Addressing violence against women in the Americas: the role of health systems Special Meeting of The Permanent Council On The Subject “Addressing Violence Against Women in the Americas”

2 1 out of every 3 women in the Americas will experience partner violence in her lifetime 1 2 3

3 Consequences of violence against women are dire Physical injury and disability Mental health problems Reproductive health problems Sexual health problems Consequences of violence against women are dire

4 Health providers and health systems have a critical role in supporting women, minimizing the impact and preventing violence from happening. women and girls experiencing violence are more likely to use health services health care providers are often women’s first point of professional contact all women are likely to seek health services at some point in their lives Why health systems?

5 Global and regional mandates approved by Ministers of Health 2016 – 2030 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 (WHA69.5) 2015-2025 Regional strategy and plan of action on strengthening the health system to address violence against women (CD54/9, Rev. 2) Global and regional mandates approved by Ministers of Health women and girls experiencing violence are more likely to use health services health care providers are often women’s first point of professional contact all women are likely to seek health services at some point in their lives Strengthen health system leadership and governance Strengthen health service delivery and capacity Strengthen programming for prevention Improve information and evidence

Health systems can

6 Health systems can Strengthen health system leadership and Publicly commit to address and condemn all forms of violence against women and girls Allocate budgets/resources to prevent and respond to violence against women and girls Integrate violence against women prevention and response in health policies, plans, programmes and budgets Advocate to adopt or reform laws and policies promoting sexual and reproductive health and rights and gender equality Designate a unit or focal point in ministries of health to address violence against women Improve coordination within health and with other sectors Strengthen health system leadership and governance

7 Health systems can Implement protocols for providing quality care, using WHO guidelines/tools  Provide comprehensive health care services to all women and girls who have experienced violence, including in humanitarian settings  Improve access to services by integrating care for women experiencing violence into existing programmes and services  Provide quality care to survivors which is woman-centered and gender-sensitive  Eliminate mistreatment and abuse of women in health care settings  Train health care providers and integrate training on violence against women and girls in pre- and in-service curriculum for all health professionals  Strengthen health service delivery and health providers’ capacity to respond to violence against women and girls 

8 Health systems can Address the needs of children witnessing intimate partner violence in their homes  Promote messages about consent and respect in intimate and sexual relationships in schools and in health education and promotion activities  Support prevention programmes that challenge norms that perpetuate male dominance or female subordination, stigmatize survivors or normalize violence  Address harmful alcohol and substance use and maternal depression as risk factors and consequences of intimate partner violence  Inform policies and programmes in other sectors about evidence-based prevention interventions, including comprehensive sexuality education and economic livelihood programmes for women Strengthen programming to prevent violence against women and girls

9 Health systems can Strengthen information collection and evidence 1. Strengthen routine reporting of statistics on violence against women and girls by including indicators and collection of data in health information and surveillance systems  2. Establish baselines for prevalence through population-based surveys and integrate violence against women and girls modules in recurring population-based surveys  3. Conduct or support analysis and use of disaggregated data on violence against women and girls  4. Conduct research to develop, evaluate and scale up health systems interventions to prevent or reduce violence against women and girls  5. Facilitate efforts by others to research violence against women and girls knowledge gaps and evaluate interventions Strengthen information collection and evidence

How PAHO/WHO is working to strengthen health systems in the Americas 10 1 Improving the availability and use of evidence for policy and program development e.g. Produce comparative reports of prevalence estimates of violence against women for the region How PAHO/WHO is working to strengthen health systems in the Americas 2 Building political will to address violence against women e.g. Support regional and global networks and co-organize conferences, including the Sexual Violence Research Forum 2017 held in Rio with 533 participants 3 Building capacity of health systems to respond to and prevent violence against women e.g. Develop, translate, disseminate normative guidance and tools

Tools by PAHO/WHO to support health systems 11 Tools by PAHO/WHO to support health systems Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines Strengthening the medico-legal response to sexual violence Health care for women subjected to intimate partner violence or sexual violence: A clinical handbook Strengthening health systems to respond to women subjected to intimate partner violence or sexual violence: A manual for health managers Training Curricula on Violence Against Women Response (forthcoming) WHO Clinical Guidelines for responding to children and adolescents who have been sexually abused Training Curricula on Violence Against Women Response

12 PAHO/WHO can help Member States’ strengthen their health systems’ capacity to address violence against women Build capacity of health care providers and key stakeholders to prevent and respond to violence against women Support the development / revision of national policies and protocols guiding the role of health systems in addressing violence against women Build capacity of researchers, National Institutes of Statistics and others to carry out quality research on violence against women Support the development of surveys to produce quality measures of violence against women that respond to SDGs

Thank you www.paho.org/violence Tools mentioned in this presentation are available at: www.paho.org/violence