Expanding the Evidence Base on Comprehensive Care for Survivors of Sexual Violence in East and Southern Africa

Council researchers and partners are determining effective responses to sexual assault and improving policies and programs in East and Southern Africa.

The Issue

Millions of women around the world suffer sexual and gender-based violence (SGBV). A recent study by the World Health Organization (WHO) reported that 35% of all women have—at some point in their lives—experienced intimate partner violence (IPV) or non-partner sexual violence. Yet this violence—and its health consequences—are rarely addressed, particularly in low-resource settings where access to care is limited.

The Population Council launched a network of partner organizations to strengthen the capacities of the medical, legal, and justice sectors in several countries to care for survivors of sexual violence and build an evidence base for SGBV programs. Since 2006, the Africa Regional SGBV Network has developed, implemented, evaluated, and expanded a multi-sectoral response model for SGBV. By employing this unique, Council-designed approach, the network seeks to reduce the impact and incidence of SGBV by:

  • Testing and documenting best practices in SGBV service provision;
  • Providing South-South technical assistance through a network of implementing partners; and
  • Influencing policy and programs through dissemination of best practices to key audiences.

The Progress

The first phase of the project, “Developing a multi-sectoral and comprehensive response to sexual and gender-based violence in East and Southern Africa,” was implemented from 2006 to 2009 and centered on improving the medical management of sexual violence, facilitating effective criminal justice responses to all cases of SGBV, and reducing levels of violence at the community level in Ethiopia, Kenya, Malawi, Rwanda, Senegal, South Africa, Uganda, Zambia, and Zimbabwe.

Since 2009, the second phase of the network has generated evidence on ways in which programs can adequately respond to SGBV throughout the region.

A third phase of the project ended in 2018.

The Impact

The Council’s work on SGBV in East and Southern Africa has had numerous impacts at the national, regional, and international levels, resulting in changes in policy and practice in a number of countries.


The Council’s pioneering work with the Kenyatta National Hospital on the acceptability and feasibility of screening for IPV among women attending for reproductive health services has led to the hospital’s adoption of routine IPV screening, a recommendation from the Ministry of Health (MoH) to pilot the screening at additional hospitals throughout the country, and incorporation of IPV management in training for the clinical management of survivors of sexual violence.

In addition, the Council’s partner, Liverpool VCT, Care and Treatment (LVCT), has strengthened numerous elements of post-rape care, including rape evidence kits and information, education, and communications materials that are widely used throughout Kenya. The lessons learned have led to a revision of police and medical forms, which have been accepted by some courts in Kenya as official evidence in assault cases.

The Council’s work on screening for IPV has also received regional and international attention. In 2012, the East, Central and Southern Africa (ECSA) Health Community passed a resolution prescribing that gender-based violence and screening for child sexual abuse be integrated into sexual and reproductive health and HIV and AIDS services throughout the ECSA region. In addition, evidence from the project is being used to inform WHO guidelines related to routine screening for IPV in other developing countries.

South Africa

Network partner Thohoyandou Village Empowerment Programme (TVEP) in South Africa has become instrumental in providing guidance to the government, and has received funding to expand its Zero Tolerance Village Alliance concept, an intervention that mobilizes communities to oppose SGBV and strengthens care and response services for survivors.


The Population Council’s implementing partner in Swaziland, the Swaziland Action Group Against Abuse (SWAGAA), is developing the country’s National Multi-Sectoral Guidelines for the Management of Sexual Violence Cases. Draft guidelines are currently under review at the Office of the Deputy Prime Minister. SWAGAA is also replicating an SGBV-focused “Safe Spaces” approach with in-school girls. The “Safe Spaces” model, pioneered by the Council, provides a platform (girls’ clubs led by trained mentors) for building vulnerable girls’ social, health, and economic assets. Through a focus on providing SGBV information, SWAGAA’s goal is to help prevent SGBV and increase reporting among in-school girls.


Following the Council’s pioneering work with the Zambia Police Service and MoH on the feasibility of police provision of EC to survivors of sexual violence, the Zambian government scaled up this approach nationally with assistance from the Population Council. Subsequently, the government requested that the Council test the feasibility of police provision of PEP (post-exposure prophylaxis for HIV) for rape survivors.

In addition, the Population Council led the development of Zambia’s National Guidelines for the Multi-Disciplinary Management of Survivors of Gender-Based Violence. This document, released in 2011, embraces the comprehensive model of care that the Council continues to promote through the network’s work.


Zambia’s model of police provision of EC has recently been replicated in Malawi and has received support from both the MoH and UNICEF Malawi—an organization engaged in establishing one-stop centers for management of SGBV throughout the country.

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