Communications Manual to Aid Key & Vulnerable Populations to Counter Opposition Messaging and Decrease Opposition Influence
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1 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
Communications Manual to Aid
Key & Vulnerable Populations to
Counter Opposition Messaging
and Decrease Opposition Influence
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 2
3 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Acronyms & Abbreviations AIDS Acquired Immune Deficiency Syndrome ARV Antiretroviral CBO Community Based Organization CIDP County Integrated Development Plan CPU Children Protection Unit CMR Case Management and Referral DFPA Danish Family Planning Association DNA Deoxyribonucleic Acid FGM/C Female Genital Mutilation and Cut GIS Geographical Information System GBV Gender Based Violence GBVRC Gender Based Violence Recovery Centre HIV Human Immunodeficiency Virus KDHS Kenya Demographic Health Survey KELIN Kenya Legal and Ethical Issues Network NGO Non-Governmental Organization OB Occurrence Book ODPP Office of Director of Public Prosecution PRC Post Rape Care PEP Post Exposure Prophylaxis SDG Sustainable Development Goals SRH Sexual Reproductive Health UN United Nations UNHCR United Nations High Commission for Refugees UNICEF United Nations International Children’s Emergency Fund
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 4
Definition of Terms
2
Eerdwijk et al (2017). White Paper: A conceptual Model of Women and Girls Empowerment. Kit Gender and Bill &
1
Melinda Gates Foundation 2017.
5 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
Foreword
The prevention and response to Gender-Based Violence as recognized by law is never
the work of one particular office. Therefore, multi-sectoral approach in coordination
is central in any effort towards eliminating GBV and support for the welfare of the
survivors of the same.
A coordinated multi-sectoral approach that involves stakeholders is paramount for
managing GBV, including timely and efficient services to victims/survivors. The Referral
Document and Map are informed by the various Government Policy documents
and Statutory frameworks, the Constitution of Kenya; Penal Code, Criminal Law
(Amendment)Act 2003, the Sexual Offences Act 2006, children’s Act 2001, Counter
Trafficking in Persons Act 2011, National Adolescent Sexual and Reproductive Health
Policy 2015, Kenya Vision 2030 medium-term Plan III among others. The Referral
Document and Map shall provide a comprehensive GBV referral mechanism that
brings on board all the relevant stakeholders and succinctly provides insight to the
survivors, on the availability of the services and where to access them.
The overall goal of the Referral Document and Map is to accelerate efforts towards
the management of all forms of GBV in Homa Bay County through the provision of
information on quality and comprehensive support services available across sectors
for the survivors and where to access them.
The Referral Document and Map take cognizance that effective GBV prevention
and response requires strong and efficient systems and structures to operationalize
laws, policies, and plans. It, therefore, provides an implementation framework with a
comprehensive model referral pathway that spells out critical roles of various service
provision points and the coordination flow therein.
Successful implementation of this document and related County SGBV policy will
require collaboration and coordination of State and non-state actors. In fulfilment of
this mandate, Homa Bay County Department of Gender and Health shall spearhead
the overall coordination of the implementation framework in close collaboration
and consultation with all actors in ensuring effective GBV prevention, response and
support of victims /survivors and their families and Community.
Allan Maleche,
Executive Director, KELINGBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 6
Executive Summary
Effective referral systems and mapping are essential in ensuring that victims of GBV
and/or households are identified, their needs correctly assessed and that they receive
cross-sectoral support until there has been a positive outcome for that survivor/
victim and/or family. In addition, having a strengthened referral system is a practical
demonstration of commitment towards ensuring that interventions positively impact
victims/survivors – that is, having a strong referral system is a commitment to
accountability to the survivors/victims and their families.
The document is divided into five chapters. Chapter one highlights the need of a
strengthened referral mechanism and existing gaps as the situation is currently. It also
gives the purpose of the referral document and map.
In chapter two, a situation analysis of the existing referral mechanism is discussed,
and the current underlying gaps in GBV service delivery analyzed. The analysis has
been carried out to provide insights on the existing services and the stakeholders
while also highlighting the gaps and challenges in the current referral pathway and
offering a clear recommendation of an ideal GBV referral mechanism. It also gives
methodologies and approaches used in data collection and the findings from the
respondents interviewed.
Chapter three comprehensively discusses the model GBV management referral
pathway that is unique and ideal to Homa Bay County. It also provides a diagram flow
of services in the model referral pathway and the broad logical framework with the
key stakeholders and the services they offer to the GBV survivors/victims.
Chapter four details the referral map that indicates the location of key GBV service
delivery points within Homa Bay County.
