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Module 1OVERVIEW ANDINTRODUCTIONEssential Services Package forWomen and Girls Subject to ViolenceCore Elements and Quality Guidelines

MODULE 1Introduction

The Essential Services Package comprises five Modules:Module 1.Overview andintroductionModule 2.HealthModule 3.Justice and policingModule 4.Social servicesModule 5.Coordination andgovernance ofcoordinationChapter 1: Introductionto essential healthservicesChapter 1: Introductionto essential justice andpolicing servicesChapter 1: Introductionto essential socialservices1.1 Introduction1.2 Purpose & scope1.3 Language and terms1.1 Introduction1.2 Purpose & scope1.3 Language and terms1.1 Introduction1.2 Purpose & scope1.3 Language and termsChapter 2Common principles,characteristics andfoundational elementsChapter 2Framework foressential servicespackageChapter 2Framework foressential servicespackageChapter 2Framework foressential servicespackageChapter 2Framework foressential servicespackage2.1 Principles2.2 Commoncharacteristics ofquality essentialservices2.3 Foundationalelements2.1 The overallframework2.2 Unique features ofthe framework specificto essential healthservices2.1 The overallframework2.2 Unique features ofthe framework specificto essential justice andpolicing services2.1 The overallframework2.2 Unique features ofthe framework specificto essential socialservices2.1 The overallframeworkChapter 3How to use this tool3.1 Essential servicesguidelines frameworkChapter 3Guidelines for essentialhealth servicesChapter 3Guidelines for essentialjustice and policingservicesChapter 3Guidelines for essentialsocial servicesChapter 3Guidelines for essentialcoordination andgovernance actionsChapter 4Tools and resourcesChapter 4Tools and resourcesChapter 4Tools and resourcesChapter 4Tools and resourcesChapter 4Tools and resourcesChapter 1:Introduction toessential servicespackage1.1 Introduction1.2 Context1.3 Purpose and scope1.4 Language and termsChapter 1: Introductionto essentialcoordination andgovernance actions1.1 Introduction1.2 Purpose & scope1.3 Language and terms

ACKNOWLEDGEMENTSDevelopment of these guidelines would not have been possible without:The courage of the many women who have experienced violence and have spoken out abouttheir experiences and the activists, especially from women’s organizations located across theglobe, who have advocated for appropriate service provision and support for women subjectedto violence.The efforts by governments who are taking actions towards ending violence against womenthrough legislative reforms, policy initiatives and implementing prevention and responseprogrammes.The main donors for the UN Joint Programme on Essential Services for Women and Girls Subjectto Violence, the Governments of Australia and Spain.The cross-sector practitioners, researchers, government representatives who attended andparticipated in all the Global Technical Consultations for this programme of work (details ofparticipants available at www.endvawnow.org and click on Essential Services).The ongoing commitment of the UN system to develop programmes and actions responding toviolence against women. The UN agencies engaged in supporting the adaptation and/or development of these guidelines have shared their time and knowledge to ensure that we continue toimprove the provision of services for women and girls subject to violence. The agency representatives are thanked for their commitment and input: Tania Farha and Riet Groenen (UN Women),Upala Devi and Luis Mora (UNFPA), Claudia Garcia Moreno and Avni Amin (WHO), Suki Beavers,Niki Palmer and Charles Chauvel (UNDP) and Claudia Baroni and Sven Pfeiffer (UNODC).The consultants who assisted in the harmonization and consolidation of all the guidelines developed for this package, Ms Eileen Skinnider and Ms Janice Watt.3Module 1 Chapter 1


