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Take action: 10 ways you can help end violence against women

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Ending violence against women is everyone’s business. Here are ten ways you can make a difference, safely and effectively. The article includes links to useful resources and helplines should you be worried about a woman or girl's safety. 

1. Listen to and believe survivors

When a woman shares her story of violence, she takes the first step to breaking the cycle of abuse.

It is on all of us to give her the safe space she needs to speak up and be heard.

It is important to remember that when discussing cases of sexual violence, a victim’s sobriety, clothes, and sexuality are irrelevant.

The perpetrator is the sole reason for assault and must bear the responsibility alone. Call out victim-blaming and counter the idea that it is on women to avoid situations that might be seen as “dangerous” by traditional standards.

Survivors of violence are speaking out more than ever before, and everyone has a role to play to ensure they can have justice.

Do not say, “Why didn’t she leave?”

Do say: “We hear you. We believe you. We stand with you.”

2. Teach the next generation and learn from them

The examples we set for the younger generation shape the way they think about gender, respect, and human rights. Start conversations about gender roles early on, and challenge the traditional features and characteristics assigned to men and women. Point out the stereotypes that children constantly encounter, whether in the media, on the street, or at school, and let them know that it is OK to be different. Encourage a culture of acceptance.

Talk about consent, bodily autonomy, and accountability in an age-appropriate way to boys and girls. For example, discuss the importance of a clear “yes” from all involved, the fact your body is yours and you make choices over what happens to it, and of how we must always take responsibility for our actions. It is important to also listen to what children have to say about their experience of the world. By empowering young advocates with information and educating them about women’s rights, we can build a better future for all.

3. Call for responses and services fit for purpose

Services for survivors are essential services.

This means that shelters, helplines, counselling, and all support for survivors of gender-based violence need to be available for those in need.

Every year, the 16 Days of Activism campaign calls for united, global action to end all forms of violence against women and girls.

This year the United Nations, together with our partners, are demanding increased investments to end violence against women and girls.

Join us in calling on governments to bridge funding gaps to address violence against women and girls , invest in prevention initiatives, ensure essential services for survivors of violence are maintained, implement prevention measures, and invest in collecting the data necessary to adapt and improve life-saving services for women and girls.

4. Understand consent

Freely given clear consent is mandatory, every time.

Rather than listening for a “no”, make sure there is a clear “yes”, from all involved. Adopt clear consent in your life and talk about it.

Phrases like “she was asking for it” or “boys will be boys” attempt to blur the lines around sexual consent, placing blame on victims, and excusing perpetrators from the crimes they have committed.

While those that use these lines may have fuzzy understandings of consent, the definition is crystal clear. When it comes to consent, there are no blurred lines.

Learn more about consent .

5. Learn the signs of abuse and how you can help

There are many forms of abuse and all of them can have serious physical and emotional effects. If you’re concerned about a friend who may be experiencing violence or feels unsafe around someone, review these signs and learn about the ways to help them find safety and support.

If you think someone is abusing you, help is available . You are not alone. If you’d like to talk with a trained advocate at a helpline, we compiled this list of resources around the world .

6. Start a conversation

Violence against women and girls is a human rights violation that’s been perpetuated for decades. 

It is pervasive, but it is not inevitable, unless we stay silent. 

Show your solidarity with survivors and where you stand in the fight for women’s rights by oranging your social media profile for the 16 Days of Activism – you can download banners for Facebook and Twitter here . 

On Instagram, you can use UN Women’s face filter to spread the word and encourage your community to do the same. 

Use #orangetheworld, #16Days, and #GenerationEquality to start your own conversation about gender-based violence, or share some of the content from our social media package .

7. Stand against rape culture

Rape culture is the social environment that allows sexual violence to be normalized and justified, fueled by the persistent gender inequalities and attitudes about gender and sexuality. Naming it is the first step to dismantling rape culture.

Every day we have the opportunity to examine our behaviours and beliefs for biases that permit rape culture to continue. Think about how you define masculinity and femininity, and how your own biases and stereotypes influence you.

From the attitudes we have about gender identities to the policies we support in our communities, we can all take action to stand against rape culture.

Learn more ways to stand against rape culture .

8. Fund women’s organizations

Donate to local organizations that empower women, amplify their voices, support survivors, and promote acceptance of all gender identities and sexualities. 

UN Women works with women’s organizations everywhere to end violence against women, assist survivors, and secure equal rights for women and girls everywhere. Donate now . 

Find out more about how women ’ s organizations prevent violence against women and girls.

9. Hold each other accountable

Violence can take many forms, including sexual harassment in the workplace and in public spaces.

Take a stand by calling it out when you see it: catcalling, inappropriate sexual comments, and sexist jokes are never okay.

Create a safer environment for everyone by challenging your peers to reflect on their own behaviour and speaking up when someone crosses the line, or by enlisting the help of others if you don’t feel safe.

As always, listen to survivors and make sure they have the support they need.

10. Know the data and demand more of it

To effectively combat gender-based violence, we need to understand the issue.  

Relevant data collection is key to implementing successful prevention measures and providing survivors with the right support. 

Gaps in gender sensitive data collection have become more glaring than ever. Call on your government to invest in the collection of data on gender-based violence.

Find out at how UN Women works to bring about a radical shift in how gender statistics are used, created and promoted .

Originally published on Medium.com/@UN_Women .

• Anti-violence interventions
• Domestic violence/interpersonal violence
• Ending violence against women and girls

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Violence Against Women Research Database

Issues and problems in the enforcement of the anti-violence against women and their children act of 2004.