Finally, the document provides recommendations on areas of improvement and a
directory with key contacts of various GBV service provision points. The document also
has annexes for the international legal instruments, regional and national frameworks
and the semi-structured questionnaire that guided the situational analysis interviews.7 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Acknowledgement The Homa Bay County GBV Referral Directory and Map was prepared under the guidance of the county department of health, and department of gender and social services of Homa Bay County, in collaboration with relevant state agencies and stakeholders, including health services implementing partners. Homa Bay County Department of Health wishes to appreciate all the stakeholders who participated in developing this referral services coordination document. It will help improve real-time response to GBV incidences, and linkage to appropriate care, for survivors and alleged perpetrators of violence. The document will as well, strengthen the involvement of community members and other stakeholders in the GBV response. Special thanks go to the Homa Bay County Executive Committee Member (CEC-M) for Health, Prof. Richard Otieno Muga, and CEC-M for Gender and Social Services, Mr. Fredrick Odero, Chief Officers for Health Dr. Gerald Akeche Celles and Dr. Iscah Moth, and the Chief Officer for Gender and Social Services, Mr. Moses Buriri Mukowa, for their leadership, encouragement and continued support for referral system strengthening, particularly in the development of this important GBV referral Directory and Map. It cannot go without recognizing the contribution made by the following stakeholders in the whole process of developing this document. They include: Mr. Moses Lilam – County Commissioner, Ms. Esther Seroney – County Commander of Police, Ms. Ruth Maloba – Principal Magistrate, Mr. George Opiyo Awino – County Referral Services, Linkages and Emergency Care Coordinator, Mr. Michael Ochola – County Gender Based Violence Coordinator, Mr. Cyrus Obaigwa – County Health Records and Information Officer, Ms. Sophy A. Obop – Director Gender, Mr. William Otago – SDGA County Director Gender, Ms. Elector A. Opar – Director Youth Affairs, Ms. Ida Pendo – Gender Officer, Mr. Obondo Vincent – PEO MoE, Mr. Joshua C. Ochogo – Senior Chief, Mr. Peter Kutere – County Director Children’s Services, Mr. Peter Obiero Gama – County Probations Officer, Mr. Evans Nyamwaro – Deputy Prisons Commander HBP, Fredrick Omoro Makini – Social Services, Philip Kabuor - NCPWD, Ms. Caroline Amondi Mboya – CPV, Mr. Mathew Ajwala – County Community Health Services Focal Person, Mr. Omuga Julius – Chairman National Parents Association (Homa Bay), Mr. Bernard Washika – Program Manager - Festo and Washika Consultancy Ltd, Mr. Edwin Nyanja – Project coordinator - Festo and Washika Consultancy Ltd, Ms. Rebecca Gitau - Program Manager, Ms. Triza Wangeci - Program Officer - Gender Violence Recovery Centre, Mr. Joel Okumu of POLAC Consultancy Associates - Lead Consultant in drafting the GBV Referral Document and Directory, Dr. David Ambogo and Dr. Walter Alando who assisted in the drawing of the GBV referral map. Further, we acknowledge the Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN) and Danish Family Planning Association (DFPA) for their financial and technical support which contributed tremendously to making this document available. We appreciate Ms. Naomi Monda, who led the KELIN Team (Linda Kroeger - SRHR Manager, Alex Muthui - M&E Advisor, Steve Biko - M&E Associate, and our communications team) in developing and designing the document and map as well as her able leadership in the process. Thank you Dr. Gordon Okomo, County Director of Health Services, Homa Bay County.
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 8 Table of Contents ACRONYMS. . ....................................................................................... 3 DEFINITION OF TERMS.. ...................................................................... 4 FORWARD........................................................................................... 5 EXECUTIVE SUMMARY......................................................................... 6 ACKNOWLEDGEMENT......................................................................... 7 CHAPTER ONE.................................................................................... 9 1.1. Introduction................................................................................. 10 1.2. Background................................................................................. 11 1.3. Purpose of Referral Document and Referral Map............................ 12 CHAPTER 2: SITUATIONAL ANALYSIS OF GENDER BASED VIOLENCE MANAGEMENT REFERRAL PATHWAY IN HOMA BAY COUNTY...................................................................... 14 2.0. Introduction................................................................................. 15 2.1. The purpose of situation Analysis.................................................. 16 2.2. Methodology and Approaches...................................................... 16 2.3. Sampled informants for interviews. . ............................................... 17 2.4. Review of laws and Policies regarding GBV in Homa Bay County............................................................................... 17 2.5. Situational Analysis findings.. ........................................................ 18 2.6. Challenges faced during data collection........................................ 22 CHAPTER 3: MODEL REFERRAL PATHWAY FOR GBV MANAGEMENT SERVICES IN HOMA BAY COUNTY............................... 24 3.0 Introduction................................................................................. 25 3.1 GBV Response and Coordination frame work.................................. 27 CHAPTER 4........................................................................................ 29 4.0. Referral Map................................................................................ 30 4.1. Service Provision Points................................................................ 31 CHAPTER 5:....................................................................................... 32 Recommendations.. ............................................................................. 33 Annex I.............................................................................................. 35 Annex II............................................................................................. 39 Annex III............................................................................................ 42 Annex IV: Questionnaire...................................................................... 68
9 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
CHAPTER 1GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 10 1.0 Introduction The vulnerability of survivors/victims of GBV is imperative when considering how referral mechanism and case management are to facilitate an appropriate and effective response. Therefore, a broader concept must be adopted that will enhance a multi-Sectoral approach and strengthen a bottom- up engagement from the Community, including the care and protection of the survivor/victim and reintegration and rehabilitation of the perpetrator. KELIN, a human rights Non-Governmental Organization working to protect and promote health- related human rights in Kenya, has taken the initiative to develop a GBV referral document and referral map. These will accelerate accountability and access to service points in response to cases of GBV but also strengthen the referral support services in Homa Bay County. Effective referral systems and mapping are essential in ensuring that victims of GBV and households are identified, their needs correctly assessed and that they receive cross-sectoral support until there has been a positive outcome for that survivor/victim and family. Having a strengthened referral system is a practical demonstration of commitment towards ensuring that interventions positively impact victims/survivors. The current referral mechanism for service delivery to the victims /survivors of GBV in Kenya only focuses on providing justice to the survivor and tends to rely on evidence. However, if the evidence is not adequately adduced usually leads to the collapse of many GBV cases in court, thus exposing the survivors/victims lives at the mercy of the perpetrators, who in some cases are normally close family members. The existing referral pathway tends to be inadequate to respond to the complexity of the needs of the GBV survivors; mental stability, urgent need for health care and support, community integration and ownership of survivors and perpetrators after serving a sentence. In addition, in many instances,
11 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
survivors of GBV have also been subjected to harmful cultural practices and exposed to HIV and
unplanned pregnancy.
