Responding to Sexual Violence through broad-based SBCC interventions: Experiences in Zimbabwe Social Behaviour Change Summit, Addis Ababa, February 2016 Kumbirai Chatora, Director Social Marketing, Population Services International Zimbabwe

Context Zimbabwe  30% of women have ever experienced Sexual Violence (SV)  80% of women who ever experienced SV did not seek help  Of those that did seek help only 3 % sought from medical personnel/social service organization  Low knowledge about available medical services leads to low uptake and late presentation; 72 hours after the event ZDHS

Program Overview 15 sites offering medical and psychosocial services – 7 PSI sites, integration of SV services with testing and counselling, treatment and SRH services – 8 NGO sites, co-located in public sector hospitals Medical and psychosocial services – HIV testing and counseling, post-exposure prophylaxis – emergency contraception, STI testing, treatment – medical examination, collection of forensic evidence Toll free hotline Referral for social and legal services

Qualitative research findings Social norms Survivors are stigmatized in the community Knowledge Do not know that they should access health services first, before legal/judicial services Do not know about medical services available for SV survivors Social support Do not know if they can talk about the abuse with friends or family; nor does she know if they would support her seeking services

Brand Positioning Statement For a survivor, seeking medical services after sexual violence is the choice that will uphold her dignity, protect her from HIV/STIs and unintended pregnancy, and give her the strength to move on. Brand Personality Non-judgmental, empathetic, empowering

Product P Primary Product: Survivors of SV will access medical services (Behavior) Supporting Product: New Start Clinics  Private, confidential and respectful environment  Trained providers and support staff  Clinical services (PEP, ECP, pregnancy testing, medical exam, HTC, )  Psychosocial support and referrals  IEC materials in waiting room  Showers and fresh clothes Supporting Product: Hotline  Trained nurse counselors  Referrals for medical, psychosocial and legal support services

Price P Non-monetary costs  Time Promote services as close as possible to the survivor so she doesn’t have to travel far Extend service hours into evening and promote Saturday services Hotline accessible 24/7  Secondary trauma – having to retell the story Have one person that works with the client all the way through the experience Train staff to ensure respectful, confidential, non- judgmental services; ensure consent to all service Promote services as those that will HELP with the trauma

Communication Objectives Increase number of clients accessing VAWG services Improve knowledge of where to access medical services after sexual violence Encourage family and friends to support survivors of SV to seek medical services within 72 hours Promote the belief that sexual violence can happen to anyone and should not be condoned

Key Communication Messages Its not your fault, you are not alone. Find comfort in someone who understands. Access medical services first within 72hrs post violence A good friend demonstrates her love and supports her friends through tough times. Encourage your friends to get medical services post rape Shunning sexual violence shows you respect and care for the women and girls in your life

Mass Media Campaign Testimonials from survivors In depth discussions on radio call in shows Radio spots, press insertions

Advocacy and Mobilization Activities Advocacy with the Police to accept medical affidavits done by nurses Sensitisation of police to refer for medical services within 72 hours Interpersonal communication sessions in collaboration with police to increase awareness of SV and importance of medical access within 72 hours

Outputs: % growth in clients seen since introduction SBCC activities in March 2014 Toll free line receiving >200 calls per month 8% increase in clients presenting within 72 hours at NGO sites in 2015 versus 2014.

Impact of mass media on SV, 2015 INDICATORS % or Mean Sig Not Exposed (N= 1852) Exposed to mass media (N= 1671) Knowledge Social Support Social norms Self-Efficacy % of men and women who reject the practice of sexual violence % of women and girls who know where to get medical services when abused

Impact of Interpersonal Communications (IPC) on SV, 2015 INDICATORS % or Mean Sig Not Exposed (N= 1839) Exposed to IPC (N= 1684) Knowledge Social Support Social norms Self-Efficacy % of men and women who reject the practice of sexual violence % of women and girls who know where to get medical services when abused

Lessons Learned Holistic approach to SBCC interventions – Marketing & Communication Strategy including 4Ps – Collaboration with survivors in campaign development process Linking SBCC interventions with clinical services Toll free line manned by nurse counsellor Mass media has a positive impact: – on number of survivors accessing medical services – in improving perceptions on availability, social support, self efficacy and social norms IPC can improve perceptions about social norms related to VAWG

Acknowledgements Karin Hatzold, PSI Ministries of Women’s Affairs and Gender and Health and Child Care, Zimbabwe Marketing & Communications Department, PSI Zimbabwe Beth Skorochod, PSI