Since   1995,   violence   against   women   (VAW)   has   captured   the attention  of the  government  and  legislators  in  the  Philippines  as  a  result  of the  demand  of  a  growing  women’s  human  rights  movement  and  the  State Obligation  of  the  Philippine  Government  under  the  Convention  on  the Elimination  of  All  Forms  of  Discrimination  Against  Women,  its  Optional Protocol as well as other international conventions. The Beijing Conference on Women in 1995 heightened the demand of women’s rights advocates for laws protecting women from violence all over the world.

Progressive reforms in laws protecting women  were brought about by several factors beginning with the democratization process that started in the 1986 People Power  Revolution after the fall of the Marcos dictatorship, the  1987  Constitution  that  has  specific  provisions  on  the  rights  of  women and fundamental equality before the law of men and women, the increasing number  of  women’s  organizations  in  the  provinces  with  links  to  Metro Manila based women’s human rights organizations, and the participation of women  legislations  who  are  becoming  increasingly  aware  of  the  need  for gender  equality  and  the  elimination  of  VAW.  This  period  marks  the contribution  of  women  legislators  who  were  elected  in  the  1992  elections and thereafter.

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• Volume 11, Issue 4
• Emerging responses implemented to prevent and respond to violence against women and children in WHO European member states during the COVID-19 pandemic: a scoping review of online media reports
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• http://orcid.org/0000-0001-8857-5703 Isabelle Pearson 1 ,
• Nadia Butler 2 ,
• Zhamin Yelgezekova 3 ,
• Åsa Nihlén 3 ,
• Isabel Yordi Aguirre 3 ,
• Zara Quigg 2 ,
• http://orcid.org/0000-0002-0907-8483 Heidi Stöckl 1
• 1 Global Health and Development , London School of Hygiene & Tropical Medicine , London , UK
• 2 Public Health Institute , Liverpool John Moores University , Liverpool , UK
• 3 World Health Organization Regional Office for Europe , Copenhagen , Denmark
• Correspondence to Isabelle Pearson; isabelle.pearson{at}lshtm.ac.uk

Objectives This study aims to explore the strategies that governments and civil society organisations implemented to prevent and respond to the anticipated rise in violence against women and/or children (VAWC) during the 2019 novel coronavirus (COVID-19) pandemic.

Design A scoping review and content analysis of online media reports.

Setting WHO European region.

Methods A scoping review of media reports and publications and a search of other grey literature (published from 1 January to 17 September 2020). Primary and secondary outcome measures included measures implemented by governments, public services and non-governmental and civil organisations to prevent or respond to VAWC during the early months of the COVID-19 pandemic.

Results Our study found that in 52 of the 53 member states there was at least one measure undertaken to prevent or respond to VAWC during the pandemic. Government-led or government-sponsored measures were the most common, reported in 50 member states. Non-governmental and other civil society-led prevention and response measures were reported in 40 member states. The most common measure was the use of media and social media to raise awareness of VAWC and to provide VAWC services through online platforms, followed by measures taken to expand and/or maintain helpline services for those exposed to violence.

Conclusion The potential increase in VAWC during COVID-19-imposed restrictions and lockdowns resulted in adaptations and/or increases in prevention and response strategies in nearly all member states. The strength of existing public health systems influenced the requirement and choice of strategies and highlights the need for sustaining and improving violence prevention and response services. Innovative strategies employed in several member states may offer opportunities for countries to strengthen prevention and responses in the near future and during similar emergencies.

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• child protection

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/ .

https://doi.org/10.1136/bmjopen-2020-045872

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Strengths and limitations of this study

This is the first study to use a systematic methodology to conduct a media search on measures taken to prevent and respond to violence against women and children during COVID-19.

This study was able to extensively search media in the Russian language and therefore provide broad coverage of many countries in Central Asia and Eastern Europe.

Use of only English and Russian search terms means that media reports from countries where these languages are widely spoken will be over-represented in the results.

Focusing largely on media reports means that innovative and unprecedented measures will be more frequently reported, thus countries which had strong baseline measures in place already may be under-represented.

Introduction

Violence against women and children (VAWC) is an important public health, gender equality and human rights issue. 1 Based on estimates by the WHO, around 25% of ever partnered women in Europe have experienced sexual and/or physical violence by a partner 2 and 12% of children aged 2–17 years were reported to have experienced violence in the past 12 months (around 15.2 million children). 3 4 During a pandemic, VAWC is likely to increase due to stress related to economic insecurity, quarantine and social isolation, disruptions in health and social services and increased house and care work while working from home. 5 6 The outbreak of the 2019 novel coronavirus (COVID-19) has been no exception. As more and more countries went into lockdown or imposed other physical distancing restrictions, there were increasing anecdotal reports from countries of a rise in VAWC. 6 7

Alongside other UN agencies, WHO has issued clinical and policy guidelines on responding to violence against women (VAW) and violence against children (VAC), including during COVID-19. 8 For governments and policy-makers, they recommend that violence prevention and response is considered in all response plans and mitigation methods, information dissemination to the public regarding available services and increased risk factors, as well as to alert essential service providers within the community to make them aware of signs that indicate violence. They recommend governments enforce rules and regulations around key risk factors for violence such as alcohol, drugs and weapons and to work across sectors and with civil society to coordinate support, including referral services. To support survivors, WHO recommends governments make provisions to allow those seeking help to safely leave the home, ensure and expand helpline functions and identify ways of making services accessible remotely. The WHO guidance also includes advice to health system managers and health providers on how to focus on VAWC in the organisation and delivery of health services, in data collection and through preventive health measures. Recommendations include providing information about services available locally that continue to offer first line support and medical treatment for survivors of violence through the first points of contact in health facilities, in line with WHO recommendations. 8

With these WHO recommendations on preventing and responding to VAWC during COVID-19 as a basis, the aim of this study was to investigate what measures were taken by governments, Non-governmental organisations (NGOs) and other civil society organisations across WHO European member states in the context of the COVID-19 pandemic, during the first 9 months of 2020.

