Sexual and Gender Based Violence (SGBV), in its various forms, is endemic in communities around the world, cutting across class, race, age, religion and national boundaries. Exposure to gender-based violence and sexual coercion significantly increases girls’ and women’s chances of early sexual debut, experiencing forced sex, engaging in transactional sex, and non-use of condoms. The impact of sexual and gender-based violence resonates in all areas of health and social programming: survivors of sexual violence experience increased rates of morbidity and mortality, and violence has been shown to exacerbate HIV transmission, among other health conditions (IGWG of USAID, 2006). While girls are the most visible survivors of sexual violence, they are far from being the only ones who suffer from the consequences: children of both sexes constitute the majority of abuse survivors, and adult men and the handicapped are minority groups who are often neglected in research and interventions.

There is growing awareness of the links between sexual and gender-based violence, health, human rights and national development in East, Central and Southern Africa (ECSA). However, there are few programmes that simultaneously address the determinants and consequences of SGBV in an integrated and comprehensive manner, with responses being implemented separately by the NGO and public sectors, and by separate line ministries within national governments. In addition to this, few guidelines or frameworks exist to guide policymakers and programme managers in developing and implementing the comprehensive response necessary to address the health and criminal justice consequences of violence, and to reduce the determinants of violent behaviour within communities. Moreover, in most situations, organizations and ministries are undertaking activities without reference to or liaison with other key actors and networks within their country or more widely in the region.

This literature review is intended to inform partners in the Population Council-coordinated regional network that aims to develop a multi-sectoral and comprehensive response to SGBV in Eastern, Central and Southern Africa. The review is structured around seven components collectively designed to meet the medical, psychological and justice needs of survivors of sexual violence. The components consist of a comprehensive review of region-specific policies, programmatic experiences and best practices relating to the appropriate medical management of sexual violence, enabling effective criminal justice responses to all SGBV cases, and the reduction of levels of violence at the community level.