Where Should Survivors Of Gender Violence Go: A Case of Two One Stop Centres in India
The set-up of these support hubs significantly impacts the quality of services they offer
My study of two government-run One Stop Centres (OSC) for victim-survivors of gender-based violence reveals that where these centres are located and who runs them are likely to determine how women receive help or access justice. India currently has 864 operational OSCs, which have assisted almost 13 lakh women, demonstrating a significant scale and reach of the government-run initiative. But more than a decade since its implementation, there have been limited efforts to explore gaps and opportunities for strengthening the centres’ functioning.
I had previously reported for Behanbox that OSCs, which are meant to provide integrated support services for victim-survivors, may be performing sub-optimally because they are unable to use their own administrative data to inform practices. This data includes information on victim-survivors who seek help from the police, hospitals, shelters, helplines, and so on.
Poor use of administrative data also feeds into and overlaps with other dimensions of health-systems response, like coordination among stakeholders, financing, training of personnel and so on, all of which interact and impact women’s access to justice. For instance, the compounded impact of delayed staff salaries, high administrative burden on caseworkers, and poor record-keeping practices in One Stop Centres could lead to victim-survivors not receiving the required support (see here, here, and here).
Globally, 682 million women face physical and/or sexual violence by intimate partners at least once in their lives. The fifth round of India’s National Family Health Survey (NFHS) found that 28.4% of women face spousal violence, very close to the global prevalence estimates. But most women in India and elsewhere in the world do not disclose such violence, and those who do seek help find it difficult to report it to the formal services like police, courts, hospitals, or social service organisations (less than 10% of women seek help from these sources in India).
It is a combination of barriers like shame, stigma, patriarchal values, and authorities’ perceived negligence or incompetence, limiting women’s trust in these agencies to report violence in the first place. So, what do women do? India’s NFHS-V shows that women keep the matter private: they reach out to their own family members (61%), husband’s family (29%), or friends (17%). These figures tell us two things: one, the current investment in prevention of and response to gender-based violence is grossly limited, and two, the existing systems, policies, and services are not working for most women.
I now look at how the distinct set-up of the two OSCs – an NGO-managed/hospital-based centre in Mumbai and a fully state-managed/non-hospital based centre in Delhi, determined service delivery or response strategies for victim-survivors of violence. I will also briefly talk about how gender-based violence policy design is erratic and bereft of women’s voices in India, based on conversations with NGO representatives who often work with and alongside government programmes like OSCs.
Set-up Determines Response
The set-up of an OSC comprises the immediate environment, staff composition, available amenities, coordination with other services (hospitals, police, shelters), etc. (see Table 1 for a snapshot of the key service delivery components of the OSCs in my study).
The closest hospital to the Delhi OSC is almost 4 km away, twice the recommended distance in the guidelines. While the guidelines also emphasise that OSCs should be ideally located within a hospital, the lack of a district hospital meant that this centre could be constructed in any available spot. This centre, also launched in 2019 like the Mumbai OSC, was, thus, housed in two repurposed rooms of a bureaucrat’s office complex in one of Delhi’s 11 districts.
On the other hand, in Mumbai’s case, the process of identifying cases is far more comprehensive than in Delhi because it is inside a hospital. The recommended number of staff at OSCs is 13. While Mumbai has 13, Delhi’s OSC has four vacant positions. Staff composition matters significantly, too. The Mumbai OSC includes trained nurse aides, and their training helps the OSC identify cases in the hospital during ward visits and refer women to the centre for psycho-social counselling and other support (most cases at the centre also come through the hospital). This is not possible in Delhi.
Most cases in Delhi are referred to the centre by the police, which means that the typology (nature of violence or crime) is already assigned instead of being assessed or interpreted at the centre. Additionally, there is only one caseworker and one counsellor at the centre. The counsellor is only present at the centre for 15 days and remains on-call for the rest of the month. Response in an under-staffed set-up may, thus, become routinised, subsuming the nuanced needs of victim-survivors.
In Delhi, for instance, the centre receives a high number of missing recovery (kidnapping) cases, and girls typically stay overnight at the centre. The centre’s primary role in these cases is to coordinate with the police: when the girls are brought in and when they are taken for their court or child welfare committee visits. A pre-determined and time-bound response process for missing recovery cases raises concerns about the quality of other critical services like psycho-social counselling at the Delhi OSC.
A short-staffed environment makes matters even more challenging. It also calls into question what constitutes coordination through One Stop Centres. Further research must locate how coordination can be made victim-survivor centric. Without diagnosis and identification of appropriate channels of support for women, there is a possibility of the service acting as yet another barrier to access justice, regurgitating apathetic responses, and decentering women’s needs.
Policy Design Is Not Survivor-Centric: Meera’s Case
I witnessed Meera’s case (not her real name), a survivor of physical and emotional violence inflicted by her husband, during my fieldwork at the Mumbai OSC. Meera and her toddler son had been brought in by the police from a women’s shelter. Meera did not know that the centre was only a pitstop in her help-seeking journey. According to the programme guidelines, a victim-survivor can receive a maximum of five days of emergency shelter. But, for Meera, the OSC had felt like home after months of searching for a safe space for herself and her son in the city.
Her time in the city had been arduous. She had been duped by an auto-driver for money and was also harassed at the women’s shelter where she was previously residing. “They hit my child…,” Meera told the caseworker about her circumstances at the women’s shelter as the caseworker put down her observations into Meera’s registration form.
