Define abbreviations and acronyms the first time they are used in the text, even after they have been defined in the abstract. Abbreviations such as IEEE, SI, MKS, CGS, sc, dc, and rms do not have to be defined. Do not use abbreviations in the title or heads unless they are unavoidable. As part of a multi-sectoral response, there are procedures that need to be applied in health care settings, police services and psycho-social services for quality response to GBV.

Standard operating procedures in a health care setting provide detail descriptions about what health care providers have to do routinely when faced with a survivor of GBV. As women and girls are more often affected by different forms of GBV with divers levels of severity, frequency and consequences compared to men, priority focus for standard care is directed towards women ( Michau et al., 2015 ). In the 57th Commission on the Status of Women for elimination and prevention of all forms of violence against women and girls, agreed conclusions called for action to:

“Address all health consequences, including the physical, mental and sexual and reproductive health consequences, of violence against women and girls by providing accessible health-care services that are responsive to trauma and include affordable, safe, effective and good-quality medicines, first line support, treatment of injuries and psychosocial and mental health support, emergency contraception, safe abortion where such services are permitted by national law, post-exposure prophylaxis for HIV infection, diagnosis and treatment for sexually transmitted infections, training for medical professionals to effectively identify and treat women subjected to violence, as well as forensic examinations by appropriately trained professionals.” ( Commission on the Status of Women, 2013 ; 57th session).

Given that the Health care system and health providers play an essential role in the identification, assessment, treatment, crisis intervention, documentation, referral, and follow-up of GBV cases, the interventions for quality management of survivors are centered on the following objectives:

In order to ensure better outcomes in the implementation of standard operating procedures (SOPs) in the management of GBV survivors, minimal training of health providers on how to use the SOPs is required. Ideally, training could be part of a comprehensive pre-service training program/curriculum that integrates prevention and awareness of GBV, response to GBV by healthcare providers, and sections on multi-sectoral response to GBV. There are five core elements identified as essential for a comprehensive and effective clinical health service response to women and girls who have experienced GBV ( UNFPA, 2015 ). They include:

1) First-line support which can include referrals;

2) Care of urgent medical issues and injuries;

3) Examination for sexual assault and treatment;

4) Assessment of mental health;

5) Management of stress management.

The management and the provision of health care services to victims of GBV should include the following step-by-step procedures: identification, evaluation, health care service delivery (with the five core elements), collection of evidence, documenting GBV, and referral. However, the order of steps may be interchangeable when handling a case of GBV except for the identification step which is unavoidably the first step.

Asking about GBV is sensitive and can sometimes be embarrassing for any service provider. There are recommendations that can boost healthcare provider confidence when inquiring about GBV and also control re-victimization ( UNFPA, 2001 ).

In a healthcare setting, the health provider has to have the capacity to identify cases of GBV against women. Even when the patient does not openly report being a victim of GBV, some conditions and behaviors are usually associated with GBV that can help health providers identify cases. Injuries such as lacerations, bruises, bites, wounds, and burns on the arms and face with explanations that are not founded and often covered by clothes, are signs to suspect GBV. Unexplained gastrointestinal and reproductive health symptoms. Reproductive health symptoms can include chronic pelvic pain, unintended pregnancies, adverse birth outcomes, and repeated urinary and sexually transmitted infections. At the level of the central nervous system, there can be signs of hearing loss, cognitive problems, frequent headaches, depression, anxiety, post-traumatic stress disorder (PTSD), sleep disorders, or repeated consultations with no clear health issues. Sometimes the victims would miss their health appointments without tangible reasons and when they do report to the health facility after follow-up, an intrusive partner or husband usually accompanies them. The woman is afraid to express herself in front of her partner or accompanying adult or appears submissive when in front of her partner or husband ( UNFPA, 2015 ).

