Strengthening Health System Responses to Gender-based Violence in EECA: A resource package 4. Principles and standards for service provision 1

Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Aim of the module To provide an overview of basic principles and standards for providing health care services to survivors of GBV 2

Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Outlook Gender-sensitive approach Survivor-/women-centered approach Human rights-based approach Integration of the health care response to GBV into existing services 3

Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Gender-sensitive approach – implications for health care providers Understand the gender-based nature of VAW Take into account the needs of specific groups of survivors (women with disabilities, pregnant women, adolescent girls, older women, sex workers, migrant women) Respect the diversity of services users and apply a non- discriminatory approach Provide services that are appropriate and tailored to the particular needs of service users Understand the impact of intimate partner violence on children 4

Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Survivor-/women-centered approach - implications for health care providers Prioritize the survivor‘s rights, needs and wishes by: -Creating a supportive and validating environment -Promoting the survivors’ recovery -Promoting the survivors’ ability to identify and express her needs and wishes -Reinforcing her capacity to make decisions about possible interventions Prioritize the right to safety survivors and their children Prioritize the survivor’s right to privacy and confidentiality Ensure the survivor’s right to dignity and avoid secondary victimization Provide services that support the survivor’s empowerment, autonomy and participation 5 H14

Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Human rights-based approach (HRBA) A HRBA seeks to redress the human rights violations that are both the root causes and the consequences of GBV Added value of the HRBA: -Adds legitimacy since it is based on universal human rights principles and standards -Establishes rights of individuals (“rights holders”) and corresponding duties of the State and non-state service providers (“duty bearers”)  shift from “welfare paradigm” -Supports the creation of accountability mechanisms -Grounded in the full spectrum of civil, political, economic, social and cultural rights 6

Strengthening Health System Responses to Gender-based Violence in EECA: A resource package HRBA – Implications for health services and providers Policies, protocols or programmes are in line with human rights standards Health services aim at empowering survivors Health services are based on an assessment of the capacities of -women survivors to access health care services -health providers to fulfil their obligations vis-à-vis survivors Processes and outcomes of health system interventions to GBV are monitored and evaluated, based on human rights standards National accountability of duty bearers for non- compliance with international and national standards 7

Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Integration of the response to GBV into existing health services Medical care for survivors of GBV should be integrated into existing services, rather than having stand-alone services A stand-alone services may be difficult to sustain and may have a potential harmful effect Integrated services may facilitate women‘s easy access to a range of care and support services There is no “one size fits all” model  take into account specific context when considering a particular model of service provision 8 H15

Strengthening Health System Responses to Gender-based Violence in EECA: A resource package Examples of integration Setting up victim support groups in hospitals (Austria) Providing hospital-based accommodation for survivors of GBV (Tajikistan) Integrating the response to domestic violence in maternity and sexual health services – MOZAIC project (UK) 9 H16 H17 H18