Key lessons

pregnancy. The effectiveness of the programme was evaluated in two urban health centres. After three months, women who received an average of two to three counselling sessions scored significantly higher on knowledge, use of safety measures and self-efficacy than women in the control group.383 The study concluded that it was feasible for Sanas y Salvas to be safely implemented on a broader scale within the public health system.

In PNG, FSCs provide important medical services to survivors of GBV. Created in 2003 at the time FSVAC was established, FSCs were originally designed as onestop centres in public hospitals, offering police, legal and counselling services to survivors of violence. In reality, most FSCs only offer medical and counselling services. There are currently 15 FSCs in 13 of the 22 provinces in PNG, established under the National Department of Health or the Provincial Health Authorities.384 Some FSC staff receive salaries from the Department of Health or through NGOs working directly with specific FSCs, but there is a heavy reliance on volunteerism, with CSOs and women’s organizations staffing many of them.385 Both the Port Moresby and Lae FSCs are considered models for high quality, survivor-centred care with specialized services for survivors of sexual assault and child sexual abuse, and private counselling rooms. However, FSCs outside of these two urban centres are more modest. A 2016 evaluation found underutilization and variation in the quality of services among the FSCs.386 Most referrals to FSCs come from the emergency department and outside the health system, such as from police and safe houses. Overall, coordination with hospitals and primary prevention was inconsistent.

• Strong community networks are of paramount importance in ensuring access to justice for GBV survivors.

Community networks, consisting of CSOs, human rights defenders, faith-based organizations and women’s organizations, are important stakeholders in supporting survivors in seeking justice. They exist in all six of the case study countries and have organizing capacity in the most hard-to-reach areas. Not only do they provide support services, but they are also engaged at the community level in creating awareness about GBV.

• Multisectoral coordination and strong referral pathways, particularly between police and other service providers, enhance access to justice.

Police officers need basic resources to respond to GBV, and strong networks between the police and local communities, including human rights defenders and customary and informal justice actors, create a handshake between grassroots networks and the legal justice system in bringing

GBV cases to legal justice, should the survivor wish to pursue formal justice.

This referral pathway should be as up to date as possible.

• Case management in complex contexts should be strengthened and scaled up through mentoring, learning exchanges and rotational learning experiences. Donors and

Government should invest heavily in case management as it has been shown to increase survivor’s access to formal justice. • Service providers require continual training and capacity building activities on their roles and responsibilities, especially duty bearers. In addition to the laws and service provision, trainings must seek to change attitudes and harmful gender and social norms around GBV that service providers may have.