Identification in the healthcare setting is usually from the provider’s skills to detect a case of GBV, reporting by another person, and self-disclosure of the victim. In healthcare settings, two approaches: universal screening and case finding facilitate the disclosure of GBV. Universal screening, also known as routine inquiry, requires asking all women presenting in health settings about their exposure to GBV while case finding, or clinical inquiry, refers to asking women about GBV, in case they present certain clinical symptoms/history and (if appropriate) to examine the women. The approach of case finding is more effective than the universal screening approach because it is based on selective and careful clinical considerations especially when the health care provider is specially trained in how to best respond and refer cases. Whereas universal screening can be burdensome in healthcare settings, especially when there is suboptimal capacity for effective response, little or no referral options and overloaded resources/providers. When victims are identified, the integrity of the victims should be a priority and patients with severe conditions are immediately sent for treatment. Ensuring a safe and effective identification of GBV victim/survivor requires the following operational steps ( UNFPA, 2015 ):

After the identification of a GBV victim/survivor, the healthcare provider will evaluate the situation and determine what step follows based on the severity of the case. The evaluation will form the baseline for decisions on medical care and follow-up. For all services that will follow, consent has to be obtained. Consent is obtained from parents in case where the victims/survivors are minors (children). In the context where the victim/survivor cannot read or write, verbal consent is obtained and documented in the patient file. The victim/survivor has to be told that he/she has the right to decide which information to disclose or to keep confidential i.e. the right to limited consent. When obtaining consent, the implications of sharing the information with other services/institutions have to be made known to the victims/survivors. Educate the victim about GBV and its negative consequences on health. All actions should be geared towards helping the victim/survivor. If the case of GBV is being disclosed by the victim/survivor themselves, provide an opportunity for them to recount what happened while talking about the type of violence and the perpetrator. Based on what has been recounted, the needs and the resources available to respond to the GBV case will be evaluated while considering the social, familial, and individual situation of the victim/survivor context. The appropriate support to be provided is determined based on the needs evaluated such that the GBV victim/survivor is protected ( UN Women, 2014 ).

Service provision is all about healthcare providers offering medical examinations and care to the GBV victim/survivor. The healthcare provider considers the fact that the victim/survivor is in an emotional state when offering care. First-line support is the first intervention or service offered to the victims/survivors of GBV. Validation is given to what the victim/survivor is saying in a supportive and non-judgmental manner. When history about violence is being recounted, the provider listens attentively without intruding. The victim/survivor should be facilitated on how to obtain legal services and other resources that the victim may think is necessary. Help victim/survivor to increase safety measures for themselves and their children wherever there is risk. The victim/survivor should be connected to social service support. Service provision is offered in privacy and confidentiality while notifying victims/survivor that confidentiality is limited due to the obligations of reporting ( UN Women, UNICEF, UNFPA, 2015 ).

First line support is followed by interventions of obtaining medical history and examinations. After asking the victim/survivor to recount in their own words what happened, a detailed documentation of the violence is documented informing about the date and time of the incident, any weapons that were used, the place, and the duration. The health care provider can also check for symptoms such as malnutrition and dehydration that can indicate the type of GBV. After obtaining the history, a complete physical examination is conducted by the healthcare provider according to WHO recommendations from head to toe and genitalia in cases of sexual violence ( WHO, 2013a ; Recommendation 11). When offering physical exams, the following principles have to be respected;

After completing a physical examination, the care for apparent injuries and urgent needed medical care follows. Any severe injuries such as cuts and wounds are cleaned as treated appropriately on the spot. Medications such as antibiotics can be provided to avoid infection, medications to relieve pain, anxiety and insomnia and anti-tetanus vaccination. In a situation of sexual violence, the capacitated health care provider should provide ( WHO, 2013a ; Recommendation 11):

Mobilize social support services after obtaining consent from the victim. Work with the victim to develop a safety plan that will include children if available. Take dispositions for follow up care where applicable ( UNFPA, WAVE, 2014 ).

More psychological and mental health attention is given to victims/survivors of intimate partner and sexual violence. Immediate psychological support consists of: Not intruding while providing practical care and support; evaluating needs and concerns in order to help patients to address basic needs (for example, food and water, information); listening to patients attentively, but not putting pressure to get them to talk; reassuring and helping patients to feel calm; facilitating linkage to information, services and social supports; protecting patients from further harm; and provide written information on coping strategies for dealing with severe stress. Psychological follow-up support should cover a period of at least 3 months and has to be watchful, especially for cases where suicidal thoughts are identified as well as alcohol and drug abuse issues. If the victim/survivor presents signs and symptoms of mental health problems, they should be referred to specialist health care providers for psychological/mental interventions ( UNFPA, 2015 ).

