Percent of health units with at least one service provider trained to care for and refer SGBV survivors
The percent of health facilities in the geographic region of study (e.g., country, region, community) with at least one provider who has been trained within the past three years in the identification, care and support of sexual and gender-based violence (SGBV) survivors.
This indicator is calculated as:
(Number of health facilities reporting that they have both documented and adopted a protocol for the clinical management of SGBV survivors/Total number of health facilities surveyed) x 100
Verification by a health facility manager of staff who have participated in a training on the service provision for SGBV survivors within the past three years. Facilities with at least one staff member who has undergone such training are counted in the numerator.
Evaluators may want to disaggregate by sex.
A survey of health units, with a query about staff participation in training on the provision of SGBV services. The survey would ideally be part of a specific study on SGBV service delivery, such as the IPPF assessment. The survey could also be part of a more general study of health units and service provision. Either way, a probability sample of health units should be selected in order to assess the situation in the geographic area of interest.
This is an indicator of readiness for health units to provide SGBV services. Health professionals need institutional support, supervision, incentives, and training to address SGBV adequately. If staff have undergone no specific training, the provision of such services could be done in an inappropriate or detrimental manner. For various reasons, however, training providers has posed particular challenges. For example, many health professionals have not been trained to recognize violence against women as a public health issue, and they often share prejudices and misconceptions about SGBV common in the wider society (USAID, 2006). Nonetheless, to increase support and care for SGBV survivors, training staff is an important step in improving access to and quality of services.
It may be difficult to get accurate information on the participation of staff in training programs without interviewing each one. Even if the staff replies affirmatively, without knowing anything about the curriculum of the program, how intensive or long it was, this indicator may not tell us very much. It might be better to query staff about their own readiness to deliver services based on their training experience, which could be done using the module for the provider interview included in the IPPF Knowledge, Attitude and Practices Survey. In addition, the number of total providers in a facility should be considered, when interpreting this indicator. For example, one provider trained in a small facility with only five total providers would be a good ratio. If the facility was large and had only one provider trained out of 20, this would be only slightly better than no providers trained since a woman would have little chance of being seen by that provider. In addition, there would be no way to know if affected individuals were actually referred to that provider.
Furthermore, this indicator reflects training, but not the quality of the training, or how well the staff member integrated what they learned into practice. It also does not indicate if it was a one-off training (which is generally insufficient for changing providers’ attitudes or practices) or if the training was ongoing.
access, training, female genital cutting (FGC), violence
People’s reactions to SGBV can be greatly influenced by personal and societal gender stereotypes. These may include the belief that a woman who dresses provocatively is to blame for being sexually assaulted; it’s not rape if the couple is dating or is married; and women cannot be perpetrators of SGBV. Training providers specifically in SGBV is essential for ensuring that clients’ needs are handled with sensitivity, compassion, and impartiality.
Bloom S. “Violence Against Women and Girls: A Compendium of Monitoring and Evaluation Indicators.” USAID, IGWG, and MEASURE Evaluation, 2008.
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.endvawnow.org/uploads/browser/files/Improving%20Health%20Sector%20Response%20to%20GBV:%20Resource%20Manual%20Dev%20Countries_English.pdf
IGWG, “Addressing Gender-based Violence Through USAID’s Health Programs: A Guide for Health Sector Program Officers”, Washington DC, July 2006.