Comprehensive Responses to Gender Based Violence in Low-resource Settings: Lessons Learned from Implementation

From 2006-2009, the Population Council undertook a programme of technical assistance and research to strengthen the evidence base on gender-based violence (SGBV) programming in sub-Saharan Africa. Based on the experiences of the partners involved, this 47-page document, published by Population Council, Zambia, reviews the findings, lessons learned, and promising practices in the provision of comprehensive SGBV services in sub-Saharan Africa. It draws on the data generated by the network partners to identify core issues in the provision of quality, comprehensive care for survivors of SGBV. These findings are intended to serve as a resource for programmers and policymakers throughout the region, and contribute to the emerging evidence-base on such programme strategies.

From the Executive Summary:

"This project created an active network of implementers and researchers across sub-Saharan Africa, all of whom were charged with developing, implementing and evaluating core elements of a comprehensive, multisectoral model for strengthening responses for survivors of SGBV, especially survivors of sexual violence. The comprehensive model includes health, criminal justice, and psychosocial services required by survivors, and works to strengthen the linkages between these sectors. Seven organizations in six countries (Zambia, South Africa, Kenya, Malawi, Zimbabwe, Ethiopia and Senegal) partnered with the Population Council to implement the comprehensive model in part or in whole, and an additional thirteen organizations actively participated in the South-South technical assistance network.

Based on the experiences of these partners, this document reviews the findings, lessons learned, and promising practices in the provision of comprehensive SGBV services in sub-Saharan Africa."

"Key findings include:

Client characteristics

• Children constitute a significant proportion of survivors seeking services.
• Girls and women represent the bulk of survivors, but boys and men also seek care.
• Guidelines are necessary, but not sufficient for providing comprehensive care.
• The process of developing national guidelines can spur multisectoral collaboration.
• Development and implementation of guidelines is often reliant upon a champion.
• Recognition of the need for guidelines and services specifically for child survivors is
  increasing.

Health services

• Several models of comprehensive, integrated care have proven feasible.
• Integrated services can improve quality and timeliness of health care.
• Ensuring and enabling HIV PEP adherence requires particular attention.
• Simple interventions can dramatically increase access to emergency contraception in
  a healthcare setting.
• Provider capacity remains an important barrier to quality, comprehensive care.
• Requirements that doctors collect forensic evidence undermine a survivor’s access to
  justice and healthcare.
• Children are underserved by adult-oriented programs.

Police and Legal responses

• Police are often the first and only point of contact for survivors.
• Police provision of emergency contraception can strengthen multisectoral collaboration and response.
• Cross-sectoral training can improve linkages between police and health sectors.
• Greater access to legal services does not necessarily entail greater utilization.
• Police officers require more training on handling child survivors.

Psychosocial support

• Interpersonal skills at the first point of contact are a critical, but often overlooked, component of quality care.
• Safe houses and temporary shelters are costly to maintain.
• More evidence is needed on effective models for providing long-term psychosocial care.

The document also offers a framework of validated indicators for monitoring and evaluating comprehensive SGBV programs, and provides reflections on successes in facilitating southsouth technical assistance among network partners."