Collecting evidence of GBV should be done by a well-trained provider in a confidential context. The victim/survivor has to be reiterated the importance of collecting evidence, especially in the context of sexual violence. The type of evidence collected consists of both medical and forensic evidence. The collection of both medical and forensic samples should be done in the same place and by the same person as this reduces the number of examinations that the patient has to undergo and can ensure that the needs of the patient are addressed more comprehensively. Before collecting any type of evidence, first obtain the consent of the victim/survivor. In the case where the victim/survivor accepts to share an evidence, they should be told how to handle the evidence material in order to preserve/not to destroy the evidence (e.g. not to wash, change clothes). After collecting the evidence, ensure that it is documented in the patient records ( UN Women, 2014 ).

Risk assessment and management interventions are important in reducing risk levels during service provision. A safety plan is developed taking in consideration risk factors and resources available. Establishing a safety plan is part of the case intervention which is essential in preventing future violent incidents or avoiding escalation or exposure to extreme situations. List the friends or neighbors of the victims who can provide shelter to the victim/survivor incase of an emergency. Neighbors can also serve as witnesses to confirm is they hear violent noises or disturbances in the house of the victim/survivor. A safety bag should be packed and kept in a place that can easily be taken for escape in case of emergency. The victim/survivor will also practice simulations on how to go out of their homes quick and safe. The survivor has to be told to make use of their sense of judgment especially in cases where the abuser can become very hysterical. In this case for the safety of you and your children, give the abuser what they want in order to calm them down. Risk factors that can initiate the development of a safety plan include situations where the victim/survivor, their children or family member has previous acts/incidents of GBV with history of convictions from the police. Violent behavior outside the family can also be considered a risk factor. The process of separation or divorce increases chances of violence. The perpetrator has more power when other family members are in agreement with abusive attitude. Illegal or legal possession of weapons are tempting to use in situations of violence. When perpetrators consume drugs and alcohol, it can cause them to reason and act irrationally and violent with regrets after effect of alcohol. If the victim/survivor experiences threats of murder, provision of a safety plan should be taken very seriously. Situations that can lead to threats of murder are changes in relationship for example. Extreme patriarchal attitudes and culture, having a possessive and jealous partner, , stalking of the victim/survivor by the perpetrator and non-compliance with police restraining order are risk factors that need to be considered when establishing a safety plan ( UNFPA, 2015 ).

Demographic information about the victim is registered in the patient record and then entered into a data base which is very confidential. Information includes an account of the incident, the medical history, results of the physical examination, tests and their results, treatment plan, medications given or prescribed, victim/survivor education and information offered, referrals. Details of any apparent injury is documented with precision using additional forms and drawings of body maps for more accurate representation. Full details on the type of GBV experienced by the victim/survivor, their relationship with the perpetrator, the type of weapons used with evidence, the availability of witnesses, and history of other previous incidents. What the victim/survivor discloses is documented in their own words by the health care provider. Any emotional and psychological symptoms are also noted. All information about GBV is documented after obtaining consent from the victim while précising that it is possible to use the information for other services ( UN Women, 2014 ).

The response needs of GBV victims/survivors are complex as they require the involvement of multiple sectors. Therefore, an effective response to GBV requires a comprehensive set of services available through a multi-sectoral coordinated response that can be ensured by an effective referral. Most often, healthcare professionals are the first to get in contact with the GBV victim/survivor. This implies that they are in the better position to refer victims for appropriate health care services intra and extra health facilities and/or to other services (police, specialized services, social protection). On the other hand, health care providers can also have to assist GBV victims/survivors referred by other service providers and other specialized services. Effective referral require that health care providers able to, identify victims/survivors of GBV; offer the victims/survivors first line support; assess any risk factors that can hamper the safety of the victims/survivors; be knowledgeable about the protection laws against GBV for which the victim/survivor has the right to benefit and are able to obtain consent for any step of the process. The steps below should be followed to ensure an effective referral ( WHO, 2013a ; UN Women, UNICEF, UNFPA, 2015 ):

WHO—which institution/organization provides services to GBV victims/survivors, adding contact information of a person (name, telephone number) that can be reached as an entry point to that service.