A shift is thus crucial from a linear perspective of justice delivery to a broader concept of psychosocial
support and economic empowerment and developing a multi-dimensional approach of bringing
on board issues of culture in the management of GBV cases in the community.
Most of the services are delivered through a vertical sector approach, which tended to focus more
on the GBV case rather than the lifelong inherent challenges the survivor may face due to the GBV.
The different service providers do not coordinate their efforts to guarantee basic services for the
survivors of GBV. Therefore, there is a need for a more comprehensive model and response system
where referral mechanisms and case management are crucial elements.
The involvement of a community in the reintegration of the perpetrators after serving a sentence
ensures complete mental healing and social accommodation, paving the ways for the perpetrators
to become champions in advocating for the elimination of GBV in the Community.
A comprehensive referral mechanism for GBV survivors and how to ensure their reintegration into
the Community is extremely pertinent. Timely momentum is growing on the response to GBV to
take a system approach that the referral document and referral map is providing rather than relying
on fragmented service delivery as the situation is currently.
1.1 Background
According to the Kenya Demographic Health Survey (KDHS 2014)2,
47% of women aged 15-49 reported that they had experienced
either physical or sexual violence. However, 33% have experienced
physical violence only; 3% have experienced sexual violence only.
47%
In addition, the survey found that the Nyanza Region in Kenya,
where Homa Bay County is located, has the second-highest rate
of GBV.
of women aged
Kenya’s long-term development blueprint Vision 2030’s Medium- 15-49 have
Term Plan II (2013–2017) clearly outlines the establishment of experienced
integrated one-stop Gender-Based Violence Recovery Centers physical or sexual
(GBVRC) in all health care facilities in Kenya. The proposed centres violence
are expected to offer medical, legal, and psychological support
to victims of Gender-Based Violence. A National Framework on
Gender-Based Violence Prevention and Response dubbed the 33%
have experienced
POLICARE has also been developed, which is a step towards the
clear coordination of the multi-sectoral efforts to prevent and violence only
respond to GBV. The proposed referral pathway document will
3%
robustly enhance service provision and strengthen community
engagement and response to GBV cases.
In 2019, KELIN3 conducted a situational analysis of the existing have experienced
laws and policies addressing Gender-Based Violence in Homa Bay sexual violence
County; an analysis of facilities, safe houses and police stations that only
can manage incidences of GBV. The findings revealed that channels
EKDHS 2014.
2
KELIN’s Situation Analysis Report 2019
3GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 12
of reporting GBV are fairly varied in the Community, dependent on prevailing situations and the
urgency with which a case needs to be handled. The three key institutions that were named include
the chief, health facility and the police. The primary point of reporting sexual assault is at a health
facility due to the time-sensitive nature of the violation, whilst for other forms of GBV, it is often to
the chief and subsequently the police. Whereas there is no single protocol for GBV cases in the
county, the most commonly cited channel of reporting is through the chief as the primary point of
contact.
While governments are mandated to manage social risks, little can be done without effective
response structures at the local level. Unfortunately, in many rural settings like Homa Bay County,
the response capacity of law enforcement and social protection structures are hindered by lack of
technical training, limited resources to facilitate a coordinated response, long distances to service
delivery points for survivors and, social norms that hinder reporting and legal redress.
Often, sexual abuse, especially of children, remains unreported because communities do not trust
the capacity of response structures and social norms that allow them to settle cases outside of
the law. Therefore, comprehensive protection requires activation of local referral pathways, such
as community leaders, women groups and religious institutions, and attention to perceptions and
practices that can impact prevention efforts and reporting.
Besides visiting the hospital, a survivor may be referred to other qualified professionals for
subsequent care appropriate to the survivor’s needs. The referral network for survivors is wide
and includes social services, psychiatrists and other medical specialists, legal services, the criminal
justice system and shelters etc.
1.2. Purpose of Referral Document and Referral Map
KELIN recognizes that prevention and response for Sexual Violence cases is not the work of one
office, and multi-sectoral coordination is central to our approach towards addressing Gender-
Based Violence for the survivors’ general well-being. This document aims to contribute to a deeper
understanding among stakeholders – including County policymakers, political leaders, civil society,
communities, and families – of the GBV services available in Homa Bay County and the referral
mechanism therein.
