The President’s Emergency Plan for AIDS Relief (PEPFAR) Guidance on GBV/HIV Integration

1. The President’s Emergency Plan for AIDS Relief (PEPFAR) Guidance on GBV/HIV Integration

2. Overview of Guidance Part 1: • Principles for working with GBV Survivors • GBV programming Part 2: • Issues, Opportunities and actions Recommended resources: Practical tools

3. Working with Survivors • Do no harm • Privacy, confidentiality, and informed consent • Meaningful engagement of PLHIV • Accountability and M&E

4. Programming Steps • Situation analysis • Employ a rights-based, gender sensitive approach • Plan for and support community participation • Special attention to young people • Identify MARPs • Workplan • Establish M&E framework and plan • Budget

5. Definition of Gender-based violence “Any act of violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering for women/men, including threats of such acts, coercion, or arbitrary deprivations of liberty, whether occurring in public or private life” (United Nations General Assembly 1993)

6. Types of Gender-Based Violence • Intimate partner violence (physical, sexual, psychological, economic) • Sexual coercion • Childhood sexual abuse • Rape • Trafficking • Rape in conflict situations • Acid throwing • Female Genital Mutilation • Honour killings • Dowry deaths --Source: WHO TEACH-VIP, 2005

7. Conceptual framework for Reducing Gender-Based Violence and Coercion Barriers and Contributing Factors HIV-Related Consequences Norms, attitudes and beliefs that condone GBV Experience of GBV in the form of forced sexual intercourse Lack of awareness and knowledge of GBV problems Lack of ability/self-efficacy to negotiate safe sex Stigma associated with GBV that keeps GBV hidden Increased risk of HIV exposure Engagement in high risk sex Experience of any form of GBV Harmful relationship dynamics Barriers to getting HIV test and knowing status Experience/fear of GBV if HIV+ status becomes known to others Those in need of HIV/AIDS services not getting them Lack of services Barriers to accessing care and treatment Weak policies/laws and legal/judicial systems Social/political tumult

8. Attitudes Regarding GBV: Men and Women Who Approve Violence Against Wives Source: Kenya Demographic and Health Survey, 2003

9. Gender strategic areas Cross-cutting approaches • Increasing gender equity in HIV/AIDS activities and services • Addressing male norms and behavior • Reducing violence and coercion • Increasing women’s and girls’ access to income and productive resources • Increasing women’s legal rights and protection

10. PEPFAR Support • 2/3 of those receiving PEPFAR-supported anti-retroviral therapy are women. This treatment provides them the opportunity to take control of and prolong their lives, increases their independence, and allows them to continue to take care of their children. • PEPFAR was the first development partner in Kenya to support both integrated gender-based violence and HIV programs at Nairobi Women’s Hospital and the provision of post-exposure prophylaxis (PEP) to women who have been raped and potentially exposed to HIV. • PEPFAR disaggregate its HIV program data by gender, a critical step to ensure HIV interventions are targeted to, and sensitive of, the unique vulnerabilities faced by women

11. EDUCATION The life skills program in primary schools has integrated GBV Addresses issues on assertiveness, gender based violence and drug and alcohol abuse Ministry of Education Sector Policy on HIV and AIDS Emphasize zero tolerance on sexual harassment, abuse or exploitation Kenya Girl Guides Association program provides girls with knowledge and skills to make good choices, and be assertive and challenges them to pursue long term opportunities, as well as making them aware of their rights. Skills building programs for street children Working with Ministry of Gender, Children and Social Development and other key stakeholders to reduce GBV in schools making them safer for all students Specific interventions

12. Interventions targeting OVCs • Almost 600,000 orphans and vulnerable children receive support from PEPFAR, half of those girls. • USAID partners have supported OVC caregivers to join Savings and Loan Associations (SLAs). Members of such groups draw small loans from their own savings to pursue small businesses, procure agricultural inputs, pay for school fees, or attend to other socio-economic needs. The groups are also rewarded for their hard work through the provision of “self-help” project support, which further boosts their income levels and food and nutritional security. • Group initiatives have included gravity feed irrigation schemes, livestock and seed multiplication, and poultry rearing.

