Has the role of the health system against gender-based violence been exhausted?

 Has the role of the health system against gender-based violence been exhausted?

One-stop crisis management centers are operating in 97 hospitals across the country to provide health care and legal assistance to victims of violence.

To make the campaign against gender-based violence effective, it needs to be permanently included in the organizational structure of the Ministry of Health and Population.

Any type of humiliating, painful or threatening behavior that occurs or may occur on the basis of gender is gender-based violence. The act of pressure, coercion or arbitrary deprivation of freedom also falls under gender-based violence.

Gender-based violence is deeply embedded in our society. It begins at the fetal stage. Abortion based on gender identity is the first stage of violence. Family and social discrimination during childhood and adolescence is the next stage.

After this, discrimination occurs at the reproductive age, sexual violence or discrimination is deprived of property and resources in old age.

A question that always arises in everyone's mind: Are only women victims of violence?

Answer: ‘No’.

Men and sexual and gender minorities are also victims, which is also confirmed by the data available in our regular health system. About 10 percent of those who seek services from one-stop crisis management centers due to gender-based violence are men. About 3-4 percent are sexual and gender minorities, while the rest are women. Even when analyzing this data, women are more likely to be affected.

Gender-based violence is an issue related to public health, human rights, and social justice. Domestic violence, sexual violence, child marriage, human trafficking, harmful traditional practices, and other forms of gender-based violence have long-term effects on women’s physical, mental, social, and sexual and reproductive health.

More than 60 percent of violence is perpetrated by acquaintances and acquaintances. Violence against women can occur in the public, private, and at any time in life.

There is a gender inequality gap in society. Different gender identities are also a major cause of discrimination. According to the Nepal Demographic Health Survey 2022, 23 percent of women aged 15 to 49 in Nepal have experienced physical violence.

The report states that 8 percent of women have experienced sexual violence in their lifetime. 27 percent have experienced physical, mental or sexual violence in their lifetime. 17 percent of women have experienced violence from their partners in the last 12 months. Of the women who have experienced sexual violence, 58 percent have neither told anyone about their pain nor sought any kind of help.

Similarly, the report shows that 14 percent do not seek help even if they tell someone, such as a friend or neighbor, about their pain. However, 28 percent of women seem to have sought help after violence. Since health institutions are the first contact and service center for victims of violence, the role of the health sector is not limited to treatment alone, but also includes psychosocial counseling, forensic evidence collection, safe referral, rehabilitation and multi-sectoral coordination, implemented by the Government of Nepal through the One-Stop Crisis Management Center (OCMC).

What is the One-Stop Crisis Management Center?

It is a multi-sectoral service system that provides free access to health care and other essential services to victims or affected persons through a single door. Through this, victims are provided with emergency health care, mental health and psychosocial counseling, forensic examination, legal aid, safe shelter, and effective referral services to the police, judicial bodies, and social rehabilitation services as needed.

The OCMC, which operates with the privacy, dignity, safety, and rights of the victim at the center, has been playing a significant role in making the health response to gender-based violence effective, accessible, and coordinated.

Is it necessary or not to provide the role of the health system against gender-based violence in the organizational structure of the Ministry of Health and Food Hygiene?

Currently, 97 hospitals across the country have one-stop crisis management centers, which is a significant achievement. This achievement needs further strengthening of its leadership, coordination, monitoring, and program management in the federal structure. This issue does not seem to have found a place in the newly approved structure of the Ministry.

It is necessary to make policy arrangements to effectively implement the right to health, gender equality, the right to a life free from violence guaranteed by the constitution, and the commitments made by Nepal at the international level.

The main foundations of which are presented below:-

- The health sector is the first and most important service point for victims of gender-based violence, which cannot be done by other sectors.

- A permanent structure is necessary to make services including the One-Stop Crisis Management Center sustainable and institutionalized.

- There is a need for clear leadership and coordination of this issue and the One-Stop Crisis Management Center service between the federal, provincial, and local levels.