The referral document will expound on the existing fragmented referral pathway for GBV services,
the services offered at each service provision point and roles of GBV actors in Homa Bay County.
The referral map will show the location and contacts of all GBV service provision points (e.g.,
health facilities, Police stations and Law Courts,) including key referral networks like chiefs and
Community-based organization offices.
This referral document and the map will be utilized to:
i. Reinforce and enhance the network of County-specific GBV working groups. The working
groups will facilitate community education and empowerment to report cases, coordinate
survivor referral, provide safe spaces and shelters, oversee response with relevant stakeholders
and service points for cases reported to community structures.
ii. Build provider capacity through continuing education, on-the-job training and supportive
supervision for comprehensive, non-discriminatory care for survivors, injury management,
forensic examination, and post-exposure prophylaxis. Other measures should include
contraception, trauma counselling, psychosocial support, legal aid, maintenance of
confidentiality, preservation of evidence, and free services such as documentation, testifying13 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
in court, and referrals (if necessary).
iii. Highlight gaps; inform resource mobilization and allocations by the Homa Bay County
government; Homa Bay County Assembly; and key non-governmental stakeholders towards
catering for survivors’ comprehensive needs beyond the obvious formal or conventional
ones.
iv. Set up response measures, tools and facilities for law enforcement, social protection and
health-related structures to which cases are reported or referred.
v. Develop a referral map that will be used to locate services provision points for the GBV
survivors; health facilities, police stations, Law Courts, chiefs’ offices and NGOs/CBOs.GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 14
CHAPTER 2
Situational Analysis of Gender-Based
Violence Management Referral Pathway
in Homa Bay County15 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY 2.0 Introduction The debate on referral mechanisms and case management for GBV and how they can ensure positive outcomes is extremely pertinent and timely. In addition, momentum is growing around the need for the responses to survivors of GBV to take a systems approach rather than relying on fragmented service delivery. From the situational analysis findings by KELIN (2019)4, there are multiple referral pathways in reporting different forms of GBV in Homa Bay County. Channels of reporting GBV are fairly varied in the Community, dependent on prevailing situations and the urgency with which a case needs to be handled. They, however, include three key institutions, namely the chief, health facility and the police. The primary point of reporting sexual assault is at a health facility due to the time-sensitive nature of the violation, while for non-sexual GBV, it is often to the chief and subsequently to the police. Whereas there is no single protocol for Sexual Gender-Based Violence cases, the popular route for reporting and seeking immediate help for sexual violence is to get to the hospital. The legal and policy framework primarily focuses on bringing the accused persons to ‘justice’ without a corresponding obligation of alleviating the conditions of the survivors of GBV. GBV survivors are often treated with less importance in the criminal justice system because the offence is perceived to have been committed against the State, not the survivor as an individual. Effective protection of the survivors can be established only by preventing GBV. Identifying risks and responding to survivors needs; psychosocial support, medical care, socio-economic empowerment KELIN’s Situation Analysis Report 2019 4
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 16
and access to justice, community reintegration using a coordinated multi-sectoral approach in
service delivery are also part of the protection. The present protection of GBV survivors in Kenya
is fraught with challenges and filled with opportunities, which should be carefully considered when
devising responses. Whereas the Kenyan legal framework provides a mechanism for addressing
GBV, the levels to which the frameworks respond to the plight of the survivors of GBV is debatable.
The Homa Bay County Referral Document and Map proposes to adopt a robust and comprehensive
referral mechanism that will be integrative and collaborative by ensuring that the survivor and
perpetrator rights are properly entrenched in the community set up for purposes of rehabilitation
and restoration.
The comprehensive referral pathway provided, if adopted, will effectively support the
security, psychological needs, medical services, social protection, justice and
prosecution services required by the survivors. It will also support rehabilitation services for the
perpetrators while harmonizing all other needed services and
building capacities to reduce if not eliminate incidences of GBV cases within Homa Bay
County.
The referral Document and Map will also act as an implementation strategy for the SGBV policy that
the Homa Bay County is developing.
2.1 The purpose of situation Analysis
The purpose of the situational analysis was to:
i. Make an assessment and provide information on existing service provision for GBV
survivors and stakeholders, including the county policymakers, political leaders, civil society,
communities, and families of the GBV survivors of the services available in Homa Bay County
and the referral mechanism therein.
ii. Provide the gaps and challenges in the referral pathway and other GBV service provision
points and the forms of GBV prevalent in Homa Bay County.
iii. Present a comprehensive assessment of the various GBV service provision points in prevention,
response and management of GBV.
iv. Get recommendations for an ideal GBV referral mechanism for Homa Bay County from the
interviewed respondents.
2.2 Methodology & Approaches
The situational analysis employed a mixed methodology for data collection. That is, primary and
secondary data collection methods.
Primary data collection
Primary data collection was done through phone interviews using a semi-structured questionnaire as
the interview guide (see Annex iv). In addition, sampled participants from various service provision
points, provided information which was critically analyzed and systemized to help develop the
referral document.
The development of a referral map for GBV service provision points; health facilities, Police stations,
Judiciary, Gender and Children offices, Chief’s offices, NGOs and CBOs were guided by using GIS
technology, which aided in developing a referral map with coordinates.17 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
Secondary data collection
This involved desktop literature review including laws, policies, national and county government
policies, Ministry specific guidelines, regional and international pronunciations on GBV and KELIN’s
project documents.
