Paper short abstract:

The HDR (2021-2022) emphasizes the diminished agency for women experiencing intimate partner violence (IPV) as an issue of human security: 27% of women globally and 30% in Colombia have experienced IPV. We investigated Colombia's novel response connecting police, legal, justice and health sectors.

Paper long abstract:

The UN HDR 2021-2022 emphasizes the loss of agency for women exposed to intimate partner violence (IPV) as an issue of human security. Roughly 27% of women globally and 30% in Colombia have experienced IPV. Notably, indicates IPV can be reduced and prevented. However, little research has documented state-led programs effective in addressing IPV in real-world conditions in low-and-middle-income settings, especially in Latin America. Such research is paramount to inform policies at the intersection of health, human security and human rights, for women.

Aims

We investigated Colombia’s la ruta única, which provides IPV-exposed women with an integrated pathway connecting the justice, prosecution, police, health system, family welfare, Comisarías de Familia (Family Commission), with legal-medical and psycho-social services. We: (1) mapped the institutional arrangements, including procedures, mechanisms and communication paths comprising the response across agencies, departments and services—to characterize it; and (2) investigated the functioning/limitations of the response by concentrating on a key actor: lawyers navigate the ruta on women’s behalf amassing understanding of the system, mechanisms of health and justice, functioning and limitations—yielding greater understanding of the quality of the response, its effectiveness and limitations.

Methods

In July 2022-August 2024, we utilized grounded theory design/methods, employing purposive and snowball sampling, conducting 40 in-depth interviews in Bogotá with government officials working across la ruta, supplemented with debriefings and field notes. University de los Andes ethics committee approved the study. Interviews were conducted in Spanish, then transcribed into Spanish and English. Through constant comparative analyses, viewing emerging themes against transcriptions, we developed broad then finer coding, with team meetings to discuss and derive final findings.

Findings

Across points of delivery, we found the highest limitations were in the health system, with high staff turnover, adverse gender norms and mistrust between health officials and lawyers, undermining protocols guiding women’s treatment, including legal statements and evidence collected. Negative police/judicial processes and norms undercut the response, minimizing the gravity of victims’ cases, resulting in an absence of protection orders, and placing women at imminent risk, with stalled legal case progression, revictimization of women, and bottlenecks. Continuing negative social constructions of gender, gender hierarchies, lower status of women, masculinities and adverse gender norms embedded in these systems and structures, and enacted by decisionmakers across government agencies, require greater interrogation and reform. We highlight selected training and reforms that could address key deficits to better meet IPV-exposed women’s needs for human security, health and justice.