CHAPTER 1:INTRODUCTION TOESSENTIAL SERVICESPACKAGE1.1IntroductionThe United Nations Joint Global Programme onEssential Services for Women and Girls Subject toViolence (the “Programme”), a partnership by UNWomen, UNFPA, WHO, UNDP and UNODC, aims toprovide greater access to a coordinated set of essentialand quality multi-sectoral services for all women andgirls who have experienced gender based violence.The Essential Services Package reflects the vital components of coordinated multi-sectoral responses forwomen and girls subject to violence. The provision,coordination and governance of essential health,police, justice and social services can significantlymitigate the consequences that violence has onthe well-being, health and safety of women andgirls’ lives, assist in the recovery and empowermentof women, and stop violence from reoccurring.Essential services can diminish the losses experienced by women, families and communities in termsof productivity, school achievement, public policiesand budgets, and help break the recurrent cycle ofviolence. The Essential Service Package also plays akey role in poverty reduction and development andefforts to achieve the newly agreed 2015 SustainableDevelopment Goals.The Programme identifies the essential services tobe provided by the health, social services, police andjustice sectors (the “Essential Services”) as well asguidelines for the coordination of Essential Servicesand the governance of coordination processes andmechanisms (the “Coordination Guidelines”). Servicedelivery guidelines for the core elements of each essential service have been identified to ensure the deliveryof high quality services, particularly for low and middleincome countries for women and girls experiencingviolence. Taken together, these elements comprise the“Essential Services Package”.The Essential Services Package aims to fill the gapbetween the agreements and obligations made atthe international level for the provision of servicesfor VAW, including the agreed conclusions of the 2013Commission on the Status of Women, and countrylevel activity by providing technical guidance onhow to develop quality essential services.” servicesresponses. These obligations are detailed in humanrights instruments, international agreements andaccompanying declarations and policies that provideglobal norms and standards upon which to build theEssential Services Package. While extensive commitment to respond to, and prevent violence againstwomen and girls has occurred at a global level overThe Essential Services Package comprises five overlapping modules: Module 1 Overview and Introduction Module 2: Health Essential Services Module 3: Justice and Policing Essential Services Module 4: Essential Social Services Module 5: Essential Actions for Coordination andGovernance of Coordination6Module 1 Chapter 1

the last decades, many women and girls have inadequate or no access to the range of supports andservices that can protect them, assist in keeping themsafe, and support them to address the short and longterm consequences of experiencing various formsof violence.1.2ContextViolence against women and girls is widespread,systemic and culturally entrenched. The UnitedNations Secretary-General has described it asreaching pandemic proportions.1 Violence againstwomen consists of “any act of gender-based violence that results in, or is likely to result in, physical,sexual or psychological harm or suffering to women,including threats of such acts, coercion or arbitrarydeprivations of liberty, whether occurring in publicor in private life.”2 Gender-based violence, violencethat is directed against a woman because she is awoman or which affects women disproportionately,3takes many forms. In addition to physical and sexualviolence, violence against women and girls includespsychological and emotional harm and abuse, sexual harassment, female genital mutilation, abuseresulting from allegations of sorcery and witchcraft,so-called honour killings of women and girls, trafficking of women and girls, female infanticide andother harmful practices. Intimate partner violenceand non-partner sexual violence are among the mostpervasive and insidious forms of violence againstwomen and girls. The term ‘violence against women’includes violence against girls, particularly girls thatcould use the essential services provided for women.intimate partner violence or non-partner sexual violence.4 More than seven percent of women globallyreported ever having experienced non-partner sexualviolence.5 Some country studies show that up to 70percent of women experience physical or sexualviolence from men in their lifetimes, the majority bya husband or other intimate partner.6 It is estimatedthat one in five girls has been abused in childhoodwith estimates from some countries as high as one inthree.7 Gender based power relations within societyput many girls at a much higher risk than boys forsome forms of violence, and sexual violence in particular. A study of men’s use of violence in selected sitesin seven countries in Asia and the Pacific revealed that26-80 percent of men reported having perpetratedphysical and/or sexual intimate partner violence,and 10-40 percent of men reported committing nonpartner rape, citing sexual entitlement as the mostcommon motivation.84 WHO, Global and Regional Estimates of Violence againstWomen, p. 2 (“Only women aged 15 years and older wereincluded, to differentiate violence against women from childsexual abuse.” p. 12), retrieved from 789241564625 eng.pdf.5 Ibid, p. 18.6 UN Women “Violence against Women: Facts and Figures” SAYNO UNiTE TO END VIOLENCE AGAINST WOMEN, and-figuresPopulation surveys have found that between 10-70% ofwomen report being physically assaulted by an intimate malepartner at some point in their lives, see Heise, L., Ellserg, M.and Gottemoeller, M. (1999) Ending Violence against Women(Baltimore, MD: John Hopkins University School of PublicHealth). The UN Secretary-General’s Study, supra note 1 statesthat violence against women affects one third of all womenin their lifetime.7 http://www.who.int/violence injury prevention/violence/status report/2014/en/ p. 148 UN Women (2013) Why do some men use violence againstwomen and how can we prevent it? Quantitative findingsfrom the United Nations Multi-country Study on Men andViolence in Asia and the Pacific (UN Women, UNFPA, UNDPand UN Volunteers).According to a 2013 global review by the WorldHealth Organization (WHO), 35 percent of womenworldwide have experienced physical and/or sexual123United Nations (2006) Secretary-General’s In-depth Study onViolence Against Women A/61/122/Add.1.Declaration on the Elimination of Violence against Women,Article 1, retrieved from l)/A.RES.48.104.En?Opendocument.See for example, the Committee on the Elimination of AllForms of Discrimination against Women (CEDAW), GeneralRecommendation No. 19, retrieved from ions/recomm.htm.7Module 1 Chapter 1