Approaches
In addressing the objectives as defined, the work was guided by the following approaches;
• Result based approach - Applied to conceive a GBV referral model that is efficient, relevant
and effective in managing GBV cases in Homa Bay County.
• Participatory and inclusive approach guided by positive values of respect for diversity –
both the survivor and service providers were involved in information collation.
• Equity – Approach was used to ensure true gender justice in service provision.
• Equality - The approach ensured fairness in handling the issues of GBV survivors.
• Accountability - The referral pathway for GBV management in Homa Bay will ensure every
duty bearer is held responsible in service delivery.
• Non-discrimination – Survivors of GBV were sampled across without biases on gender and
sexuality.
• Evidence-based approach - The data collection process relied on the evidence adduced
by the survivors and the service providers in making critical decisions on the best alternative
referral pathway and reviewing the already existing literature on GBV.
• Gender-responsive – The approach was used to enhance equal participation of the sampled
survivors and service providers of GBV.
• Child-friendly - survivors of violence who were children were separated and interviewed on
their own to help boost their esteem to speak out.
• Flexibility Approach for contextualization of socio-cultural, religious and geographical
realities.
• Survivor Centered Approach - During data collection, survivors of GBV were treated with
dignity, respect and were assured of confidentiality of the information they provided.
• The gender and development Approach -This approach was used to analyze the key
empowerment programs and clinical services available for the survivors of the GBV.
2.3 Sampled informants for interviews
The sampled informants were:
Medical Personnel (55), Judicial officers (4), chiefs and Assistant chiefs (43), Children officers (7),
Gender officers (1), Community Health Workers (8), project officers of various NGOs and CBOs (20),
Police Officers (21) and survivors (8) at the Community level in Homa Bay County.
The sampling was done at a confidence level of 90% with an error margin of 10%. They were
interviewed to understand their roles in the referral pathway and the existing gaps therein.
2.4 Review of laws and Policies regarding GBV in Homa
Bay County
At the National level, the existing legislative and policy framework was used to streamline processes
and GBV service provision among various actors, including police, health providers, security, non-
state actors, and other regulatory authorities. See Annexes I and II.GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 18
2.5 Situational Analysis findings
The hallmark of the findings upon which the Referral document and map is anchored was the
desktop review of the KELIN’s Situational Analysis of Laws and Policies addressing GBV in Homa
Bay County 2019. The report has provided comprehensive baseline information that has assisted in
the identification of the gaps existing in the current referral pathway and services for GBV in Homa
Bay County.
of the services are delivered through a vertical sector approach, which tends to focus more
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GBV case complemented
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after serving a sentence ensures complete mental healing and social accommodation
paving the ways for the perpetrators to become the champion in advocating for
Phone interviews were also conducted with specific service providers to aid the contextualization
eliminating GBV in the community.
of the desktop research. The target included providers offering services to GBV survivors or other
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mechanism Theforkey findings
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table I. reintegration in the community is extremely pertinent. Timely momentum is growing on
the response to GBV to take a system approach that the referral Directory and Map is
providing rather than relying on fragmented service delivery as the situation currently.
Table 1: GBV Service Provider, Services, Gaps and the Survivor Requirements.
919 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
10
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 20
1121 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Health Services The health facilities contacted provide similar services save for a few like Makongeni Health Centre, which had a safe house built as a partnership program with Plan International. Homa Bay Referral Hospital has a GBVRC unit that was recently launched and is in the process of being operationalized. The rest of the health facilities offer clinical services and referrals to the survivors of GBV to the functional GBVRC at JOOTRH Kisumu. The GBVRC, a partnership with Nairobi Women Hospital, will offer trauma counseling alongside the clinical services required by the survivor. Forensic training has also been adequately done in collaboration with the existing partners, the main challenge being the existence of a government laboratory to carry out a forensic test. The samples for such have to be taken to Kisumu, where the government chemist is located. Most of the facilities also lack trauma counselors. Police Gender Desk Services The police officers interviewed had the gender desk in their stations save for the newly established police stations. The officers were aware of the GBV and its manifestation, and they offer GBV services just like for ordinary offenders due to inadequate training on matters GBV and the challenge of staff turnover, some of the stations like Homa Bay police station had children protection units with a boarding facility for temporal custody, they were also in the radius of health facility to ease the service provision especially the clinical services. For the sexual violence cases, the Police Gender Desk does not charge the filling of P3 forms save for other cases of assault where the P3 filing is charged at Kshs.1000. Challenge noted was the informal settlement of GBV cases by survivors with the perpetrator’s family, hampering service delivery to the GBV survivors. County Department of Gender and Social Services The department provides the following services: Follow up and referral services to the survivors, GBV policy formulation and coordination, socio-economic empowerment program, e.g. offering revolving funds. However, the challenge noted was inadequate resources to support referrals and even psychosocial and socio-economic support for the survivors of GBV. NGOs/CBOs in Homa Bay County Most of the non-governmental organizations and Community based organizations interviewed preferred having their offices in Homa Bay town, save for a few that operated in areas like Ndhiwa, Oyugis town and Rodi Kopany town in the outskirts of Homa Bay town. They offer rescue services, advocacy, training and sensitization to the Community, follow-ups of GBV cases. Some, like EGPAF and FHOK, offer clinical services, Plan International and Mango Tree provide safe shelter in partnership with the County government; they also provide socio-economic support. However, they face common challenges ranging from inadequate resources, cultural norms that perpetuate GBV, low commitment from the decision-makers to respond to GBV and local administration being accomplices in GBV hampering justice delivery. Children Services Government officers offer children services in the Sub counties. The interviewed officers offer similar services as provided for in the law that governs the operations and guideline of the Children
