Tackling gender-based violence in Nepal

Gender based violence (GBV) is a national issue in Nepal. Over a quarter of married women have experienced physical, sexual, or emotional violence and two-thirds of victims don’t talk about their experiences or seek help. As a response, the Nepal Ministry of Health and Population (MoHP) has piloted seven hospital-based One Stop Crisis Management Centres (OCMCs). First introduced in 2011, OCMCs coordinate a comprehensive range of services for survivors of GBV, providing not only treatment for physical and psychological ailments, but also offering legal protection, personal security, and rehabilitation services.

Our UKAid-funded Nepal Health Sector Support Programme (NHSSP) has provided technical assistance to the MoHP since the inception of the OCMC project. Technical advisors from NHSSP have helped expand and develop the scheme. They have supported the Government of Nepal in devising OCMC operational guidelines and GBV clinical protocols, as well as creating review processes to further strengthen the programme.

To ensure OCMC services are of a high quality, NHSSP has offered various training sessions. Doctors, nurses, and other staff have been taught basic counselling techniques for GBV survivors, and Training of Trainer sessions have been held to enable trained staff members to pass on their skills. 125 service providers have attended courses held across the country, enabling them to provide on-the-job training to fellow staff members at their respective hospitals. The sessions enhanced their understanding of GBV issues, improved their record-keeping skills, as well as strengthening multi-sectoral coordination within and between health care departments and partners.

The programme has received praise from those working with the new OCMCs. “I receive very good support and guidance from NHSSP,” said one Case Management Committee Coordinator from the Dang OCMC. “One day, a woman visited, complaining about an ear problem. During the process of examining and taking her health history, I gently enquired about her pain. At first, she was hesitant and said that it started suddenly, but after some exploring and conversation, she voluntarily divulged that her husband had punched her in the ears. I feel that the OCMC is one of the best options for GBV survivors, where survivors’ multi-faceted issues and needs are addressed.”

One crucial element has been to make OCMCs accessible, by removing barriers faced by women, poor, and excluded people. Various actors and organisations have been involved, including the Prime Minister’s Office and other relevant governmental commissions, helping more than 10,700 people receive support over the last five years.

The OCMC project has been scaled up in recent years, with 16 OCMCs being established in 2017 and a further 11 scheduled to open in 2018/19. By 2019, it is expected that 55 OCMCs will be operating in 55 districts, with an official mandate from the Prime Minister’s Office for the establishment of OCMCs in all of Nepal’s 77 districts, suggesting that this trend will continue. This expansion is a result of the integral role OCMCs have played in Nepali hospitals, coordinating with healthcare units and external agencies to develop an effective systems-response to GBV cases.

Now entering its third phase, NHSSP will continue to support the MoHP in monitoring the OCMCs’ functionality and efficiency. The programme also plans to take steps to streamline reporting to ensure the numbers of reported cases of GBV are accurate and to provide medical professionals with training in medico-legal matters and in psychosocial counselling, to further enhance the service provided.