WHAT—what sort of assistance they can expect to receive from a specific service provider, adding cost information related to that service.

WHERE—where exactly is the place (the exact address) of the indicated services.

The conditions and behaviors of victims associated to GBV in a law enforcement station such as a police station are slightly different from those in a health care setting but similar for the most part of it. In a law enforcement setting, most GBV Victim/survivors change their minds from making a complaint upon arrival although it is possible to identify signs of GBV when observing the victim/survivor. Cases can also be identified from disclosure by a neighbor or relative. Some of the hindrances that cause the victims/survivors not to make their complaints are:

In addition to the conditions and behaviors that can indicate a situation of GBV in a health care setting, other behaviors that the victim puts up that could be a signal to the police are: substance abuse, anxiousness of being in danger always with fear of everything accompanied by trembling physical reactions. Attempts to justify the abuser with the belief that the abuser will change. When the victim is not consistent in saying what happened believing that things are under control especially when the partner refuses to leave the presence of the victim/survivor when being interviewed. Also when the victim/survivor is indecisive and says that “it is normal for people to be abusive. Another strong condition is when the victim/survivor does not have a phone ( UNFPA, 2015 ).

When asking about GBV at the time of interaction with the victim/survivor in a police station, there are some specific actions that should be done to avoid re-victimization. The police officer should keep the gun aside in order to avoid re-victimization of the victim/survivor. Apart from keeping the gun away, the same way you interact with the victim/survivor in a health care setting is the same way the service provider in the police station has to behave with a GBV case.

Even in a police setting, victim/survivor autonomy and confidentiality is important after ensuring security. The victim/survivor in a police setting has to get the impression that the law enforcement officers are committed to safety and manage the situation seriously at the initial contact. The procedures to be carried out when faced with a GBV victim/survivor are: identification, evaluation, legal assistance/investigation, collect evidence, documentation, and referral.

Identification at an institution of law enforcement can be through self-disclosure by the victim/survivor or through a health provider or a relative. On the other hand, the law enforcement officer may meet the victim/survivor at the premises after a phone call. After an emergency phone call during intervention, the police officer has to ( UNODC, 2010 , UNFPA, 2015 ).

When the victim/survivor reports to the police premises asking for assistance or has been referred from other institutions/services:

After identification, the next steps which consist of legal assistance/investigation, collection of evidence, documenting GBV, and referral, should be determined by the police officer after carrying out an evaluation. The procedures for evaluation in a police or law enforcement setting is the same as in the health care setting apart from specific exceptions. For all services that will follow, consent has to be obtained. Consent is obtained from parents in case where the victims/survivors are minors (children). In the context where the victim/survivor cannot read or write, verbal consent is obtained and documented in the patient file. The victim/survivor has to be told that he/she has the right to decide which information to disclose or to keep confidential i.e. the right to limited consent. When obtaining consent, the implications of sharing the information with other services/institutions have to be made known to the victims/survivors. All actions should be geared towards helping the victim/survivor. If the case of GBV is being disclosed by the victim/survivor themselves, provide an opportunity for them to recount what happened while talking about the type of violence and the perpetrator. Reduce the number of times a victim/survivors have to recount their story as much as possible. Based on what has been recounted, the needs and the resources available to respond to the GBV case will be evaluated while considering the social, familial, and individual situation of the victim/survivor context. Phrases should be formulated towards the victim in a non-judgmental manner, using a sympathetic voice. The victim/survivor should be given the opportunity to express their expectations from the law enforcement service for any assistance or intervention. The assistance/intervention to be provided should be that should be provided to be tailored according to the expectations to protect the GBV victim/survivor ( UN Women, 2014 ).

The interventions or service provision to a GBV victim/survivor is very crucial because it enables the identification of evidence to support the report statements of the victims/survivors. Most GBV occurs in private behind closed doors and usually the victims/survivors statement is the only testimony available for law enforcement officers. Meanwhile, the police officers cannot depend only on the report statement of the victim/survivor to build a solid case against the suspect or the perpetrator. Collecting evidence is crucial to support the prosecution file and prove that the perpetrator is guilty. As such, the police or justice will have a grounded right to issue and enforce protection orders for the victim/survivor ( UNODC, 2010 ). During investigation, the police officer follows these steps.

