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Webinar agenda

Strengthening Referral Pathways for Children and Adolescents Affected by Sexual Violence Lessons from Kenya and Uganda. Webinar agenda. Overview Introduction to the Companion Guide Country context and approach Key Outcomes and Lessons Kenya Uganda

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Webinar agenda

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  1. Strengthening Referral Pathways for Children and Adolescents Affected by Sexual ViolenceLessons from Kenya and Uganda

  2. Webinar agenda Overview Introduction to the Companion Guide Country context and approach Key Outcomes and Lessons Kenya Uganda Reflection on Next Steps and Broader Application Questions and Discussion

  3. Introduction to the Companion Guide

  4. Introduction to the Companion Guide • Companion to 2012 PEPFAR clinical management technical considerations • Aim: generate understanding / facilitate clinical & community service linkages to ensure comprehensive care for child and adolescent survivors of sexual violence and exploitation

  5. Rationale for project Need for guidance on how a comprehensive referral system should function, and what such a system should include Limited national protocols on delivery of comprehensive services tailored to child & adolescent needs, including critical short and long-term medical, psychosocial, safety/protection, legal/justice, and other social services.

  6. Setting the scene USAID requested 4Children to identify potential for applying content of Companion Guide in practical settings AIDSFree partner, Encompass Health, worked with 4Children to undertake preliminary scoping in Kenya, August 2016 Pilot began in Kenya, 2017 and expanded to Uganda, late 2017

  7. Country Context and Approach

  8. Country context SIMILARITIES High levels of sexual violence against both girls and boys, yet low levels of reporting and service uptake National policies on sexual violence stress multisectoral prevention and response … …yet little concrete guidance on coordination & referrals Referral pathways dependent on service and resource availability, and programme focus Growing focus on case management key entry point

  9. Approach to pilot Government buy-in and commitment Focus on referrals

  10. Participatory focus • Participatory workshops with strong focus on cross-learning between sectors & joint identification of priority interventions. • Justice & police, alongside community & clinical services • Focus on creative & practical solutions built on existing resources, networks & systems

  11. PILOTING THE GUIDE IN KENYA

  12. Kenya – key steps Department of Children’s Services authorized pilot and subsequently led process Identified two pilot counties – Turkana & Nakuru Entry point was pilot of National Case Management & Referral Pathway guidelines Held county level meetings to contexualise pilot Mapped referral systems & identified potential improvements

  13. Kenya – key outcomes Developed common messages and visuals, particularly around why, where, when of reporting Strengthened mutual understanding of roles, bottlenecks & contributions of all actors in the referral pathway Recognition that the efficacy of the referral system is a reflection of how well actors work together and share resources. Recognition that despite resource and capacity limitations, referrals can work

  14. Lessons learned - Kenya Case management considered key by government and non-state actors, yet different tools and processes are used, impacting on: Uptake of cases by police and judiciary Survivors’ psychosocial health MIS plays key role in updating # of SV cases & monitoring service access - offers opportunity for non-state actors to align CM tools and processes

  15. Lessons learned – Kenya (2) Urgency & uptake of child SV cases restricted due to children’s general role in society & gender norms Household income is key determinant to gauge whether survivors access the range of needed services and support

  16. PILOTING THE GUIDE IN UGANDA

  17. Uganda – key steps Objective to identify and document lessons learned, promising practices, innovative approaches to strengthen referrals and coordination of sexual violence cases Held 2 multi-sectoral meetings for four districts in central Uganda in early 2018 Included health, education, social welfare, police, child protection and justice sectors (Government & non-government )

  18. Uganda – key steps (2) Generated common understanding of what a referral pathway could look like and its purpose, identified common messages on SGBV Reviewed progress on enhancing referrals, coordination and developed job aids & future actions

  19. Uganda: Key outcomes Recognized responsibilities of all stakeholders in the referral pathway - developed job aids to address bottlenecks: Disseminated job aids to UCHL and other districts to facilitate appropriate rereferrals Disseminated the report at MGLSD National learning event on the child wellbeing Informed 4Children’s support to MGLSD on strengthening referrals harmonized case management. Increase in SGBV cases reported and referred

  20. Sample job aid

  21. Uganda: Lessons learned Hindrances High caseloads and demanding work schedules limit best interests of the child. Limited understanding of different stakeholder’s roles in referral pathway hinders effective referral Miss use of forms required by different service providers hinders progression along the referral pathway Financial costs related to reports and referrals e.g. charge for forms, transport costs to magistrate courts, etc.

  22. Lessons learned – Uganda (2) Relationships and networks are critical to functioning referral systems Involvement of police and justice is crucial Religious leaders and teachers hold positions of authority and trust & could play critical role in reporting incidences of violence if included in referrals

  23. Lessons learned – Uganda (3) Raising awareness and sensitization on focused and targeted actions to strengthen the child protection system can be done with minimal or no additional costs Although coordination mechanisms often exist at district level, SGBV not commonly present PSS is recognized as a key service, but little guidance as to what it entails and who should provide it

  24. REFLECTIONS ON NEXT STEPS AND BROADER APPLICATION

  25. Next steps & broader application 2018 - INSPIRE strategies & orientation manual offer additional rationale & suggestions Key lesson: essential to start with local context, but Companion Guide offers practical approaches and tools that can aid sharing and practical responses Already being applied in other contexts e.g. 4Children Haiti exploring checklist on progress toward quality service delivery

  26. Summary report available at OVCsupport.org https://ovcsupport.org/resource/strengthening-referral-pathways-for-children-and-adolescents-affected-by-sexual-violence/ Companion Guide available here: https://aidsfree.usaid.gov/resources/prc-companion-guide

  27. Thank you! • Kenya • Daniel Oloo, former programme manager, CRS • MarygorretMogoka, Assistant Director DCS • All Kenyan DCS colleagues in Nakuru & Turkana counties, and all other ministry & NGO participants • Uganda • Michelle Ell, Lydia Acola & Brenda Kyomugisha, 4Children Uganda • Irene Kulabako, Consultant • Participants from MGLSD, other ministries and NGOs in the district workshops

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