Together Against GBV

Posted October 18, 2017

By Bethany Corrigan, Senior Technical Advisor, GBV, PSI

Are there any Harry Potter fans out there? Remember, when Severus Snape said the Dark Arts are a many-headed monster? He described that, in battling such a beast, you must be prepared for anything. Each time a neck is severed, another head sprouts in its place. As Snape cautions, “You are fighting that which is unfixed and mutating…”

Sound daunting? Well, if you can empathize with this metaphor, you’re one step closer to understanding what it’s like to tackle gender-based violence (GBV). Much like the many-headed beast, GBV is complicated, “many and varied.” It often operates in secret where it’s hard to reach. Every time we think we find a way to victory, a new challenge pops up.

Did you know that an estimated 1 in 3 women will experience some form of GBV in her lifetime – a majority from an intimate partner? I say estimated because GBV isn’t as easy to identify and document as malaria, or tuberculosis, or even HIV. GBV is underreported because survivors may face greater violence for speaking out.

Did you know GBV is associated with, poverty, substance abuse, unintended pregnancy, reproductive health risks and STI transmission? Women who experience GBV are at a 1.5 times greater risk for HIV transmission.

October isn’t just for Harry Potter-themed Halloween parties and costumes, it’s also Domestic Violence Awareness Month (DVAM) – a time to speak out and talk with one another openly about these issues and what we can do about them. So in the spirit of DVAM… how can we address GBV, this multi-sector global threat to health and wellbeing? The same way we would fight a multi-headed monster; bring it into the light and work with others whose skills complement ours to battle the heads from every angle.

PSI is committed to putting beneficiaries at the center of programs. Working in GBV is no different. It’s our responsibility to understand the context where survivors work and live. To assess their challenges, risks and needs.

We work to bring the risks and effects of GBV into the light by learning from, sharing knowledge, and collaborating, with partner organizations, governments and communities. PSI’s expertise is in recognizing healthcare providers as community leaders and in building the sensitivity and capacity of the healthcare workforce to raise community awareness and safely identify survivors and connect them to services. To address survivors’ other needs, we collaborate with partners who have expertise in other fields. By strengthening linkage and referral networks and leveraging resources, we ensure that GBV survivors are connected to support across sectors beyond healthcare (such as legal, economic, educational, and psychosocial support).

This Domestic Violence Awareness Month, I encourage you to find a monster-head that you’re best suited to tackle. Maybe it’s learning, raising awareness or volunteering at a shelter. Just remember, no one can beat the monster alone, but there is hope when we fight together.

Banner photo: © Population Services International / Banner Photo by: Zoeann Murphy

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In rural Ethiopia, women and girls often face significant barriers in accessing healthcare facilities, which can be located hours away. Moreover, there is a prevailing stigma surrounding the use of contraception, with concerns about potential infertility or the perception of promiscuity. To address these challenges, the Smart Start initiative has emerged, linking financial well-being with family planning through clear and relatable messaging that addresses the immediate needs of young couples—planning for the lives and families they envision. Smart Start takes a community-based approach, utilizing a network of dedicated Navigators who engage with women in their localities. These Navigators provide counseling and refer interested clients to Health Extension Workers or healthcare providers within Marie Stopes International-operated clinics for comprehensive contraceptive counseling and services.

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In 2022, 328 thousand malaria cases were recorded by CHWs); 6.5 thousand severe malaria cases were referred to health centers, according to the national health information system.

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Beyond the observed interactions with patients, supervisors heard from community members that they were pleased that CHWs were able to provide essential malaria services in the community. And the data shows the impact.

In IM-supported areas of Mali, 36% of CHWs in the first round were competent in performing the RDT, which rose to 53% in the second. 24% of CHWs in the first round compared to 38% in the second were competent in the treatment of fever cases and pre-referral counseling. Between both rounds, availability of ACT increased from 80 percent to 90 percent.

Supportive supervision with interviews and observations at sites improved the basic competencies of CHWs between the first and second rounds, and additional rounds will help to understand the longer-term programmatic benefits.

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Here’s what it looks like in practice.

In July 2020, PSI Angola, alongside the Angolan digital innovation company Appy People, launched Kassai, an eLearning platform that targets public sector health workers in Angola. Through funding from USAID and the President’s Malaria Initiatve (PMI), Kassai features 16 courses in malaria, family planning, and maternal and child health – with plans to expand learning topic areas through funding from ExxonMobil Foundation and private sector companies. A partnership with UNITEL, the largest telecommunication provider in Angola, provides all public health providers in Angola free internet access to use Kassai.

Kassai’s analytics system to follow learners’ success rate and to adjust the course content to learners’ performance and needs. Kassai analytics are integrated with DHIS2 – the Health Management Information System (HMIS) of Angolan MOH, to be able to link learners’ knowledge and performance with the health outcomes in the health facilities. The analytics track learners’ performance by course and gives visibility by health provider, health facility, municipality, and province. Each course has pre-and post-evaluation tests to track progress of learning, too.

By the end of 2022, there were 6,600 unique users on the Kassai platform and 31,000 course enrollments. PSI Angola’s partnership with UNITEL, the largest telecommunication provider in Angola, allows for free internet access to learn on the Kassai for all public health providers in Angola. Building on its success for malaria training, Kassai now also provides courses in family planning, COVID-19, and maternal and child health. This reduces training silos and provides cross-cutting benefits beyond a single disease.

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Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

Building community health worker capacity to deliver malaria care

Taking a market-based approach to scale sanitation in Ethiopia

Promoting self-managed care like Self-testing and Self-Sampling

Using peer coaches to counter HIV stigma in South Africa

simplifying consumers’ journey to care in Vietnam

Engaging the private sector for disease surveillance in Myanmar

Training health workers in Angola

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