In a crime scene, collecting evidence is done by forensic scientists or crime scene technicians. Professional examination from forensic scientists or crime scene technicians, increases the likelihood that injuries will be properly documented and strong evidence collected to support the investigation and prosecution of the perpetrators. During medico legal examination, other officers are not present except the professional forensic examination staff. Medico legal examinations are conducted in a prompt and gender sensitive manner that respects the dignity of the victim/survivor ( UNODC, 2010 ); Everything done during the medico legal exam is documented. The officer explains the process of collecting evidence to the victim/survivor guided by the following steps;

Officers shall protect the integrity of the evidence and guard the chain of custody by making sure they are: properly marking, packaging, and labelling all evidence collected which can include:

In a law enforcement setting, risk assessment and management also have to be carried out in order to come up with a reliable safety plan just as in a health setting. The identification of risk factors enables the establishment of a safety plan and these are the same as in a health care setting. Risk assessment and management interventions are important in reducing risk levels during service provision. A safety plan is developed taking in consideration risk factors and resources available. Establishing a safety plan is part of the case intervention which is essential in preventing future violent incidents or avoiding escalation or exposure to extreme situations. List the friends or neighbors of the victims who can provide shelter to the victim/survivor incase of an emergency. Neighbors can also serve as witnesses to confirm is they hear violent noises or disturbances in the house of the victim/survivor. A safety bag should be packed and kept in a place that can easily be taken for escape in case of emergency. The victim/survivor will also practice simulations on how to go out of their homes quick and safe. The survivor has to be told to make use of their sense of judgment especially in cases where the abuser can become very hysterical. In this case for the safety of you and your children, give the abuser what they want in order to calm them down. Risk factors that can initiate the development of a safety plan include situations where the victim/survivor, their children or family member has previous acts/incidents of GBV with history of convictions from the police. Violent behavior outside the family can also be considered a risk factor. The process of separation or divorce increases chances of violence. The perpetrator has more power when other family members are in agreement with abusive attitude. Illegal or legal possession of weapons are tempting to use in situations of violence. When perpetrators consume drugs and alcohol, it can cause them to reason and act irrationally and violent with regrets after effect of alcohol. If the victim/survivor experiences threats of murder, provision of a safety plan should be taken very seriously. Situations that can lead to threats of murder are changes in relationship for example. Extreme patriarchal attitudes and culture, having a possessive and jealous partner, stalking of the victim/survivor by the perpetrator and non-compliance with police restraining order are risk factors that need to be considered when establishing a safety plan ( UNFPA, 2015 ).

Documentation of a GBV incident in the police service is done using a specific form which varies across countries. The form is structured in such a way that it captures information about the victim/survivor and perpetrator during first contact, interviewing, investigation and the final step when the police officer summarizes the complete case. Documenting GBV incidents in a police service should have the following information;

The police officer may need to refer the victim/survivor for other services after assessment or upon request by victim/survivor ( UN Women, UNICEF, UNFPA, 2015 ). The procedures for referral at the law enforcement office are the same as in the health care setting. During referral the police officer has to consider the following steps;

WHO—which institution/organization provides services to GBV victims/survivors, adding contact information of a person (name, telephone number) that can be reached as an entry point to that service.

WHAT—what sort of assistance they can expect to receive from a specific service provider, adding cost information related to that service.

WHERE—where exactly is the place (the exact address) of the indicated services.