This study is based on a scoping review of media reports, journal articles and official organisational reports, including information from webinars and other expert meetings. Searches were conducted in English and Russian. For any article, study or report to be included, they had to include data on at least one measure implemented in the context of the COVID-19 pandemic, either in response to or to prevent VAW and/or VAC. Reports also had to have been published between 1 January 2020 and 17 September 2020 and provide data for any member state of the WHO European Region, including the self-governing territories of Kosovo and Greenland, or data that encompassed multiple countries including at least one of the aforementioned countries. The search excluded reports that did not provide at least one measure or only recommended measures without stating that they had been implemented.

Media review

A review of media reports published between 1 January 2020 and 17 September 2020 was conducted. A search of online news reports in English was conducted using the International Newsstream of ProQuest, limited to the Asian, European and Middle Eastern news streams. The search strategy included terms related to COVID-19 and VAWC and was restricted to the WHO European member states, with no language restrictions. A full search strategy can be found in the online supplemental methods 1 . Reports were all exported into Excel and screened at the full-text stage.

Supplemental material

For the Russian language media reports, searches were conducted using East View Information Service. To increase coverage, an additional search was conducted in Yandex.ru. A full search strategy for the Russian-language reports can be found in online supplemental methods 2 . A hand search was conducted for Radio Liberty’s Central Asian branches, as well as Sputnik News. Results of the hand searches were exported manually, the reviewer screened the abstract/title and exported those deemed relevant into the Excel sheet. Those included at the title and abstract stage were then screened in further detail for inclusion at the full-text stage.

Publication review

A search was conducted to review any publications that were published between 1 January 2020 and 17 September 2020 concerning the COVID-19 pandemic and VAWC. For the non-Russian language articles, this search was conducted in OVID, restricted to Ovid MEDLINE(R) and In-Process & Other Non-Indexed Citations and Daily and using the search strategy outlined in online supplemental methods 3 , with no language restrictions. Publications from OVID were imported into the Excel sheet to be reviewed at the title/abstract stage and if relevant, screened at the full-text stage. A separate search was conducted in Russian using Google Scholar with a translation of the search strategy. Google Scholar was linked to eLibrary.ru and CyberLeninka. Full texts that met the inclusion criteria were extracted into the Excel workbook. High-level organisational websites were searched in both English and Russian and any reports that met the inclusion criteria were also included for the full-text review, along with any relevant information collected from organisational webinars that occurred during this time and were attended/accessible to the research team.

Quality assurance

Three reviewers contributed to the screening of the media reports and publications and data extraction. A trial screen and data extraction were conducted where each reviewer screened and extracted data in parallel for a subset of search results. The results of the trial screen were compared between reviewers and, once consistency was confirmed, each reviewer separately screened and extracted data from an allocated percentage of the database search results. Overall, 10% of the data extracted by each reviewer, excluding the Russian language search, were checked by a second reviewer to ensure consistency.

Data extraction and management

All included results were stored and analysed within an Excel workbook. For each measure, the description of the strategy was extracted and subsequently each strategy was labelled ‘government led and/or sponsored’ or ‘NGO and civil society’. Where a measure was led by a government and at least one NGO or civil organisation, the measure was labelled as ‘multiple’ (please note: measures led by local NGO and civil organisations along with external country governments were labelled as ‘NGO and civil society’, United Nations (UN) agencies were considered as ‘NGO and civil society’ and European Union (EU) funded measures were considered 'government led and/or sponsored’). Where the measure’s leading body was unclear from the extracted text, a Google search was conducted for clarification, and if it remained unclear then it was labelled ‘unclear’. Each unique measure contained in the text extract was also assigned a topic code. Topic codes were created through thematic analysis at the data extraction stage as the researchers’ understanding of the types of strategies used were developed. These topic codes were used to group the data with similar responses. Where responses fell under multiple topic codes, the reference was duplicated so that it could fall under each code. The country, region, date of publication and the source of the data (where available) were also extracted.

Patient public involvement

No patient or public member was involved in the study.

The ProQuest search for media reports yielded 1610 reports (after removing duplicates) to be included in the full-text search. The Russian-language media search yielded 95 results that were considered for full-text screening. Of the 1705 screened reports, 187 media reports were included in the analysis (exclusion reasons are displayed in online supplemental table 1 ). The publication search using the OVID database yielded a total of 157 publications, out of which 6 were included in the analysis. The Russian language database search resulted in seven publications, of which one was included. The hand searching of both Russian and non-Russian language grey literature reports of international organisations and NGOs and other civil society groups resulted in 158 additional unique reports to be included in the study. The majority of measures reported in this study are from media reports and we rely only on the information those media reports provided. The research team did not conduct further checks on the information provided. The publications found did not include any primary data collection regarding measures to prevent and respond to VAWC during COVID-19. They did, however, cite additional measures announced through media platforms, most often online newspaper articles. Due to this, the publications were used to supplement the results of our media search with the additional media reports cited through the publications and did not offer any examples of primary data analyses.

Responses implemented to protect women and children from violence during the COVID-19 pandemic

Our study found reports to illustrate that in 52 out of 53 WHO European member states, at least one measure to prevent or respond to VAWC had been implemented in the context of the pandemic. The most common types of measures were government-led or government-sponsored measures, of which at least one example was reported for 50 of the 53 member states and in territories Kosovo and Greenland. NGO and civil society-led responses were reported at least once in 40 of the 53 member states and in the territory of Kosovo. table 1 displays the full breakdown of the types of measures across countries, with further details reported in online supplemental table 2 .

