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

A resource package

5.3. Ethical considerations in evaluating interventions against gender-based violence

Collecting data on sensitive topics such as GBV often raises a number of ethical questions and safety concerns. This is especially the case when the survivor of violence is interviewed. The following concerns should always be taken into account when interviewing survivors: ensuring safety of respondents since they often live with their abuser; protecting confidentiality since breaching it could provoke an attack; making sure the interview process is non-discriminatory and does not cause distress. The inherent risks entailed in collecting data for monitoring and evaluation can only be justified if the interview is used to provide information on available services and if findings are used to raise awareness of the issue and improve services for women who experience violence. Having a comprehensive understanding of the risks, ethical concerns, and the practical realities can help minimize the dangers and potential for re-traumatization of the participants; it can also increase the likelihood of women disclosing relevant and accurate information and create an opportunity to receive feedback on services provided.

The recommendations below are based on the WHO Guidelines for interviewing trafficked women and Ethical and safety recommendations for research on domestic violence against women and have been adapted for this context. They do not explicitly discuss the different risks and obligations of interviewing females who are minors, although many of the same principles will apply. The recommendations should be used in conjunction with existing professional standards applicable to the work being conducted.

Box 28: Ethical and safety principles

  1. The safety and well-being of respondents and the personnel is paramount, and should guide all decisions
  2. Much of the information provided will be extremely personal. Protecting confidentiality is essential to ensure both women’s safety and data quality. Interviews should be conducted in a private setting. Instead of names, unique codes should be used to distinguish questionnaires.
  3. The setting and interview must include actions aimed at reducing any possible distress caused to the participants. The respondents should always have the opportunity to either stop the interview or not answer particular questions. All questions about violence and its consequences should be asked in a supportive and non-judgmental manner. In addition, care needs to be taken to ensure that the language of the questionnaire cannot be interpreted as being judgmental, blaming or stigmatizing.
  4. It is essential to listen carefully and to respect each woman's assessment of her situation and risks to her safety. One should recognize that each woman will have different concerns, and that the way she views her concerns may be different from how others might assess them.
  5. All personnel conducting interviews should be carefully selected and receive specialized training and on-going support. The training must provide a mechanism to confront and overcome own biases, fears and stereotypes regarding abused women.
  6. Ideally, monitoring and evaluation is completely independent from management and implementation. However, in a setting of health-care providers, there might be a dual role of interviewing women in order to collect data - in this case focusing on monitoring and evaluation - and counselling. Whenever possible, it is therefore recommended to work in teams of two, so that one can take the role of asking questions whereas the other takes the role as counsellor, if necessary.
  7. Findings should be properly interpreted and used to advance (institutional) policies and practical interventions. In the context of monitoring and evaluation efforts, the data gathered should be used to enhance the institutional response to violence against women.

Source: WHO 2003a