Despite the high prevalence of GBV in the Country, many survivors never seeks help. The recent demographic health survey in Nepal (NDHS, 2011) found out that three quarters of women who had experienced physical or sexual violence had not sought any help and two thirds had never mentioned the violence to anyone. Nepal, as a patriarchal society with deep rooted gender beliefs, although has ratified the many conventions as CEDAW and BPFA, still is not able to address the GBV prevention and response system due to the geographical extremities, traditions and the political instability.

The government has developed different schemes and acts to reduce the GBV and established Women and Children Service centers, safe homes as the response, however, the implementation of such acts and the quality of these services remain questionable. In 2007, when Apeiron established CASANepal, a safe home, there was insignificant number of safe homes in the Country and quality of the services offered were unsatisfactory. To address this problem, Apeiron started CASANepal as a safe home to provide Rescue, Rehabilitation and Reintegration (3 R’s) to the survivors of GBV. The safe home has evolved and has added the fourth R of Referral services in order to provide the holistic service to its clients.

CASANepal was started with the main objective to ‘strengthen the existing support systems serving survivors of gender based violence and their children’.

The specific objectives are:

  1. To increase the access to services (shelter, medical, psycho-social and legal) for most vulnerable survivors of gender based violence in the Country.
  2. To enhance knowledge and awareness of the women on harmful practices such as child and forced marriages, sexual health and reproductive rights, women’s rights etc.
  3. To develop the income generation skills for the women to be independent.

According to the project’s Theory of Change, CASANepal, fighting with all the barriers women have to face in life, works in five areas of interventions:

  1. GBV Response (Safe shelter, Counseling and care)
  2. GBV Prevention (Family counseling, Empowerment of the survivors)
  3. Micro-enterprise and skills development & Support (Income-generating skills, Literacy)
  4. Rights Awareness & Education Support (Women’s rights awareness, NFE)
  5. Institutional Collaboration (Referral system)

These areas of interventions are in-built in the Case Management Protocol of CASANepal. The protocol prescribes how CASANepal implements numerous services to help the survivors achieve their plans. It is a working process and provide instructions on how to improve services that is tailor-made and assures best possible option throughout the resident’s stay in CASANepal.

The Case Management Protocol recommends step-by-step process to be taken for each individual that approaches CASANepal. There are 12 steps prescribed which are as follows;

STEP 1: Identification of the survivor

This is the first step of the case management. A survivor is identified through various sources. Usually, they reach CASANepal through the referrals from agencies such as Nepal Police, Women and Children Offices, Hospitals, women’s groups and other like-minded organizations. After the initial assessment of the case with the referring organizations, they are brought to CASANepal.

STEP 2: Response to immediate physical needs

Once the survivor is in CASANepal, her immediate physical needs are responded to. The staff makes their best effort to make them at ease and comfortable by not asking any questions first but to take care of them and build a good relationship with them.

STEP 3: Orientation about the safe home and its services

After the immediate physical needs are fulfilled, the survivors are oriented by the staff about the safe home and its services. This gives an opportunity for the them to understand about the project and decide if they want to participate in the project or not. During this step, the survivor is asked if she wishes to contact the family. If she wishes to, the staff will contact the family and if she doesn’t wish to, she is not forced to.

STEP 4: First Case Meeting

The first case meeting usually takes place within 7 days of the survivor’s entry in the safe home. The staff of the safe home (Psychosocial counselor, supervisor and social worker) sit with the survivor and informally discuss how her stay has been for the last week. Until this meeting, the survivor is not asked about her case, experience or the reason she is in the safe home. This meeting will initiate the relationship of the staff with the survivor in order to plan for her rehabilitation. No detailed discussions are done, however, some hints about the survivors case, her wishes, her plans are gathered by the staff.

It may happen that, the survivor may need totally different solution than that of the safe home. In more than few instances, CASANepal has received cases who need complete mental rehabilitation services. She might need to be institutionalized or seen by the psychiatrist. In these circumstances, the survivor needs to be referred to another facility which is specialized in specific services.

If the survivor does not need to be referred in other institution, then she will be taken into the safe home as the resident.

STEP 5: Safe Home Intake

The survivor will be taken into the safe home as a resident after it is decided that she doesn’t need to be referred to other services and she needs CASANepal. Long term plan regarding logistics, scholarship for her children, group works etc… will be made. During this time, other assessments will also be conducted. She will be provided with new clothes as per the season, monthly supply of the cleaning items such as soaps, toothpaste and stationaries.

STEP 6: Assessments

The initial assessments will be conducted by the safe home staff within the 4th week of the resident’s stay in CASANepal. The assessments will be done in five sections;

  1. General health assessment
  2. Psycho-social assessment
  3. Legal assessment
  4. Literacy level assessment
  5. Family assessment

These assessments will help to a) have the preliminary status of the resident before the interventions and b) have the foundations for developing the individual case plans.