• View inline

Reported measures in WHO European member states, including territories Kosovo and Greenland (categorised by type, number of countries and percentage of countries)

Most media reports used the term domestic violence, often without clarity as to whether the term was used to encompass both children and adults. Unless stated otherwise, in this report, the term domestic violence is interpreted to cover both women and children. Out of the 53 member states and two additional territories included in the study, all but one country reported measures to prevent or respond to ‘domestic violence’, 33 (60%) implemented measures to prevent or respond to VAW explicitly and 32 (58%) to VAC explicitly.

Government-led or sponsored measures

The most frequently reported national or regional government measures were media and other information dissemination campaigns, reported in 39 member states through various media channels. The Irish Department of Justice, for example, collaborated with frontline services to develop television, radio and social media advertisements highlighting their continued support for those subjected to abuse. 9 In Slovenia, the city of Ljubljana distributed leaflets with VAWC NGO contact numbers, along with the digital broadcasting of violence hotline numbers on public screens. 10

Regarding high-level intersectoral approaches, governments at the national and regional level created government task forces to help prevent and respond to VAWC during COVID-19. In Belgium, the Brussels and Walloon governments created a task force in order to monitor shelters, assist actors in the field, rapidly identify emerging needs and spread information and awareness. 11 The government of Luxembourg created a crisis management system to mitigate the risk of increased VAWC. 12

A number of countries dedicated specific funding for measures to prevent and respond to VAWC, including the UK, France, Israel, Ireland, Italy, Sweden and Kosovo. 11 13–18 The government of Iceland also included investment in efforts to combat domestic violence in their national financial aid package announcement. 19

Various government guidance packages and policies were announced, either specifically for VAWC or with measures to respond to VAWC included, across member states (see online supplemental table 1 for details). This included the creation of a committee in Israel to examine the national incidence of women killed during lockdown,and an interagency communication strategy on VAWC during the COVID-19 crisis in Georgia. 11 20

In terms of service coordination, multiple examples were found of government-led measures for VAWC, primarily supporting the maintenance and expansion of VAWC helplines and shelters. Methods varied from the introduction of new helplines numbers, such as text messaging numbers introduced in France and Israel, to the introduction of WhatsApp services in Spain. 11 14 21 The maintenance of shelters was also reported as a key priority for governments during this time, with measures taken to ensure they remained open or were expanded, for example, by providing them with hotels or additional accommodation. 22–28 A few governments also provided personal protective equipment (PPE) and COVID-19 testing for staff and survivors and declared shelter staff as essential workers to exempt them from lockdown measures. 11 29–32

In terms of moving VAWC resources such as psychosocial support and counselling online, 15 governments (14 member states plus Kosovo) announced technology-based solutions, including a new government-led email address accessible to survivors and professionals in Portugal and the French online resource, stopblues.fr, that provides support and aids reporting of violence. 11 33

Pharmacies and supermarkets were also used to spread information; some governments sought to physically disseminate information such as numbers for VAWC helplines and relevant service providers, while other governments implemented pop-up counselling centres in some supermarkets. 11 24 34 Pharmacies, specifically, were also encouraged by governments to participate in the European scheme using the ‘Mask-19’ code word, whereby pharmacy visitors could mention ‘Mask-19’ if they required help for domestic violence. 11 35–38

Several member states reported working with the police to address the expected rise in VAWC during COVID-19. In Ireland, the police service proactively contacted every previous survivor of domestic abuse known to them. 39 The government of Andorra created a video tutorial updating police officers on the VAWC guidelines protocol 11 and the Norwegian police implemented a comprehensive set of measures to react to changes in the levels of violence and ensure that police would focus on VAWC cases. 11 To ensure survivors could access required services, apps were identified for them to use to contact the police; in Czechia, the government disseminated the ‘Bright Sky’ app to allow survivors to contact support organisations and the police and also to access advice and store evidence. 11

Other measures focused on improving legal processes and provisions include the fast tracking, prioritising and extension of legal processes surrounding cases of VAWC. In particular, in Croatia, allowances were made for court deadlines missed by survivors due to COVID-19; while in Serbia, the High Court Council declared that despite the courts closing, domestic violence cases would continue to be processed. 11 40 In the Russian Federation, newspapers reported the introduction of mandatory reporting, obliging the police to investigate cases of VAWC even without an official request from the survivor. 41 In several other countries, governments introduced rules to ensure that in situations of abuse the perpetrator is evicted instead of the survivor. 11 42–44 In Kyrgyzstan, a bill was passed increasing detention of perpetrators of domestic violence from 3 to 48 hours. 45 Policies around releasing prisoners early or granting pardons under the pandemic situation excluded prisoners convicted on VAWC charges from release in several member states. 46–51

Some government measures were targeted at improving the response to those experiencing violence. In many countries facing stricter lockdown rules, such as Italy, Spain and Kosovo, governments announced that the stay home orders and strict curfews did not apply to survivors who were seeking support. 42 43 52 Furthermore, in Malta and Ireland, women and children known to be trapped in abusive homes were reportedly provided rent supplements. 53 54 Governments in Czechia, France and the UK also promoted the use of couriers and postmen to check in with survivors of abuse. 11 18 27

In some cases, governments and NGOs jointly led measures to prevent and respond to VAWC. A technical group was formed in Montenegro within the European Union and UN Women-led regional programme to prepare guidance for institutions on how to deal with VAWC during COVID-19. 11 In Albania, the Women Forum Elbasan collaborated with state police to allow beneficiaries to be accompanied by police patrol, ensuring that they could access VAWC services despite the lack of transport available during the pandemic. 55 Furthermore, in Uzbekistan, a joint project with the United Nations Development Programme and the Ministry for Supporting Mahallas and Families prepared flyers that were distributed to pharmacies in Tashkent City and Tashkent region of Uzbekistan in order to reach vulnerable groups of the population and provide them with referral numbers in case of violence. 56 Measures that were not attributable to an organising body but picked up in the search included the printing of VAWC helpline numbers on milk bottles in Germany. 57 In Sweden, a popular landlord company distributed flyers with VAWC-related information to all its tenants. 57

