53 programs, programs for batterers and child welfare services. For example, in El Salvador, the Salvadoran Institute for the Development of Women is a government agency that coordinates the “Program to Strengthen the Family” _(Programa de Saneamiento de la Relación Familiar)_ , a multi-sectoral effort to address GBV among public and private institutions in El Salvador (Valdez, 1999).

A large literature exists on caring for survivors of physical and sexual abuse within specific professional disciplines, but research on the effectiveness, quality and impact of social service programs is scarce in low and middle-income countries. Most evaluations document numbers of persons served, services provided, and types of cases reported (e.g. InterAmerican Development Bank, 2002). Some conduct informal studies of quality, by gathering information on service quality, client satisfaction, or qualitative perspectives of survivors (e.g., Guedes et al., 2002).

One of the few rigorous evaluations of integrated services for abused women was conducted in the United States by Sullivan and Bybee (1999). This randomized, longitudinal study evaluated the impact of community-based advocacy services in the United States on outcomes such as levels of physical violence, psychological abuse, depression, quality of life, and social support. This study found that women who received advocacy services were more than twice as likely to experience no violence in the two-year post-intervention period, compared with women who did not receive such services; moreover, these women reported a higher quality of life and social support, and had less difficulty obtaining community resources. While research has documented the impact of comprehensive services in Latin America and the Caribbean on the proportion of women who know what services exist and where and the number of women who seek help, the final impact on probability of revictimization is unknown.

# **_Batterer programs_**

Most batterer programs have been carried out in high-income countries. In Canada, Europe, and the United States, there are many treatment programs for abusers that include a variety of theoretical and programmatic approaches. Most programs have a duration of 8–12 weeks and are court-mandated. Few evaluations have been conducted to measure the effectiveness of this strategy. Attendance data, however, indicate that approximately half of the men drop out before completing the program. Of those that do finish, approximately half of them stop using physical violence, at least for some period of time (Edelson 1995). The only randomized controlled trial to-date was carried out on a batterers program run by the United States Navy, which found no reduction in abuse compared with controls (Dunford, 2000).

Increasingly, NGOs and governments in Latin America and the Caribbean have attempted to reduce violence against women by organizing treatment programs for male batterers. Most are run by NGOs, but they often depend on court-mandated attendance as an alternative to criminal sanctions. Prominent examples include the Instituto Noos in Brazil (White, Greene, and Murphy, 2003) and CORIAC in Mexico (Morrison and Biehl, 1999). Battered women often identify treatment or counseling for their husbands as a high priority (e.g. Ellsberg,