1. 11/21/2018
Population Council Interventions in Post-Conflict Settings in the Great Lakes Region
Since 2015, the Council has been providing technical assistance for the implementation of SGBV response model in post-conflict settings in the Great Lakes Region (GLR). In addition, we’ve been evaluating these models and providing TA for research uptake around these interventions. Today, we would like to share information on two such models which we recently tested in Uganda.
George Odwe and Chi-Chi Undie
HEARD SGBV Prevention Methodological Workshop
Durban, South Africa
September 26-28, 2017

2. ‘Africa Regional SGBV Network’ partner countries
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‘Africa Regional SGBV Network’ partner countries
(PHASE 3: )
Kenya
Rwanda
South Africa
Swaziland
Uganda
Zambia
South Africa
Swaziland
Kenya
Ethiopia
Uganda
Zambia
However, first of all, we should start by pointing out that we have led a network of implementing partners in SGBV work for over a decade now. We are known as the Africa Regional SGBV Network, and we are currently in our third phase of funding, which will run until early next year. We currently have implementing partners in at least 6 countries. This network of partners works to design, implement, and evaluate innovative SGBV response models under the strategic guidance and with technical assistance from the Population Council.
Rwanda

3. Current projects in the Great Lakes Region
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Kenya
LVCT Health in health facilities:
Enhancing access to PRC services for children in Kenya: A feasibility study
Kenyatta National Hospital in schools, health facilities:
Feasibility of routine screening for CSA in schools and health facilities
Rwanda
UNHCR and its implementing partners in health facilities:
Integrating of routine screening protocols for SGBV
Uganda
Engaging with girl’s clubs, school principals, teachers to mitigate SGBV
TVEP, UNHCR and its implementing partners in communities:
Establishing a ‘Zero Tolerance Village Alliance’ to prevent SGBV
Since this meeting is focusing specifically on the GLR, we wanted to point out that we have a number of current or recently completed projects in the region, including in Kenya, Uganda and Rwanda. However, our presentation today focuses on Uganda, which is the context in which we have evaluated SGBV interventions in post-conflict areas.
wamwanja Refugee Settlement in Kamwenge District, Western Uganda

4. Post-Conflict Context
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Post-Conflict Context
Rwamwanja Refugee Settlement, Uganda
99% from DRC
Culture of silence around SGBV
Yet, high levels of SGBV, including various forms of IPV
High levels of rape-related pregnancy
Low literacy levels
What we learned from our baseline and process monitoring information

5. Intervention I: Routine screening for SGBV
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Intervention I: Routine screening for SGBV
Provider training to screen for SGBV
Routine screening of clients
Referral of survivors to SGBV Response Unit for comprehensive care
Routine screening involves training health providers to ask clients about their SGBV experiences in an appropriate manner, and to offer supportive refers for further care.

6. Routine screening for SGBV
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Routine screening for SGBV
Strengths
Weaknesses
Low-cost, ‘simple’ intervention
Builds on existing health facility structures
Builds on providers who are trusted by survivors as medical professionals
Increases survivor detection and linkage to comprehensive care
Facilitates profiling of survivor population
Requires monitoring for long-term sustainability
Staff turnover may hamper processes
Pointless without strong psychosocial support (capacity for this needs to be built – staffing and staff expertise)
Facilitates profiling: through screening, we were able to build a profile of the SGBV survivor population in this refugee setting: we discovered that a considerable proportion were experiencing not only various types of IPV simultaneously, but also had a history of non-partner sexual violence. This led to the realization that survivors were grappling with multiple traumas, and that psychosocial support has to be strengthened to deal with this reality.
Requires monitoring: the tendency with screening is for providers to begin with enthusiasm, but this enthusiasm can easily wane if there is no monitoring, or no institutionalization of screening protocols.

7. Routine screening for SGBV: Snapshot of results
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Routine screening for SGBV: Snapshot of results
Almost 8,500 clients screened over 5 months
10% identified as being SGBV survivors
96% referred for further care
63% adhered to the referrals
High levels of survivor and provider satisfaction with the intervention
63% adhered – quite high compared to similar studies among the general population. Could have been much higher if the implementers had only screened in sites where on-site GBV care was available, as advised. The evaluation report is available on our website for anyone interested in learning more.

8. 11/21/2018
Intervention II: The ‘Zero Tolerance Village Alliance’ (ZTVA) – A Community-Based SGBV Prevention Model
BE SURE TO MENTION that this model was pioneered by our partner in South Africa, TVEP, and that they also provided TA for the intervention to be implemented by UNHCR implementing partners in this refugee setting.
This intervention is described in full in our evaluation report, which is available on our website. However, in a nutshell, it is an intensive community mobilization model built upon multiple trainings for community members and training of trainers. Both men and women are trained after selection by a community stakeholders forum which must sign an MoU with the program implementers, committing to meeting a series of criteria before the status of a ‘zero tolerance’ village is bestowed on it. The intervention draws on two main theories: achievement motivation theory, which has to do with the idea that human beings have the need for achievement and are motivated to achieve a standard of excellence if such a standard is set. This is where the series of criteria comes in (e.g., a specific number of trainings to be carried out to reach a certain number of community members, the establishment of a stakeholders forum, etc.). The model also draws on labeling theory – i.e., the idea that what we ‘label’ a person or a community as, is almost like a self-fulfilling prophecy. Villages that do meet the criteria are labelled as zero tolerance zones against SGBV, with a large billboard to show for it, and a colorful, official award ceremony for further labeling. Together, these activities are meant to help change social norms around SGBV and to popularize the idea of fighting against it in a community.

9. The ‘Zero Tolerance Village Alliance’
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The ‘Zero Tolerance Village Alliance’
Strengths
Weaknesses
Adaptable – can build on existing community structures
Highly effective in preventing SGBV in communities
Involves community-wide engagement, and thus affects various sectors simultaneously
Fosters community ownership
Relatively costly (but adaptable to cost-saving measures)
Originally designed to be strongly literacy-based
Labor intensive
Adaptable: In its original form in South Africa, this was not a cheap intervention, but we found that the refugee setting had structures that we could build upon to significantly reduce the costs in this post-conflict setting in Uganda. The trainings were incorporated into ongoing trainings, and we built on existing community outreach structures. No need to reinvent the wheel, provided the content of the SGBV training is incorporated, and you are reaching a critical mass with the info.
Fosters community ownership: Through tangible things the community can see, like billboards, the big ceremony, the awards, the community gifts, etc.

10. The ‘Zero Tolerance Village Alliance’: Snapshot of results
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The ‘Zero Tolerance Village Alliance’: Snapshot of results
Statistically significant reductions in the occurrence of:
Physical IPV for women (from 69% to 38%) and men (from 6% to 2%)
Sexual IPV for men (from 4% to 0%)
Non-partner physical violence in the last one month for women (from 12% to 4%) and men (from 34% to 6%)
Non-partner sexual violence in the last one month for women (from 13% to 5%)
You can read more about these results in the report, which is available online.

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References
Undie C., et al “Effectiveness of a Community-Based SGBV Prevention Model in Emergency Settings in Uganda: Testing the ‘Zero Tolerance Village Alliance’ Intervention.” Nairobi, Kenya: Population Council.
Undie C., Birungi H., Namwebya J., Taye W., Maate L., Mak’anyengo M., Katahoire A., Kazungu D.A., Kusasira D, Mirghani Z., Karugaba J “Screening for Sexual and Gender-Based Violence in Emergency Settings in Uganda: An Assessment of Feasibility.” Nairobi, Kenya: Population Council.

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