NGO-led and/or civil society-led measures

Media campaigns and information dissemination were also one of the most frequently reported measures used by NGOs and civil organisations to prevent and respond to VAWC during COVID-19, reported across 24 member states plus Kosovo. Their strategies varied but were most often based around radio, television and social media. For example, the Union of Women Associations of Heraklion in Greece ensured a constant presence on TV shows, news channels and radio commercials to spread awareness of VAW during COVID-19. 38 An online awareness campaign, Stopfisha, was launched via social media in France as a response to the suspected rise in revenge porn as a result of lockdown. This campaign helped to find survivors of abuse and assist them in reporting it. 58 59 As well as raising awareness and providing service contact details, social media was also used by NGOs and civil organisations to help those facing VAWC to seek help. For example, in Poland, a fictitious online cosmetic store was set up through Facebook where survivors of domestic violence could request help by pretending to order goods. 60

Similar to the use of social media, NGOs and civil organisations in 24 member states plus Kosovo used online methods, and five member states developed apps, in order to facilitate access to VAWC support services and/or to provide them with psychological and legal support through online platforms such as Zoom and Skype. NGOs across member states provided services via Telegram, WhatsApp and Viber. 18 61–66 The NGO SPAVO in Cyprus purchased 35 smart watches for women facing domestic violence that had built-in safety alarms. 67

The maintenance and expansion of helplines and helpline services were key measures taken by NGOs and civil society groups across 19 member states, plus Kosovo. NGO-led shelters in Ireland expanded capacity by collaborating with Airbnb, in France a sports stadium was used and in Italy collaborations emerged with Booking.com and also a former convent. 23 68 69 In the Republic of Moldova, to overcome government-imposed quarantine measures that meant shelters were unable to accept new residents, the NGO Promo-LEX rented an apartment. 13 To ensure that helplines remained functional and could meet demand, measures included increasing the number of helpline volunteers, creating chat/SMS messaging options and expanding helpline hours. 11 55 70–75 New helplines were also set up by NGO and civil organisations in several members states. 11 74 76–80 In France, the new helpline, ‘Don’t Hit’, was launched in April to provide counselling and specialist psychological assistance to perpetrators of violence. 11 Furthermore, systems were reportedly set up to allow helpline staff to work from home and PPE and/or COVID-19 testing were made available to VAWC centre staff in several countries. 11 55 The NGO ‘CAM Firenze’ in Italy organised fortnightly peer-support meetings to help staff with their emotional management and well-being during the pandemic. 72 In addition, one Belgian NGO set up open air face-to-face appointments, where survivors could receive support while on a socially distant walk with centre staff. 38

Similar to the previous measures taken by governments to use pharmacies and supermarkets as help points for survivors, NGOs in North Macedonia, Italy and Greece also used them for the physical distribution of leaflets and posters with relevant VAWC service provision details. 38 55 81

Other NGO and civil organisation measures conducted in only a few countries include proactive contacting and monitoring of both perpetrators (Luxembourg and Slovenia) and known survivors (Serbia, Republic of Moldova, Italy and Belgium). 11 38 55 72 Furthermore, food and/or hygiene packages were distributed to vulnerable populations, including those affected by violence, in Malta, Naples (Italy), North Macedonia and Albania and financial and/or in-kind support was provided to vulnerable groups in Bosnia and Herzegovina, Spain and Montenegro. 11 55 82–85 Other forms of support include the provision of free rail travel by a rail company in the UK (in partnership with the NGO Women’s Aid) and in Serbia, where public transport was abolished during the pandemic, multiple NGOs provided private transport for survivors to access their facilities. 55 Furthermore, UK-based dentists were called on to update their guidelines for telephone assessments under lockdown to help them continue to assess the risk of VAWC in patients with facial injuries. 86

Measures to prevent and respond to VAWC were also implemented by international organisations. In Kosovo, body cameras were provided by UN Women to the police’s domestic violence department to ensure sufficient evidence was collected during call outs. 87 In Serbia, the United Nations Development Programme supported public prosecutors from eight prosecution districts to organise online multiagency meetings to process cases of VAWC. 40 The All-Ukrainian Charity Foundation, UNICEF and the United Nations Foundation supported sociopsychological assistance mobile crews in the Ukraine. 88

Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

• Data supplement 1
• Data supplement 2

Twitter @Isabellepson, @zeequigg

Contributors All authors contributed to the development of the study protocol and the planning of the paper, provided feedback on all drafts of the paper and edited the final manuscript. IP, NB and ZY conducted the media, publication and grey literature searches (IP and NB in English, ZY in Russian) and content analysis. IP was the lead author of the article. All authors approved the final manuscript.

Funding This work was supported by WHO Europe grant number WHO Ref 2020/1021489.

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

Author note All references to Kosovo in this document should be understood to be in the context of the United Nations Security Council resolution 1244 (1999).

