3.5.3 Gender-based violence

Evidence demonstrates that the incidence of gender-based violence (GBV), such as sexual assault, harassment, sexual exploitation and domestic violence, increases during emergencies. There is mounting evidence of increased GBV in post-conflict situations as well. It is important to consider the root causes, contributing factors and examples of GBV when assessing, designing and implementing a GBV program (SPRINT, 2009):

• Root cases include disrespect for human rights, abuse of power, and gender inequality.
• Contributing factors include conflict, poverty, lack of education, sexual factors, physical, emotional/mental, economic, harmful traditional practices (HTP), alcohol/drug abuse, lack of police protection and lack of secure domiciles/areas.
• Examples of GBV include domestic violence, child marriage, dowry abuse, verbal emotional abuse, sexual abuse, FGM, marital rape, verbal emotional abuse based on gender, and rape.

CARE has vast experience in addressing root causes and contributing factors to GBV and country offices are encouraged to integrate this work into emergency preparedness, planning and response.   GBV requires a very well coordinated multi-sectoral response that includes the following services: health, psychosocial, legal/justice, and security and protection. This response must result in addressing a protection system in place especially for women and girls, the provision of quality care for survivors, and raising awareness of services available for prevention and treatment. Survivors of sexual assault need access to quality post-rape care that includes post-exposure prophylaxis for HIV, antibiotics for sexually transmitted infections (STIs), emergency contraception, counselling and support. All programs should include a referral system that links survivors with the different services. Referral systems from outreach workers for access to health facility services, protection and legal services need to be established. Coordinate with the protection sector where applicable to create synergies between sectors and overall interventions.

Please refer to Annex 8.5.14 for clinical management guidelines and refer to Chapter 9.1 Gender, for information on how to plan and implement a quality program and for details on the non-health aspects of GBV programming.  To provide these services health worker staff need training and follow-up supervision that is based on the WHO guidelines.  Please refer to Annex 26.5.14 for links to the WHO Clinical Management for Rape Survivors and information on other resources for training in clinical management.