PEPFAR Gender Special Initiative: Sexual Gender-Based Violence

In 2007, PEPFAR’s Gender Technical Working Group launched the Sexual Gender-based Violence (SGBV) Initiative in Rwanda and Uganda to complement ongoing efforts to develop an evidence base on sexual violence (SV) programming in Africa. The Population Council outside link and the Health Policy Initiative outside link, in collaboration with Raising Voices outside link, provided technical assistance (TA) for 10 implementing partners, which served 18 clinical sites in Uganda and Rwanda. The total for this initiative, including clinical partners in each country and the two TA providers, cost $2.4 million at the project’s end in December 2010.

The initiative sought to strengthen comprehensive health services for survivors, including post-exposure prophylaxis, referrals from health facilities to other support services, and linkages between communities and health services to facilitate access to services. The initiative promoted a “South-to-South” exchange of programmatic experience, protocols, and tools among organizations in the three participating countries. Partner needs for TA were remarkably consistent across organizations, resulting in a standard set of activities to prepare service delivery sites and communities for the initiative. The activities included:

  • Health care provider training
  • Development of facility-level implementation guidelines
  • Assistance with community linkages
  • Strengthening linkages between clinical services and other stakeholder groups to facilitate access to health services.

Lessons Learned:

  • Require clear terms of engagement for partners. Ensuring organizations and projects have access to extensive TA is critical to effective SGBV programming. However, coordination of multiple partners across countries can be challenging, requiring clear terms of engagement and accountability for all partners.
  • South-to-South collaboration is effective. South-to-South collaboration and TA from the Population Council, the Health Policy Initiative, and Raising Voices on community linkages are effective ways to build capacity and mobilize local partners to respond to SGBV by allowing them to learn from other programs in similar contexts and receive ongoing support from organizations and experts from similar sociocultural contexts.
  • South-to-South partners need time to learn from each other. Like any project that involves community engagement, TA requires that both implementers and partners spend considerable time and resources observing, discussing, and participating in activities at the local level. Language constraints and staff turnover can often inhibit this process.

The efforts of the SGBV Initiative are expected to expand SV services, improve service quality, increase service uptake, and provide an evidence base for scaling up such efforts in the future. In each country, partners are implementing a standard set of interventions to strengthen health services, increase the number of referrals from the health facility to other support services, and promote linkages between clinical services and other stakeholder groups to facilitate SV survivors’ access to health services.

A 10-step resource guide for establishing comprehensive SV services in the clinical setting for field staff and partners to strengthen their services for survivors with a focus on community linkages is available below.

Step by Step Guide for Strengthening SV Services Toolkit (PDF, 3.11 MB)

Executive Summary (PDF, 176 KB)

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