After Meera was escorted to the only bed at the centre, the caseworker told me about her observations about Meera and the next steps the centre would take to ensure that she is accommodated with another reliable service within five days of her arrival (per the guidelines). Having only a bed also meant that the centre wasn’t equipped to keep more than one victim-survivor at a time, making it imperative to assess cases and forward them to aligned services swiftly.
The Challenge Of Mental Healthcare
After Meera’s medical check-up the next day, they were figuring out which shelter was most suitable for her and her child. Meera was also taken to the psychiatric ward. She was diagnosed with severe depression and anxiety. Even though the caseworkers and counsellors at the centre are trained rotationally on the mental health consequences of gender-based violence, it is challenging to manage these cases.
One of the caseworkers said: “Mental health cases are tough because finding rehabilitation for them is difficult. The police don’t want them back…[Long-term/women] shelters also have their own processes for admitting, some have age criteria, some are only for beggars….” The Delhi OSC deliberately avoids such cases, admitted their caseworker. She also added that they were not equipped to handle such cases, but it was difficult to explain this to the police (who bring most of the cases to this OSC).
Cases of mental health are documented under ‘Civil Crime’ in OSCs’ administrative data. The sub-categories include issues such as depression or anxiety, substance abuse, reproductive issues, etc. But OSCs are not equipped to handle these cases. One representative from an OSC in Madhya Pradesh said: “Apathy is present here too, but we can’t totally blame the centre. Like in our hospital, there is no special psychiatric ward. Often, women with mental illness are found abandoned on the street and brought by the police…” She added that there are local guidelines which inhibit OSCs from housing victim-survivors with mental health challenges.
Though poor mental health is the most common symptom for women who face violence, there seem to be limited efforts to up-skill or sensitise all personnel who are in contact with the victim-survivor. The NGO-managed centre periodically trains its staff on trauma-informed approaches to response, whereas the caseworker and counsellor at the state-managed OSC do not receive any such training. When I asked their counsellor if they would benefit from such training, she said that her degrees in social work were enough. She also had informal support from her seniors.
The combined evidence, thus, suggests that most OSCs in the country are ill-equipped to handle cases sensitively, but the set-up is also critically linked to the quality and capacity of response. Meera’s experience would have been very different if she were to reach the Delhi OSC; but then she probably would have never been offered its services, given the centre’s incapacity to support victim-survivors with severe mental health conditions.
The apathy in gender-based violence policy design is symptomatic of a bureaucratic system that deems response through One Stop Centres as a technical service. The rigid and standardised response strategies reduce women to mere scheme beneficiaries and inhibit a survivor-centric response. This is, as I highlight here, even more likely in the Delhi OSC than the Mumbai one because it has better capacity to diagnose, verify, and support victim-survivors based on its location, staff composition, and staff training.
The Waning Role of NGOs
Since the implementation of the One Stop Centre programme, state governments have either managed the centres themselves through contractual staff or by involving NGOs. But the revamped programme seems to limit the role of NGOs in managing operations, as the guidelines do not mention them in either supporting or fully managing the centre’s operations. This is a critical departure from India’s welfare strategy, which has historically relied on the expertise of NGOs for providing specific kinds of services. Such ambiguity in OSC programme guidelines also complicates the state’s accountability towards violence against women as a public health concern.
In 2019, the Maharashtra government selected the NGO running Mumbai’s OSC. But it was reassigned from being an “implementation agency” to a “support agency” in 2024. This was, however, only a nominal change. I spoke to one of the NGO representatives, who said, “…even if strategic partnership has changed, not much has changed in terms of what we do…”. This indicates that the state continues to depend on the NGO’s years of specialisation in preventing and responding to violence against women, regardless of their change in status based on the revision in guidelines.
It is then also perplexing why non-state actors are not consulted in programme/policy design to better understand needs. One representative from a Delhi-based organisation, which has worked with OSCs on occasion, said: “…public consultations, especially victim-survivors’ voices, are missing in policy design. We need specialists to work on such sensitive issues. We are also willing to work together [with the state]…” In her experience, officials (police, medical staff, etc.) involved in the justice process are insensitive to the needs of victim-survivors. Among the police, she added, insensitivity stems from poor training at early stages of recruitment and work overload. In a situation where systemic apathy towards victim-survivors persists, One Stop Centres’ coordination role with aligned institutional actors—the police, hospital, and court, is also compromised.
For reimagining One Stop Centres, thus, the first step is to revisit the programme’s design. Learning from best practices, such as Mumbai OSC’s hospital-based/NGO-operated response, which prioritises trauma-informed personnel training and a strategic case identification process, is urgent. Overall efforts should promote ways for more women to feel comfortable seeking help. As one NGO representative in my study summarised: “The state and the NGOs must not compete for providing these services. A woman should have the option to go wherever she wants.”
The Mission Shakti guidelines for One Stop Centres also emphasise better coordination among existing safety services for women. But how would this consider women’s needs? Meera, for instance, did not want to go to the women’s shelter again, but protocols dictated that she and her son be placed in one.
The big questions on how care, accountability, and just practices are integrated into gender-based violence policy design remain. Relying on more centralised tactics by limiting NGOs’ involvement in policy deliberation, design, and implementation is definitely not the answer.
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