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Violence against women in the Philippines: barriers to seeking support

Isabel kristine m. valdez.

a College of Medicine, University of the Philippines, Manila, Philippines

Ma.Veronica Pia N. Arevalo

Janine patricia g. robredo.

b Ateneo School of Medicine and Public Health, Pasig City, Philippines

Sabrina Laya S. Gacad

c Center for Women's and Gender Studies, University of the Philippines, Diliman, Quezon City, Philippines

Marie Aubrey J. Villaceran

Gertrudes r. libang.

d General Assembly Binding Women for Reforms, Integrity, Equality, Leadership, and Action (GABRIELA), Quezon City, Philippines

Edelina P. Dela Paz

e Social Medicine Unit, College of Medicine, University of the Philippines, Manila, Philippines

Krissi Shaffina Twyla A. Rubin

f Center for Gender Equality & Women's Human Rights, Commission on Human Rights, Quezon City, Philippines

Michelle Ann B. Eala

g College of Medicine, University of the Philippines, Manila, Philippines, 547 Pedro Gil Street, Manila, 1000, Philippines

The Philippines is among one of the most gender-equal countries in the Western Pacific region.​​ 1 Nevertheless, it is evident that the sociocultural landscape lags behind: one in four Filipino women has experienced gender-based violence, and 41% of victims do not seek help. 2 Despite existing laws and a widespread local anti-violence against women (VAW) movement, multiple barriers to help-seeking exist, and it is ultimately the economic, sociopolitical and cultural structures in the Philippines hindering VAW victims from seeking support.

Like in other Asian countries, Filipino women are stifled by a patriarchal society emphasizing male dominance in family structures and larger social institutions. 3 Traditionally, Filipino men are household heads and breadwinners; women are deemed subservient, hence economic abuse is common in VAW cases, 4 and a high acceptance of justified wife beating exists. 2 Women's pleasures are considered objects to pursue or control, hence they are regarded as a vulnerability. Few women seek help because of expectations to be self-sacrificing, thus giving up safety and security in favor of family reputation. Defying gender norms invites objectification, shame, guilt, and even justification of violence, hence the culture of victim-blaming. 3

Through public debasing of women, condoning rape jokes and sexual remarks, openly harassing female supporters, associating femininity with weakness, and encouraging the military to “shoot women ‘communist rebels’ in the vagina,” the current administration under President Duterte personifies sexism, shaping society's perception of women. This misogyny is tolerated by many citizens, including some women of power. Coined “feminists of convenience,” these individuals advocate women's rights yet remain silent about the President's behavior for personal and family gains and to avoid political backlash. 3 In their silence, the culture of impunity prevails.

It is apparent that women's rights is not the administration's priority, and this manifests systemically through complex referral pathways, fragmented documentation systems, and a slow judicial process. With stringent policies (curfews, checkpoints, and rationed quarantine passes) restricting mobility, this unsettling reality has intensified during the COVID-19 pandemic. VAW victims are trapped in their homes, unable to seek help and alternative shelter. 5 Escalation of VAW-related and help-seeking internet search activity is not coincidental. 6 Moreover, health, social, and legal services are largely inaccessible, a situation exacerbated by the diversion of national resources to the pandemic response. Reproductive health services are disrupted by 77-85%, 7 and the adolescent birth rate is 31 per 1000 women. While 10.1% of all live births occur in the 15-19 age group, only 3.2% of these are sired by men of the same age, 8 suggesting duress and power imbalance. 9

Also vulnerable are women facing multiple and intersecting forms of discrimination, such as transgender women, indigenous women, women with disabilities, poverty-stricken women, and internally displaced women. The additional barriers of stigma, discrimination, State neglect, and harassment from law enforcers contribute to their distrust in the system, making them less likely to report to the police. 5 , 7 Poverty and job insecurity aggravate the situation: women resort to prostitution, and online classes compound the risk of children's sexual exploitation with increased internet exposure. 5 , 11

With the pandemic further threatening women's safety, the priority is ensuring functional, responsive, and accessible VAW responses that are survivor-centered and trauma-informed. Community-based first responders should still be reachable during quarantine. Healthcare providers must be trained for selective enquiry and first-line support of survivors.Referral pathways should be simplified to expedite care and assistance: upon identification of victims, a blanket referral to sexual and reproductive health providers, psychiatric aid, legal assistance, protective shelters, and livelihood assistance can be made. Establishing an active, centralized VAW surveillance system must take into consideration mobility under community restrictions. More accessible communication channels, like social media, must be made available and maximized. Marginalized women should be included in surveillance and protected in legislation, and VAW survivors should be consulted to improve service delivery.

Organizing women, educating them of their rights, promoting rights to pleasure and safety, and encouraging help-seeking behaviors while changing policies that increase vulnerability to VAW will foster women empowerment. Ensuring full implementation of the Magna Carta of Women 10 is imperative in eliminating discrimination. This includes changing gender bias norms, non-discriminatory employment, leave benefits, equal opportunity for education and training, increased information access, and more women in leadership roles to advocate policy reform. Women prefer getting help from their community, 11 hence community-based reporting and response systems should be strengthened in conjunction with bystander education to change sociocultural norms that condone VAW. Ultimately, institutional cultures perpetuating VAW must be tackled with interdisciplinary and intersectoral social and public health interventions, and the community must work hand-in-hand with an accountable government to end VAW in the Philippines.

Contributors

IKMV and MVPNA were in charge of literature search, data analysis, interpretation, and writing. IKMV, MVPNA, JPGR, MABE, SLSG, MAJV, GRL, EDP, and KSTAR all worked to revise and review the manuscript.

Declaration of interests

We declare no conflicts of interest.

Annual Observance of the 18-Day Campaign to End Violence Against Women (VAW)

Campaign Theme (2016-2021): VAW-Free Community Starts with Me

Campaign Theme (2022 - 2027): UNiTed for a VAW-Free Philippines 

Violence Against Women (VAW) and girls is not just a major public health problem but also a grave violation of human rights. It extremely manifests gender inequity, targeting women and girls because of their subordinate status in the society. The United Nations define VAW as “any act of gender-based violence that results in, or likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life.” Violence and the threats of violence can be experienced by every woman of any age, skin color, gender identity, ethnicity, religion, disabilities, economic, and social status.

