International concern over genderbased violence (GBV) has increased considerably in recent years, and the international humanitarian response to GBV in populations affected by armed conflict, disaster and displacement has also grown exponentially over the past decade. In the aftermath of Typhoon Haiyan in the Philippines, for example, the UK government announced a £21.6 million aid package to protect women and girls from sexual violence.+Liz Ford, Typhoon Haiyan: UK Aid Delivery Must Assess Risk of Violence Against Women, The Guardian, 14 November 2013, www.theguardian.com. At the same time, however, there remains a lack of data on and understanding of good practice in relation to GBV programming in humanitarian contexts, and a lack of consensus on how to apply GBV concepts and terminology. While good practice standards, guidelines and training do exist, little in the way of evidence from GBV programming has been collected and consolidated in a coherent way, and there is confusion around how to define, prioritise, prevent and respond to gender-based violence in humanitarian contexts.
This article provides an overview of good practice in GBV programming, drawn from a literature review funded by the UK Department for International Development.+The literature review Preventing and Responding to Gender-based Violence in Humanitarian Contexts: Mapping and Analysing the Evidence and Identifying the Gaps, by Rebecca Holmes and Dharini Bhuvanendra is available on the DFID website at http://r4d.dfid.gov.uk. Key findings are summarised in an HPN Network Paper (NP 77), available from the HPN website at http://www.odihpn.org/hpn-resources/network-papers/preventing-and-responding-to-gender-based-violence-in-humanitarian-crises. Although the studies looked at in the review are very contextspecific, they enable us to draw indicative conclusions about the types of GBV programming that can work in emergencies. The emerging lessons discussed here are drawn from the following types of interventions:
- Prevention interventions:
- Awareness-raising at the community level.
- Womens empowerment.
- Response interventions:
- Psychosocial care.
- Community-based healthcare.
- Prevention and response interventions:
- Multi-sectoral, including economic empowerment, psychosocial counselling, referrals, legal assistance and counselling, awareness-raising and community training activities.
Emerging lessons and indicative good practice
Monitoring and evaluating changes in the incidence of violence and attributing this to a programme intervention is challenging. One programme, the International Rescue Committee (IRC)s economic and social empowerment programme in Burundi (EA$E), measured changes using a randomised control trial of its intervention. The EA$E programme compared the impacts of its economic programme (Village Saving and Loan Associations) with and without an additional component comprising integrated tailored discussions. The six-session discussion group series, called Talking about Talking (TaT), provided opportunities for dialogue about joint economic decisionmaking between men and women in the household, and challenged gender norms about financial decision-making (money and assets) using non-threatening entry points focusing on improving overall household wellbeing and participatory methods.+International Rescue Committee, Getting Down to Business: Womens Economic and Social Empowerment in Burundi (New York: IRC, n.d.). The TaT intervention created significant and positive changes in the incidence of reported intimate partner violence: women in the high or moderate risk category at baseline reported a 22% reduction in the incidence of violence in the two weeks before the evaluation, and a 46% reduction in physical harm.
Other types of programmes report important impacts in terms of changing attitudes, perceptions and knowledge around GBV in the community and at the household/ individual level. Innovative awareness-raising activities, such as cinema, radio, behaviour change and education, seem to be particularly effective at increasing recognition of different types of violence (not just physical, but also other forms of violence such as early marriage and female genital mutilation (FGM)), reducing levels of victim blame, decreasing acceptance of violence and increasing knowledge of rights and legal issues. One study suggested that the more exposure participants had to the messages, the stronger the effect.+Search for Common Ground, Informing Refugees and Returnees on Gender Based Violence: Program Evaluation (Kinshasa: Search for Common Ground, 2011). At the household/ individual level, targeted and tailored awareness-raising and discussion groups, including men or specifically targeting men (via mens groups), have also been found to reduce the acceptance of violence, improve empathy for survivors and increase knowledge of gender relations and womens rights. However, a key challenge highlighted across numerous studies is that attitudes, perceptions and gender norms are difficult to shift. These include womens reproductive and sexual rights (e.g. a married womans right to refuse to have sex with her husband) and the entrenched norms around the gendered division of labour within the household (e.g. a woman deciding to go to work while her husband stays at home and takes care of the children). None of the programmes reviewed measured changes in attitudes and perceptions in the long term, and only a few noted changes in wider community attitudes beyond the target group.+Beyond Borders, Rethinking Powers SASA! Adaptation in Haiti: Project Final Report for UUSC (Washington DC: Beyond Borders, 2013).
