Table 4 Summary of key accountability strategies for SRH in humanitarian settings

The development and use of humanitarian principles, codes of conduct, and legal instruments

Principles and codes of conduct:

Fundamental principles and codes of conduct developed by international NGOs, UN agencies, and other international humanitarian and development stakeholders serve as a guide for expected behavior. There are 3 somewhat distinct streams of principles and codes relating to:

• 1) UN commitments to preventing and addressing GBV, and women’s peace and security, including sexual violence in conflict;

o Example: UN resolution 1325, which recognized rape and sexual violence as a war crime and provided an organizing framework for the creation of specific mechanisms to prevent violations and to prosecute perpetrators

• 2) UN commitments to ending SEA perpetrated by UN peacekeepers or other humanitarian workers; and,

o Example: UN Secretary General’s Bulletin on SEA, which defined SEA and the duties of UN personnel to prevent and address SEA

• 3) NGO-led processes for accountability for service delivery and protection of affected populations; NGOs formed organizations that elaborated quality and/or accountability standards and supported members to meet those standards

o Examples: People in Aid, SPHERE, Humanitarian Accountability Partnership, Core Humanitarian Standard Alliance

Legal Instruments and access to justice:

Both formal and hybrid (formal and informal) instruments have been developed by host countries, international NGOs, UN agencies, and affected populations themselves to support affected population access to justice for SRH, primarily in camp settings. These include creating legal aid programs, training the judiciary, supporting individuals to pursue cases, and raising awareness among affected populations about their rights and entitlements. Hybrid approaches combine formal and informal community structures in community-based complaints mechanisms. Such mechanisms require community engagement in development and implementation, and include follow up and remedy mechanisms.

The development and use of technical, performance, and impact standards

UN agencies and NGOs developed technical, performance, and impact standards as a means to assess the quantity and quality of care provided to affected populations in humanitarian settings and promote accountability on SRH and RR services provided.

• Examples: MISP, scorecards, needs assessment tools, tools to monitor the operationalization of standards, and quality improvement

“Listening and responding”

Humanitarian agencies created mostly close-ended and some open-ended feedback mechanisms that focus on the rights and needs of affected populations to participate and provide input on their SRH and RR needs.

• Examples: community help desks, feedback boxes, community meetings, call centers, face to face or unified (group) feedback, participatory action research, and community scorecards.

Accountability demands made by affected populations

Local women’s groups/civil society

Women’s groups and other civil society organizations advocated for their self-identified needs and demands, ranging from participation in program planning to protesting their exclusion from these processes.

Local development and use of dispute resolution mechanisms

These strategies are typically informed by customary (not codified) law, and focus on compensation and conciliation.