Strengthening Gender-based violence (GBV) coordination in emergencies: a synthesis of practitioner-driven, globally applicable recommendations

Strengthening Gender-based violence (GBV) coordination in emergencies: a synthesis of practitioner-driven, globally applicable recommendations | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Strengthening Gender-based violence (GBV) coordination in emergencies: a synthesis of practitioner-driven, globally applicable recommendations Philomena Raftery, Alina Potts, Melanie Hyde, Yermeyn York Wuyke, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7215940/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 07 Mar, 2026 Read the published version in Conflict and Health → Version 1 posted 10 You are reading this latest preprint version Abstract Introduction Gender-based violence (GBV) is a global public health and human rights crisis, requiring coordinated efforts to ensure effective prevention, risk mitigation, and response particularly in emergencies. Despite policy commitments and increased recognition of the importance of addressing GBV in emergencies, funding remains insufficient, inconsistent, and poorly aligned with the changing humanitarian and global health financing landscape. Furthermore, limited evidence on GBV coordination effectiveness limits its consideration in aid prioritisation decisions. This paper synthesizes evidence on GBV coordination in humanitarian and public health emergencies and presents global recommendations to inform policy and practice. Methods Using a rigorous three-phase qualitative methodology—comprising evidence synthesis, case study analysis, and a global expert practitioner consultation—we developed a comprehensive framework and present strategic recommendations to strengthen GBV coordination in emergencies. We further explore the implications of shifting funding landscapes, including the withdrawal of U.S. government support, on the future of GBV coordination. Results Our findings identify seven strategic recommendations aimed at investing in, sustaining, and transforming GBV coordination efforts globally. Key priorities include expanding the GBV coordination workforce, including for risk mitigation, prioritizing GBV coordination within public health emergencies, and investing in information management systems and strategic research. To sustain GBV coordination, we recommend adapting funding models, diversifying financial sources, advancing national leadership and localization, and implementing context-specific coordination approaches, including at the sub-national level. Furthermore, we propose that emergencies can serve as catalysts for broader social and legal transformations that advance GBV prevention and gender equality. Conclusion Our findings provide practical, evidence-based recommendations and a global framework for policymakers, donors, and practitioners to strengthen and sustain GBV coordination in diverse emergency contexts. Sustained progress will require collective commitment to prevent, mitigate, and respond to GBV, even as global health priorities shift, funding landscapes change, and resistance to gender equality intensifies. Gender-based violence GBV Coordination humanitarian emergencies Figures Figure 1 Key message What is already known on this topic Effective GBV coordination is critical in emergencies, but existing models face challenges due to limited evidence on functionality and effectiveness, fluctuating funding, and insufficient resourcing and investment. This study was needed to synthesize practitioner-driven insights and provide globally relevant, evidence-informed recommendations to strengthen GBV coordination. What this study adds This study presents seven globally applicable strategic recommendations developed through a systematic synthesis of evidence, case studies, and expert practitioner consultations. It provides a comprehensive framework for strengthening GBV coordination in emergencies. How this study might affect research, practice or policy The findings offer actionable guidance for policymakers, donors, and practitioners to strengthen and sustain GBV coordination globally, particularly amidst evolving global health priorities and resource constraints. The recommendations can inform the development of flexible, context-sensitive coordination models, support investment in national capacities, and stimulate further research into the integration of GBV coordination across diverse emergency contexts. Introduction Gender-based violence (GBV) is a global public health crisis and a serious violation of human rights. Rooted in gender inequality, it disproportionately affects women and girls and results in profound public health, social, and economic consequences ( 1 ). GBV includes sexual, physical, emotional, psychological, economic, institutional violence, and harmful traditional practices, all of which can result in serious health outcomes such as injury, psychological trauma, increased risk of sexually transmitted infections (STIs), including HIV, adverse reproductive outcomes, and mortality ( 2 ). The increasing frequency, duration, and severity of humanitarian and public health emergencies amplify vulnerabilities to GBV while simultaneously disrupting health care and protective systems ( 1 ). Globally, one in three women and girls experience physical or sexual intimate partner violence (IPV) or non-partner sexual violence during their lifetime ( 1 – 3 ). Although data collection on GBV in emergencies remains challenging and likely underestimates true prevalence, existing evidence indicates elevated rates of sexual violence, IPV, technology-facilitated abuse, and reduced access to essential services ( 2 , 4 – 6 ). For example, in Ukraine, IPV reports to police increased by 40% in the first five months of 2023 compared to the same period in 2022, while conflict-related sexual violence continues to be documented ( 7 ). Public health emergencies such as the Ebola and COVID-19 outbreaks have similarly intensified GBV risks while restricting service access during lockdowns ( 8 ). Addressing survivors' needs requires comprehensive, coordinated responses supported by adequate resources and collaboration across diverse stakeholders at both global and field levels. Despite progress driven by the United Nations humanitarian cluster system (2005), the establishment of the GBV Area of Responsibility (AoR)(2006), and the global Call to Action on Protecting Women and Girls in Emergencies (2013), persistent challenges hinder effective GBV coordination in emergencies( 1 , 9 ). Despite these policy commitments and increased recognition of the importance of addressing GBV in emergencies, funding remains insufficient, inconsistent, and poorly aligned with the changing humanitarian and global health financing landscape. Furthermore, a lack of published evidence on the effectiveness of GBV coordination limits its consideration in aid prioritisation decisions. Compounding the situation, the recent U.S. funding cuts, particularly from USAID and exacerbated by declining support from several European donors, has severely disrupted GBV coordination and responses in crisis-affected settings, Preliminary 2025 data from the GBV AoR indicate that the United States was the largest GBV donor in 2024, contributing USD 131.1 million, or 36% of the total GBV funding (USD 366.1 million) under the Global Humanitarian Overview ( 10 ). Of 24 contexts with Humanitarian Response Plans, the US funded GBV programming in 19, amounting to USD 91.1 million. However, in 2025, US contributions have markedly declined to USD 5.8 million, representing only 9.4% of the sector’s total USD 61.6 million ( 10 ). This significant reduction has led to widespread service disruptions, weakened coordination mechanisms, and diminished national and local partner capacity ( 10 ). International NGOs managing large GBV programs have faced substantial budget cuts, resulting in staff layoffs, furloughs, and program closures. Critical services, including women and girls’ safe spaces, cash and voucher assistance, and medical and psychosocial care for survivors of sexual violence, have been drastically curtailed, endangering survivors health and safety ( 10 ). This paper synthesizes recent evidence on GBV coordination in humanitarian and public health emergencies, and presents global recommendations to inform future policy and practice. We use new empirical evidence to refine a previously published framework for GBV coordination, drawing on a case study in Lebanon and a 2025 global consultation with GBV coordination experts ( 9 ). We also examine the future of GBV coordination in light of shifting funding landscapes, including the withdrawal of U.S. government support. The updated framework offers a globally relevant, practice-driven model for strengthening effective and context-sensitive GBV coordination. METHODOLOGY This study employed a three-phase, qualitative approach to refine a globally relevant framework and key recommendations for strengthening GBV coordination in emergencies. We integrated evidence synthesis, in-depth case study analysis, and a global expert practitioner consultation to ensure both rigour and relevance. Phase 1 Evidence Synthesis A 2022 scoping review synthesized global evidence from peer-reviewed and grey literature on GBV coordination in humanitarian and public health emergencies. The review identified 28 relevant publications which provided the foundation for an evidence-based framework highlighting key components needed for effective GBV coordination ( 9 ). Phase 2 Lebanon Case Study Between 2019 and 2022, an in-depth case study was carried out, exploring GBV coordination in Lebanon’s protracted crisis from 2012 to 2022 ( 11 , 12 ). Lebanon’s humanitarian landscape—characterized by a large-scale influx of Syrian refugees, restrictive refugee policies, a political and economic crisis over more than a decade and the COVID-19 pandemic—provided critical insights relevant to other complex emergencies. Data collection included 38 remote in-depth interviews, seven coordination meeting observations, and document review to explore the evolution of GBV coordination. A 2022 workshop with GBV task force members and key informants refined the analysis. Given the in-depth nature and extended duration of Phase 2, findings from the Lebanon case study feature prominently in this article. Phase 3 Global Practitioner Consultation In February 2025, a global consultation was held with six GBV coordination experts with experience in Venezuela, Lebanon, Pakistan, Cameroon, Nigeria, South Sudan, Kenya, and the East African region. Through a semi-structured group discussion process, the experts reviewed findings from Phases 1 and 2 to reflect on their relevance to other settings, identify important themes in GBV coordination and reached consensus on key recommendations to enhance GBV coordination globally. Further written input was integrated from a GBV specialist involved in the Ukraine crisis response, contributing further insights from an ongoing protracted humanitarian crisis. Ethics Statement Ethical approval for Phases 1 and 2 of the study was obtained from the London School of Hygiene and Tropical Medicine Observational / Interventions Research Ethics Committee (Project ID: 16208) in September 2019 and the institutional review board of the American University Beirut (Protocol Number: SBS-2020-0067) in February 2021. Phase 3 did not require ethics approval, as participants in the global consultation were considered collaborators and were included as co-authors; therefore, informed consent was not required. Results and Discussion The future of GBV coordination - challenges and recommendations The findings from the three phases of the study were synthesized into seven strategic recommendations, presented within a revised global framework for strengthening GBV coordination (Fig. 1 ). Building on the original framework published in 2022, this updated version incorporates insights from the Lebanon case study and global consultation to address evolving challenges, emerging themes, and shifting priorities in GBV coordination ( 9 ). The seven recommendations are organized across three interconnected dimensions — invest, sustain, and transform — to guide the strengthening of GBV coordination in emergency contexts worldwide. The critical challenges identified through the research, along with the corresponding recommendations, are detailed below. 