Ensure protocols/guidelines are in place to support standardized implementation of national and sub-national policies

• In general, protocols and guidelines establish what services should be provided, by whom, how, and the mechanism for monitoring them (Velzeboer, 2003). They standardize quality of care and provide clear procedures for staff to more confidently and effectively address violence against women and girls in accordance with their obligations.  Protocols are an important step in institutionalizing violence programmes and raising awareness among personnel (Velzeboer, 2003).

• As for any specialty in medicine, protocols are needed to standardize survivor care based on evidence. Having norms and protocols in place also provides tools for monitoring quality of care (Ellsberg and Arcas, 2001).

• Protocols and guidelines are generally created as reference tools for service providers to assist them in providing specific types of care to survivors.  They can be developed at the national, sub-national, and institutional levels.

• It may be helpful to have a “Standards Committee”, which could be established by the national health ministry or health department, that is responsible for setting standards, developing standardized protocols and guidelines, and monitoring the extent and quality of training and protocol and guidelines implementation (Jewkes, 2006).

• Sexual assault responses require additional standards with respect to bodily integrity and dignity, including in medical and forensic procedures, as well as specific mental health needs (Council of Europe, 2008a).  See examples in the table below.

• Protocols must also address the needs of different demographic populations of survivors.   For example, statistics show in many countries a considerable percentage of rapes occur to children under the age of 14 (Kim et al., 2007a; Chang, 2004; Peterson, 2005). Adolescent girls may need different programmes than adult women or women who attend antenatal care.  Paediatric programmes often only address child abuse.  Disabled women and girls and older women may also need to know they can access specialized services (Beaulaurier, 2007). (See section on special considerations when working with specific populations for more information.)

• Drafting health sector policies on violence is only the first step in a longer process.  The policies must be disseminated as widely as possible, through training to health workers, as well as through community education to the society at large.   Raising awareness of the health policies is an important way of promoting accountability of the health sector (Ellsberg and Arcas, 2001).  One useful method for professional dissemination is to create a process for accreditation, licensure and certification on violence against women and girls for health professionals.

 See all of the tools available for the health sector.