13. Support to Women and Vulnerable children • NEP girls’ orphanage – supports a girls’ orphanage in the region, • They have an initiative that helps rescue girls from trafficking circles • Empower MARPs

14. Policy and advocacy interventions • PEPFAR has an interagency Gender Working Group dedicated to incorporating gender into all PEPFAR programming, and now sits on the Gender Technical Working Group at the GOK • USAID is a member of the National Committee for the Abandonment of FGM/C that supports networking and collaboration among key stakeholders. This committee is chaired by the Ministry of Gender, Children, and Social Affairs, which developed a National Plan of Action for the Elimination of FGM/C in Kenya • USAID has worked with Njuri Ncheke Elders in the wider Meru area and other key leaders, Individuals and organizations working in HIV/AIDS and OVC activities; who have been sensitized on concepts in OVC care and inheritance rights of widows and orphans through the WPOIR (Women Property Inheritance Rights/OVC Initiative project.)

15. Women empowerment Interventions in Democracy and Governance • USAID supports various projects/activities that seek to (a) advance women’s legal rights and (b) promote and enhance women’s participation in political sphere and in governance. These are:- • Civil Society Advocacy Programs • Conflict Mitigation and Reconciliation Program • Political Party Strengthening • Parliamentary Program

16. Civil Society Advocacy Programs • Support programs that advocate for policy/legal reforms. In the recent years, we have supported groups working on - • Revisions to the Sexual Offenses Act • Incorporation of female-friendly policies into the National Land Policy • Incorporation of women’s concerns into Vision 2030 (this is the government’s blue print for development). • A common women’s agenda was put forward and incorporated into the draft Constitution.

17. Conflict Mitigation and Reconciliation Program • USAID is supporting community-based as well as community-driven mechanisms/structures including, District Peace Committees that involve women. • Activities that raise awareness, sensitize and educate communities on the negative impact of gender-based violence • Establishment of women’s grassroots’ networks (i.e. networks that preach and promote reconciliation and peaceful resolution of differences) • Mainstream gender in the national policy on land conflict management

18. Political Party Strengthening • The USG political parties program focuses on strengthening parties’ internal democracy by promoting gender equity and youth participation. Activities include: • Assisting parties to set up structures and develop policies that promote internal democracy and by extension gender • Leadership training for women including helping them to develop action plans • The follow-on program (2009) will focus on providing support to candidates from marginalized groups i.e. women

19. Parliamentary Program • The Program targets critical committees in Parliament that either (a) scrutinize draft legislation or (b) provide oversight to government. providing subject- matter experts (including gender experts) to give opinions and analysis to the committees. • Through the PIN network, the program facilitates interaction between Parliament and CSOs (including CSOs working on gender issues). • Under the new Standing Orders, there is opportunity to advance gender issues through new openings - such as public petitions and public hearings. • Work with the Women Caucus.

20. ECONOMIC GROWTH: GENDER EQUITY AND WOMEN EMPOWERMENT INTERVENTIONS • The Economic Growth program supports activities that: • enhance the competitiveness of horticulture, maize and dairy agricultural value chains by reducing inefficiencies that originate from gender-based constraints • increase opportunities for women at all levels of target agricultural value chains • increase women’s access to financial services to enhance their economic opportunities • improve women’s representation in environment and natural resource governance, their rights & entitlements to natural resources such as land and benefits from conservation enterprises

21. Economic Growth: Policy Interventions Support policy reforms that advocate for women’s rights: • Undertook assessments on women’s land tenure and property rights in agriculture and environment sectors to inform the National Land Policy and clauses on women’s land rights • Supports a program on securing rights to land and natural resources for improved biodiversity and livelihoods, targeting indigenous landless communities at the North Coast, women are among core beneficiaries. • Supported the Micro Finance Act and formulation of women friendly financial products. Women form larger proportion of micro finance borrowers.

22. Economic Growth: Gender integration strategies Strategies used to reach more women include: • promoting gender equitable opportunities in USAID-supported agricultural value chains and natural resource managementprograms • Support of horticultural crops, livestock products and conservation products traditionally favored by women • Promoting the concept of ‘farming as a family business’ to improve household gender relations • Direct targeting of project activities to more women to reduce gender inequities in supported projects

23. Conclusion…. • Integration into HIV • Stand-alone GBV services/centers • Wrap around services/interventions • Diversity in funding • Strategic Information

24. Emma Mwamburi emwamburi@usaid.gov Mary Mwangi mmwangi@ke.cdc.gov THANK YOU