Gender-based Violence Initiative Synthesis Report

This report offers insights and lessons learned from the Gender Based Violence Initiative (GBVI), which was designed to integrate gender-based violence (GBV) prevention and response into existing HIV prevention, care, and treatment programmes at health facility, community, and policy levels in the Democratic Republic of Congo (DRC), Mozambique, and Tanzania. In 2015, AIDSFree conducted a review of this three-year United States President's Emergency Plan for AIDS Relief (PEPFAR) initiative to identify lessons that can inform PEPFAR and other donor initiatives in designing future investments in GBV prevention and response. This report synthesises the findings and lessons learned from the three individual country reviews (also available for downloading below).

The report explains how the programme sought to integrate GBV prevention and response into existing HIV programmes. "This included developing national guidelines, strengthening coordination across sectors, and building the capacity of and linkages between clinic-and community-based services in GBV prevention, as well as response, within the context of the existing HIV prevention, care, and treatment." The report offers a brief review of the three country initiatives, which were designed to address the needs of each country and align with existing government and civil society response to GBV and HIV. It highlights the national and provincial objectives which among others include: strengthening the GBV prevention and response through increased awareness of GBV and its relationship to HIV, GBV laws, policies, and guidelines; and changing attitudes and behaviours that perpetuate GBV.

Looking at the impact of the programme in terms of reach, the report claims that "[o]verall, the GBVI achieved substantial increases in the number of individuals reached, the GBV services provided, and the health facilities equipped to provide GBV services in a short period." It makes the point that "[s]tarting up integrated programming such as the GBVI takes effort and extensive coordination, but the number of individuals reached in only three years speaks to the value of integrating GBV prevention and response into existing HIV programming and to the need for such integrated services. The approaches and lessons learned from the GBVI can be applied to other countries and contexts to integrate GBV into existing HIV platforms."

The report discusses in some detail the individual successes and contributions of the programme at both global and country levels, which includes national-policy-level contributions, institutional-level contributions, and community-level contributions. In relation to communication, it states that "the GBVI's contributions at the community level were a key part of its success in all three countries. First and foremost were the initiative's awareness-raising efforts. The GBVI sought to raise awareness not only about GBV but also about the links between HIV and GBV. In all three countries, to address harmful attitudes and social norms that contribute to the continuation of the cycle of violence, the GBVI used social and behavior change communication efforts and community based training programs such as the Stepping Stones and Men as Partners curricula to engage both men and women."

In addition to awareness raising, the GBVI also built capacity at the community level by engaging and training community leaders and volunteers. This included training "activistas" in Mozambique and "relais communautaires" in the DRC to build capacity and ensure that their efforts were successfully integrated into the broader institutional response to GBV and HIV.

The report also highlights some of the contributions toward establishing multisectoral and partner strategies, its contributions towards building evidence of specific programmatic approaches and multicomponent models, and contributions towards country ownership and sustainability.

In terms of lessons learned at both global level and country level, the report indicates that, "although the three GBVI countries were contextually different in terms of GBV and HIV prevalence and patterns, socioeconomic demographic context, and security status, many of the GBVI"s achievements and lessons learned were consistent among them and can also be applied to other regions and in other efforts to prevent and respond to GBV in HIV programs globally." In terms of communication for social change, it cites two specific lessons learned related to programming and service delivery at country level:

• Build capacity and awareness at all levels to deliver effective GBV and HIV services: Building clinical service-provider capacity is important, but the GBVI's focus on also training government officials, community and traditional leaders, and non-clinical service providers was also critical as those involved in policy making, training, supervision, and community leadership need training on GBV and HIV. "Training should include GBV sensitization and awareness, post-GBV care, and proper referral services and processes and should emphasize GBV integration into the cascade of HIV, family planning, and sexual and reproductive health services. Training and capacity building also need to extend beyond technical and clinical aspects to include behavior change communication and sensitization, because service providers, policy makers, and community leaders often hold the same harmful gender attitudes as the broader population."
• Engage a broad range of community stakeholders on GBV and HIV prevention and response, with a focus on men and boys: "Community awareness and mobilization efforts are key and should use evidence-based behavior change communication programming and activities to shift norms around gender inequality and GBV. By focusing on community-level interventions and using existing community organizations and volunteers to carry out awareness-raising and sensitization activities, GBV and HIV programs can achieve major gains even with limited resources. In all the GBVI countries, community leaders and volunteers acted as extension agents and helped to rollout the initiative at the community level."

Click here to download "Lessons from the Gender-Based Violence Initiative in the Democratic Republic of Congo" in PDF format.

Click here to download "Lessons from the Gender-Based Violence Initiative in Mozambique" in PDF format.

Click here to download "Lessons from the Gender-Based Violence Initiative in Tanzania" in PDF format.