World Health Organization
Background
The World Health Organization (WHO) is the directing and coordinating authority on international health within the United Nations System. It supports the attainment by all peoples of the highest possible level of health. Health is defined in WHO's Constitution as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. WHO supports countries as they coordinate the efforts of multiple sectors of the government and partners to attain their health objectives and support their national health policies and strategies. WHO’s work on violence against women spans more than twenty years and includes: a) Building the evidence base on the size and nature of violence against women in different countries and developing methodologies and ethical and safety guidelines for measuring violence and its consequences; b) Establishing norms and standards for the health systems’ response to violence against women, particularly for intimate partner violence, sexual violence and female genital mutilation, including development of guidelines and tools (e.g. clinical handbook, training curricula, capacity assessment tools, strengthening health system job aids); c) Supporting countries (Ministries of Health and other relevant partners) to implement such tools, including in humanitarian settings and through participation in the Joint UN Programme on essential services for women subject to violence; d) Building evidence through research and data collection and development of prevalence estimates and global monitoring for different forms of VAW; e) Advocacy for strengthening the role of the health sector in multisectoral response to address VAW and for the integration of strategies to address VAW in existing health programmes such as those for sexual and reproductive and maternal and child health, HIV prevention, mental health, adolescent health and others.
Policy framework
See main instruments above. In addition, WHO’s work on violence against women is based on several resolutions by its governing bodies: World Health Assembly Resolution WHA49.25, Prevention of violence: a public health priority (1996); World Health Assembly Resolution WHA50.19, Prevention of Violence(1997); World Health Assembly Resolution WHA56.24, Implementing the recommendations of the World report on violence and health (2003); African Regional Committee Resolution AFR/RC54/R6, Child sexual abuse: a silent health emergency (2004); and the European Regional Committee Resolution EUR/RC55/10, Prevention of injuries in the WHO European Region. In May 2008 the World Health Assembly, adopted a resolution against FGM, which urges all Member States to, among others, enact and enforce legislation, support and enhance community-based efforts, and develop and promote guidelines for care of victims. More recently, the2014 World Health Assembly resolution WHA67.15 on “Strengthening the role of the health system in addressing violence, in particular against women and girls, and against children” ; Strategy and Plan of Action on Strengthening the Health System to Address Violence against Women, PAHO (2015); and World Health Assembly resolution WHA 69.5 WHO global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children (2016).
Areas of Focus
WHO supports and undertakes research, develops guidelines and tools, strengthens the capacity of national health systems to develop policy and strengthen their response and services for survivors of violence against women and engages in advocacy and partnerships to address violence against women. Its efforts on violence against women include intimate partner violence, sexual violence, female genital mutilation (FGM), child and adolescent sexual abuse, child abuse and maltreatment, and violence against health workers. WHO also collaborates with IOM on the health of migrants and people who have been trafficked, including responding to violence. This work is being undertaken across a number of areas of work in WHO and by the different levels in WHO: at Headquarters, regional and country level. WHO participates in many UN inter-agency activities, processes, and partnerships, including UN Action (on sexual violence in conflict), the the Inter-agency Standing Committee, the Inter-Agency Working Group (IAWG) on reproductive health in humanitarian settings, the response to gender based violence in humanitarian settings through the health cluster, and UNAIDS Outcome Framework. It participates in the UN Joint Programme on Essential services for women subject to violence and a Joint Programme on strengthening methodologies and measurement and building national capacities for VAW data.