- It is necessary to coordinate the role of the policy level to provide integrated management of health services related to gender-based violence, mental health, sexual and reproductive health, and forensic services, etc.

A health structure with clear responsibilities of the health sector is necessary for the implementation of national and international commitments, because since no single sector can cover the campaign against gender-based violence, it is called multi-sectoral.

Sarkar The response that the health sector has so far provided is only 28 percent of the access to the One-Stop Crisis Management Center, which is being provided by the health sector. This tells us that there is still work to be done.

To date, among the sectors that have presented some progress and achievements on behalf of Nepal in international forums on gender equality or gender-based violence, the One-Stop Crisis Management Center system and service is also a major achievement.

If this issue is not included in the structure of the health sector for a policy and coordinating role in the federal structure of such an important service, it will be a leadership crisis for this sector itself.

Health response to gender-based violence is an integral part of the health service system. Therefore, it is necessary to institutionalize it within the permanent organizational structure of the Ministry of Health and Food Hygiene, not as a project or temporary program, with clear responsibilities, sufficient human resources, a sustainable budget, and an effective monitoring system.

Gender Based Violence (GBV) and Policy Response (Nepal)

 Gender Based Violence (GBV) and Policy Response (Nepal) 

Unit VI: Gender Based Violence (GBV) and Policy Response (Nepal) 

• Sociological approach to understand violence against women

• GBV in Nepal

• Policy response

Required readings

Toffanin, Angela Maria (2012) "Research on violence against women: a sociological perspective,"

Interdisciplinary Journal of Family Studies, vol. 17(1), pp. 15-30.

OPM and CoM (2012) A Study on Gender-Based Violence Conducted in Selected Rural Districts of

Nepal, Executive Summary, Kathmandu: Office of the Prime Minister and Council of Ministers,

pp. VI-XXI.

Saathi, The Asia Foundation, and DFID (2010) Nepal: Preliminary Mapping of Gender Based Violence,

Kathmandu: Saathi, pp. 1-21.

Policy response

Nepal Law Commission (2009) Domestic Violence (Offence and Punishment) Act, 2066 (2009),

Kathmandu.

Nepal Law Commission (2007) Human Trafficking and Transportation (Control) Act, 2064

(2007), Kathmandu.

OPM and CoM (2012), Ending Gender Based Violence and Gender Empowerment: National Strategy

and Action Plan, 2012, Kathmandu: Office of the Prime Minister and Council of Ministers (text in

Nepali).

Additional reading

MoHP, New ERA, and ICF International Inc. (2012) Nepal Demographic and Health Survey 2011.

Kathmandu, Nepal: Ministry of Health and Population, New ERA, and ICF International,

Calverton, Maryland, Chapter 14.

### Unit VI: **Gender-Based Violence (GBV) and Policy Response (Nepal)**

This unit focuses on the sociological understanding of violence against women, the specific situation of GBV in Nepal, and the policy measures taken to address it. Understanding GBV through a sociological lens helps identify the structural and cultural factors that perpetuate such violence.

#### 1. **Sociological Approach to Understanding Violence Against Women**

   - **Violence against women** is a sociological issue rooted in power dynamics, gender inequality, and patriarchal norms. Sociological perspectives help us see how social structures, cultural norms, and institutional practices condone or challenge GBV.

   - **Angela Maria Toffanin** (2012) emphasizes that violence against women is often normalized through cultural and social practices that reinforce male dominance and female subordination. This violence manifests in various forms, including physical, sexual, psychological, and economic abuse, and it intersects with other social categories such as class, caste, ethnicity, and geography.

   - A sociological approach looks at how violence is sustained not just at the interpersonal level but through larger societal forces, including media, legal systems, and economic policies, which may perpetuate gender inequalities.

#### 2. **GBV in Nepal**

   - In Nepal, **Gender-Based Violence** is a pervasive issue, deeply rooted in traditional norms and values that favor male dominance. Women in Nepal face various forms of violence, such as domestic violence, sexual harassment, trafficking, and dowry-related violence.