In terms of response to GBV, improved access to services for victims of violence can be achieved not only by increasing the provision of services, but also by ensuring that services are delivered appropriately and are sensitive to survivors needs and the context. Services such as mobile clinic visits, increasing the capacity of staff to understand, coordinate and refer GBV survivors to relevant services and ensuring confidentiality and cultural sensitivity in the delivery of services have been identified as important features. This has resulted in improved access to healthcare (and response within 72 hours), better-quality services and improved referrals to a range of services, including health, counselling and legal assistance. Many of these design and implementation features have also involved community partnerships, such as community protection committees and establishing focal points or gender desks to deal with GBV, and awareness-raising techniques. Reductions in the harmful effects of violence have also been reported from psychosocial counselling interventions, such as reduced post-traumatic stress disorder, depression and anxiety and improved social skills.
Providing counselling and therapy in groups is important to the success of these programmes. As reported in an intervention in Afghanistan, the group approach helped women to express and verbalise their complaints, provided an avenue to share their problems with others in an appropriate manner and improved their social skills.+S. Manneschmidt and K. Griese, Evaluating Psychological Groups Counselling with Afghan Women: Is This a Useful Intervention?, Torture, 19(1), 2009. Ensuring that therapy sessions are delivered by skilled staff who have received appropriate training and supervision, as well as adapting the therapy to the target group notably illiterate participants and those potentially exposed to on-going violence or in difficult contexts have also been identified as important programme features to ensure the appropriate care of survivors of violence.+J. K. Bass et al., Controlled Trial of Psychotherapy for Congolese Survivors of Sexual Violence, New England Journal of Medicine, 368(23), 2013; S. Hustacheet al., Evaluation of Psychological Support for Victims of Sexual Violence in a Conflict Setting: Results from Brazzaville, Congo, International Journal of Mental Health Systems, 3(7), 2009.
Implications for future GBV programming in emergencies
Reviewing good practice in responding to GBV in emergencies points to a number of lessons for future programming not only in terms of what has worked well, but also in identifying challenges and offering suggestions for what needs to be done differently. While every context is different, a number of implications for policy and practice can be drawn out.
Firstly, there is a pressing need to promote the collection of data on GBV, and to share and disseminate this data to inform GBV programming. Partnerships with research institutions can be established to conduct prevalence research in ways that do not take resources away from GBV programmes during the earliest stages of a crisis, and GBV data could be shared more widely, while at the same time safeguarding confidentiality. The accessibility of data also needs to be improved in order to promote learning across different contexts and interventions. A centralised database of evaluations could be established,+The GBV Information Management System is a good starting point for this. See http://www.gbvims.com. and longitudinal studies, where feasible, are also needed to better understand long-term gains and the sustainability of interventions.
Secondly, ensuring that programmes are appropriate to survivors needs and the cultural and social context is critical. However, documentation and evaluation of complex multi-sectoral programmes and coordination functions remain limited, and we still do not know what factors contribute to good outcomes and effective programmes, and which aspects of GBV are more or less critical in different contexts. For example, what measures are in place to address transactional sex or trafficking in emergency contexts? What types of intervention might be needed to respond to intimate partner violence (sexual and nonsexual) versus rape perpetrated as an act of war?
A number of studies in the review highlighted the importance of fluid or adaptable programmes which could respond to contextual changes, and which are culturally appropriate to the context. This is seen as particularly important in complex emergencies. Many studies also flagged up the importance of involving men in programmes, suggesting that a balance needs to be found between a women-focused approach and the inclusion and integration of men, and the provision of appropriate gender-responsive services. There is a need to recognise the programming implications of working with men and boys in the prevention and response to violence, as well as identifying the needs of men and boys as survivors of violence. A number of studies also highlighted the need for girl-friendly services to address the specific types of violence that girls may face (e.g. FGM).
Thirdly, investment in building staff capacity and improving coordination is important to ensure the effective implementation of programmes. Studies highlighted the need to invest in continuous specialised and culturally appropriate training to staff (men and women) as well as other relevant service providers (such as the police). Strengthening coordination mechanisms between sectors and programmes, and between institutions and agencies, is necessary to build synergies with other organisations to support GBV programming.
Fourthly, monitoring and evaluation mechanisms must be strengthened across GBV programming. Establishing and improving monitoring and evaluation mechanisms would ideally involve GBV implementing organisations incorporating robust monitoring systems and independent evaluations in programme plans and budgets, which would provide findings on the effects of interventions, including baseline and end-line data collection and analysis.
Finally, given the limited number of studies included in the review, more evidence on interventions in emergency settings is needed. Particular research gaps include the need to generate evidence on the incidence of violence, particularly as the majority of studies reviewed focused on prevention, as well as the access, quality and outcomes of services for GBV response interventions; understanding the type of gender-based violence addressed at specific stages of emergencies (and whether interventions are appropriate to the needs of survivors of particular types of GBV at specific times); generating evidence on the impacts of GBV interventions in post-disaster settings; and collecting and analysing evidence from across countries and regions to expand the evidence base.
Dharini Bhuvanendra is an independent researcher working for the Overseas Development Institute (ODI). Rebecca Holmes is a Research Fellow in the Social Protection Programme at ODI.