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An integrated approach to gender-based violence care in Ethiopia

The armed conflict in Northern Ethiopia has resulted in widespread gender-based violence (GBV); however, the number of GBV cases are substantially underreported, due to stigma and limited healthcare capacity to provide emergency care and outreach activities. By partnering with national and regional stakeholders, this transdisciplinary research seeks to examine the current state of GBV care to answer the question, how can gender-based violence services be integrated into routine and emergency care in Amhara, Ethiopia?

Background
In Amhara, Ethiopia the need for GBV survivors to access sexual and reproductive care has increased, while service provision has drastically diminished due to the political conflict and subsequent healthcare facility destruction in Northern Ethiopia. The extent of GBV and the needs of survivors are unclear, but the integration of GBV services into newly-restored healthcare facilities seems promising. 

Objectives
The objectives are to:

  1. Assess the demand for GBV services by investigating the prevalence of GBV, experiences of stigma, common mental health disorders, healthcare needs of survivors, help-seeking behaviors, and barriers to service use
  2. Assess existing GBV services, including formal and informal modes of care, and healthcare worker competencies to provide services
  3. Co-create an integrated, survivor-centered approach to care delivery for high-quality GBV services
  4. Develop insights for research, policy, and practice on GBV care in health systems in post-conflict affected areas

Approach
We apply a community-engaged mixed-methods approach to understand the scope of GBV, associated stigma and barriers to GBV services. Together with local stakeholders, this project will also explore the needs of women and girls and how services can be made available, accessible and of high quality. Frequent engagement with diverse stakeholders to co-design, implement and reflect on project developments are key to the success of this project. These stakeholders include Ethiopian National Ministries, the Amhara Regional Health Bureau, humanitarian organizations, health workers, community-based organisations, communities affected by GBV, religious institutions and Bahir Dar University.

Athena’s role
Athena provides technical assistance on all research components and co-leads the qualitative assessment of GBV with Bahir Dar University. We provide knowledge and experience as a leader in health system innovation and transdisciplinary research; and we possess a wealth of expertise in sexual reproductive health, health systems, health-related stigma and mental health research.

Lessons and outcomes
As part of the theory of change of this project, the outputs of this project contribute to our understanding of the needs of GBV survivors and the required and feasible health system response. The short-term outcome within this study is the service delivery models and protocols, including a detailed description of required workforce competencies for integrated GBV care. These models are anticipated to include, but are not limited to, services and referral systems at all levels (community – tertiary) of care, encompassing the individuals social, mental and physical needs as well as community-based interventions. 

Project kick-off activities in North and South Wollo, Amhara

Project details

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