1. Strengthen and expand the GBV coordination workforce, including for risk mitigation Challenge : Skilled, experienced, and longterm dedicated GBV coordinators are critical for successful coordination, as they play a key role in fostering collaboration, mobilizing resources, and driving strategic decision-making ( 13 ). Research underscores the influence of long-term GBV coordinators in shaping funding priorities, establishing data management systems, and sustaining coordination mechanisms ( 9 , 12 ). In Lebanon, leadership continuity was instrumental in building trust across national, local and international actors and strengthening sub-national and inter-agency collaboration ( 11 , 12 ). However, across multiple settings high turnover rates, recruitment barriers, and having to manage dual operational and coordination roles continued to undermine the effectiveness of GBV responses ( 9 ). Power imbalances and resource asymmetries for national organizations also limits their contributions to coordination ( 9 ). The decline in US funding has jeopardized GBV coordination structures, with 40% of National Coordinator and 35% of National Co-coordinator positions across emergency settings dependent on US support ( 10 ). In February 2025, key national coordination roles in Iraq, Venezuela, the Pacific, Mali, Afghanistan, Colombia, and Sudan faced possible termination while sub-national coordination positions had already been eliminated in Sudan, South Sudan, Syria, and Ethiopia ( 10 ). Although global guidance exists, GBV risk mitigation remains inconsistently integrated across sectors due to its frequent de-prioritization by non-GBV sectors and limited capacity of GBV coordinators to provide sustained support and capacity building amidst high humanitarian staff turnover ( 9 , 14 , 15 ). Additionally, risk mitigation efforts in public health emergencies are frequently weak or absent, with responders often unaware of existing GBV guidelines ( 16 ). While coordination teams offer technical guidance and advocate for integration—such as in Cameroon’s collaboration with WASH, nutrition, and food distribution sectors and Lebanons GBV risk mitigation mentorship approach —their influence on implementation is often limited because of power dynamics between sectors, donor-driven priorities and limited accountability mechanisms on GBV risk mitigation across sectors ( 12 , 17 ). Recommendation : Invest in building a skilled and experienced GBV coordination workforce across humanitarian and public health sectors. Early deployment of experienced coordinators—skilled in trust-building, collaboration, cultural competence, communication, and strategic planning—is essential in new crises. Capacity sharing with local staff and organizations should be adequately resourced to enable them to assume coordination roles. Accountability for GBV risk mitigation must be reinforced by integrating GBV experts from the onset of emergencies, enforcing sector-wide standards, and mandating the inclusion and financial support of local women's organizations in response planning ( 14 , 18 ). Donors should require explicit GBV risk reduction measures in all sectoral strategies ( 17 ). Strengthening inter-cluster coordination is critical to address persistent gaps in role clarity and accountability that undermine effective GBV risk mitigation ( 19 – 21 ). Close collaboration between Health Cluster and GBV actors is necessary to ensure clinical management of rape and IPV services are delivered as lifesaving interventions. Strategic models—such as Lebanon’s 2017 mentorship system and academic-civil society partnerships supporting coordination capacity transfer in countries neighboring Ukraine—offer promising approaches to enhance impact ( 6 , 12 ). 2. Prioritize GBV coordination in public health emergencies Challenge : Despite mounting evidence that public health emergencies exacerbate GBV, coordination remains systematically deprioritized by public health institutions, governments, and donors. Previous outbreaks—including Ebola, Zika, and COVID-19—have demonstrated how economic insecurity, social isolation, and disrupted health services fuel GBV ( 8 , 9 , 22 , 23 ). For instance, during the COVID-19 pandemic, resources were redirected towards outbreak control, away from essential GBV services, including through the repurposing of women-led safe spaces into isolation centers. Findings from the Global Health Cluster’s COVID-19 Task Team underscored the need for context-specific GBV risk assessments, improved referral pathways, and remote service provision to mitigate the barriers faced by survivors during public health crises ( 24 ). In Lebanon, the GBV task force successfully adapted referral systems, leveraged GBV data for coordination, and developed remote services for marginalized groups, including LGBTIQ + individuals, migrants, persons with disabilities, and adolescent girls ( 25 , 26 ) ( 11 ). Recommendation : Systematically integrate GBV coordination into public health emergency preparedness and response policies and frameworks. Globally, GBV coordination and programming innovations piloted during COVID-19, including remote GBV service models, should be standardized and expanded for future emergencies ( 14 , 16 , 27 ). Women-led safe spaces must be preserved and prioritized as critical survivor-led platforms, and community engagement mechanisms should be leveraged for GBV prevention. The inclusion of GBV coordinators within WHO-led response teams is essential to ensure a robust health response and GBV risk mitigation across all response pillars. Investments in a trained GBV workforce dedicated to addressing GBV in public health crises is needed, to ensure a transition toward a more operational and proactive GBV coordination role for WHO and partners. 3. Invest in data, knowledge management and strategic research Challenge : Effective GBV coordination relies on robust data and knowledge management systems, which require strategic investment in data collection, analysis, information management, research and communication ( 28 ). Collecting and utilizing data on GBV is essential for planning context-appropriate interventions, yet this remains particularly challenging in emergencies due to the sensitive nature of the issue and operational constraints ( 29 ). Common challenges include donor and agency leadership prioritizing data collection based on external reporting requirements rather than actionable insights, reluctance among organizations to share information, and the use of incompatible data collection tools across agencies, limiting comparability ( 20 ). The implementation of the GBV Information Management System (GBVIMS) has significantly strengthened coordination in many settings; however, limited implementation, lack of dedicated information managers, and data sharing restrictions continue to impede strategic collaboration ( 28 ). In Lebanon, GBVIMS was established as the first nationally coordinated GBV data system, providing standardized data that informed coordination and programming throughout both protracted and compounding crises ( 11 , 12 , 28 , 30 ). A dedicated GBVIMS coordination role was transitioned to a national staff member contributing to sustainability, and consistent data analysis informed coordination and programming ( 11 , 12 ) ( 9 ). In contrast, the absence of a dedicated GBVIMS nformation manager in Nigeria negatively affected data management efforts. Furthermore, triangulating GBVIMS data with other sources is essential to develop a comprehensive understanding of GBV risks and support coordination ( 18 ). Despite advancements in data collection tools, challenges remain in balancing standardization with contextual adaptation; for example, modifications to safety audit tools in Northeast Nigeria have compromised data quality and consistency. Strengthening interagency research and monitoring and evaluation (M&E) is allso necessary to assess intervention effectiveness and guide implementation. Insufficient M&E staff presence in hard-to-reach areas of Syria and Nigeria have undermined service quality monitoring. A 2010 review of GBV research in Lebanon highlighted persistent challenges, including study duplication, fragmented funding, and the absence of a centralized repository, underscoring the need for a coordinated research platform ( 31 ). Recommendation : Invest in dedicated information management positions and systems, such as GBViMS, that can harmonise and integrate GBV data and other sources and ensure field-level data is actionable for coordination and programming. Establish a global strategic research agenda on GBV coordination, including in public health emergencies, and create a centralized repository for GBV research in emergencies. Strengthening data collection, analysis, and research strategies will enhance GBV coordination effectiveness, support evidence-based advocacy, and improve survivor-centered service delivery. A coordinated global research platform would reduce duplication, identify gaps, and promote cross-context learning to inform future responses. 4. Enhance national leadership and advance localization Challenge : While National governments hold the legal responsibility for coordinating humanitarian assistance, they are often marginalized within international coordination structures (20, 32). This reflects foreign actors’ perceptions that government counterparts lack capacity, may divert aid, or are unwilling to recognize GBV as a form of direct or indirect violence against civilians during conflict or displacement ( 33 ). Some crisis-affected governments view GBV programming as foreign or imperialist, further complicating engagement ( 34 ) ( 20 ). Lebanon's experience illustrates both the potential and limitations of government-led coordination. While active leadership between 2015–2019, supported by a UN-funded position, helped stabilize the refugee responses through multi-year planning and humanitarian collaboration, fluctuating political will, limited institutional capacity, overwhelmed public institutions, and economic instability undermined sustainability of GBV services and coordination ( 12 , 32 , 35 , 36 ). Similar challenges exist globally, where GBV remains insufficiently integrated into national policies and budgets. Sustained advocacy with economic and fiscal government actors is critical to demonstrate the long-term value of investing in GBV prevention and response. National and local organizations, particularly civil society organizations (CSOs), often possess deep contextual knowledge and a nuanced understanding of community needs, positioning them to deliver culturally appropriate and effective interventions. However, national and local actors face significant barriers to engagement in humanitarian coordination, including language difficulties, financial and logistical constraints, and limited familiarity with the system ( 20 ). In conflict or sectarian settings such as Lebanon, international actors may perceive local NGOs as lacking neutrality, while local organizations may feel marginalized by coordination mechanisms that prioritize international standards over local knowledge. Lebanon’s experience demonstrates how meaningful local engagement can strengthen GBV coordination. National and local CSOs played a critical role in sustaining and expanding services alongside government bodies, UN agencies, and international NGOs throughout the COVID-19 pandemic, the Beirut Blast, and in insecure areas ( 9 , 35 – 37 ) ( 11 ). However, further inclusion of Syrian refugee-led organizations (RLOs) in coordination, policy, and decision-making processes was needed ( 38 , 39 ). In contrast, the Haiti earthquake response illustrates the consequences of excluding local actors, as international agencies dominated coordination while disregarding local knowledge ( 9 ). In Cameroon, the absence of a formally activated GBV sub-cluster led to reliance on regional sub-working groups, where local leadership eventually emerged following targeted UN-led capacity-building efforts. Persistent financial and logistical barriers require innovative and cost-effective approaches to strengthen local engagement, such as mobile training teams and regional knowledge-sharing networks. Recent findings from the GBV AoR’s February 2025 analysis on the impact of U.S. funding cuts highlight the vulnerability of national NGOs, which experienced the highest rate of funding suspensions (95%) and received the fewest waivers (5%) compared to international NGOs and UN agencies ( 10 ). Recommendation : Enhance National GBV leadership and support strategic transitions from humanitarian-led to government-owned GBV coordination systems during acute, protracted crises and recovery phases by integrating GBV responses into national health and social protection frameworks and promoting co-funding mechanisms. Marginalizing or excluding government actors risks undermining shared responsibility, trust-building, and long-term impact. Deliberate transition planning is essential to ensure the continuity of GBV coordination and services once emergency funding diminishes and international actors withdraw. Promising examples include government-led GBV sub-sectors in northeast Nigeria and the integration of GBV services into Pakistan’s national health budget. However, many governments lack the financial resources and technical capacity to sustain these efforts independently. High-level advocacy, including by Humanitarian and Resident Coordinators, as well as civil society-led advocacy within national parliaments and public forums, is critical to secure government co-funding and the integration of GBV services into national systems. ( 33 , 40 ). The institutionalization of core GBV services, such as women’s safe spaces and case management, within national health and social service structures—as implemented through Lebanon’s social development centres—can enhance sustainability beyond the crisis phase ( 12 ). Capacity-building must also target government agencies and coordination bodies, as demonstrated in Cameroon and Lebanon, where government engagement enhanced GBV coordination and promoted the sustainability of interventions ( 12 ). Promote localization to ensure sustained GBV coordination across all phases of acute emergencies, protracted crises, and recovery efforts ( 9 , 14 , 20 , 32 , 37 ). This requires moving beyond tokenistic inclusion toward equitable leadership by local and women-led organizations in GBV coordination. Long-term capacity-building, direct funding, and sustained partnerships are essential, aligning with global commitments to decolonize aid and redistribute power ( 12 , 37 ). Lebanon’s experience underscores the value of meaningful local engagement, where mutually beneficial partnerships between international and UN actors, national authorities, and CSOs enhanced GBV coordination throughout multiple crises ( 12 ). Efforts to reinforce national coordination mechanisms—particularly those led by women-led organizations—are gaining traction in countries like Nigeria, where CSOs are taking on co-leadership roles at the state level. GBV Case Management Task Forces can serve as effective platforms for both coordination and capacity building as seen in South Sudan and Lebanon ( 12 ). During the COVID-19 pandemic well-resourced and politically connected CSOs, alongside the presence of senior gender-focused government officials, played a pivotal role in advancing national GBV policies across multiple settings ( 40 ). Global initiatives such as the Call to Action and the GBV AoR’s Global Localization Team should be expanded to further promote women’s leadership and local engagement in GBV response ( 1 , 41 ) ( 14 , 37 , 42 ). 5. Implement context- appropriate and adaptable coordination mechanisms Challenge : Political, social, and cultural contexts can have a significant influence on GBV coordination and contextual understanding is critical to design and implement appropriate coordination mechanisms. In Lebanon's sectarian political system, for example, coordinating multiple stakeholders with conflicting affiliations and political agendas posed challenges ( 12 ). Patriarchal norms, weak legal protections, and overlapping crises heightened GBV risks, while restrictive refugee policies, low legal residency among refugees, and limited livelihood opportunities hindered survivors' access to services and complicated their delivery, requiring careful navigation by GBV coordinators ( 12 , 43 ). Cultural sensitivities and limited government expertise also posed challenges for policy-level engagement on GBV ( 11 , 12 ). Understanding how policy actors frame GBV is essential to enable constructive dialogue; for instance, in Pakistan, modifying terminology to avoid sensitivities surrounding "gender-based violence" facilitated coordination efforts. GBV coordination mechanisms must also respond to the evolving nature of crises. Failures in coordination during Typhoon Haiyan in the Philippines and the Syria crisis resulted in fragmented, reactive, and competitive responses ( 44 ). Conversely, Lebanon’s coordination structures adapted over time to address overlapping mandates and crises ( 11 , 20 ). Evidence highlights the value of investing in subnational coordination, which enables faster, contextually informed decision-making and fosters the participation of operational actors, particularly CSOs ( 20 , 45 ). In Lebanon, subnational coordination with dedicated GBV coordinators played a key role in enhancing the participation of local CSOs and improving service delivery through a harmonized approach while addressing regional challenges, offering a replicable model for other contexts ( 12 ). Recommendation : Establish context-specific and adaptable GBV coordination structures that are informed by a nuanced understanding of local sociopolitical and policy environments ( 11 , 12 ). Coordination mechanisms should be regularly reviewed and adjusted to reflect changing contexts, with particular investment in subnational coordination, localized guidance, and flexible operational approaches. National and local actors should be central to these coordinated, multi-sectoral efforts. 6. Diversify funding models and increase sustainable funding Challenge : Despite heightened policy commitments to addressing GBV, existing funding mechanisms remain misaligned with the evolving humanitarian and global health financial landscape. Funding for GBV is both insufficient and inconsistent; over the past decade, only a minimal fraction of humanitarian aid has been allocated to this sector, including less than 1% of UN consolidated appeals in 2023 ( 14 ) ( 15 ). Short-term funding cycles continue to hinder sustainable capacity building, limit prevention efforts, and restrict long-term systemic change ( 39 ). In Lebanon, donor support and senior leadership helped prioritize and fund GBV; however, funding still only accounted for 1.3% of total humanitarian assistance in 2020, falling short amid escalating needs during compounded crises ( 11 , 12 ). Similarly, in protracted crises such as Cameroon and Northeast Nigeria, overall reductions in humanitarian aid have led to declining GBV resources despite rising needs and expectations to maintain innovation and impact. Beyond the amount of funding, the manner in which it is distributed poses challenges due to structural donor practices—such as imposing conditions, favouring large international NGOs over local organizations, and the politicization of funding. Recent humanitarian funding cuts underscore the pressing need to diversify and stabilize funding streams. In countries like Cameroon and Venezuela, these cuts jeopardize nearly half of the GBV response budget, including funding for essential GBV coordination roles. Our Phase 3 study participants noted heightened competition for limited resources among both international and local NGOs, especially following the substantial decrease in U.S. GBV funding. Findings from the GBV AoR estimated that in Ethiopia, the suspension of US funding forced 17 of 66 partners to stop operations across 98 districts, reducing GBV response capacity by 34% and cutting coverage from 38–24.5%, affecting nearly half a million people ( 10 ). In Yemen, funding cuts are expected to impact 400,000 women and girls by closing 22 Safe Spaces, stopping cash assistance for 9,741 survivors, and denying psychosocial support to 6,000 survivors ( 10 ). Furthermore, GBV response actors must now navigate an increasingly complex advocacy landscape while seeking alternative financing mechanisms to maintain life-saving services. In response to US funding cuts, advocacy strategies have shifted to align with changing political preferences, including the use of alternative terminology to preserve support for GBV efforts while resisting the erosion of feminist language. Recommendation : Shift towards flexible, diversified, multi-year funding models that can adapt to respond effectively to rapidly evolving humanitarian contexts ( 30 , 38 ). Strengthen advocacy efforts at both global and national levels to identify alternative financing mechanisms and secure sustainable, dedicated funding for GBV coordination and services, especially amid growing uncertainty in global health funding and reduced reliance on traditional donors ( 14 ). Senior leadership within UN agencies, NGOs, and governments can play a pivotal role in securing adequate resources, while targeted awareness-raising efforts can sustain political will and long-term investment in GBV programming. Transitioning to needs-based funding allocation, coupled with innovative, coordinated advocacy and stronger government engagement, is imperative to ensure continuity of services in fragile and conflict-affected contexts. Promoting collaboration across organizations is equally important. Moving beyond siloed approaches, fostering collective thinking, and forming creative partnerships—such as consortiums between international and local NGOs—can help overcome financial barriers and strengthen technical capacity, as seen in Venezuela. Expanding global dialogue to share innovations and coordinate responses can further enhance collective impact. Strategies like those employed by the GBV Task Force in Lebanon to support local GBV staff through compounded crises could serve as adaptable models in other affected settings ( 11 ). 7. Leverage emergencies as catalysts for transformative change Challenge : Although emergencies exacerbate GBV risks, they can also serve as catalysts for transformative change when robust coordination mechanisms exist to sustain and scale such efforts, particularly when these initiatives are survivor-led and grounded in a rights-based approach. In Lebanon, the compounded crises prompted significant improvements in GBV coordination, evolving from weak initial structures into a comprehensive, multi-sectoral, survivor-centered framework ( 9 , 12 ). This progression laid the foundation for nationally led systems; however, as in other protracted crises, Lebanon’s GBV services remained heavily dependent on international funding, technical support, and leadership, particularly amid its economic crisis ( 11 , 12 ). Significant investments were made in expanding services, such as specialized legal and mental health support, as well as assistance for marginalized populations—including adolescent girls and LGBTIQ + individuals—although these remained insufficient ( 11 , 12 , 36 ). The compounded crises prompted coordinated GBV and mental health responses that integrated child protection, education, and psychosocial support to address issues like child marriage and adolescent girls' needs ( 14 , 43 , 46 – 48 ). Evidence from both Lebanon and South Sudan illustrates how coordinated, multisectoral approaches can embed GBV prevention and response within broader humanitarian and development systems, driving structural change. More broadly, Lebanon’s protracted crisis served as a catalyst for significant legal and policy reforms over the past decade, creating opportunities to reshape the landscape for women’s rights ( 12 , 14 ). Substantial progress was achieved in reforming GBV and gender-related frameworks, driven primarily by national and local actors, with humanitarian engagement playing a supportive catalytic role ( 12 , 30 , 36 ). In Ukraine, the emergency response similarly prompted significant legal and policy changes that strengthened GBV prevention and response both domestically and in host countries receiving refugees ( 6 ). In the WHO European Region, the designation of violence against women as a Special Initiative further illustrates how humanitarian crises can elevate GBV onto national and regional political agendas ( 49 ). However, while these developments are promising, policy reforms and improved coordination alone are insufficient to achieve transformative change. Sustained progress requires confronting entrenched power dynamics and structural inequities within both humanitarian systems and affected societies at multiple levels. Recommendation : Leverage emergencies strategically as opportunities to drive systemic transformation in GBV prevention and response. Ensure sustained, evidence-based investment in legal reforms, GBV prevention, and the institutionalization of coordination systems to achieve lasting, transformative change. Contextually tailored interventions that engage directly with underlying gender norms can yield sustained positive societal impacts ( 48 ). Gender and protection actors should strengthen partnerships with feminist organizations, child protection actors, and other stakeholders to challenge harmful gender norms and shift power dynamics. In protracted crises, long-term prevention requires sustained efforts to address gender power dynamics across multiple levels of the socio-ecological framework ( 14 ). Recovery planning should embed GBV prevention through ongoing investment in feminist movements, women’s leadership, economic empowerment, inclusive policy-making, and representative coordination structures. To advance GBV prevention in protracted emergencies, actors should adopt context-specific, multisectoral strategies grounded in robust evidence, including research from What Works, systematic reviews, and UN prevalence data ( 50 ). Targeted adolescent programming offers an important opportunity to address specific GBV risks such as child marriage, trafficking, and female genital mutilation. Similarly, greater utilization of the Women, Peace and Security agenda can institutionalize gains, strengthen local organizations, and advance prevention efforts by embedding gender equality in peacebuilding and recovery processes. Conclusion This paper highlights current challenges in GBV coordination in humanitarian and public health emergencies, drawing on prior research, insights from GBV practitioners, and updated global evidence. We present a refined globally-relevant framework for strengthening GBV coordination in emergencies. Seven strategic recommendations emerged to invest, sustain and transform GBV coordination globally. These include expanding the GBV coordination workforce, prioritizing GBV coordination within public health emergencies, and strengthening information management and strategic research capacities. To sustain GBV coordination, we recommend adapting funding models, diversifying financial sources, advancing national leadership and localization, and implementing context-specific coordination approaches, including at the sub-national level. Finally, emergencies offer opportunities for transformative change when power hierarchies are addressed and systemic inequities confronted in ways that reinforce longer-term efforts led by feminist movements. The current global landscape, particularly the withdrawal of U.S. government funding, underscores the fragility of existing GBV coordination mechanisms and highlights the urgent need for sustained political and financial commitment. To ensure that GBV remains a core humanitarian priority, stakeholders at national, regional, and international levels must mobilize long-term, flexible resources, advocate for enabling policies, and invest in and sustain GBV coordination systems. The future of GBV coordination depends on collective action not only to respond to GBV but also to prevent and mitigate it, particularlly amid shifting global priorities, funding constraints, and broader pushback against gender equality. Declarations Disclaimer: Any opinions stated within this document reflect those of the authors and not necessarily of the United Nations Population Fund or the World Health Organization. Acknowledgments: We gratefully acknowledge the contributions of GBV coordinators and experts who participated in the global consultation, including co-authors and Erica Talentino and Liliane Munezero. We extend special thanks to the GBV Area of Responsibility (AoR), particularly Shiva Sharifzad, for facilitating contact with GBV coordinators to organize the consultation and for providing preliminary data on the impact of US funding cuts for GBV programming in humanitarian settings. Ethics approval and consent to participate Ethical approval for Phases 1 and 2 of the study was obtained from the London School of Hygiene and Tropical Medicine Observational / Interventions Research Ethics Committee (Project ID: 16208) in September 2019 and the institutional review board of the American University Beirut (Protocol Number: SBS-2020-0067) in February 2021. Phase 3 did not require ethics approval, as participants in the global consultation were considered collaborators and were included as co-authors; therefore, informed consent was not required. Consent for publication Not applicable Availability of data and materials The datasets analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Authors' contributions PR conceived, designed and coordinated the study, with inputs from AP and JP. PR designed study tools, collected and analysed data, drafted the manuscript, revised all versions and wrote the final draft. AP, JP and MH contributed to interpretation of findings. All authors provided critical review and approved the final version for submission. Funding: No funding was received to conduct or publish this research. References Call to Action on Gender-Based Violence. Call to Action on Protection from Gender-based Violence in Emergencies. Available at: https://www.calltoactiongbv.com/. Accessed 24 June 2025. 2013. World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013. Garcia-Moreno C JH, Ellsberg M, Heise L, Watts CH, WHO Multi-country Study on Women's Health and Domestic Violence against Women Study Team,. Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence. Lancet. Lancet. 2006;368(9543):1260-9. Vu A, Adam A, Wirtz A, Pham K, Rubenstein L, Glass N, et al. The Prevalence of Sexual Violence among Female Refugees in Complex Humanitarian Emergencies: a Systematic Review and Meta-analysis. PLoS currents. 2014;6:ecurrents.dis.835f10778fd80ae031aac12d3b533ca7. Wachter K, Horn R, Friis E, Falb K, Ward L, Apio C, et al. Drivers of Intimate Partner Violence Against Women in Three Refugee Camps. Violence Against Women. 2018;24(3):286-306. World Health Organization. Humanitarian Reproduction Programme, 2023, Ukraine Case Study. Available at: https://www.srhr.org/gbvemergencies/case-study-ukraine/. Accessed 11 June 2025. 2023. Patten P SRotS-GoSV. Conflict-Related Sexual Violence: Report of the United Nations Secretary-General. Available at: https://www.refworld.org/reference/themreport/srsgsvc/2024/en/148831. Accessed 10 June 2025. UN Office of the Special Representative of the Secretary-General on Sexual Violence in Conflict. 2024;S/2024/292. Stark L, Meinhart M, Vahedi L, et al. The syndemic of COVID-19 and gender-based violence in humanitarian settings: leveraging lessons from Ebola in the Democratic Republic of Congo. BMJ Global Health. 2020(5):e004194. Raftery P, Howard N, Palmer J, Hossain M. Gender-based violence (GBV) coordination in humanitarian and public health emergencies: a scoping review. Confl Health. 2022;16:37. Gender Based Violence Area of Responsibility. Analysis of the Funding cuts on the GBV Sector. Preliminary analysis February 2025. 2025. Raftery P, Usta J, Kiss L, Palmer J, Hossain M. Gender based violence (GBV) coordination in a complex, multi-crisis context: a qualitative case study of Lebanon’s compounded crises (2019–2023). Conflict and Health. 2023;17(1):50. Raftery P, Usta J, Hossain M, Palmer J. A positive yet complicated case of gender-based violence coordination: a qualitative study of Lebanon's protracted humanitarian emergency, 2012-22. Disasters. 2024;48(4):e12625. Gender-Based Violence Area of Responsibility. Handbook for Coordinating Gender-based Violence Interventions in Emergencies. Available at: https://gbvaor.net/sites/default/files/2019-07/Handbook%20for%20Coordinating%20GBV%20in%20Emergencies_fin.pdf. Accessed 14 June 2025. 2019. Murphy M, Bourassa A. Gap Analysis of Gender-Based Violence in Humanitarian Settings: a Global Consultation. Available at:https://www.elrha.org/docs/document/elrha_gapanalysis_gbv_accessible_pdf_2021.pdf?file_url=document/uuqunv5vpd18n7r890ctinga03/c7peqt7a8kbomddwvxh3kwzaxda/original?content-type=application%2Fpdf&name=elrha_gapanalysis_gbv_accessible_pdf_2021.pdf. Accessed 24 June 2025. London: Elrha; 2021. Murphy M, Potts A, Nassif G, Khalfalla LA, Kaisi J, Modi AT, et al. Violence against women and girls in conflict: progress and priorities. The Lancet. 2024;404(10471):2495-8. International Rescue Committee. Are We There Yet? Progress and challenges in ensuring life-saving services and reducing risks to violence for women and girls in emergencies. Available at: https://www.rescue.org/report/are-we-there-yet-progress-and-challenges-ensuring-life-saving-services-and-reducing-risks. Accessed 15 June 2022. 2015. UNFPA, UNHCR, IRC, UNICEF, IMC. Evaluation of Implementation of 2005 IASC Guidelines for Gender-based Violence Interventions in Humanitarian Settings in the Syria Crisis response. Available at: https://www.unhcr.org/research/evalreports/57a4a85f7/evaluation-implementation-2005-iasc-guidelines-gender-based-violence-interventions.html.Accessed: 15 June 2022. 2015. Kelly JTD., Ausubel E., Kenny E., et al. Measuring gender-based violence risk mitigation in humanitarian settings: results from a comprehensive desk review and systematic mapping. BMJ Open. 2021;11:e050887. Knox Clarke P, Campbell L. Exploring coordination in humanitarian clusters. London: ALNAP; 2015. Knox Clarke P, Campbell L. Improving Humanitarian Coordination. London: ALNAP/ODI; 2016. Steets J, Grünewald F, Binder A, de Geoffroy V, Kauffmann D, Krüger S, et al. Cluster Approach Evaluation 2 Synthesis Report. Global Public Policy Institute; 2010. Peterman A. PA, O’Donnell M., Thompson K., Shah N., Oertelt-Prigione S., van Gelder N.,. Pandemics and Violence Against Women and Children. Available at: https://www.cgdev.org/sites/default/files/pandemics-and-violence-against-women-and-girls.pdf. 2020. Meinhart MVL, Carter S, Poulton C, Palaku P, Stark L. Gender-based violence and infectious disease in humanitarian settings: lessons learned from Ebola, Zika, and COVID-19 to inform syndemic policy making. Conflict and Health. 2021;15. Global Health Cluster COVID-19 Task Team. Barriers to Gender Based Violence (GBV) health services in humanitarian settings during COVID-19. Available at: https://healthcluster.who.int/docs/librariesprovider16/meeting-reports/barriers-to-gbv-health-services-during-c19-in-humanitarian-settings-fin-061221.pdf. 2021. Roesch E AA, Gupta J, García-Moreno C.,. Violence against women during covid-19 pandemic restrictions. BMJ. 2020(7):369. Call to Action on Protection from Gender-Based Violence in Emergencies. Statement issued by the Call to Action on Protection from Gender-Based Violence in Emergencies (Call to Action) on the impacts of the COVID-19 pandemic on GBV and relevant considerations in its humanitarian response. Available at: https://1ac32146-ecc0-406e-be7d-301d317d8317.filesusr.com/ugd/1b9009_de85e8269c1d47f6b175e6d304102871.pdf. Accessed 15 Aug 2022. 2020. UNFPA. COVID-19 / UNFPA best practices and lessons learned in humanitarian operations in the Arab region. Available at: https://arabstates.unfpa.org/sites/default/files/pub-pdf/covid-19_best_practices_-_english_-_141020-2.pdf. Accessed 25 Aug 2022. 2020. International Solutions Group. Evaluation of the Gender Based Violence Information Management System (GBVIMS). Prepared For: UNFPA. Available at: http://www.gbvims.com/wp/wp-content/uploads/GBVIMS-Evaluation-Brief.pdf. Accessed: 15 June 2022. 2014. Bain A., Guimond MF. Impacting the lives of survivors: using service-based data in GBV programmes. London: ODI; 2014. ABAAD, UNFPA. Mapping gender-based violence programmes, services, and policies in Lebanon. Available at: https://www.abaadmena.org/documents/ebook.1626097663.pdf. Accessed 24 June 2025. 2020. Wetheridge L., Usta J. Review of Gender-Based Violence Research in Lebanon. Available at: https://lebanon.unfpa.org/sites/default/files/pub-pdf/4-Review-of-GBV-Research-in-Lebanon.pdf. Lebanon: UNFPA; 2010. Knox Clarke P, Obrecht A. Good humanitarian action is led by the state and builds on local response capacities. London: ALNAP; 2016. Moro LN, Palmer J. Meeting report: The impact of global aid funding cuts on people and programmes in South Sudan. Availlable. at:https://www.socialscienceinaction.org/fr/ressources/rapport-de-la-reunion-sur-limpact-des-reductions-du-financement-de-laide-mondiale-sur-les-personnes-et-les-programmes-au-soudan-du-sud/. Accessed 24 June 2025. The Institute of Development Studies and Partner Organisations; 2025. Al-Refaei S. The security implications of using feminist methodologies to study gender-based violence in Yemen. Frontiers in Research Metrics and Analytics. 2024;Volume 9 - 2024. Hanley T, Ogwang K, Procter C. Evaluation of UNHCR prevention and response to SGBV in the refugee population in Lebanon (2016–2018). Available at: https://www.alnap.org/system/files/content/resource/files/main/5c23c2ad4.pdf. Accessed 14 Dec 2021. Lebanon: UNHCR; 2018. Irish Consortium on GBV. Responding and Empowering GBV Services in Lebanon in Response to the Syrian Crisis. Available at: https://www.gbv.ie/wp-content/uploads/2019/03/ICGBV-Report-CSW-63-In-violence-we-forget-who-we-were-Final.pdf. Accessed: 15 June 2022. 2019. Gender-Based Violence Area of Responsibility Localization Task Team. Gender-based violence (GBV) localization: humanitarian transformation or maintaining the status quo? A global study on GBV localization through country-level GBV sub-clusters. Available at: https://careevaluations.org/wp-content/uploads/GBV-Localization-Mapping-Study-Full-Report-FINAL.pdf. Accessed 14 Dec 2021. 2019. Mansour K. UN Humanitarian Coordination in Lebanon. The Consequences of Excluding Syrian Actors. Available at https://www.chathamhouse.org/sites/default/files/publications/research/2017-03-30-un-humanitarian-coordination-lebanon-mansour.pdf. Accessed 30 July 2022. London: Chatham House; 2017. Boustani M, Carpi E, Gebara. H, Mourad Y. Responding to the Syrian crisis in Lebanon. Collaboration between aid agencies and local governance structures.Available at: http://pubs.iied.org/10799IIED. Accessed 07 Aug 2022. London: IIED; 2016. Gordon R, Cheeseman N, Rockowitz S, Stevens LM, Flowe HD. Government responses to gender-based violence during COVID-19. Front Glob Womens Health. 2022;3:857345. Gender-based Violence Area of Responsibility. Gender-Based Violence Area of Responsibility (GBV AoR) Strategy 2021-25. Available at: https://gbvaor.net/sites/default/files/2021-09/SPS%20J17956%20-%20Gender-Based%20Violence%20Area%20of%20Responsibility%20GBV%20AoR%205%20Year%20Strategy%202021-2025_SINGLES_LR6.pdf. Accessed 24 June 2025. Geneva: GBV AoR; 2021. International Rescue Comittee. Building Local Thinking Global (BLTG). Available at: https://gbvresponders.org/womens-movement-building/building-local-thinking-global/. Accessed 18 Sep 2022. 2022. Government of Lebanon and United Nations. Lebanon Crisis Response Plan 2017- 2021 (2021 update). Available at: https://reliefweb.int/report/lebanon/lebanon-crisis-response-plan-2017-2021-2021-update. Accessed 27 Feb 2022. 2021. Comes T., Van de Walle B., Van Wassenhove L. The Coordination-Information Bubble in Humanitarian Response: Theoretical Foundations and Empirical Investigations. Production and Operations Management. 2020;29(11):2484–507. Clarke N, Loveless, J., Ojok, B., Routley, S. and Vaux, T. . Report of the Inter-agency Humanitarian Evaluation (IAHE) of the response to the crisis in South Sudan. Geneva: IAHE; 2015. World Bank. Lebanon Economic Monitor, Fall 2021: The Great Denial. Available at: https://www.worldbank.org/en/country/lebanon/publication/lebanon-economic-monitor-fall-2021-the-great-denial. Accessed Feb 2022. 2022. Fouad F M, Barkil-Oteo A, Diab JL. Mental health in Lebanon’s triple-fold crisis: The case of refugees and vulnerable groups in times of COVID-19. Front Public Health. 2021:1049. UNICEF. Underneath the surface: Understanding the root causes of violence against children and women in Lebanon. Available at: https://www.unicef.org/lebanon/media/5251/file/UNICEF_Lebanon_Social_Norms_research1_EN.pdf%20.pdf. Accessed 13 Feb 2022. 2021. World Health Organization (WHO) Regional Office for Europe. The Regional Director’s Special Initiative to respond to Violence against Women and Girls, WHO European Region. Accessible at: https://www.who.int/europe/initiatives/special-initiative-on-violence-against-women-and-girls-sivawg. Accessed 11 June 2025 2025 What Works to Prevent Violence. What Works to Prevent Violence. Available at: https://www.whatworks.co.za/. Accessed 24 June 2025 2019 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 07 Mar, 2026 Read the published version in Conflict and Health → Version 1 posted Editorial decision: Revision requested 29 Dec, 2025 Reviews received at journal 10 Dec, 2025 Reviewers agreed at journal 21 Nov, 2025 Reviews received at journal 24 Sep, 2025 Reviewers agreed at journal 09 Sep, 2025 Reviewers agreed at journal 24 Aug, 2025 Reviewers invited by journal 22 Aug, 2025 Editor assigned by journal 28 Jul, 2025 Submission checks completed at journal 28 Jul, 2025 First submitted to journal 25 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7215940","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":505465891,"identity":"00f850d2-2fac-45b4-b127-cfe655c9ce71","order_by":0,"name":"Philomena 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University","correspondingAuthor":false,"prefix":"","firstName":"Mazeda","middleName":"","lastName":"Hossain","suffix":""},{"id":505465899,"identity":"1497dbdb-b29a-4549-b303-d2ec74675e7d","order_by":8,"name":"Jennifer Palmer","email":"","orcid":"","institution":"London School of Hygiene \u0026 Tropical Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jennifer","middleName":"","lastName":"Palmer","suffix":""}],"badges":[],"createdAt":"2025-07-25 16:08:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7215940/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7215940/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13031-026-00770-9","type":"published","date":"2026-03-07T15:57:09+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":90382738,"identity":"c1f817b7-2e76-47ed-becf-9f9229d67ebf","added_by":"auto","created_at":"2025-09-02 06:54:28","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":395365,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGlobal framework for strengthening GBV coordination\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7215940/v1/bd961426a5dc2893dd68009e.png"},{"id":104250590,"identity":"bb698f14-fd71-4a55-a438-f14b12efb346","added_by":"auto","created_at":"2026-03-09 16:00:53","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1206218,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7215940/v1/3a76866e-ef31-4b96-890e-3aa7e75ed21b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Strengthening Gender-based violence (GBV) coordination in emergencies: a synthesis of practitioner-driven, globally applicable recommendations","fulltext":[{"header":"Key message ","content":"\u003cp\u003e\u003cem\u003eWhat is already known on this topic\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEffective GBV coordination is critical in emergencies, but existing models face challenges due to limited evidence on functionality and effectiveness, fluctuating funding, and insufficient resourcing and investment. This study was needed to synthesize practitioner-driven insights and provide globally relevant, evidence-informed recommendations to strengthen GBV coordination.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eWhat this study adds\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study presents seven globally applicable strategic recommendations developed through a systematic synthesis of evidence, case studies, and expert practitioner consultations. It provides a comprehensive framework for strengthening GBV coordination in emergencies.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHow this study might affect research, practice or policy\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe findings offer actionable guidance for policymakers, donors, and practitioners to strengthen and sustain GBV coordination globally, particularly amidst evolving global health priorities and resource constraints. The recommendations can inform the development of flexible, context-sensitive coordination models, support investment in national capacities, and stimulate further research into the integration of GBV coordination across diverse emergency contexts.\u003c/p\u003e"},{"header":"Introduction","content":"\u003cp\u003eGender-based violence (GBV) is a global public health crisis and a serious violation of human rights. Rooted in gender inequality, it disproportionately affects women and girls and results in profound public health, social, and economic consequences (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). GBV includes sexual, physical, emotional, psychological, economic, institutional violence, and harmful traditional practices, all of which can result in serious health outcomes such as injury, psychological trauma, increased risk of sexually transmitted infections (STIs), including HIV, adverse reproductive outcomes, and mortality (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe increasing frequency, duration, and severity of humanitarian and public health emergencies amplify vulnerabilities to GBV while simultaneously disrupting health care and protective systems (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Globally, one in three women and girls experience physical or sexual intimate partner violence (IPV) or non-partner sexual violence during their lifetime (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e–\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Although data collection on GBV in emergencies remains challenging and likely underestimates true prevalence, existing evidence indicates elevated rates of sexual violence, IPV, technology-facilitated abuse, and reduced access to essential services (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e–\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). For example, in Ukraine, IPV reports to police increased by 40% in the first five months of 2023 compared to the same period in 2022, while conflict-related sexual violence continues to be documented (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Public health emergencies such as the Ebola and COVID-19 outbreaks have similarly intensified GBV risks while restricting service access during lockdowns (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAddressing survivors' needs requires comprehensive, coordinated responses supported by adequate resources and collaboration across diverse stakeholders at both global and field levels. Despite progress driven by the United Nations humanitarian cluster system (2005), the establishment of the GBV Area of Responsibility (AoR)(2006), and the global Call to Action on Protecting Women and Girls in Emergencies (2013), persistent challenges hinder effective GBV coordination in emergencies(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Despite these policy commitments and increased recognition of the importance of addressing GBV in emergencies, funding remains insufficient, inconsistent, and poorly aligned with the changing humanitarian and global health financing landscape. Furthermore, a lack of published evidence on the effectiveness of GBV coordination limits its consideration in aid prioritisation decisions.\u003c/p\u003e\u003cp\u003eCompounding the situation, the recent U.S. funding cuts, particularly from USAID and exacerbated by declining support from several European donors, has severely disrupted GBV coordination and responses in crisis-affected settings, Preliminary 2025 data from the GBV AoR indicate that the United States was the largest GBV donor in 2024, contributing USD 131.1\u0026nbsp;million, or 36% of the total GBV funding (USD 366.1\u0026nbsp;million) under the Global Humanitarian Overview (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Of 24 contexts with Humanitarian Response Plans, the US funded GBV programming in 19, amounting to USD 91.1\u0026nbsp;million. However, in 2025, US contributions have markedly declined to USD 5.8\u0026nbsp;million, representing only 9.4% of the sector’s total USD 61.6\u0026nbsp;million (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). This significant reduction has led to widespread service disruptions, weakened coordination mechanisms, and diminished national and local partner capacity (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). International NGOs managing large GBV programs have faced substantial budget cuts, resulting in staff layoffs, furloughs, and program closures. Critical services, including women and girls’ safe spaces, cash and voucher assistance, and medical and psychosocial care for survivors of sexual violence, have been drastically curtailed, endangering survivors health and safety (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis paper synthesizes recent evidence on GBV coordination in humanitarian and public health emergencies, and presents global recommendations to inform future policy and practice. We use new empirical evidence to refine a previously published framework for GBV coordination, drawing on a case study in Lebanon and a 2025 global consultation with GBV coordination experts (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). We also examine the future of GBV coordination in light of shifting funding landscapes, including the withdrawal of U.S. government support. The updated framework offers a globally relevant, practice-driven model for strengthening effective and context-sensitive GBV coordination.\u003c/p\u003e"},{"header":"METHODOLOGY","content":"\u003cp\u003eThis study employed a three-phase, qualitative approach to refine a globally relevant framework and key recommendations for strengthening GBV coordination in emergencies. We integrated evidence synthesis, in-depth case study analysis, and a global expert practitioner consultation to ensure both rigour and relevance.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003ePhase 1\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003eEvidence Synthesis\u003c/em\u003e\u003c/p\u003e\u003cp\u003eA 2022 scoping review synthesized global evidence from peer-reviewed and grey literature on GBV coordination in humanitarian and public health emergencies. The review identified 28 relevant publications which provided the foundation for an evidence-based framework highlighting key components needed for effective GBV coordination (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003ePhase 2\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003eLebanon Case Study\u003c/em\u003e\u003c/p\u003e\u003cp\u003eBetween 2019 and 2022, an in-depth case study was carried out, exploring GBV coordination in Lebanon’s protracted crisis from 2012 to 2022 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Lebanon’s humanitarian landscape—characterized by a large-scale influx of Syrian refugees, restrictive refugee policies, a political and economic crisis over more than a decade and the COVID-19 pandemic—provided critical insights relevant to other complex emergencies. Data collection included 38 remote in-depth interviews, seven coordination meeting observations, and document review to explore the evolution of GBV coordination. A 2022 workshop with GBV task force members and key informants refined the analysis. Given the in-depth nature and extended duration of Phase 2, findings from the Lebanon case study feature prominently in this article.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003ePhase 3\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003eGlobal Practitioner Consultation\u003c/em\u003e\u003c/p\u003e\u003cp\u003eIn February 2025, a global consultation was held with six GBV coordination experts with experience in Venezuela, Lebanon, Pakistan, Cameroon, Nigeria, South Sudan, Kenya, and the East African region. Through a semi-structured group discussion process, the experts reviewed findings from Phases 1 and 2 to reflect on their relevance to other settings, identify important themes in GBV coordination and reached consensus on key recommendations to enhance GBV coordination globally. Further written input was integrated from a GBV specialist involved in the Ukraine crisis response, contributing further insights from an ongoing protracted humanitarian crisis.\u003c/p\u003e\u003cp\u003e\u003cem\u003eEthics Statement\u003c/em\u003e\u003c/p\u003e\u003cp\u003eEthical approval for Phases 1 and 2 of the study was obtained from the London School of Hygiene and Tropical Medicine Observational / Interventions Research Ethics Committee (Project ID: 16208) in September 2019 and the institutional review board of the American University Beirut (Protocol Number: SBS-2020-0067) in February 2021. Phase 3 did not require ethics approval, as participants in the global consultation were considered collaborators and were included as co-authors; therefore, informed consent was not required.\u003c/p\u003e"},{"header":"Results and Discussion","content":"\u003cp\u003e\u003cb\u003eThe future of GBV coordination - challenges and recommendations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe findings from the three phases of the study were synthesized into seven strategic recommendations, presented within a revised global framework for strengthening GBV coordination (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Building on the original framework published in 2022, this updated version incorporates insights from the Lebanon case study and global consultation to address evolving challenges, emerging themes, and shifting priorities in GBV coordination (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The seven recommendations are organized across three interconnected dimensions \u0026mdash; invest, sustain, and transform \u0026mdash; to guide the strengthening of GBV coordination in emergency contexts worldwide. The critical challenges identified through the research, along with the corresponding recommendations, are detailed below.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\n\u003ch3\u003e1. Strengthen and expand the GBV coordination workforce, including for risk mitigation\u003c/h3\u003e\n\u003cp\u003e\u003cem\u003eChallenge\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eSkilled, experienced, and longterm dedicated GBV coordinators are critical for successful coordination, as they play a key role in fostering collaboration, mobilizing resources, and driving strategic decision-making (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Research underscores the influence of long-term GBV coordinators in shaping funding priorities, establishing data management systems, and sustaining coordination mechanisms (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In Lebanon, leadership continuity was instrumental in building trust across national, local and international actors and strengthening sub-national and inter-agency collaboration (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). However, across multiple settings high turnover rates, recruitment barriers, and having to manage dual operational and coordination roles continued to undermine the effectiveness of GBV responses (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Power imbalances and resource asymmetries for national organizations also limits their contributions to coordination (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The decline in US funding has jeopardized GBV coordination structures, with 40% of National Coordinator and 35% of National Co-coordinator positions across emergency settings dependent on US support (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). In February 2025, key national coordination roles in Iraq, Venezuela, the Pacific, Mali, Afghanistan, Colombia, and Sudan faced possible termination while sub-national coordination positions had already been eliminated in Sudan, South Sudan, Syria, and Ethiopia (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAlthough global guidance exists, GBV risk mitigation remains inconsistently integrated across sectors due to its frequent de-prioritization by non-GBV sectors and limited capacity of GBV coordinators to provide sustained support and capacity building amidst high humanitarian staff turnover (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Additionally, risk mitigation efforts in public health emergencies are frequently weak or absent, with responders often unaware of existing GBV guidelines (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). While coordination teams offer technical guidance and advocate for integration\u0026mdash;such as in Cameroon\u0026rsquo;s collaboration with WASH, nutrition, and food distribution sectors and Lebanons GBV risk mitigation mentorship approach \u0026mdash;their influence on implementation is often limited because of power dynamics between sectors, donor-driven priorities and limited accountability mechanisms on GBV risk mitigation across sectors (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cem\u003eRecommendation\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eInvest in building a skilled and experienced GBV coordination workforce across humanitarian and public health sectors. Early deployment of experienced coordinators\u0026mdash;skilled in trust-building, collaboration, cultural competence, communication, and strategic planning\u0026mdash;is essential in new crises. Capacity sharing with local staff and organizations should be adequately resourced to enable them to assume coordination roles. Accountability for GBV risk mitigation must be reinforced by integrating GBV experts from the onset of emergencies, enforcing sector-wide standards, and mandating the inclusion and financial support of local women's organizations in response planning (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Donors should require explicit GBV risk reduction measures in all sectoral strategies (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Strengthening inter-cluster coordination is critical to address persistent gaps in role clarity and accountability that undermine effective GBV risk mitigation (\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Close collaboration between Health Cluster and GBV actors is necessary to ensure clinical management of rape and IPV services are delivered as lifesaving interventions. Strategic models\u0026mdash;such as Lebanon\u0026rsquo;s 2017 mentorship system and academic-civil society partnerships supporting coordination capacity transfer in countries neighboring Ukraine\u0026mdash;offer promising approaches to enhance impact (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003e2. Prioritize GBV coordination in public health emergencies\u003c/h3\u003e\n\u003cp\u003e\u003cem\u003eChallenge\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eDespite mounting evidence that public health emergencies exacerbate GBV, coordination remains systematically deprioritized by public health institutions, governments, and donors. Previous outbreaks\u0026mdash;including Ebola, Zika, and COVID-19\u0026mdash;have demonstrated how economic insecurity, social isolation, and disrupted health services fuel GBV (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). For instance, during the COVID-19 pandemic, resources were redirected towards outbreak control, away from essential GBV services, including through the repurposing of women-led safe spaces into isolation centers. Findings from the Global Health Cluster\u0026rsquo;s COVID-19 Task Team underscored the need for context-specific GBV risk assessments, improved referral pathways, and remote service provision to mitigate the barriers faced by survivors during public health crises (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). In Lebanon, the GBV task force successfully adapted referral systems, leveraged GBV data for coordination, and developed remote services for marginalized groups, including LGBTIQ\u0026thinsp;+\u0026thinsp;individuals, migrants, persons with disabilities, and adolescent girls (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cem\u003eRecommendation\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eSystematically integrate GBV coordination into public health emergency preparedness and response policies and frameworks. Globally, GBV coordination and programming innovations piloted during COVID-19, including remote GBV service models, should be standardized and expanded for future emergencies (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Women-led safe spaces must be preserved and prioritized as critical survivor-led platforms, and community engagement mechanisms should be leveraged for GBV prevention. The inclusion of GBV coordinators within WHO-led response teams is essential to ensure a robust health response and GBV risk mitigation across all response pillars. Investments in a trained GBV workforce dedicated to addressing GBV in public health crises is needed, to ensure a transition toward a more operational and proactive GBV coordination role for WHO and partners.\u003c/p\u003e\n\u003ch3\u003e3. Invest in data, knowledge management and strategic research\u003c/h3\u003e\n\u003cp\u003e\u003cem\u003eChallenge\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eEffective GBV coordination relies on robust data and knowledge management systems, which require strategic investment in data collection, analysis, information management, research and communication (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Collecting and utilizing data on GBV is essential for planning context-appropriate interventions, yet this remains particularly challenging in emergencies due to the sensitive nature of the issue and operational constraints (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Common challenges include donor and agency leadership prioritizing data collection based on external reporting requirements rather than actionable insights, reluctance among organizations to share information, and the use of incompatible data collection tools across agencies, limiting comparability (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). The implementation of the GBV Information Management System (GBVIMS) has significantly strengthened coordination in many settings; however, limited implementation, lack of dedicated information managers, and data sharing restrictions continue to impede strategic collaboration (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). In Lebanon, GBVIMS was established as the first nationally coordinated GBV data system, providing standardized data that informed coordination and programming throughout both protracted and compounding crises (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). A dedicated GBVIMS coordination role was transitioned to a national staff member contributing to sustainability, and consistent data analysis informed coordination and programming (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). In contrast, the absence of a dedicated GBVIMS nformation manager in Nigeria negatively affected data management efforts.\u003c/p\u003e\u003cp\u003eFurthermore, triangulating GBVIMS data with other sources is essential to develop a comprehensive understanding of GBV risks and support coordination (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Despite advancements in data collection tools, challenges remain in balancing standardization with contextual adaptation; for example, modifications to safety audit tools in Northeast Nigeria have compromised data quality and consistency. Strengthening interagency research and monitoring and evaluation (M\u0026amp;E) is allso necessary to assess intervention effectiveness and guide implementation. Insufficient M\u0026amp;E staff presence in hard-to-reach areas of Syria and Nigeria have undermined service quality monitoring. A 2010 review of GBV research in Lebanon highlighted persistent challenges, including study duplication, fragmented funding, and the absence of a centralized repository, underscoring the need for a coordinated research platform (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cem\u003eRecommendation\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eInvest in dedicated information management positions and systems, such as GBViMS, that can harmonise and integrate GBV data and other sources and ensure field-level data is actionable for coordination and programming. Establish a global strategic research agenda on GBV coordination, including in public health emergencies, and create a centralized repository for GBV research in emergencies. Strengthening data collection, analysis, and research strategies will enhance GBV coordination effectiveness, support evidence-based advocacy, and improve survivor-centered service delivery. A coordinated global research platform would reduce duplication, identify gaps, and promote cross-context learning to inform future responses.\u003c/p\u003e\n\u003ch3\u003e4. Enhance national leadership and advance localization\u003c/h3\u003e\n\u003cp\u003e\u003cem\u003eChallenge\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eWhile National governments hold the legal responsibility for coordinating humanitarian assistance, they are often marginalized within international coordination structures (20, 32). This reflects foreign actors\u0026rsquo; perceptions that government counterparts lack capacity, may divert aid, or are unwilling to recognize GBV as a form of direct or indirect violence against civilians during conflict or displacement (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Some crisis-affected governments view GBV programming as foreign or imperialist, further complicating engagement (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e) (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Lebanon's experience illustrates both the potential and limitations of government-led coordination. While active leadership between 2015\u0026ndash;2019, supported by a UN-funded position, helped stabilize the refugee responses through multi-year planning and humanitarian collaboration, fluctuating political will, limited institutional capacity, overwhelmed public institutions, and economic instability undermined sustainability of GBV services and coordination (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Similar challenges exist globally, where GBV remains insufficiently integrated into national policies and budgets. Sustained advocacy with economic and fiscal government actors is critical to demonstrate the long-term value of investing in GBV prevention and response.\u003c/p\u003e\u003cp\u003eNational and local organizations, particularly civil society organizations (CSOs), often possess deep contextual knowledge and a nuanced understanding of community needs, positioning them to deliver culturally appropriate and effective interventions. However, national and local actors face significant barriers to engagement in humanitarian coordination, including language difficulties, financial and logistical constraints, and limited familiarity with the system (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). In conflict or sectarian settings such as Lebanon, international actors may perceive local NGOs as lacking neutrality, while local organizations may feel marginalized by coordination mechanisms that prioritize international standards over local knowledge. Lebanon\u0026rsquo;s experience demonstrates how meaningful local engagement can strengthen GBV coordination. National and local CSOs played a critical role in sustaining and expanding services alongside government bodies, UN agencies, and international NGOs throughout the COVID-19 pandemic, the Beirut Blast, and in insecure areas (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). However, further inclusion of Syrian refugee-led organizations (RLOs) in coordination, policy, and decision-making processes was needed (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). In contrast, the Haiti earthquake response illustrates the consequences of excluding local actors, as international agencies dominated coordination while disregarding local knowledge (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). In Cameroon, the absence of a formally activated GBV sub-cluster led to reliance on regional sub-working groups, where local leadership eventually emerged following targeted UN-led capacity-building efforts. Persistent financial and logistical barriers require innovative and cost-effective approaches to strengthen local engagement, such as mobile training teams and regional knowledge-sharing networks. Recent findings from the GBV AoR\u0026rsquo;s February 2025 analysis on the impact of U.S. funding cuts highlight the vulnerability of national NGOs, which experienced the highest rate of funding suspensions (95%) and received the fewest waivers (5%) compared to international NGOs and UN agencies (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cem\u003eRecommendation\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eEnhance National GBV leadership and support strategic transitions from humanitarian-led to government-owned GBV coordination systems during acute, protracted crises and recovery phases by integrating GBV responses into national health and social protection frameworks and promoting co-funding mechanisms. Marginalizing or excluding government actors risks undermining shared responsibility, trust-building, and long-term impact. Deliberate transition planning is essential to ensure the continuity of GBV coordination and services once emergency funding diminishes and international actors withdraw. Promising examples include government-led GBV sub-sectors in northeast Nigeria and the integration of GBV services into Pakistan\u0026rsquo;s national health budget. However, many governments lack the financial resources and technical capacity to sustain these efforts independently. High-level advocacy, including by Humanitarian and Resident Coordinators, as well as civil society-led advocacy within national parliaments and public forums, is critical to secure government co-funding and the integration of GBV services into national systems. (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). The institutionalization of core GBV services, such as women\u0026rsquo;s safe spaces and case management, within national health and social service structures\u0026mdash;as implemented through Lebanon\u0026rsquo;s social development centres\u0026mdash;can enhance sustainability beyond the crisis phase (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Capacity-building must also target government agencies and coordination bodies, as demonstrated in Cameroon and Lebanon, where government engagement enhanced GBV coordination and promoted the sustainability of interventions (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePromote localization to ensure sustained GBV coordination across all phases of acute emergencies, protracted crises, and recovery efforts (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). This requires moving beyond tokenistic inclusion toward equitable leadership by local and women-led organizations in GBV coordination. Long-term capacity-building, direct funding, and sustained partnerships are essential, aligning with global commitments to decolonize aid and redistribute power (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Lebanon\u0026rsquo;s experience underscores the value of meaningful local engagement, where mutually beneficial partnerships between international and UN actors, national authorities, and CSOs enhanced GBV coordination throughout multiple crises (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Efforts to reinforce national coordination mechanisms\u0026mdash;particularly those led by women-led organizations\u0026mdash;are gaining traction in countries like Nigeria, where CSOs are taking on co-leadership roles at the state level. GBV Case Management Task Forces can serve as effective platforms for both coordination and capacity building as seen in South Sudan and Lebanon (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). During the COVID-19 pandemic well-resourced and politically connected CSOs, alongside the presence of senior gender-focused government officials, played a pivotal role in advancing national GBV policies across multiple settings (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). Global initiatives such as the Call to Action and the GBV AoR\u0026rsquo;s Global Localization Team should be expanded to further promote women\u0026rsquo;s leadership and local engagement in GBV response (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003e5. Implement context- appropriate and adaptable coordination mechanisms\u003c/h3\u003e\n\u003cp\u003e\u003cem\u003eChallenge\u003c/em\u003e:\u003c/p\u003e\u003cp\u003ePolitical, social, and cultural contexts can have a significant influence on GBV coordination and contextual understanding is critical to design and implement appropriate coordination mechanisms. In Lebanon's sectarian political system, for example, coordinating multiple stakeholders with conflicting affiliations and political agendas posed challenges (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Patriarchal norms, weak legal protections, and overlapping crises heightened GBV risks, while restrictive refugee policies, low legal residency among refugees, and limited livelihood opportunities hindered survivors' access to services and complicated their delivery, requiring careful navigation by GBV coordinators (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). Cultural sensitivities and limited government expertise also posed challenges for policy-level engagement on GBV (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Understanding how policy actors frame GBV is essential to enable constructive dialogue; for instance, in Pakistan, modifying terminology to avoid sensitivities surrounding \"gender-based violence\" facilitated coordination efforts.\u003c/p\u003e\u003cp\u003eGBV coordination mechanisms must also respond to the evolving nature of crises. Failures in coordination during Typhoon Haiyan in the Philippines and the Syria crisis resulted in fragmented, reactive, and competitive responses (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). Conversely, Lebanon\u0026rsquo;s coordination structures adapted over time to address overlapping mandates and crises (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Evidence highlights the value of investing in subnational coordination, which enables faster, contextually informed decision-making and fosters the participation of operational actors, particularly CSOs (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). In Lebanon, subnational coordination with dedicated GBV coordinators played a key role in enhancing the participation of local CSOs and improving service delivery through a harmonized approach while addressing regional challenges, offering a replicable model for other contexts (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cem\u003eRecommendation\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eEstablish context-specific and adaptable GBV coordination structures that are informed by a nuanced understanding of local sociopolitical and policy environments (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Coordination mechanisms should be regularly reviewed and adjusted to reflect changing contexts, with particular investment in subnational coordination, localized guidance, and flexible operational approaches. National and local actors should be central to these coordinated, multi-sectoral efforts.\u003c/p\u003e\n\u003ch3\u003e6. Diversify funding models and increase sustainable funding\u003c/h3\u003e\n\u003cp\u003e\u003cem\u003eChallenge\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eDespite heightened policy commitments to addressing GBV, existing funding mechanisms remain misaligned with the evolving humanitarian and global health financial landscape. Funding for GBV is both insufficient and inconsistent; over the past decade, only a minimal fraction of humanitarian aid has been allocated to this sector, including less than 1% of UN consolidated appeals in 2023 (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Short-term funding cycles continue to hinder sustainable capacity building, limit prevention efforts, and restrict long-term systemic change (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). In Lebanon, donor support and senior leadership helped prioritize and fund GBV; however, funding still only accounted for 1.3% of total humanitarian assistance in 2020, falling short amid escalating needs during compounded crises (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Similarly, in protracted crises such as Cameroon and Northeast Nigeria, overall reductions in humanitarian aid have led to declining GBV resources despite rising needs and expectations to maintain innovation and impact. Beyond the amount of funding, the manner in which it is distributed poses challenges due to structural donor practices\u0026mdash;such as imposing conditions, favouring large international NGOs over local organizations, and the politicization of funding.\u003c/p\u003e\u003cp\u003eRecent humanitarian funding cuts underscore the pressing need to diversify and stabilize funding streams. In countries like Cameroon and Venezuela, these cuts jeopardize nearly half of the GBV response budget, including funding for essential GBV coordination roles. Our Phase 3 study participants noted heightened competition for limited resources among both international and local NGOs, especially following the substantial decrease in U.S. GBV funding. Findings from the GBV AoR estimated that in Ethiopia, the suspension of US funding forced 17 of 66 partners to stop operations across 98 districts, reducing GBV response capacity by 34% and cutting coverage from 38\u0026ndash;24.5%, affecting nearly half a million people (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). In Yemen, funding cuts are expected to impact 400,000 women and girls by closing 22 Safe Spaces, stopping cash assistance for 9,741 survivors, and denying psychosocial support to 6,000 survivors (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Furthermore, GBV response actors must now navigate an increasingly complex advocacy landscape while seeking alternative financing mechanisms to maintain life-saving services. In response to US funding cuts, advocacy strategies have shifted to align with changing political preferences, including the use of alternative terminology to preserve support for GBV efforts while resisting the erosion of feminist language.\u003c/p\u003e\u003cp\u003e\u003cem\u003eRecommendation\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eShift towards flexible, diversified, multi-year funding models that can adapt to respond effectively to rapidly evolving humanitarian contexts (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Strengthen advocacy efforts at both global and national levels to identify alternative financing mechanisms and secure sustainable, dedicated funding for GBV coordination and services, especially amid growing uncertainty in global health funding and reduced reliance on traditional donors (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Senior leadership within UN agencies, NGOs, and governments can play a pivotal role in securing adequate resources, while targeted awareness-raising efforts can sustain political will and long-term investment in GBV programming. Transitioning to needs-based funding allocation, coupled with innovative, coordinated advocacy and stronger government engagement, is imperative to ensure continuity of services in fragile and conflict-affected contexts. Promoting collaboration across organizations is equally important. Moving beyond siloed approaches, fostering collective thinking, and forming creative partnerships\u0026mdash;such as consortiums between international and local NGOs\u0026mdash;can help overcome financial barriers and strengthen technical capacity, as seen in Venezuela. Expanding global dialogue to share innovations and coordinate responses can further enhance collective impact. Strategies like those employed by the GBV Task Force in Lebanon to support local GBV staff through compounded crises could serve as adaptable models in other affected settings (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003e7. Leverage emergencies as catalysts for transformative change\u003c/h3\u003e\n\u003cp\u003e\u003cem\u003eChallenge\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eAlthough emergencies exacerbate GBV risks, they can also serve as catalysts for transformative change when robust coordination mechanisms exist to sustain and scale such efforts, particularly when these initiatives are survivor-led and grounded in a rights-based approach. In Lebanon, the compounded crises prompted significant improvements in GBV coordination, evolving from weak initial structures into a comprehensive, multi-sectoral, survivor-centered framework (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). This progression laid the foundation for nationally led systems; however, as in other protracted crises, Lebanon\u0026rsquo;s GBV services remained heavily dependent on international funding, technical support, and leadership, particularly amid its economic crisis (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Significant investments were made in expanding services, such as specialized legal and mental health support, as well as assistance for marginalized populations\u0026mdash;including adolescent girls and LGBTIQ\u0026thinsp;+\u0026thinsp;individuals\u0026mdash;although these remained insufficient (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). The compounded crises prompted coordinated GBV and mental health responses that integrated child protection, education, and psychosocial support to address issues like child marriage and adolescent girls' needs (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan additionalcitationids=\"CR47\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). Evidence from both Lebanon and South Sudan illustrates how coordinated, multisectoral approaches can embed GBV prevention and response within broader humanitarian and development systems, driving structural change.\u003c/p\u003e\u003cp\u003eMore broadly, Lebanon\u0026rsquo;s protracted crisis served as a catalyst for significant legal and policy reforms over the past decade, creating opportunities to reshape the landscape for women\u0026rsquo;s rights (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Substantial progress was achieved in reforming GBV and gender-related frameworks, driven primarily by national and local actors, with humanitarian engagement playing a supportive catalytic role (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). In Ukraine, the emergency response similarly prompted significant legal and policy changes that strengthened GBV prevention and response both domestically and in host countries receiving refugees (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). In the WHO European Region, the designation of violence against women as a Special Initiative further illustrates how humanitarian crises can elevate GBV onto national and regional political agendas (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). However, while these developments are promising, policy reforms and improved coordination alone are insufficient to achieve transformative change. Sustained progress requires confronting entrenched power dynamics and structural inequities within both humanitarian systems and affected societies at multiple levels.\u003c/p\u003e\u003cp\u003e\u003cem\u003eRecommendation\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eLeverage emergencies strategically as opportunities to drive systemic transformation in GBV prevention and response. Ensure sustained, evidence-based investment in legal reforms, GBV prevention, and the institutionalization of coordination systems to achieve lasting, transformative change. Contextually tailored interventions that engage directly with underlying gender norms can yield sustained positive societal impacts (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). Gender and protection actors should strengthen partnerships with feminist organizations, child protection actors, and other stakeholders to challenge harmful gender norms and shift power dynamics. In protracted crises, long-term prevention requires sustained efforts to address gender power dynamics across multiple levels of the socio-ecological framework (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Recovery planning should embed GBV prevention through ongoing investment in feminist movements, women\u0026rsquo;s leadership, economic empowerment, inclusive policy-making, and representative coordination structures. To advance GBV prevention in protracted emergencies, actors should adopt context-specific, multisectoral strategies grounded in robust evidence, including research from What Works, systematic reviews, and UN prevalence data (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e). Targeted adolescent programming offers an important opportunity to address specific GBV risks such as child marriage, trafficking, and female genital mutilation. Similarly, greater utilization of the Women, Peace and Security agenda can institutionalize gains, strengthen local organizations, and advance prevention efforts by embedding gender equality in peacebuilding and recovery processes.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis paper highlights current challenges in GBV coordination in humanitarian and public health emergencies, drawing on prior research, insights from GBV practitioners, and updated global evidence. We present a refined globally-relevant framework for strengthening GBV coordination in emergencies. Seven strategic recommendations emerged to invest, sustain and transform GBV coordination globally. These include expanding the GBV coordination workforce, prioritizing GBV coordination within public health emergencies, and strengthening information management and strategic research capacities. To sustain GBV coordination, we recommend adapting funding models, diversifying financial sources, advancing national leadership and localization, and implementing context-specific coordination approaches, including at the sub-national level. Finally, emergencies offer opportunities for transformative change when power hierarchies are addressed and systemic inequities confronted in ways that reinforce longer-term efforts led by feminist movements.\u003c/p\u003e\u003cp\u003eThe current global landscape, particularly the withdrawal of U.S. government funding, underscores the fragility of existing GBV coordination mechanisms and highlights the urgent need for sustained political and financial commitment. To ensure that GBV remains a core humanitarian priority, stakeholders at national, regional, and international levels must mobilize long-term, flexible resources, advocate for enabling policies, and invest in and sustain GBV coordination systems. The future of GBV coordination depends on collective action not only to respond to GBV but also to prevent and mitigate it, particularlly amid shifting global priorities, funding constraints, and broader pushback against gender equality.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDisclaimer:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAny opinions stated within this document reflect those of the authors and not necessarily of the United Nations Population Fund\u0026nbsp;or the World Health Organization.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully acknowledge the contributions of GBV coordinators and experts who participated in the global consultation, including co-authors and Erica Talentino and Liliane Munezero. We extend special thanks to the GBV Area of Responsibility (AoR), particularly Shiva Sharifzad, for facilitating contact with GBV coordinators to organize the consultation and for providing preliminary data on the impact of US funding cuts for GBV programming in humanitarian settings.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for Phases 1 and 2 of the study was obtained from the London School of Hygiene and Tropical Medicine Observational / Interventions Research Ethics Committee (Project ID: 16208) in September 2019 and the institutional review board of the American University Beirut (Protocol Number: SBS-2020-0067) in February 2021. Phase 3 did not require ethics approval, as participants in the global consultation were considered collaborators and were included as co-authors; therefore, informed consent was not required.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePR conceived, designed and coordinated the study, with inputs from AP and JP. PR designed study tools, collected and analysed data, drafted the manuscript,\u0026nbsp;revised all versions and wrote the final draft. AP, JP and MH contributed to interpretation of findings. All authors provided critical review and approved the final version for submission.\u0026nbsp;\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received to conduct or publish this research.\u003c/p\u003e\n\n"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCall to Action on Gender-Based Violence. Call to Action on Protection from Gender-based Violence in Emergencies. Available at: https://www.calltoactiongbv.com/. Accessed 24 June 2025. 2013.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. 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The Coordination-Information Bubble in Humanitarian Response: Theoretical Foundations and Empirical Investigations. Production and Operations Management. 2020;29(11):2484\u0026ndash;507.\u003c/li\u003e\n\u003cli\u003eClarke N, Loveless, J., Ojok, B., Routley, S. and Vaux, T. . Report of the Inter-agency Humanitarian Evaluation (IAHE) of the response to the crisis in South Sudan. Geneva: IAHE; 2015.\u003c/li\u003e\n\u003cli\u003eWorld Bank. Lebanon Economic Monitor, Fall 2021: The Great Denial. Available at: https://www.worldbank.org/en/country/lebanon/publication/lebanon-economic-monitor-fall-2021-the-great-denial. Accessed Feb 2022. 2022.\u003c/li\u003e\n\u003cli\u003eFouad F M, Barkil-Oteo A, Diab JL. Mental health in Lebanon\u0026rsquo;s triple-fold crisis: The case of refugees and vulnerable groups in times of COVID-19. Front Public Health. 2021:1049.\u003c/li\u003e\n\u003cli\u003eUNICEF. Underneath the surface: Understanding the root causes of violence against children and women in Lebanon. Available at: https://www.unicef.org/lebanon/media/5251/file/UNICEF_Lebanon_Social_Norms_research1_EN.pdf%20.pdf. Accessed 13 Feb 2022. 2021.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO) Regional Office for Europe. The Regional Director\u0026rsquo;s Special Initiative to respond to Violence against Women and Girls, WHO European Region. Accessible at: https://www.who.int/europe/initiatives/special-initiative-on-violence-against-women-and-girls-sivawg. Accessed 11 June 2025 2025 \u003c/li\u003e\n\u003cli\u003eWhat Works to Prevent Violence. What Works to Prevent Violence. Available at: https://www.whatworks.co.za/. Accessed 24 June 2025 2019 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"conflict-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"conf","sideBox":"Learn more about [Conflict and Health](http://conflictandhealth.biomedcentral.com/)","snPcode":"13031","submissionUrl":"https://submission.nature.com/new-submission/13031/3","title":"Conflict and Health","twitterHandle":"@Conflict_Health","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Gender-based violence, GBV Coordination, humanitarian emergencies","lastPublishedDoi":"10.21203/rs.3.rs-7215940/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7215940/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction\u003c/h2\u003e\u003cp\u003eGender-based violence (GBV) is a global public health and human rights crisis, requiring coordinated efforts to ensure effective prevention, risk mitigation, and response particularly in emergencies. Despite policy commitments and increased recognition of the importance of addressing GBV in emergencies, funding remains insufficient, inconsistent, and poorly aligned with the changing humanitarian and global health financing landscape. Furthermore, limited evidence on GBV coordination effectiveness limits its consideration in aid prioritisation decisions. This paper synthesizes evidence on GBV coordination in humanitarian and public health emergencies and presents global recommendations to inform policy and practice.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eUsing a rigorous three-phase qualitative methodology\u0026mdash;comprising evidence synthesis, case study analysis, and a global expert practitioner consultation\u0026mdash;we developed a comprehensive framework and present strategic recommendations to strengthen GBV coordination in emergencies. We further explore the implications of shifting funding landscapes, including the withdrawal of U.S. government support, on the future of GBV coordination.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eOur findings identify seven strategic recommendations aimed at investing in, sustaining, and transforming GBV coordination efforts globally. Key priorities include expanding the GBV coordination workforce, including for risk mitigation, prioritizing GBV coordination within public health emergencies, and investing in information management systems and strategic research. To sustain GBV coordination, we recommend adapting funding models, diversifying financial sources, advancing national leadership and localization, and implementing context-specific coordination approaches, including at the sub-national level. Furthermore, we propose that emergencies can serve as catalysts for broader social and legal transformations that advance GBV prevention and gender equality.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eOur findings provide practical, evidence-based recommendations and a global framework for policymakers, donors, and practitioners to strengthen and sustain GBV coordination in diverse emergency contexts. Sustained progress will require collective commitment to prevent, mitigate, and respond to GBV, even as global health priorities shift, funding landscapes change, and resistance to gender equality intensifies.\u003c/p\u003e","manuscriptTitle":"Strengthening Gender-based violence (GBV) coordination in emergencies: a synthesis of practitioner-driven, globally applicable recommendations","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-02 06:45:44","doi":"10.21203/rs.3.rs-7215940/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-29T17:01:23+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-10T18:47:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"255891097886468174563622550358052435399","date":"2025-11-21T09:08:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-24T22:38:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"70088471208068384863372637626801832131","date":"2025-09-09T16:37:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"186875706126649515123502602484250694480","date":"2025-08-24T16:34:09+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-22T14:27:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-28T06:08:43+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-28T06:08:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"Conflict and Health","date":"2025-07-25T15:58:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"conflict-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"conf","sideBox":"Learn more about [Conflict and Health](http://conflictandhealth.biomedcentral.com/)","snPcode":"13031","submissionUrl":"https://submission.nature.com/new-submission/13031/3","title":"Conflict and Health","twitterHandle":"@Conflict_Health","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a3092f8a-67f4-463b-87ca-92b3f0de7994","owner":[],"postedDate":"September 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-09T16:00:25+00:00","versionOfRecord":{"articleIdentity":"rs-7215940","link":"https://doi.org/10.1186/s13031-026-00770-9","journal":{"identity":"conflict-and-health","isVorOnly":false,"title":"Conflict and Health"},"publishedOn":"2026-03-07 15:57:09","publishedOnDateReadable":"March 7th, 2026"},"versionCreatedAt":"2025-09-02 06:45:44","video":"","vorDoi":"10.1186/s13031-026-00770-9","vorDoiUrl":"https://doi.org/10.1186/s13031-026-00770-9","workflowStages":[]},"version":"v1","identity":"rs-7215940","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7215940","identity":"rs-7215940","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}