International Center for Research on Women, 1120 20th Street NW, Suite 500 N., Washington, DC, USA.
Independent Consultant, Beirut, Lebanon.
Health Policy Plan. 2018 Sep 1;33(7):767-776. doi: 10.1093/heapol/czy050.
As the landscape of humanitarian response shifts from camp-based to urban- and informal-tented settlement-based responses, service providers and policymakers must consider creative modes for delivering health services. Psychosocial support and case management can be life-saving services for refugee women and girls who are at increased risk for physical, sexual and psychological gender-based violence (GBV). However, these services are often unavailable in non-camp refugee settings. We evaluated an innovative mobile service delivery model for GBV response and mitigation implemented by the International Rescue Committee (IRC) in Lebanon. In October 2015, we conducted in-depth interviews with IRC staff (n = 11), Syrian refugee women (n = 40) and adolescent girls (n = 26) to explore whether the mobile services meet the support needs of refugees and uphold international standards for GBV service delivery. Recruitment was conducted via purposive sampling. Data were analysed using deductive and inductive approaches in NVivo. Findings suggest that by providing free, flexible service delivery in women's own communities, the mobile model overcame barriers that limited women's and girls' access to essential services, including transportation, checkpoints, cost and gendered expectations around mobility and domestic responsibilities. Participants described the services as strengthening social networks, reducing feelings of idleness and isolation, and increasing knowledge and self-confidence. Results indicate that the model requires skilled, creative staff who can assess community readiness for activities, quickly build trust and ensure confidentiality in contexts of displacement and disruption. Referring survivors to legal and medical services was challenging in a context with limited access to quality services. The IRC's mobile service delivery model is a promising approach for accessing hard-to-reach refugee populations with critical GBV services.
随着人道主义应对措施的重点从营地为基础转向城市和非正规帐篷定居点为基础，服务提供者和政策制定者必须考虑提供卫生服务的创造性模式。心理社会支持和病例管理对于面临更高身体、性和心理性别暴力（GBV）风险的难民妇女和女孩来说是救命服务。然而，这些服务在非营地难民环境中往往无法获得。我们评估了国际救援委员会（IRC）在黎巴嫩实施的一项创新的基于移动的性别暴力应对和缓解服务提供模式。2015 年 10 月，我们对 IRC 工作人员（n=11）、叙利亚难民妇女（n=40）和少女（n=26）进行了深入访谈，以探讨移动服务是否满足难民的支持需求，并坚持性别暴力服务提供的国际标准。通过目的性抽样进行了招募。使用 NVivo 中的演绎和归纳方法对数据进行了分析。调查结果表明，通过在妇女自己的社区提供免费、灵活的服务提供，移动模式克服了限制妇女和女孩获得基本服务的障碍，包括交通、检查站、费用以及围绕流动性和家庭责任的性别期望。参与者将这些服务描述为加强社会网络、减少无所事事和孤立感，以及增加知识和自信。结果表明，该模式需要熟练、有创造力的工作人员，他们能够评估社区对活动的准备情况，在流离失所和混乱的情况下迅速建立信任并确保保密性。在获得高质量服务有限的情况下，将幸存者转介给法律和医疗服务具有挑战性。IRC 的移动服务提供模式是为难以接触到的难民人口提供关键性别暴力服务的有前途的方法。