For these assessments, different agencies with the expertise on the subject matter may be consulted such as LACC (Legal Aid Counseling Center) for legal assessment and JHPIEGO (John Hopkins Programs for International Education in Gynaecology and Obstetrics) for health assessments.

Psychosocial assessment, Literacy level assessment and Family assessment will be conducted by the in-house psycho-social counselor and NFE facilitator.

Based on these assessments, the psycho-social counselor will prepare a case study and will be kept confidential.

STEP 7: Second Case Meeting

Within the 6th week of the residents stay, second case meeting will be conducted with her in order to develop her own customized case plan. The psycho-social counselor who also acts as the case manager facilitate the process. Each resident will have her own case plan according to her needs, wishes and interests. The case plan is a vital tool to ensure the best possible outcomes for the resident’s rehabilitation, development and future. Case plans make it clear to CASANepal staff and to the residents why CASANepal is involved, which issues are to be addressed and what are the responsibilities for each individual.

The case plan will focus on three main components of the individual resident.

  1. Socio-economic rehabilitation

Contributing to the CASANepal’s Theory of Change intervention of Micro-enterprise and skill development and support, each resident will have the socio-economic rehabilitation component in her case plan. This plan will create self-confidence amongst the residents, strengthening them financially. It helps them to lead a productive life with dignity. The attitude of the family towards the survivors are also positively changed.

In this component, occupational training are offered to the residents as per their interest and capacity. CASANepal proudly offers diversified vocational rehabilitation, employment placement and enterprise set up for the residents.

      2. Psycho-social rehabilitation

All of the survivors have come across traumatic experiences in the events of violence. The residents are therefore provided with recovery-oriented care of all the residents. More often than not, the underlying psycho-social problems is the main factor which hinders the survivor’s willingness and strength to be ‘normal’ again. The feeling of worthlessness is one of the major psychological problems faced by the GBV survivors approaching CASANepal in its 10 years.

The psycho-social counselor will make individual counseling plans as per the need of the resident. The counselor is a full-time staff which means that she is available whole day if someone needs her assistance. During the sessions, the counselor also provides various therapies such as dance therapy, talking therapy and eye movement therapy etc.

The counseling sessions are also conducted in a group which in itself is a therapeutic activity. These group sessions provide the survivors with a safe and supportive space for them to explore a range of issues and interact with other.

     3. Re-integration plan

Pre-reintegration activities are planned in this component. This may outline the key stakeholders’ involvement for the survivor’s reintegration. Family counseling and couples counseling are the main activities that are planned in addition to the resettlement plan if the residents do not wish to return to their communities of origin.

STEP 8: Implementation of the Case Plan

As per the case plan, the residents are facilitated to carry out the actions. Each resident will have access to:

  1. Skill Development Training

The skill development training are further categorized in two sections:

1.a)  Professional Training

These training are long term (1-6 months) skill development training which will help the women to earn sufficient income to be independent. These training are selected with the residents as per their interest, capacity and market’s demand.

For example: tailoring, beauticians, security guards, Montessori teachers etc.

1.b) Home based production training

In comparison to the professional training, these training are short term. However, these training are helpful to earn small income in their spare time as well as in their own homes. The training are: candle making, sour candy making, knitting and recycled plastic handicraft making.

      2. Individual counselling and Group counselling

      3. Therapeutic Activities

      4. Life skill awareness sessions

      5. Scholarship support for the children

      6. Distribution of the seed capital

STEP 9: Final Case Meeting

Two weeks before the resident’s exit from CASANepal, a final case meeting is conducted with the counselor, supervisor, social worker and the survivor. In this meeting, the reintegration/resettlement plan is revised again with the survivor. All the information about how to contact whom in case of any trouble, referral points, advises are passed on the to survivor for the one last time before they exit. The final preparations for the resident to leave CASANepal are updated. The final case meeting will also help the resident to be mentally prepared about her exit plans.

In the Final Case Meeting, the two main driving questions would be

  • Has the goals been achieved ?

During the time the survivor stays in the safe home, her goals as previously planned might not be fulfilled due to many different reasons such as changes in the situations at home front or within herself, delay in legal procedures etc.

If the goals have not been achieved, the case plan will be revised and the steps 8 onward will be taken again.

If the goals have been achieved, the final questions will be

  • Does the survivor need more assistance?

Even if the previously planned goals have been achieved, the survivor may have developed different needs during the stay.

If she needs more assistance , the case plan will be revised and the steps 8 onward will be taken again.

If she doesn’t need more assistance, she will be prepared to exit CASANepal.

STEP 10: Case Closure

Once the survivor is ready to leave CASANepal, her case is closed. The case closure usually takes place after ensuring that the family and/or community has addressed the survivors protection concern than she no longer needs a safe home.

During the case closure, the survivors’ evaluation of the services provided by CASANepal will be conducted to Service Feedback Forms. These feedback are very important for the case management as well as the safe home operations and are continuously analyzed.

In addition to the evaluation of services, follow up plan will be made. Each survivor will be followed up regularly by the safe home supervisor and the psycho-social counselor.