Health sector response

critical importance. The report highlights, inter alia, the importance of promoting community buy-in, providing support and security for staff and residents, exit and placement planning for residents from the outset, undertaking shelter mapping, and coordination and exchange between government and civil society programmes.380

Though shelters are not widely available across South Sudan, there is a shelter in Wau and select others across states. In the absence of formal shelters, women, parents and community members house survivors. A key informant noted that safe spaces are being created organically by women, recalling how when South Sudanese women gather to sew bedsheets or complete other duties in women-only spaces, they share stories and sing songs together, thus creating their own, organic way of processing trauma. Women in women-only spaces play an essential role in GBV awarenessraising, access to services, and creating networks for psychosocial support. The importance of supporting these spaces to amplify women’s voices was underscored by a key informant working in a CSO in South Sudan:

“A lot of our stories are being told by international organizations, not by South Sudanese women themselves. There is value in creating spaces where women can share their stories themselves, can write about their experiences and the work that they do themselves without someone speaking on their behalf or for them.”

Survivors of violence may need health services, particularly in the immediate aftermath of experiencing violence. Comprehensive medical services will often offer first-line support, medical history and examination, clinical care of injuries, mental health assessment and management or referral, evidence collection and risk assessment and management.

In Honduras, the Ministry of Health was the first Honduran institution to address GBV through national policies and services. In the 1990s, the ministry, with support from the Pan American Health Organization, created family counselling centres in several of the country’s primary care centres to provide legal and psychological support to women who suffer from IPV, sexual violence and domestic violence.381 Furthermore, universal screening is mandated for women in all health consultations, including during prenatal care. Nevertheless, these standards are not fully implemented, and few women actually receive domestic violence services within the health system. Although several family counselling centres do exist, they primarily receive survivors and perpetrators who are mandated by the courts to receive counselling, rather than from within the health services.382

The Honduran Ministry of Health recently piloted an innovative programme, called Safe and Sound (Sanas y Salvas), to improve the health sector’s response to IPV among pregnant women. The programme, based on similar programmes carried out in South Africa, Australia and the US, created a new procedure for screening and counselling for women who experienced IPV during