   - The **Office of the Prime Minister and Council of Ministers' (OPM and CoM) 2012 report** on GBV in rural districts highlights that GBV is often underreported, especially in rural areas, due to fear, shame, and lack of access to justice. It identifies factors such as poverty, lack of education, and social isolation as exacerbating the issue of GBV.

   - **Saathi, The Asia Foundation, and DFID’s (2010) report** provides a preliminary mapping of GBV in Nepal, identifying critical gaps in the legal and social support systems for victims. It points out the importance of community-based interventions and the role of civil society in raising awareness and providing support services.

#### 3. **Policy Response**

   - Nepal has implemented several legislative and policy frameworks aimed at curbing GBV:

     - **The Domestic Violence (Offence and Punishment) Act, 2066 (2009)** provides legal recourse for victims of domestic violence and criminalizes acts of violence within households. This law aims to protect women and children from domestic abuse, although enforcement remains a challenge.

     - **The Human Trafficking and Transportation (Control) Act, 2064 (2007)** addresses the growing issue of human trafficking, particularly women and children trafficked for labor and sexual exploitation. The law outlines severe penalties for traffickers but faces limitations in terms of implementation, especially in rural areas.

     - The **National Strategy and Action Plan (2012)** outlines the government’s strategy for addressing GBV. It emphasizes gender empowerment and seeks to involve multiple stakeholders, including governmental bodies, civil society, and international organizations, to ensure a coordinated response to GBV.

   - Despite these legislative measures, the challenge lies in effective enforcement, particularly in rural areas where traditional patriarchal attitudes are deeply entrenched. Awareness programs, capacity-building for law enforcement, and the establishment of support systems like shelters and hotlines for victims are crucial to making these policies effective.

#### **Additional Reading**

   - The **Nepal Demographic and Health Survey 2011** (Chapter 14) provides statistical insights into the prevalence of GBV in Nepal. It highlights the high rates of domestic violence, sexual violence, and child marriage, underscoring the need for more robust policy interventions and community awareness programs.

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### Key Takeaways:

- **Sociological Perspectives on GBV**: Gender-based violence is not an isolated act of individual pathology but a social issue shaped by broader cultural, structural, and institutional forces. Understanding these forces is key to addressing GBV effectively.

- **GBV in Nepal**: The problem of GBV in Nepal is widespread, with rural women being particularly vulnerable due to traditional gender norms, poverty, and lack of education. Reports and studies underscore the need for comprehensive interventions.

- **Policy Response**: Nepal has taken legislative steps to address GBV, but gaps in enforcement, cultural resistance, and lack of resources remain major hurdles. The success of these laws depends on improving legal literacy, access to justice, and support for survivors.

This unit helps students critically analyze the social dimensions of GBV and evaluate the effectiveness of policy responses, particularly in the Nepalese context.

Here are 10 potential exam questions covering key topics from the **Sociology of Gender** course. These questions address important conceptual, theoretical, and practical issues related to gender and feminist theory, particularly in the context of Nepal.

### 1. **Social Construction of Gender**

   - How do sociologists differentiate between sex and gender, and how is gender socially constructed in everyday life?

   - Discuss Judith Lorber’s concept of “doing gender” and how it relates to gender as a routine accomplishment in social interactions.

   - Explain the gender division of labor and how it reflects the social construction of sex roles in society.

### 2. **Feminist Theories**

   - Critically analyze Simone de Beauvoir’s contribution to **Liberal Feminism** with reference to her work *The Second Sex*. How does she explain women’s subordination through the notion of "the other"?

   - Examine Maria Mies’ **Socialist Feminism** and her argument on the social origins of the sexual division of labor. How does this perspective challenge capitalist patriarchy?

   - Discuss the central themes of **Third-wave Feminism** as articulated by Chandra Talpade Mohanty in “Under Western Eyes Revisited.” How does Mohanty critique Western feminist approaches to global struggles?