Several studies suggest that, globally, half of all femalehomicide victims are killed by their current or formerhusbands or intimate partners. 9decades, many women and girls have little or noaccess to the support and services that can protectthem, assist in keeping them safe, and address theshort and long-term consequences of experiencingviolence. Thus, government commitment to addressing violence against women and girls is critical toachieving the goals of these Guidelines.Violence against women and girls has detrimental andlong lasting consequences to the well-being, healthand safety of women and girls, along with economicconsequences, effects on educational outcomes,and impact on the productivity and development ofsocieties and countries. While extensive commitmentto respond to, and prevent violence against womenand girls has occurred at a global level over the lastThe international obligation to exercise due diligencerequires States to establish effective measures toprevent, investigate and prosecute cases of violenceagainst women. This includes effective means torespond to each case of violence, as well as address thestructural causes and consequences of the violence, byensuring comprehensive legal and policy frameworks,gender sensitive justice systems and police, availablehealth and social services, awareness raising activitiesand ensuring the quality of all measures.9 See for example, UNODC, Global Study on Homicide 2013, p.14, available at atistics/GSH2013/2014 GLOBAL HOMICIDEBOOK web.pdf.1.3Purpose and scopeThe purpose of the Essential Services Package is tosupport countries as they work to design, implementand review services for all women and girls who arevictims and survivors of violence, in a broad range of settings and situations. The Package is a practical tool forcountries setting out a clear roadmap on how to ensurethe provision and coordination of quality services ofall sectors. It is designed to ensure that the services ofall sectors are coordinated and governed to respond ina comprehensive way, are women-centred and wherenecessary, child-centred, and are accountable to victimsand survivors and to each other. The guidelines for eachcore element of the essential services are designed toensure a quality response to violence against womenand girls.place to ensure that services are being delivered andare of the required quality.While the Guidelines may be applied to other forms ofviolence against women and girls, they are primarilyintended for situations of intimate partner violence,and non-partner sexual violence. The focus is primarily on responding to violence by taking action at theearliest stages of violence, and intervening to preventthe reoccurrence of violence. These guidelines focuson services and responses designed for women buttake into consideration the needs of those girls whoare of an age where they may use such services.Where relevant, these guidelines also highlight whatneeds to be considered for women and girls who areaccompanied by their children when using essentialservices. Not only are women and girls overwhelmingly the victims of male violence and abuse, the UnitedNations acknowledges that violence against women“is a manifestation of the historically unequal powerrelations between men and women which have ledto domination over and discrimination against women by men”.10 As a result, the dynamics of violenceThe way in which essential services are implementedwill vary from one country to another. Some countriesmay already have the described services in place;others may need to adapt existing services or progressively implement new services, or take additionalmeasures to meet these standards. It is critical thateach country has a plan in place to achieve identifiedstandards, and to ensure that measurement andaccountability processes and mechanisms are in10 United Nations Declaration on the Elimination of Violenceagainst Women.8Module 1 Chapter 1