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 22 department core functions such as; basic counseling, referral to police for arrest, testifying in courts, referral to the registration of births and referral to borstal institution for rehabilitation. Some of the noted challenges included inadequate counseling services, remoteness of the offices in terms of accessibility, especially those in the rural areas like Suba North and some Sub counties like Rangwe do not have children offices. In addition, the children department offers socio-economic support to orphans and vulnerable children. Judicial Services The judicial services are offered at the four law courts; Mbita, Homa Bay Town, Ndhiwa and Oyugis (Kosele); they all have cases of GBV ongoing. The cases face challenges of witnesses’ withdrawal or provision of inadequate evidence linking the cases. The services offered to the GBV survivors are free. Survivors Interviewed Extracting information from the survivors is a challenging task bearing in mind some of them are still reeling from the aftermath of GBV and the associated trauma. The interviewed ones had experienced physical violence, emotional violence, domestic violence and widow disinheritance, and they were not aware of where to get assistance apart from the hospital, community health workers and chiefs had supported some. They had also attended local training though they were not sure of who organized the training. They were counseled and treated at the hospital, and they were also assisted in obtaining and filling the P3 forms at the police station. The challenges they undergo mostly is the threat and fear of the perpetrators as some live with them in the same community, some are their close relatives. They did not know of the existence of safe shelter hence were desperate about their security and lives. 2.6 Challenges faced during data collection This section summarizes limitations and challenges experienced during the data collection phase. A key challenge was the delay as we await authorization from the client to conduct interviews. However, the authorization was given after letters of introduction were sent to the relevant County and National Government departments targeted for interview. Challenges experienced with the Survivors The survivors reached on the phone calls were very shy of releasing the details of the stories concerning their experiences; hence it took a long time to convince them of the confidentiality and non-victimization of the required information. Challenges experienced with the Chiefs /Assistant Chiefs. There was a lack of full discloser of the needed information. However, with more probing, a lot of information was extracted concerning service delivery. Some Chiefs and Assistant Chiefs don’t have offices; hence, locating their offices on the map was difficult. Challenges experienced with the Community Health Workers Health workers are spread across the county; many are in far-flung areas without network reach. This made it difficult to cover eight Sub Counties, especially Suba North and South in the areas like
23 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Mfangano Island, where network coverage is poor. Still, the information gathered was sufficient enough to inform of the situation concerning service delivery. Challenges experienced with the Judiciary Judiciary officers were not initially available for interviews as they had closed for holidays; later on, we interviewed the judicial officers in the four law courts in the County; Mbita, Kosele (Oyugis) Homa Bay Town and Ndhiwa law courts. Challenges experienced with the Health Facilities Personnel There were 283 health facilities in Homa Bay County, we sampled 55 facilities and all of them could be reached on the phone. Still, the facilities’ challenges were common, as they ranged from poor infrastructure to inadequate personnel and limited support, unavailability of resources to handle GBV cases, and even personnel who lacked adequate training on trauma counseling and the filling of PRC and p3 forms. Challenges faced with Police Gender Desk Some officers reached were not well conversant with the issues of SGBV and could only refer to other colleagues who were equally not available for interviews, some of the officers’ phones went unanswered, or they had been transferred out of Homa Bay County. GBV in some stations is still treated like any other crime and not given the deserved attention and priority.
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 24
CHAPTER 3
Model Referral Pathway for GBV
Management Services in Homa Bay
County25 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY 3.0 Introduction Understanding GBV is imperative when considering how referral mechanisms and case management facilitate an appropriate and effective response. A significant success in the shift from an individualized understanding of GBV to broader concepts has been realized. This includes a shift in focus from a primarily ‘welfare’ response to broader socio-economic and cultural concepts of vulnerability. And from considering individual GBV -affected persons to broader notions of vulnerability that link GBV to other vulnerabilities like HIV, unplanned pregnancies, and other medical challenges on the survivors. It is now increasingly recognized that GBV vulnerability is multi-dimensional, complex and dynamic, both across sectors and across a wide range of stakeholders. Nevertheless, practical experience of successfully translating this more complex analysis of GBV vulnerability into policy and practice in a coordinated and systematic fashion remains limited. This has equally affected service delivery in a more holistic approach that brings together all sectors. Effective referral mechanisms and case management systems are essential in ensuring that vulnerable persons and households are identified, their needs correctly assessed and that they receive cross- sectoral support until there has been a positive outcome for that person and family. Having robust service delivery and GBV management systems is a practical demonstration of commitment towards ensuring that interventions positively impact the Community. Having a comprehensive referral and case management system is a commitment to accountability to vulnerable persons at all levels. A broader referral pathway management system offers a framework within which all sectors playing a role in meeting the needs of survivors/ victims must communicate and act together so that the dynamic, multi-dimensional and complex nature of survivors’ needs and that of their families are met. The spread of GBV service provision points in Homa Bay County due to its geographical placement of rural set-up and vastness has a monumental impact on case management and other auxiliary services. In addition, the social services roles of the community, the medical and clinical services required by the survivors and perpetrators, the cultural dynamics and the emerging challenges like COVID 19 pandemic has greatly hampered the delivery of statutory services to the survivors/ victims of GBV. Therefore, “The strength of a case management system is its collaborative nature which oversees the process of assessment, planning, facilitation, coordination and advocacy for services to meet the individual care, protection and justice needs of persons vulnerable to violence, abuse, exploitation, and neglect.” (UNICEF Malawi, 2012). The referral document and maps will provide a comprehensive model that clearly shows what services Non-Medical Practitioners and Medical practitioners are to offer and the clear role of the Judiciary in Case Management, and the community role in supporting survivor’s rehabilitation in the Community.
