The Health-Sector Response to Gender-Based Violence and Sexual Reproductive Health Programmes in Commonwealth and Selected African Countries: A Mixed-Methods Systematic Review and Meta-Analysis

Abstract

The health sector needs to provide a comprehensive evidence-based response to survivors of gender-based violence (GBV). Violence against women and girls (VAWG) and GBV are one of the most prevalent forms of violence and has sexual reproductive health and rights (SRHR) impacts. This paper determines the prevalence and diversity of responses to GBV, VAWG, and SRH, and describes the interventions and associated health outcomes in the 31 Commonwealth and other selected African countries. A narrative synthesis described the diversity of interventions for GBV, VAWG, and SRHR. A meta-analysis of eligible randomised controlled trials (RCTs) was conducted to evaluate the efficacy of interventions aimed at enhancing SRHR knowledge and attitudes among adolescents, couples, and partners. We included 60 studies on GBV, VAWG and SRHR interventions. Nine studies were included in the meta-analysis. A range of education-based interventions for SRHR were implemented resulting in improved SRHR knowledge and attitudes among adolescents, couples, and partners (OR 2.47, 95% CI: 1.51–4.03). When compared with cluster RCTs (OR 2.28, 95% CI: 1.49–4.80), RCTs provided moderate evidence of improving SRHR knowledge and attitudes (OR 1.78, 95% CI: 1.14–2.77). Home-based visits, education-based interventions, one-way or two-way SMS with health education messages, and youth-friendly health services (YFHS) may all be essential for enhancing SRHR knowledge and attitudes among partners, couples, and adolescents.