young men
 Efforts to empower girls
 Efforts to improve the institutional response to young
survivors of GBV
 Efforts to increase safety of girls and young women in
educational settings
Why address GBV in
Humanitarian Programs?
Women and girls often experience violence in
conflict settings.
Levels of physical and sexual violence against
women are significant during and after armed
conflict and natural disaster.
Women and girls also are at risk of GBV during
reconstruction.
How can Humanitarian Programs
address GBV?
Interventions:
Prioritize girls’ and women’s safety and security
Implement the minimum initial service package for
RH needs of populations in humanitarian crisis
Integrate GBV response into all primary healthcare
and HIV services
How can Humanitarian Programs
address GBV? (continued)
Approaches:
Comply with international guidelines regarding
GBV in conflict in conflict settings
Ensure that organizations collaborate to avoid
gaps
Support efforts to pilot initiatives in natural
disaster settings
Change and adapt programs as situations
stabilize
Why invest in Monitoring and Evaluation
of GBV interventions?
Expand the knowledge base about effective ways
to prevent and respond to GBV
Improve program designs to ensure GBV
interventions benefit women as intended
Correct flaws in program design that may place
women/girls at increased risk of GBV
Provide evidence to policymakers and donors
about GBV approaches that work
How can USAID-funded programs
invest in Monitoring and Evaluation?
Support efforts to improve research and evaluation
methods related to GBV
Require all GBV programs to have a strong M&E
component
Ensure that evaluations of health programs
consider GBV
Support scientific evaluations of GBV programs
funded by other donors
Invest in intervention research designed to build
the evidence base about effective GBV prevention
and response
Want to know more?
 Key resources section includes
Academic research
Tools, manuals, guidelines
Case studies
Works cited
 Access Addressing Gender-based Violence through
USAID’s Health Programs: A Guide for Health Sector
Program Officers at:
http://www.igwg.org/Publications.aspx
Available in English, French, and Spanish
References
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Dunkle, Kristin, Rachel Jewkes, Heather Brown, Glenda Gray, James A. McIntyre, and
Sioban D. Harlow. 2004. “Prevalence and Patterns of Gender-based Violence and
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American Journal of Epidemiology 160(3): 230–239.
Enarson, E. 1998. Surviving Domestic Violence and Disasters. Vancouver, BC: Simon
Fraser University.
Garcia-Moreno, C. and C. Watts. 2000. “Violence Against Women: Its Importance for
HIV/AIDS.” AIDS 14 (Suppl. 3):S 253-265.
Guedes, A. 2004. Addressing Gender-Based Violence from the Reproductive Health/HIV
Sector: A Literature Review and Analysis. Washington, DC: USAID, Bureau for
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References, continued
IASC Task Force on Gender and Humanitarian Assistance. 2005. Guidelines for GenderBased Violence Interventions in Humanitarian Emergency Settings: Focusing on
Prevention of and Response to Sexual Violence in Emergencies. Geneva: IASC Task
Force on Gender and Humanitarian Assistance.
International Rescue Committee (IRC). 2004. Gender- Based Violence Program Strategy:
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Krug, E.G., L. L. Dahlberg, J. A. Mercy, A.B. Zwi, and R. Lozano. 2002. World Report on
Violence and Health. Geneva: World Health Organization.
Maman, Suzanne, Jacquelyn Campbell, Michael D. Sweat, and Andrea C. Gielen. 2000.
“The Intersections of HIV and Violence: Directions for Future Research and
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United Nations High Commissioner for Refugees (UNHCR). 2003. Guidelines for
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World Health Organization (WHO). 2001. PuttingWomen First: Ethical and Safety
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