Strengthening Health System Responses to Gender-based Violence in Eastern Europe and Central Asia

A resource package

General advice for working on referral systems

Ideally, multi-agency initiatives should involve actors from all agencies dealing with gender-based violence that play a role in improving services and prevention. However, practice has shown that it is not easy to get all the actors to the same table. In many countries, the involvement of the justice system, especially the prosecutors’ offices and criminal judges, has proven particularly difficult.


A good practice example for a successfull medical initiative is Medica Zenica in Bosnia and Herzegovina, which has grown from the single commitment of a gynaecologist into a region-wide well-working referral system. Details on Medica Zenica

Activists from multi-agency initiatives have come to the conclusion that, in order to start a project that has a good chance of continuing for some time, it is not necessary to involve all the agencies from the beginning.
On the contrary, too many participants can make it difficult to work in a goal-oriented way and to achieve concrete results. Given that most initiatives suffer from a paucity of resources and cannot afford to establish a complex organisational structure, it is important to start small and grow slowly in line with increasing resources. The other important starting point is to act according to the motto: “Whoever is interested in participating in the initiative is the right person”. That means you start with people from agencies that are committed to the issue and who are serious about wanting to improve their agency‘s practice. Research and practice indicate that multiagency initiatives work effectively if they involve management representatives as well as front-line staff. It has also been shown that participants who are not committed to the cause and who only attend because they want to be present or who have been ordered to join can do more harm than good and block, slow down or even prevent progress.
Therefore, it may be advisable to start with a rather small group of committed members and enlarge the initiative slowly. Staff in agencies may change, which can work to the advantage or disadvantage of a multi-agency initiative: it can mean a big loss when an engaged member leaves the agency or the job, but personnel changes in an agency may also afford an opportunity to involve a more supportive person. As has already been stated, it can be very effective to involve people from management as well as practitioners who are experts regarding what actually happens in an agency’s everyday practice.
It is also important to note that it is not necessary for all the actors to be involved at the same time. There can be different working groups as well as temporary projects relating to special issues which may involve agencies that are not permanent members of the multi-agency initiative. Thus, there can be permanent members that form a steering group and others that are involved as called for by the work programme.



  • Start small
  • Grow slowly in accordance with the resources available
  • Act according to the principle: “Whoever is committed to the cause is the right person”
  • Seek to broaden the base and influence of the multi-agency initiative
  • Seek to involve members at both the management and the “grass-roots” levels

Source: Adapted from: WAVE Bridging Gaps