against women, the forms of violence that womenexperience, the severity, frequency and consequencesare very different from violence experienced by men.victims of violence. The Guidelines, while universallyapplicable, have been developed specifically withconsideration for low to medium income countries.It is also important to note that these guidelines donot focus on interventions in crisis or humanitariansettings. However the responses described withinthese guidelines are complementary, to the extentpossible within current guidelines, to those that focuson crisis/humanitarian settings.The scope of the Essential Services Package is complemented by the focus of UNICEF, which, amongother things, works to ensure all children live freefrom violence. UNICEF will continue to developsignificant guidance and responses for children as1.4Language and termsCoordination is a central element of the response toviolence against women and girls. It is required byinternational standards that aim at ensuring that theresponse to violence against women and girls is comprehensive, multidisciplinary, coordinated, systematic andsustained. It is a process that is governed by laws andpolicies. It involves a collaborative effort by multi-disciplinary teams and personnel and institutions from allrelevant sectors to implement laws, policies, protocolsand agreements and communication and collaborationto prevent and respond to violence against women andgirls. Coordination occurs at the national level amongministries that play a role in addressing this violence,at the local level between local-level service providers,stakeholders and, in some countries, at intermediatelevels of government between the national and locallevels. Coordination also occurs between the differentlevels of government.of the State and to administer the sanctions imposedfor violations of laws.Gender based violence is “any act of violence that isdirected against a woman because she is a woman orthat affects women disproportionately”.11Governance of coordination has two major components. The first component is the creation of lawsand policies required to implement and support thecoordination of Essential Services to eliminate orrespond to violence against women and girls. The second component is the process of holding stakeholdersaccountable for carrying out their obligations in theircoordinated response to violence against women andgirls and ongoing oversight, monitoring and evaluationof their coordinated response. Governance is carriedout at both the national and local levels.Health system refers to (i) all activities whose primarypurpose is to promote, restore and/or maintain health;(ii) the people, institutions and resources, arrangedtogether in accordance with established policies, toimprove the health of the population they serve.12Core elements are features or components of theessential services that apply in any context, and ensurethe effective functioning of the service.Essential Services encompass a core set of servicesprovided by the health care, social service, police andjustice sectors. The services must, at a minimum,secure the rights, safety and well-being of any womanor girl who experiences gender-based violence.Health care provider is an individual or an organizationthat provides health-care services in a systematic way.An individual health-care provider may be a healthcare professional, a community health worker; orany other person who is trained and knowledgeablein health. Organizations include hospitals, clinics,Formal justice systems are justice systems that are theresponsibility of the State and its agents. They includegovernment supported laws, and institutions such aspolice, prosecution services, courts, and prisons thathave the responsibility to enforce and apply the laws11 CEDAW, General Recommendation No. 19, para 6.12 WHO, Health System Strengthening: Glossary, found at www.who.int/healthsystems/Glossary January2011.pdf.9Module 1 Chapter 1

Non-partner sexual violence “refers to violenceby a relative, friend, acquaintance, neighbor, workcolleague or stranger”.15 It includes being forced toperform any unwanted sexual act, sexual harassmentand violence perpetrated against women and girlsfrequently by an offender known to them, includingin public spaces, at school, in the workplace and inthe community.primary care centres and other service delivery points.Primary health care providers are nurses, midwives,doctors or others.13Intimate partner violence is “the most common formof violence experienced

1.1 Introduction 1.2 Context 1.3 Purpose and scope 1.4 Language and terms Chapter 1: Introduction to essential health services 1.1 Introduction 1.2 Purpose & scope 1.3 Language and terms Chapter 1: Introduction to essential justice and policing services 1.1 Introduction 1.2 Purpose & scope 1.3 Language and terms Chapter

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