Population Council Projects | Comprehensive Care for Survivors of Sexual Violence in Zambia

PROJECT
Comprehensive Care for Survivors of Sexual Violence in Zambia

This study, carried out in three districts of Zambia’s Copperbelt Province, works to develop a model of comprehensive care for survivors of sexual assault. The project began in early 2005 as an effort to reduce unwanted pregnancy among survivors of sexual assault through the provision of emergency contraception (EC). In early 2007, the project will enter its second phase, expanding its focus to include increasing survivors’ access to justice, HIV and AIDS services, and psychosocial counseling. These activities will comprise part of the Council’s multicountry initiative to develop models of comprehensive care for survivors of sexual violence across Africa.

The study’s first phase worked to test the assumption that provision of EC through appropriate “first points of institutional contact”—identified through formative research as police and emergency room personnel—provides an incentive for survivors to seek institutional support and then serves as a bridge to further health, legal, and psychosocial support services.

At the outset of the project, a rapid assessment of sexual assault service provision was undertaken in the Copperbelt. It found that 91 percent of victims report to the police before seeking medical care, with considerable attrition between the police station and health facilities. Of those who did visit a health facility, over 82 percent of eligible women presented within 72 hours of the assault, although only 37 percent received EC. These findings demonstrated a clear need to introduce police provision of EC, while at the same time strengthening the capacity of health facilities to provide these services.

Assessment results were considered during an intensive multisectoral workshop convened in the Copperbelt. This three-day meeting introduced over 50 representatives from the health, police, judicial, and social support sectors to the range of issues associated with sexual assault through discussions, expert presentations, and site visits. The meeting helped generate a broad-based consensus on the need to reform existing support services.

Service delivery began in early 2006, with the training of police and health providers in EC provision. After extensive negotiations with the Ministry of Health and the Ministry of Home Affairs, a training program was developed to certify police officers as employer-based distributors of EC. A total of 31 officers from 20 police stations have received instruction under this curriculum to date.

Awareness-raising activities were also an important element of the project’s first phase. An informational, brochure, “Emergency contraception for rape survivors,” was developed for use in project sites, and companion posters are in production. Police and health community outreach groups also have been enlisted to provide information on sexual assault and EC to rural audiences.

The project is now being expanded with support from the Swedish International Development Cooperation Agency under a multicountry Population Council initiative. Drawing on experiences from Kenya, South Africa, and Zambia, this initiative looks to develop a model of comprehensive care for survivors of sexual and gender-based violence.

Location

Copperbelt Province, Zambia

Duration

2004–2006

Population Council researchers

John Skibiak, Jill Keesbury

Non-Council collaborators

Chandwa Ng’ambi (Copperbelt Provincial Health Office, Ministry of Health)

Peter Kanunka (Zambia Police Force)

Mary Zama (consultant)

Donors

The William and Flora Hewlett Foundation

Swedish International Development Cooperation Agency

US Agency for International Development

Publications/Resources
Council researchers' names appear in boldface type.

2006
Keesbury, Jill. "Emergency contraception for survivors of sexual assault in Zambia," presentation at Second African Conference on Sexual Health and Rights, Nairobi, 20 June.

Keesbury, Jill, John Skibiak, and Mary Zama. “Rapid assessment of sexual assault in Zambia’s Copperbelt Province.” Nairobi: ECafrique.