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 26 Fig 1: Proposed GBV Management Referral Pathway for Homa Bay County
27 3.1. GBV Response and Coordination Framework The GBV response and coordination framework describes the comprehensive flow of services for the GBV survivors in a model referral pathway. The description of services at every service point is given in depth from the point where a case has occurred (community) to where the survivors of GBV gets justice. Table 2: GBV Response and Coordination Framework
28
In case of Sexual Violence or an incident related to a minor, there It is incumbent upon everyone in the Community to provide information
is mandatory reporting and specific procedures to follow up to keep on what is available. Share what you know and let the survivor decide
evidence for potential legal investigation. The minor needs to be given if s/he wants to access them.
maximum protection to gain full confidence when testifying.
• If the survivor is a child… Children are particularly vulnerable to
Cases of sexual violence rely heavily on corroborated evidence; any kind of violence hence unable to make a decision. Therefore,
therefore, it is imperative for the parties involved in the case to ensure it is important to ensure the child/adolescent is always in the
the maximum safety of the available evidence. company of a trusted adult, ideally selected by the child.
If DNA has to be available, then Government Chemist will provide the • Do no harm. Do not seek out child survivors. It is not your job to
necessary test for such evidence to be adduced. investigate if a child/adolescent is experiencing violence. Doing
so can lead to more violence and risks for the child/adolescent.
• It is important to note that every sector in the referral pathway Instead, be approachable if a child/adolescent wants to seek
plays an integral part in ensuring that justice is served and the your help. If you have concerns that a child/adolescent is being
survivor’s welfare is adequately addressed. abused, contact the Child Abuse Hotline – 116 for advice.
If someone has experienced Physical or Sexual Violence, encourage Ensure the safety of the child. The physical and emotional safety of
them to access health services as soon as possible. To prevent Sexually the child is the primary concern. This can be particularly complicated
Transmitted Infections (STIs) it is important to access health services when the parent/caregiver or someone close to the child is the alleged
within 72 hours and within 120 hours to prevent Unwanted Pregnancy perpetrator. Consider the child’s safety throughout all interactions with
and HIV infections. him or her and with any next steps taken.29 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
CHAPTER 4
Referral Map & Service Provision Points30
4.1 Referral Map
The referral map (https://www.kelinkenya.org/wp-content/uploads/2021/08/Final-Referral-Map.pdf) will provide detailed information of the various
GBV service delivery points using the coordinates provided from the GIS technology mapping specific location point of the various services within
the referral pathway. This is an important guideline for the various actors and survivors on the accessibility of the services and the promotion of
quality services offered.
Gender-Based Violence Referral Points in Homa Bay County31 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY 4.2 Service Provision Points The interactive (link provided) and static map indicate the location of key GBV service delivery points that include health facilities, police stations, the Judiciary, NGO’s and CBO’s, chief’s offices, children’s offices and gender offices within Homa Bay County. https://www.kelinkenya.org/wp-content/uploads/2021/08/Final-Referral-Map.pdf
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 32
CHAPTER 5
Recommendations33 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
5.0 Recommendations
The recommendations provided are to assist decision-makers in enhancing service delivery and
boosting the support for the survivors of GBV in Homa Bay County. It is imperative to note that
improved multi-sectoral coordination in service delivery is key to managing Gender-Based Violence
in the County.
The recommendations thus are;
• Enhance targeted resource mobilization and effective utilization of the same at the various
service delivery points.
• Participatory monitoring and evaluation is key to enhanced service delivery for the survivors
at the health facilities.
• A strengthened Data and Health Information Systems (DHIS) management and sharing is
key to evaluating the GBV prevalence and strategic response mechanism at every location in
the county to address the same.
• Enhanced capacity building (by NGOs, National Government) for strategic players (police
officers, chiefs, community health workers, e.tc) in service delivery points is vital in enhancing
comprehensive service provision to the survivors of GBV in the County.
• Partners need to cascade and enhance service provision in the remote areas like the Islands
within the lake that are within the jurisdiction of Homa Bay County.
• Enhanced lobbying and buy-in from the policy and decision-makers need to be improved
to help anchor SGBV policy into County laws and CIDP and ADP for programming and
budgeting.
