Service delivery points providing appropriate medical, psychological, and legal support for women and men who have been raped or experienced incest

 

The number or percent of service delivery points (SDP) that provide medical, psychological, and legal support and/or referrals appropriate to meet the needs of females and males who have been raped or experienced incest.  SDPs can include health units of any type or level (public, private, non-governmental, community-based; primary, secondary or tertiary care) and facilities providing services specifically for victims of sexual and gender based violence (SGBV).

Appropriate services for survivors of rape and incest include identification of survivors, necessary medical services, counseling, and referrals to community-based resources such as legal aid, safe shelter and social services. For further detail on related indicators for SGBV, see Bloom (2008).     

This indicator is calculated as:

(Number of SDPs providing appropriate medical, psychological, and legal support for women and men who have experienced rape or incest / Total number of SDPs in a designated area) x 100


The indicator can be calculated using data from surveys of health care facilities or other SDPs that provide care for survivors of rape and incest. The survey can be part of a specific study on SGBV using standard assessments, such as IPPF, UNFPA/Ipas, and SVRI, or part of a more general study of health facilities and service provision. A probability sample of SDPs can be selected in order to assess services in the geographic area of interest. All SDPs that can answer questions affirmatively about provision of medical, psychological and legal support or referral services and/or show corresponding records documenting these services are included in the numerator. Data can be disaggregated by the type of facility or program (public, private, non-governmental, community-based; primary, secondary or tertiary); the range of services available, age and sex of clients, and by other relevant factors such as districts and urban/rural location.


Facility records, specialized surveys with sections on facility and provider services, such as IPPF (2004), UNFPA/Ipas (2008) an SVRI (2008).


This indicator measures access to quality care for survivors of rape and incest across the range of health care facilities and SDPs. Short and long-term health risks from incest and rape for women and girls include gynecological problems, STDs, HIV/AIDS, early sexual experiences, early pregnancy, infertility, unwanted pregnancy, abortion, pelvic inflammatory disease, re-victimization, high-risk behaviors, depression, substance abuse, suicide, and death (Stevens, 2002). In turn, health risks for male victims can include infections, STDs, HIV/AIDS, re-victimization and/or victimizing others, high-risk behaviors, depression, substance abuse, suicide, and death. The provision of adequate care for survivors of rape and incest is vital in the prevention and response to SGBV. Clinic visits made by SGBV survivors present an opportunity to address and ameliorate the effects of violence, as well as help prevent future incidents. In order to help survivors and take advantage of these opportunities, health facilities and related SDPs need to be prepared to deliver appropriate services. This indicator relates to achieving Millennium Development Goals: #3. promote gender equality and empower women; #5. improve maternal health; and #6. combat HIV/AIDS.


This indicator measures the availability of services for rape and incest survivors, but does not capture specific aspects of or barriers to access including physical availability (e.g., travel time, transportation and hours of operation), cost, medical supplies, information, referrals, and quality of services.


violence, integration, access, sexually transmitted infection (STI), HIV/AIDS, quality

With the focus on women and girls being the victims of SGBV, males may be reluctant to seek out services because of cultural beliefs that boys and men cannot be victims. SDPs may be ill-equipped to address male survivors of SGBV, including lack of provider training in caring for males and fewer agencies and networks (e.g., shelters, legal or social services) accepting referrals of males.


 

Bloom S., 2008, Violence Against Women and Girls: A Compendium of Monitoring and Evaluation Indicators.  USAID, IGWG, and MEASURE Evaluation. https://www.cpc.unc.edu/measure/tools/gender/violence-against-women-and-girls-compendium-of-indicators

International Planned Parenthood Federation, 2004, Improving the health sector response to gender-based violence: A resource manual for health care professionals in developing countries, IPPF/WHR Tools/02/September 2004. http://www.ippfwhr.org/sites/default/files/GBV_cdbookletANDmanual_FA_FINAL.pdf

Stevens, L. 2002. ‘A practical approach to gender-based violence: A programme guide for health care providers and managers’ developed by the UN Population Fund. Int. J of Gyn & Obstet. 78 (Suppl. 1): S111-S117. http://www.unfpa.org/webdav/site/global/shared/documents/publications/2001/genderbased_eng.pdf

Sexual Violence Research Initiative. 2008. Assessment Instruments Used to Study Healthcare-Based Interventions for Women Who Have Experienced Sexual Violence. Available at: http://www.svri.org/evaluation.htm

UNFPA/Ipas, 2008, Getting it Right! A practical guide to evaluating and improving health services for women victims and survivors of sexual violence, Chapel Hill, NC: Ipas.  www.ipas.org/~/media/Files/Ipas%20Publications/SVGUIDEE08

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