New WHO Guidance on the Intersection of Systems Strengthening and Sexual Violence

On 25 November, the International Day for the Elimination of Violence against Women, and as part of the #16days of Activism to End Gender-Based Violence, WHO launched a new manual for improved quality of care to survivors of violence: Strengthening health systems to respond to women subjected to intimate partner violence or sexual violence: A manual for health managers. It is based on the WHO guidance on care for survivors of intimate partner violence and sexual violence (2013) and on the WHO health systems building blocks (2007).

The new manual highlights the importance of leadership, governance and accountability as an overarching principle and considers issues of policy change, budgeting and financing, community engagement and sectoral coordination. It addresses strengthening the healthcare workforce and improving supplies infrastructure for service delivery. The manual includes information on data, monitoring and evaluation, and scaling up. It also considers the diverse access points for survivors in need of services (pharmacies as well as facility-based) and what information needs to be provided to them.

Emergency contraception is included in the comprehensive, concrete approaches that stakeholders can take to ensure access to essential treatments throughout.

“Access to emergency contraception is a core element of the response to violence against women. Work with pharmacies to determine which formulations are available on the market and can be procured. Accordingly, determine what information about dosage and timing needs to be provided to women. Ensure that your staff have the correct information and are able to provide this information to women who need emergency contraception. You may consider developing a written policy to support best practices regarding provision of emergency contraception”

  • Policymakers can ensure that commodities for post-rape care, such as EC, are included on national essential medicines lists (see ICEC/RHSC/UNCoLSC EML Search tool).
  • Health services managers can ensure EC is on all lists and forms throughout the health system to prevent stock-outs or expirations, issues which EC pills have faced (EC is included in the related job aid). The guidance also notes the emergency reproductive health kits that are procured for humanitarian settings (Kit 3), which include ECPs.
  • Overall, stakeholders should “align the health system response with legal frameworks, including identifying and redressing procedures or policies that are barriers to access –such as requiring police reports before providing EC.”

As additional resources from ICEC, please see this fact sheet on EC for survivors of sexual assault and this blog post on barriers to access.