• Enhanced collaboration with the key service delivery points (Health services, chiefs, community
health workers e.tc) on the referral pathway is key to managing GBV cases. In addition, there
is a need for closer working among the very stakeholders, e.g., Health department, health
department, police, judiciary, and other GBV service providers, to strengthen rehabilitation
and restitution of the survivors in the Community.
• Partners should collaborate and support the Children Protection Units (CPU) and even help
put up more in various police stations across the county.
• An integrated GBVRC unit needs to be put up across all health facilities in the county.
• More safe shelters are needed, especially in Rachuonyo North, Rangwe and Suba North. This
will help support survivors, especially in remote rural areas.
• Partners can also work closely with the National Police Service to help put up a POLICARE
Center in the county to strengthen the response and coordination of GBV cases.GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 34
ANNEX35 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Annex I Table I: Matrix Summary of Key International Laws /Instruments
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 36
37 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 38 Source: Bastick, Hug and Takeshita for DCAF. 2011. International and Regional Laws and Instruments related to Security Sector Reform and Gender.
39 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Annex II Table II: Summary of national legislative framework addressing GBV in Kenya
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 40
41 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Source: Kenyan Parliamentary Laws and Policies
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 42 Annex III: Referral Directory a) Referral Directory - Homa-Bay County Health Management Team (CHMT) Name of County: Homa Bay Sub County: Homa Bay Town Ward: Central Sub Location: Township Geo Code:....……...…… MFL Code:....…….......……Date: ........................
43 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Compiled by: George Opiyo Sign: ............................. Design: SNO Date: 30-06-2021 Verified by:...............................Sign:........................Design:........................ Date:..............................
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 44 b) Referral Directory - Homa Bay Referral Program Name of County: Homabay Sub County: Homabay Town Ward: Central Sub Location:........................... Geo Code:....…......… MFL Code:.......…......…Date: 23.06.2021
45 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Compiled by: George Opiyo Sign: .......................Design: SNO Date: 30.06.2021 Verified by:........................... Sign:........................ Design:............... Date:......................
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 46 c) Referral Directory - Makongeni Sub-County Hospital Name of County: Homabay Sub County: Homabay Town Ward: Central Sub Location: Arujo Geo Code:....…......… MFL Code: 19858 Date: 25.06.2021
47 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Compiled by: Abortho Godfrey Sign: .......................Design: Clinical Officer Date: 25.06.2021 Verified by:........................... Sign:........................ Design:............... Date:......................
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 48 d) Referral Directory - State Department for Gender Name of County: Homabay Sub County:....................................... Ward: ........................................ Sub Location: ............……............Geo Code:....…......… MFL Code:.......…......…Date: .........................
49 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY Compiled by: William Otago Sign: .......................Design: CPD Date: 24.05.2021 Verified by:........................... Sign:........................ Design:............... Date:......................
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 50 e) Referral Directory - County Department of Gender & Social Services Name of County: Homabay Sub County: Homabay Town Ward: Central Sub Location: Asego Geo Code:....…......… MFL Code:.......…......…Date: 31.05.2021 Compiled by: Sophie A. Obop Sign: .......................Design: Director Date: 31.05.2021 Verified by:........................... Sign:........................ Design:............... Date:......................
51 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY f) Referral Directory - Law Court Name of County: Homabay Sub County: Homabay Town Ward:.......................................... Sub Location: Township Geo Code:....…......… MFL Code:.......…......…Date: 27.05.2021
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 52 Compiled by: Ruth Maloba Sign: .......................Design: Chief Magistrate Date: 27.05.2021 Verified by:........................... Sign:........................ Design:............... Date:......................
53 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY g) Referral Directory - Homa Bay County Police Headquarter Name of County: Homa Bay Sub County: Homa Bay Town Ward: H/Bay Sub Location: Homa Bay Town Geo Code: 34.4592.E MFL Code:....…….......……Date: 25-5-2021
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 54 Compiled by:.................................... Sign: .......................Design:.........................Date: ............................ Verified by:......................................... Sign:........................Design:........................ Date:..............................
55 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY h) Referral Directory - Homa Bay GK Prison Name of County: Homa Bay Sub County: Homa Bay Ward: Township Sub Location: ASEGO Geo Code:................... MFL Code:....……....……Date: 25-05-2021
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 56 Compiled by: Dominic Orina Mita Sign: .......................Design: PC Date: 25.05.2021 Verified by: Evans Nyamwaro Sign:........................ Design: Deputy OFC Date: 25.05.2021
57 GBV - REFERRAL DOCUMENT AND MAP FOR HOMABAY COUNTY i) Referral Directory - Homa Bay Women Prison Name of County: Homa Bay Sub County: Homa Bay Ward: Central Sub Location:..................................Geo Code:................... MFL Code:....……....……Date:........................ Compiled by: Otieno Beatrice Sign: .......................Design: CIP Date: 25.05.2021 Verified by: Evans Nyamwaro Sign:........................ Design: SP Date: 25.05.2021
GBV - REFERRAL DOCUMENT AND MAP FOR HOMA BAY COUNTY 58 j) Referral Directory - Probation & After Care Service Name of County: Homa Bay Sub County: Homa Bay Town Ward: H/bay Town Central Sub Location:Township Geo Code:................... MFL Code:....……....……Date: 27.05.2020
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