Resources
Gender based violence quality assurance tool (standards for the provision of high quality post-violence care in health facilities (2018)
Responding to children and adolescents who have been sexually abused: WHO clinical guidelines (2017)
Strengthening health systems to respond to women subjected to intimate partner violence or sexual violence: A manual for health managers (2017) Global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children (2016)
Ethical and safety recommendations for intervention research on violence against women. Building on lessons from the WHO publication: Putting women first: ethical and safety recommendations for research on domestic violence against women (2016)
Strengthening the medico-legal response to sexual violence (2015) (with UNODC)
Health care for women subjected to intimate partner violence or sexual violence: a clinical handbook – field testing version (2014) (with UNW and UNFPA)
Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines (2013)
Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence (2013)
16 Ideas for addressing violence against women in the context of the HIV epidemic: A programming tool (2013)
Preventing intimate partner and sexual violence: taking action and generating evidence, 2010
WHO multi-country study on women’s health and domestic violence against women – Report – initial results on prevalence, health outcomes and women’s responses (2005)
UNICEF contributed significantly to building the global evidence base, leading or co-leading on major research, studies and publications. In 2014, UNICEF published the largest-ever compilation of data on violence against children – “Hidden in Plain Sight: A Statistical Analysis of Violence against Children”, followed by a dedicated statistical report on violence against adolescents’ girls - “A Statistical Snapshot of Violence against Adolescent Girls”. In 2015, UNICEF released an analysis of current levels, trends and projections of child marriage in Africa. Despite persistent challenges, an increase in the quality and rigor of data around violence against children, including sexual violence was noted in 2015, with 32 data-driven studies produced globally. In addition, a “Diagnostic Review and the Study on the Structural Determinants of violence against children and women” was completed by UNICEF in 2015 by the University of Cape Town. Jointly with WHO, Center for Disease Control and other partners, a multi-sectoral package of evidence-based interventions to prevent and respond to violence against children was developed.
WHO conducts review and evidence-based advocacy with groups such as the Interparliamentary Union that works with parliamentarians on topics such as child, early and forced marriage and sexual reproductive health in order to get them more engaged in legislation related to this issue. WHO conducted a review of legislation on child, early and forced marriage in the Asia-Pacific Region and also collaborated with the parliament of Bangladesh to develop legislation on child, early and forced marriage in 2015.
WHO is developing a health systems manual for managers, based on the clinical guidelines, to design, plan, and implement services for survivors of intimate partner violence and sexual violence.
WHO, with support from UNA, developed a methodology for measuring the experience and perpetration of violence among women and men in conflict/humanitarian settings, which has been further developed by partners and is currently being tested.
WHO is developing clinical guidelines to respond to children and adolescents who have been sexually abused for use by health care providers.
WHO provides support to its collaborating centres and research institutions to strengthen capacity to implement research – including on ethical and safety aspects of conducting research on violence against women, and through workshops and courses on appropriate research methods for this topic. To facilitate this effort, WHO and RTI (Response to Interventions) International published ethical and safety guidelines for interventions research on VAW in 2016.
WHO is one of the 13 UN entities of UN Action, leading knowledge pillar by contributing to improved evidence for understanding the scale of sexual violence in conflict and how to respond effectively. In 2015, WHO together with UNODC published a toolkit on 'strengthening the medico-legal response to sexual violence', which aims to support service provision and coordination in low-resource settings, available in English and French. It is being field tested in several countries with the aim of improving coordination across the multiple stakeholders involved.
In Afghanistan, with support from the WHO, the Ministry of Public Health is training nearly 7000 health providers and upgrading health facilities in all provinces over the next 5 years to deliver Gender Based Violence services to survivors based on implementation of a national treatment protocol and the WHO clinical handbook for responding to intimate partner violence or sexual violence. In Uganda, health providers in 3 districts were trained based on updated national training guidelines to deliver care and services for GBV to survivors. Similar efforts are underway in India and Namibia.
The 'Global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children’ was endorsed by the 193 Member States of WHO at the May 2016 World Health Assembly. This plan encourages actions by MS, national and international partners and WHO along 4 strategic directions: Strengthening the health systems leadership and governance; providing comprehensive health, including SRH, services and training health providers ; strengthening prevention programming; and improving evidence and information to address violence against women and girls.
In 2014, WHO convened an expert group for consensus on indicators to monitor target 5.2. of the SDGs on elimination of violence against women and girls. The recommendations of this group contributed to the final set of indicators that were agreed for monitoring SDG target 5.2.