A step-by-step guide to strengthening sexual violence services in public health facilities: Lessons and tools from sexual violence services in Africa

Sexual violence (SV) is a serious health and human rights problem across Africa that disproportionately affects women and girls. Survivors require comprehensive and sensitive care to mitigate the negative health consequences of SV, minimize psychological trauma, and promote long-term reintegration and recovery. Despite high levels of sexual violence and a growing recognition of the need to improve the management of rape and sexual assault, many public health facilities in Africa do not currently have capacity to provide comprehensive, patient-centered SV care to adult and child survivors. Public facilities face numerous challenges including lack of specialized SV training, general understaffing and lack of resources, and gaps in essential clinical services. Community and family attitudes, feelings of shame, low awareness about SV and SV services, and lack of funds for transportation or medical services create further challenges that prevent or inhibit many survivors from seeking essential care. This guide provides practical guidance on the steps necessary to establish and strengthen SV services within existing public health facilities, improve linkages to other sectors, and engage local communities around issues of sexual violence