Strengthening Linkages Between Clinical and Social Services For
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STRENGTHENING LINKAGES BETWEEN CLINICAL AND SOCIAL/COMMUNITY SERVICES FOR CHILDREN AND ADOLESCENTS WHO HAVE EXPERIENCED SEXUAL VIOLENCE A COMPANION GUIDE STRENGTHENING LINKAGES BETWEEN CLINICAL AND SOCIAL/COMMUNITY SERVICES FOR CHILDREN AND ADOLESCENTS WHO HAVE EXPERIENCED SEXUAL VIOLENCE A COMPANION GUIDE This publication is made possible by the generous support of the American people through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) with the U.S. Agency for International Development (USAID) under the terms of Cooperative Agreement Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree), number AID-OAA-A-14-00046. The contents are the responsibility of AIDSFree and do not necessarily reflect the views of USAID, PEPFAR, or the U.S. Government. AIDSFree The Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree) Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Cooperative Agreement AID-OAA-14-000046. AIDSFree is implemented by JSI Research & Training Institute, Inc. with partners Abt Associates Inc., Elizabeth Glaser Pediatric AIDS Foundation, EnCompass LLC, IMA World Health, the International HIV/AIDS Alliance, Jhpiego Corporation, and PATH. AIDSFree supports and advances implementation of the U.S. President’s Emergency Plan for AIDS Relief by providing capacity development and technical support to USAID missions, host-country governments, and HIV implementers at the local, regional, and national level. Recommended Citation Levy, Marcy, Lyn Messner, Malia Duffy, and Jennifer Casto. 2016. Strengthening Linkages Between Clinical and Social/Community Services for Children and Adolescents who Have Experienced Sexual Violence: A Companion Guide. Arlington, VA: Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree) Project. JSI Research & Training Institute, Inc. 1616 Fort Myer Drive, 16th Floor Arlington, VA 22209 USA Phone: 703-528-7474 Fax: 703-528-7480 Web: aidsfree.usaid.gov CONTENTS Acronyms ......................................................................................................................................................... vii Acknowledgments .......................................................................................................................................... ix Introduction and Overview ............................................................................................................................ 1 Why this Guide? ....................................................................................................................................................... 1 Target Audience/s ................................................................................................................................................... 2 How to Use this Guide ........................................................................................................................................... 2 Section 1: Background/Rationale ................................................................................................................ 4 Gaps in Providing an Adequate Response ..................................................................................................... 8 Section 2: Approaches for Integrated, Multisectoral Response ....................................................... 11 Integrated Care Approach ................................................................................................................................. 12 Standardized Nationwide Centers ................................................................................................................. 15 Ladderized Model ................................................................................................................................................. 15 Section 3: The Minimum Package ............................................................................................................ 17 Medical and Forensic Care and Treatment ................................................................................................. 19 Safety and Protection Services ........................................................................................................................ 20 Psychosocial Support Services ......................................................................................................................... 24 Legal/Justice Services .......................................................................................................................................... 27 Other/Social Support .......................................................................................................................................... 30 Section 4: Roles and Coordination of Various Stakeholders and Essential Elements for Bridging Community-Facility Stakeholders ........................................................................................... 33 Checklist: Essential Elements for Bridging Community-Facility Stakeholders ............................... 42 Section 5: Mandatory Reporting ............................................................................................................... 45 Section 6: Referral Pathways and Community/Facility Coordination .............................................. 48 Checklist: Setting Up a Referral Pathway/Coordination Network ...................................................... 49 Section 7: Case Management .................................................................................................................... 55 Section 8: Guiding Principles for Working with Children and Adolescents who have Experienced Sexual Violence and Exploitation...................................................................................... 60 Section 9: Program Highlights ................................................................................................................... 63 v 1. Thohoyandou Victim Empowerment Programme, South Africa .................................................... 64 2. Women and Child Protection Units, the Philippines .......................................................................... 69 3. Livingstone Child Sexual Abuse One Stop Centre, Zambia ............................................................. 72 4. The Mirabel Centre, Nigeria ......................................................................................................................... 76 5. Regional GBV Referral Networks, Swaziland ......................................................................................... 80 6. The Teddy Bear Clinic for Abused Children, South Africa ................................................................ 84 7. Thuthuzela Care Centres, South Africa .................................................................................................... 90 Annex 1: Glossary of Terms ........................................................................................................................ 92 Annex 2: List of Resources/Tools .............................................................................................................. 93 References ....................................................................................................................................................... 99 vi ACRONYMS ACE(s) adverse childhood experience(s) AIDSFree Strengthening High Impact Interventions for an AIDS-free Generation CAVE Vigilance Committees to Alert, Watch and Listen (French acronym) CPSP Court Preparation and Support Programme CPU Child Protection Unit GBV gender-based violence IRC International Rescue Committee NAPCWA National Association of Public Child Welfare Association NGO nongovernmental organization PEP post-exposure prophylaxis PEPFAR U.S. President’s Emergency Plan for AIDS Relief PTSD post-traumatic stress disorder SWAGAA Swaziland Action Group Against Abuse TCC Thuthuzela Care Centre TVEP Thohoyandou Victim Empowerment Program USAID U.S. Agency for International Development WCPU Woman and Child Protection Unit WHO World Health Organization VA victim advocate ZTVA Zero Tolerance Village Alliance vii viii ACKNOWLEDGMENTS Thank you to the PEPFAR Gender and Orphans and Vulnerable Children Technical Working Groups for their vision and guidance in the development of this guide. We are deeply grateful to the many individuals who contributed to this resource by participating in interviews, serving as part of the Technical Advisory Group (TAG), answering questions, sharing resources, and reviewing specific sections. This resource would not be possible without their support. In particular, we extend our gratitude to the following individuals: Shaheda Omar (Teddy Bear Clinic, South Africa); Bernadette Madrid (Child Protection Unit, University of the Philippines Manila); Rudo Masanzu (Faculty of Forensic and Legal Medicine, UK and consultant, Zimbabwe); Rebecca Davis (Center for International Social Work, Rutgers University); Cebile Manzini-Henwood (Swaziland Action Group Against Abuse, Swaziland); Fiona Nicholson (Thohoyandou Victim Empowerment Programme, South Africa); Chi Chi Undie (Population Council, Kenya); Itoro Eze-Anaba (Mirabel Center, Nigeria); Derrick Sialondwe (Livingstone Child Sexual Abuse One Stop Centre, Zambia); Abigail Erickson (International Rescue Committee, U.S.); Neckvillius Kamwesigye (John Snow, Inc., Uganda); Sanni Bundgaard (International Rescue Committee,