4. Principles and standards for service provision

1. 4. Principles and standards for serviceprovision

2. Aim of themodule • To provide an overview of basic principles and standards for providing health care services to survivors of GBV

3. Outlook • Gender-sensitive approach • Survivor-/women-centeredapproach • Human rights-basedapproach • Integration of thehealth care responseto GBV intoexistingservices

4. 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

5. Survivor-/women-centeredapproach -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 H14

6. Human rights-basedapproach (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

7. 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

8. Integration of theresponseto GBV intoexistinghealthservices • 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 H15

9. Examplesofintegration • 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) H16 H17 H18