Global estimates by the  World Health Organization indicate that about 1 in 3 women (35%) worldwide has experienced either physical and/or sexual violence from intimate partner or non-partner in their lifetime. In the Philippines, the National Demographic Health Survey 2017  released by the Philippine Statistics Authority revealed that 1 in 4 Filipino women, aged 15-49, has experienced physical, emotional or sexual violence from their husband or partner.

Because VAW appears as one of the country’s pervasive social problems, various measures and mechanisms have been employed and implemented to address it. One of which is the 18-Day Campaign to End VAW, an advocacy campaign that is observed annually from November 25 to December 12 as mandated by Proclamation 1172 s. 2006.

This campaign aims to:

• Promote awareness on the forms of violence against women and girls;
• Provide information on laws protecting women and girls;
• Feature VAW-related services that people can access and avail; 
• Promote the strengthening of a prevention and response system on VAW; and
• Gather public support for the campaign

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ANTI-VIOLENCE AGAINST WOMEN AND CHILDREN (VAWC)(R.A.NO. 9262)

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Ending Violence against Women and Children in the Philippines: Opportunities and challenges for collaborative and integrative approaches

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Executive Summary

While the fields working to end VAC and VAW have largely developed separately, recent reviews and analyses of large datasets have identified multiple intersections between VAC and VAW including: co-occurrence, shared risk factors, similar underlying social norms, common consequences, intergenerational effects, and the period of adolescence as unique period of heightened vulnerabilities to both types of violence. These intersections suggest that collaboration between the sectors is essential to a more effective prevention and response. Integration of certain aspects VAC and VAW prevention and response across services, programmes, and policies may also be advantageous. However, there are key areas of divergence between the traditional approaches in the VAC and VAW fields that have created challenges to collaboration and may suggest some disadvantages to fully integrative approaches. To date there are no evidence-based or widely accepted integrative models.

This multi country study, commissioned by UN Women, UNICEF and UNFPA, explored existing examples of collaboration and integration of VAC and VAW policies, services, and programmes, as well as challenges and future opportunities in the East Asia and Pacific region, with a focus on four countries – Cambodia, Papua New Guinea, the Philippines, and Viet Nam.

Key research questions This research initiative sought to answer following overarching questions through dialogues and interviews with relevant stakeholders in each country:

What are the existing VAW and VAC policies, action plans, programmes (prevention) or services (response/support)?

What are some examples of policies, action plans, programmes, or services where there is some evidence of VAW and VAC integration (i.e.: addressing both VAW and VAC at the same time)? Include any efforts to try to develop cohesive strategies or plans or collaboration.

How do VAW-focused and VAC-focused stakeholders collaborate or interact? How do donors drive the VAW-VAC agenda?

What are the areas of tension between VAC and VAW work? How do various stakeholders address areas of tension between VAW and VAC?

a. Under what circumstances are boy-children accommodated in places of safety?

b. How are adolescents’ complex needs met and rights protected?

c. How are mothers viewed and “processed” in VAC cases?

• What are some opportunities within the existing policies, action plans, programmes or services where integration and/or collaboration could be introduced or enhanced?

Key findings

Violence against children (VAC) and violence against women (VAW) affect the lives and welfare of millions of people around the world. Many women and children in the Philippines suffer multiple types of violence. The multiple negative sequelae of this violence can be long-lasting throughout the lifespan and across generations as well as impacting on individuals, relationships, communities, and broader society.

Agenda and priorities

• The Philippines has good quality national prevalence data on some forms of VAW and VAC; however, administrative data are poorly coordinated thus not allowing for a holistic picture to understand gaps between national prevalence and service delivery.

• There is no mechanism to ensure national prevalence data on VAC are regularly collected. VAW data is regularly obtained from the National Demographic and Health Survey.

• While there are no data or studies to date on VAW-VAC intersections in the Philippines, stakeholders are aware of various important

intersections in vulnerabilities. Structured data collection protocols or studies would provide useful evidence for policy and programming.

• Improved access to and analysis of reliable data, as well as dissemination of findings, could assist in strategic funding or budget guidelines for the gender and development budget and the child protection budget. Government, legislation and policy • Multiple government departments have a role in both VAC and VAW and serve on the InterAgency Council on Violence Against Women and Their Children (IACVAWC): Department of Social Welfare and Development (DSWD), Department of Interior and Local Government, Philippine National Police, Department of Justice, Department of Health, Department of Education, Department of Labor and Employment, Civil Service Commission, Commission on Human Rights, Council for the Welfare of Children, National Bureau of Investigation, and National Commission on the Role of Filipino Women. This committee did not appear to drive specific integration efforts.

• The Philippine Commission on Women is the primary policy-making and coordinating body on women’s empowerment and gender equality.

• The Philippine Plan of Action to End Violence Against Children includes roles for DSWD, the Department of Education, Department of Justice, Council for the Welfare of Children and the Department of Interior and Local Government.

• The main pieces of legislation applicable to VAC and VAW are Anti Child Abuse Law (RA 7610), Anti-Rape Law (RA 8353), and Anti-Violence Against Women and their Children Act of 2004 (RA 9262).

• While there are councils and committees set up to address VAC and VAW and many service providers see both VAC and VAW survivors, there are no formal integration policies or programming guidelines.

Access to justice

• VAW desks at the barangay or village level facilitate access to justice and support services for VAW and VAC survivors primarily through referral to the Women and Child Protection Desk (WCPD) at police stations.

• Protection Orders, mediation, settlement, conciliation, or arbitration are remedies offered to survivors within the barangay level but the WCPD can refer cases for review to enter the court system.

• There are multiple barriers to accessing justice including a large burden on victims to collect evidence from multiple sources, long and drawn out justice procedures, lack of sensitive or protective judicial processes (especially for children), as well as economic and social stigma issues.