There are declarations and conventions that have been developed to mitigate violence against women. The development of legislations against GBV especially violence against women originates from the Universal Declaration of Human Rights of 1948 that forms the most basic international foundation for combating violence. It lays out principles of equality, security, liberty, integrity, and dignity for all people, including women. In 1993, the United Nations (UN) World Conference on Human Rights in Vienna paved the way for the integration of women's rights in both public and private spheres. another UN Declaration on the Elimination of Violence Against Women (DEVAW) was adopted by the General Assembly, calling on states to “exercise due diligence to prevent, investigate, and punish violence against women, whether those acts are perpetrated by the state or by private persons” ( UN Women, 2012 ). The Beijing Declaration and Platform for Action adopted at the 4th World Conference on Women in 1995 set strong terms for the elimination of VAW. A major step in establishing rights for women was the 1979 Convention on the Elimination of All Forms of Violence Against Women (CEDAW), which has been ratified by 188 nations ( Klugman, 2017 ). In addition, the Istanbul Convention that applies in both times of peace and armed conflict, has been recognised as the most powerful legally binding set of comprehensive standards for preventing and combating violence against women in Europe and beyond ( CETS 210-Council of Europe, 2011 ). These declarations and conventions developed to prevent and protect from violence done against women are used and ratified by many nations of both developed and still developing countries. More recent dispositions consist of the United Nations 2030 Sustainable Development Goals, where “all forms of discrimination against women and girls have to be eliminated”.

Psycho social service delivery to victims/survivors of GBV is a component of social services that ensure their rights, safety and wellbeing. Psycho social services include provision of helpful information on legal rights, hotlines for help and safe accommodation. Psycho social service providers are most often considered as counsellors who provide assistance to GBV victims/survivors. The objectives of the standard operating procedures to offer care to GBV victims/survivors are the same as in a health care setting and in the police service. The objectives in psycho social service provision also constitute linking the victim/survivor to other services. For the standard operating procedures to be implemented properly, minimal training of service providers is needed. However, what is better is for the standard operating procedures to be part of a more comprehensive training that includes sections on multi-sectoral response to GBV, specific response to GBV of psycho-social services and prevention and awareness. Basic psycho social service provision must be supported by core elements which include: informed consent and confidentiality, accessibility, referral, risk assessment and management, appropriately trained staff and workforce development, monitoring and evaluation, and system coordination and accountability ( IASC, 2005 ; UNFPA, 2001 ). The social services provided to GBV victims/survivors should cover:

Effects of GBV on victims/survivors are most often chronic and may sometimes end up with psychopathologies. Psychological conditions/behaviors that might occur in situations of GBV include:

Some psychological effects specific incase of the sexual form of GBV violence include:

The interaction with a GBV victim/survivor when offering a psycho social service is the same as in a health care setting and in a law enforcement setting. What is peculiar about services in a psycho social service is that environment where the social service is being offered gives an impression on the victim/survivor. This affects the way the victim/survivor will provide information and be open to the social service counsellor. Sometimes the victim/survivor may not have food due to limited funds. Therefore, the environment where social services are offered should always take dispositions to secure refreshments, snacks and water to the victim/survivor. After physical needs are met, the counsellor can now proceed with addressing the upper layers from Maslow’s hierarchy of needs ( Robert, 2009 ). At the moment of discussion with a GBV victim/survivor avoid putting a table in between counsellor and victim/survivor as this can hinder communication. The sitting position with the victim/survivor should be such that it creates equality in power. A round table discussion is more appropriate or better still a no table in between. Also the counsellor should avoid having face-to-face and eye ball to eye ball watching the victim as this can give an impression of confrontation which can hinder communication.

When offering psycho social services, the security of the victim/survivor is a priority followed by the confidentiality of anything discussed. The aim of offering social services is to help the victim gain control of their lives and have more self confidence by applying actions to reduce isolation or alienation, improve family integration, obtain legal services and supporting economic independence. Similar to a health care setting and a police setting, the steps in the procedures of responding to a GBV case in a psychosocial service consist of identification, evaluation, intervention, documenting GBV, referral, and case management coordination. The steps can follow any order but it is primordial to start with the identification step.

