A gendered crisis – supporting survivors with reproductive health and rights

Prior to COVID-19, one in three women worldwide experienced physical or sexual violence, mostly by an intimate partner and the pandemic has made this worse. Early reports indicate a 30-60% rise in domestic violence, with restricted movement, social isolation with abusers, and economic insecurity putting women further at risk.  

We know that as the risk of sexual and gender-based violence rises, so does the need for sexual and reproductive health and rights. Our MSI providers are sometimes the first and only person a survivor will choose to disclose their experiences to and are in a unique position to offer first line care, with initial emotional support, sexual and reproductive healthcare, and referrals to specialist services. 

During COVID-19, as our teams have seen a rise in cases of sexual and gender-based violence, here’s how our programmes have adapted to ensure survivors can access the right support: 

1. Ensuring our frontline staff – including contact centre staff – are trained to support survivors 

Since the start of the COVID-19 pandemic, calls to domestic violence helplines have increased five-fold, so we have trained MSI call centre staff to support survivors of violence, too. 

In the UK, our programme saw a 33% rise in domestic violence reports within the first few months of lockdown. Fortunately, each facility and call centre is equipped with a safeguarding lead, so, when the UK government allowed the roll-out of telemedicine abortion care - permitting clients to access care over the phone and medication via post – our trained safeguarding practitioners were able to risk assess client’s needs and develop an appropriate care plan. 

In tandem, we are conducting training for our frontline providers and call centre staff across eight country programmes. Thanks to support from the Australian Government’s Department of Foreign Affairs and Trade (DFAT), MSI providers in Vietnam, Cambodia, Timor Leste, Papua New Guinea, Pakistan, Bangladesh, Nepal, and Myanmar, will be trained on MSI’s first line approach to sexual and gender-based violence as part of RESPOND - a COVID-19 response programme safeguarding sexual and reproductive healthcare and rights in the Asia Pacific region. 

2. Engaging men with community campaigns on gendered violence 

As advocates for gender equality, challenging the harmful social norms that can normalise and drive sexual and gender-based violence is central to our mission.  

With support from DFAT, we are rolling out community campaigns focused on building awareness on sexual and gender-based violence and its harmful impacts, each tailored to the community setting and local cultural norms. In Papua New Guinea, these sessions are focused on building awareness amongst men on the important role they play in challenging sexual and gender-based violence.  

In Tanzania, in partnership with the UK’s Foreign, Commonwealth & Development Office (FCDO) and Global Affairs Canada, we have taken a similar approach, engaging men and male community leaders in discussions on gender roles and power norms that exist at a community level, and their impact on gendered-violence.

3. Establishing referral pathways for specialist care 

At the heart of our sexual and gender-based violence care is partnership. MSI is not a provider of comprehensive gender-based violence services, so it is essential our teams know where to refer to for specialist support, such as refuges, legal advice, mental health support or financial rehabilitation services.  

These referral pathways can work both ways. In Zimbabwe, where nearly 45% of women report that their first sexual encounter was non-consensual, MSI partners with Katswe Sistahood, a youth movement supporting survivors. Our referral pathway means survivors can access free sexual and reproductive healthcare services, including HIV testing, STI management, cervical cancer screening and preventative therapy, contraception, and post-abortion care.

4. Partnering across the health system to support survivors 

Ensuring all survivors receive the care they need, when they need it, requires the support of the entire health system, particularly public sector facilities.  

In partnership with Global Affairs Canada, MSI’s programme in Mali is training public sector providers to deliver first-line care to survivors of SGBV, including providing sexual and reproductive healthcare and referring survivors to the legal, financial, or psycho-social support they need. 

With support from FCDO, MSI’s programme in Tanzania partnered with the International Rescue Committee to support public sector facilities with minimum standards in gender-based violence, so nurses have the core skills to support survivors with appropriate care. 

5. Advocating for improved sexual and reproductive health and rights for survivors 

Finally, we use our voice as a global healthcare provider to advocate for the elimination of sexual and gender-based violence, and the right to bodily autonomy and choice.  

In Kenya, MSI - with support from the Children’s Investment Fund Foundation (CIFF) - is working with local women's groups to raise awareness of the sexual and gender-based violence commitments made by the Government of Kenya at the Generation Equality Forum earlier this year, holding commitment makers to account.  

Meanwhile, we are advocating for improved access to sexual and reproductive health and rights for survivors. Our team in Zimbabwe are part of a cross-partner taskforce advocating for abortion law reform to ensure timely access to safe abortion for survivors of rape. And in the UK, we are advocating for abortion via telemedicine to be offered permanently, using our data demonstrating that telemedicine is safe and effective, and the preferred option for most clients - particularly for vulnerable clients, such as survivors of sexual violence, who might prefer to keep their service secret.

While the COVID-19 pandemic has led to a rise in sexual and gender-based violence, many governments have diverted resources from sexual and reproductive health and rights to the COVID-19 response. To protect women facing violence, we must ensure that their voices are heard, and the services they need are available. To find out how to partner with MSI and enable us to reach women with essential services when needed most, visit our partnership page. 

To find out more about ensuring SRHR for women facing violence, watch our webinar with the World Health Organisation, Katswe Sistahood, and MSI team members in Zimbabwe and the UK.