• There are no guidelines for examining intersections between VAW and VAC in any of the judicial or law enforcement protocols.

Response and support services

• There are referral guidelines for VAC and VAW survivors but these have not been integrated nor do they address intersectionality.

• While individual service providers may take an integrative approach when dealing with a VAW or VAC case, this is not protocol-driven. Most service providers called for a separation and specialization of VAC and VAW cases.

• Women and Child Protection Units (WCPU) are usually based within hospitals; however, again, there are not specific integration protocols that provide guidance on managing the various intersections between VAC and VAW but rather that adult and child survivors can access services from this Unit. The intake form for VAW cases includes a query on the children’s welfare. There is collaboration between medical doctors, social workers, and police officers under WCPU; however, they are unable to complete forensic rape examinations because they do not have the facilities or kits available.

• There are few shelters available to women and children and most of them are consistently at or over capacity. Many shelters house both domestic violence survivors and trafficking victims. The shelter provides various services including psychological, livelihood strengthening, social services, medical and dental, dietary services, and orientation to the laws that protect women in the hopes that the women will be able to live independently and seek help if they experience violence again.

Few shelters will accept repeat visits from the same survivor. The shelters are not designed for children. However, in some cases women arrive with their children and the shelters are forced to accommodate them. They generally do not accommodate boys over age 7. There are Havens for Children (separate ones for girls and for boys) but these homes are also for children in conflict with the law, trafficking victims, or orphans thus are not ideal for children having to leave violent homes with their mother. There are no recovery or support services for children within the women’s shelter.

• Adolescent girls are particularly vulnerable because neither the children’s home nor the women’s shelter has the capacity to serve such cases. Therefore, they are often sent to shelters run by non-governmental organiztions (NGOs) if such support is needed.

Humanitarian emergencies

• As in other countries, humanitarian emergencies appear to offer good opportunities for innovation and collaboration on VAC and VAW issues; however, this rapid partnership work does not usually translate into ongoing cohesive and collaborative programming.

• A recent example in the Philippines is the response to Typhoon Haiyan during which GBV Watch Groups led by women were initiated by a local NGO to patrol communities to enhance protection of women and children. These Watch Groups are continuing in the communities and there are plans to initiate them in other communities in rural areas.

• It would be useful to conduct a postemergency analysis to glean lessons learned and key success strategies to collaborative and innovative efforts that address both VAW and VAC in an integrative way.

Prevention programming

• Many stakeholders interviewed for this study considered secondary prevention approaches – for example early identification of and intervention with victims to prevent an escalation or recurrence of violence – as the main effort to prevent VAW and VAC.

• Awareness-raising was the most commonly described approach to primary prevention of VAW and VAC; however, this approach has been shown to be ineffective in preventing violence.

• Economic empowerment of women (especially survivors of violence) was a prevention strategy used by some NGOs and shelters but no evaluation data on prevention of either VAW or VAC were available for these.

• There are some prevention programmes engaging men lead by MSWD and DSWD.

• UNICEF Philippines has supported some positive parenting programmes to prevent VAC but these have not addressed VAW prevention.

• UNFPA worked with the Department of Education to operationalize school-based Comprehensive Sexuality Education, under the mandate of the national Responsible Parenthood and Reproductive Health Law. The curricula is in accordance with international standards and includes components covering gender-based violence and gender equality.

• UN Women is supporting a Safe Cities project to reduce sexual harassment in public spaces.

• Some NGOs have engaged in various prevention projects including addressing problematic gender norms within religious communities to prevent VAW, and preventing online exploitation of youth.

• While prevention programming is, theoretically, a key opportunity for integration of VAW and VAC work, most prevention programmes lack strong evaluations of outcomes and impact available, thus making it difficult to understand the effectiveness of different approaches.

Further, VAC and VAW projects tend to focus on different sets of outcomes making it difficult to gain insight into integrative, accelerative, or cross-cutting impacts on both VAC and VAW.

Integration of VAW and VAC approaches

• It appears that collaboration has worked best when VAW and VAC stakeholders come together on a specific issue (e.g., statutory rape, humanitarian crisis) rather than more broad. This means that there are no overarching efforts at dealing with areas of divergence to develop an overall integrative way forward. This focused kind of collaboration also means that some areas of convergence or synergy between VAW and VAC work may be missed.

Recommendations

• In general, the study participants suggested that integration was not an approach they felt was ideal and there were repeated calls for separated, specialized policies, services, and programmes to address VAC and VAW. However, given the lack of resources as well as the existence of several services that address both VAC and VAW, it seems that pursuing some integrative or collaborative VAC-VAW approaches are warranted.

• Services and programming for adolescents is a particular gap in the Philippines. Generally, adolescents are considered children under the law. More advocacy, research, and innovation is needed to meet adolescents’ needs with regard to VAC and VAW.

• Intake forms and referral guidelines could be reviewed to prompt integrative case management for VAW and VAC survivors.

• VAW and VAC stakeholders, including UN agencies, may engage in a mapping activity to understand the various approaches they are taking and find synergies or strategic opportunities for integration or other kinds of collaboration. This activity could lead into work to develop a theoretical framework of integrative VAC-VAW approaches that are relevant and feasible within the Philippines taking into account the varied resources and needs in different parts of the country.

• Staff at WCPUs, WCPDs, and the VAW desks would benefit from on-going training and capacity building in both VAW and VAC issues - it appears that separate, specialist units are unlikely and therefore service providers will have to continue to work with both VAC and VAW survivors.

• Improvements in both national prevalence and administrative data collection and management could provide opportunities for research on adolescent issues, and intersections between VAC and VAW. The availability of reliable and high quality data could inform ongoing policy, programming, and service work to comprehensively and effectively address VAC and VAW in the Philippines.

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