Identification in a psychosocial service can be done through referral or by self disclosure. Before starting to implement any response interventions, first obtain consent of the victim/survivor. Ensure that the victim/survivor is safe and information provided is confidential. Quickly address any urgent physical needs or life threatening conditions. The counsellor attempts to gain the trust of the victim/survivor prior to addressing any psycho-social needs. The steps for identification are almost the same as in a health care setting and in a police or law enforcement setting aside certain particularities;

The evaluation steps includes information about the psychological needs and the physical needs of the victim/survivor as well as the social life, relationships and economic status. Based on these, the evaluator will then decide on the appropriate or priority next steps in the procedure that the victim/survivor has to benefit from. The evaluation process is similar to that of a law enforcement setting and a health care setting. Consent is obtained from parents in case where the victims/survivors are minors (children). In the context where the victim/survivor cannot read or write, verbal consent is obtained and documented in the patient file. The victim/survivor has to be told that he/she has the right to decide which information to disclose or to keep confidential i.e. the right to limited consent. When obtaining consent, the implications of sharing the information with other services/institutions have to be made known to the victims/survivors. Educate the victim about GBV and its negative consequences on health. All actions should be geared towards helping the victim/survivor. If the case of GBV is being disclosed by the victim/survivor themselves, provide an opportunity for them to recount what happened while talking about the type of violence and the perpetrator. Based on what has been recounted, the needs and the resources available to respond to the GBV case will be evaluated while considering the social, familial, and individual situation of the victim/survivor context. The appropriate support to be provided is determined based on the needs evaluated such that the GBV victim/survivor is protected ( UN Women, 2014 ). Other particularities when evaluation is being done in a psycho social service consist of the following steps;

All psycho-social service provision are offered to GBV victims/survivors in a manner that is adaptable, sustainable, holistic and multi-sector. The interventions are aimed to reduce the negative effects of GBV by establishing an individualized plan that addresses the needs as identified during evaluation. Crisis counselling can be offered in person, via telephone, mobile phone, e-mail and in various locations and diverse settings. The aim of crisis counselling is to achieve immediate safety, make sense of their experience, reaffirm their rights and alleviate feelings of guilt and shame. In extreme cases, there are long term psychosocial services such as psychotherapy which can be offered. During crisis counselling the following actions are offered by the counsellor;

Long term psycho social and counselling services can either be formal or informal. These services could include support groups, individual counselling, and a 24-hour hotline. Within the community, informal counselling services could be support groups of victims/survivors as well as faith based and community based group interventions. These services are effective in addressing the psychological needs of victims/survivors who are experiencing depression, anxiety, and/or post traumatic stress disorders. The services take into consideration the following actions;

Sometimes, when victims/survivors leave their homes of danger, they need immediate accommodation services as a place of safety and refuge for them and their children if any. Psycho social services need to implement the following actions;

Other support services provided during psycho social response to GBV victims/survivors consist of;

Risk assessment and management of GBV victims/survivors in a psycho social service setting is the same as in a law enforcement setting and a health care setting. Identification of risk factors help in the establishment of an adequate safety plan. The risks factors that can draw the attention of the psycho social service provider consist of; situations where the victim/survivor, their children or family member has previous acts/incidents of GBV with history of convictions from the police. Violent behavior outside the family can also be considered a risk factor. The process of separation or divorce increases chances of violence. The perpetrator has more power when other family members are in agreement with abusive attitude. Illegal or legal possession of weapons are tempting to use in situations of violence. When perpetrators consume drugs and alcohol, it can cause them to reason and act irrationally and violent with regrets after effect of alcohol. If the victim/survivor experiences threats of murder, provision of a safety plan should be taken very seriously. Situations that can lead to threats of murder are changes in relationship for example. Extreme patriarchal attitudes and culture, having a possessive and jealous partner, stalking of the victim/survivor by the perpetrator and non-compliance with police restraining order are risk factors that need to be considered when establishing a safety plan ( UNFPA, 2015 ).

Documentation about GBV during psycho social service provision is done using standardized forms, charts and registers. It should be noted that the guidelines across countries will determine how comprehensive the information should be. The information collected provides a comprehensive summary about the GBV incident. Data collected is useful for monitoring and reporting purposes about GBV as well as a baseline to evaluate the multi sectoral response of GBV in a nation. Information document in a psycho social service includes;

The referral system should be effectively coordinated with other services to ensure prompt and safe response to the needs of the victim/survivor. The service providers should be aware of the referral system between institutions and/or organizations and have the contact details of the different service providers. Offering referral services in a psycho social service is similar to that of a law enforcement setting and a health care setting but has certain peculiarities ( UNFPA, 2015 ).

During referral in a psycho social setting, the provider should do the following actions: