Table 1.

Changes over time in GBV Nepal context

Stage in time (year)	Key actors	Changes over time around GBV ‘frames’	Health sector context	Broader contextual factors
1997-2002	Government of Nepal SAATHI (local NGO) and other women’s groups Ministry of Women and Social Welfare	First recognition of GBV as major impediment to development and women’s equality First prevalence study on GBV	No recognition of GBV as a health issue. Focus was on women’s police cell (safety and security of women) and rehabilitation (through NGOs) Only one study on GBV prevalence, but none on its health consequences	Democratization process leading to proliferation of women’s NGOs Nepal’s adoption of principles of 1995 Beijing Conference Government’s commitment to women’s empowerment and gender equality
2002-2005	Ministry of Health and Population Samanita (private consultancy group)	Recognition of GBV as a public health concern, particularly for safe motherhood and women’s health	MoHP, through Safe Motherhood Plan, plans for creation of GBV service delivery systems in hospitals MoHP developed a training Manual and a protocol for health staff on GBV service provision First survey on linkages between IPV and pregnancy published, showing lack of training and knowledge among health providers (OBGYN, midwifes) around GBV	Adoption of Abortion Law Published research on linkages between GBV and maternal mortality and morbidity National concern for maternal mortality and strong focus on reducing it
2006-2008	Government of Nepal •MoHP •UNFPA	Recognition of the right of women to be free from GBV acts, which are seen as punishable by law Government call for legal framework around GBV, and a study on health consequences of GBV	With the revised Safe Motherhood Plans (2006), MoHP shifted GBV focus from service implementation to primary prevention (community awareness) and rights-based approaches Creation of Gender Equality and Social Inclusion Unit within MoHP	Adoption of new Constitution (legitimizing right to be free from GBV) Legal revisions to promote gender equality UNFPA study on Nepal Gender Equality recognizing GBV as important element of SRH and calling for the integration of IPV in safe motherhood and other RH programmes
2009-2014	Prime Minister Office •MoHP	Recognition of GBV as a national priority needing concerted effort Legitimization of MoHP role in integrating GBV services into health sector	Recognition of GBV as integral part of health service provision MoHP as leading actor in health sector response to GBV with creation of 15 OCMCs in 2011	Adoption of DV Law Government declared Year against GBV First National Plan of Action Against GBV National Strategy and Action Plan on Gender Empowerment and to End GBV More studies published on GBV