Although coordinated response efforts are taking place in many countries (and in some, over a long period of time), relatively few have been formally evaluated. This may be due to a lack of resources, the difficulty of obtaining reliable information or because it is challenging to isolate and track those indicators that can measure the changes achieved by coordination.
When increased reporting of violence against women occurs, it can be difficult to determine the cause. Ideally, increased coordination will result in greater confidence of victims/survivors in reporting violence to authorities. Such reporting could increase due to greater consistency and quality of response to victims/survivors resulting from coordination. Another cause could be that increased reporting is the result of a decline in tolerance of violence through prevention efforts generally where reporting is taking place. It is also possible that violence has actually increased. Certainly, all three of these causes could be present.
Despite limited formal evaluation, informal assessments of the results and impact of a range of forms of coordinated responses have indicated a number of benefits for victims/survivors, communities and society at large. Like many issues that require the involvement of multiple actors, coordination is also practically understood to be better than fragmentation (Worden, 2001). Much of the research on CCRs has shown positive victim services and safety outcomes and has indicated that collaboration among domestic violence responders has a positive impact on the criminal justice system. When CCRs are involved in cases, victims are more likely to receive services; have decreased PTSD (posttraumatic stress disorder) symptom severity, depression, and fear; express greater readiness to leave the abuser; and demonstrate greater engagement with prosecution (court attendance and case disposition) (Klevens, 2008).
Of the coordinated responses that have been assessed, the CCR model for intimate partner violence implemented in the United States is the most widely evaluated, with several studies identifying reductions in re-victimisation. An evaluation (Klevens & Cox, 2008) of ten CCRs in the US concluded that:
? CCRs that emphasize coordination between the justice sector and probation/police responses are more effective for perpetrators with an extensive criminal history;
? In areas where a CCR has been established for at least six years, there are significantly lower levels of re-victimisation; and
? The availability of particular services for victims/survivors (e.g., safe housing and advocates) increased victim’s/survivor’s contact with other violence against women services, such as health and legal.
Another multi-site evaluation conducted in five areas in the US with domestic violence task forces (Hirschel, 2012 and Worden, 2001) identified some key indicators of success. These included:
? The involvement of the judiciary;
? Standardized routine police practices, such as report writing and making case information available to other agencies; and
? Coordinating bodies that are dynamic and which frame debate, challenge and conflict as routes to problem solving.
A survey of 41 domestic violence coordinating councils in one US state found that they were more likely to be successful in achieving their goals both within the criminal justice system and in other community sectors when they showed evidence of:
? A shared mission;
? An inclusive climate;
? Shared power in decision-making;
? Strong leadership; and
? A representative group of active members.
An evaluation of ten intervention projects in Germany showed that multi-sectoral coordinated projects can achieve lasting change in systems’ response to intimate partner violence, leading to the establishment of specialist units in police and prosecution services and the provision of specialist protection and support for victims/survivors (Federal Ministry for Family Affairs, Senior Citizens, Women and Youth, Germany, 2004; Grieger et al., 2004).
Research into coordinated responses to sexual violence, such as Sexual Assault Response Teams (SARTs) in the US, also indicates a successful prosecution or positive impact in relation to criminal justice system outcomes compared to non-coordinated response. For example, one study (Nugent-Borakove et al., 2006) using a control sample found that in SART areas:
? cases were reported more quickly;
? more forensic evidence, including DNA, was recovered;
? victims/survivors were more likely to participate in the criminal justice process;
? it was more likely that criminal charges would be brought and that prosecutors would prosecute; and
? there was some evidence of a greater likelihood of conviction.
Another study, involving a random sample of 100 Sexual Assault Nurse Examiner (SANE) programmes, found that SANEs consistently offered comprehensive medical and emotional care services to victims/survivors (Campbell et al., 2006). Where victims/survivors had access to an advocate through a sexual assault service, they were more likely to make a police report, access more medical services and report fewer negative experiences with police officers and medical staff (Campbell, 2006). The presence of SANEs also improved working relationships, communication and collaboration between medical and legal professionals (Campbell et al., 2005).
Coordinated responses to sexual assault where Rape Crisis Centres were at the center of the care continuum have also been found to be more participatory and effective in responding to the needs of victims/survivors (Martin, 2005).
The one-stop model has been established in parts of Asia, including Bangladesh, India, the Philippines and Thailand, following early piloting in Malaysia, and is increasingly being adopted in parts of Africa (e.g., Rwanda and Nigeria). Although no formal evaluation is readily available, the benefits of one-stop centres are that services for survivors are located in one place, facilitating access and referrals and reducing bureaucracy and duplication. The potential for secondary trauma to survivors is reduced through prompt and sensitive intervention. There is also increased likelihood of successful criminal investigation and prosecution due to prompt forensic examination and specialized facilities for the collection, documentation, and preservation of evidence (Population Council, 2008).
Analysis of the Malaysian One-Stop Crisis Centre model indicates that the level of existing health infrastructure, and the human and financial resources needed may make the one-stop model challenging to implement in low-income countries, where addressing violence through hospitals and health clinics (i.e. primary care responses) equipped to do so, may be more suitable (Colombini et al., 2011).