   - How does **Radical Feminism** explain women’s subordination through the lens of sexual politics? Refer to Kate Millett’s *Sexual Politics* in your response.

### 3. **Patriarchy and Beyond**

   - Compare and contrast the different feminist interpretations of patriarchy. How do Marxist, Radical, and Socialist feminists conceptualize patriarchy differently?

   - Drawing on Deniz Kandiyoti’s concept of "bargaining with patriarchy," explain how women negotiate their roles and rights within patriarchal structures in everyday life, especially in the context of household dynamics.

### 4. **Sociological Debate on Power and Empowerment**

   - How do Pierre Bourdieu, Michel Foucault, and Jean Baudrillard conceptualize power? Discuss the relevance of their theories to understanding gendered power dynamics.

   - Critically assess feminist interpretations of power, focusing on the notion of empowerment. How does Srilatha Batliwala’s critique of empowerment challenge traditional development frameworks?

### 5. **Gender-Based Violence and Policy Response (Nepal)**

   - Discuss the sociological approach to understanding violence against women, focusing on structural and cultural explanations. What are the main drivers of GBV in Nepal, according to recent studies?

   - Evaluate the effectiveness of Nepal’s policy responses to gender-based violence, such as the Domestic Violence Act (2009) and the Human Trafficking Act (2007). What challenges remain in implementing these policies at the local level?

These questions should help you engage critically with the course content and prepare for your upcoming Sociology of Gender examination.

Here are 10 comprehensive questions based on the **Sociology of Gender** course content. These questions are designed to help you prepare for your Master's examination:

### 1. **Social Construction of Gender**

   - How is gender socially constructed, and in what ways does it differ from biological sex? Draw on the work of William Little, Ron McGivern, and Judith Lorber in your response.

### 2. **Gender as Routine Accomplishment**

   - Critically analyze West and Zimmerman’s concept of “doing gender.” How does this theory explain the role of everyday interactions in reinforcing gender roles?

### 3. **Gender Division of Labour**

   - Explain the historical and sociological reasons behind the gender division of labor. How do sex roles contribute to this division, and what are its implications for gender inequality?

### 4. **Liberal and Socialist Feminism**

   - Compare and contrast **Liberal Feminism** (as represented by Simone de Beauvoir) and **Socialist Feminism** (as represented by Maria Mies). How do these perspectives explain women’s subordination and their paths to liberation?

### 5. **Third-Wave and Radical Feminism**

   - How does **Third-Wave Feminism**, as explained by Chandra Talpade Mohanty, differ from earlier waves of feminism? Additionally, discuss **Radical Feminism** with reference to Kate Millett’s theory of sexual politics.

### 6. **Capitalist Patriarchy**

   - Discuss Zillah Eisenstein’s theory of **capitalist patriarchy**. How does the intersection of capitalism and patriarchy affect gender relations in both the workplace and the home?

### 7. **Bargaining with Patriarchy**

   - Explain Deniz Kandiyoti’s concept of **bargaining with patriarchy**. How do women navigate and negotiate their rights within patriarchal structures, especially in developing countries like Nepal?

### 8. **Power and Empowerment**

   - Compare the sociological theories of power as conceptualized by Pierre Bourdieu, Michel Foucault, and Jean Baudrillard. How do these theories apply to gender relations and feminist debates on power and empowerment?

### 9. **Feminist Methodology**

   - What are the key critiques feminist scholars have of positivism, and how do these critiques inform the development of **feminist methodology**? Discuss the importance of reflexivity and social change in feminist research.

### 10. **Gender-Based Violence and Policy Response in Nepal**

   - Provide an analysis of the sociological approach to understanding **gender-based violence (GBV)** in Nepal. How effective are Nepal’s legal and policy frameworks, such as the **Domestic Violence (Offence and Punishment) Act, 2009**, in addressing GBV? What challenges remain in enforcement?

These questions encompass major themes from the course, ensuring a broad coverage of topics for your exam preparation.