The Copperbelt model of integrated care for survivors of rape and defilement: Testing the feasibility of police provision of emergency contraceptive pills

The Zambian Ministry of Home Affairs (Police Service), Ministry of Health (MOH) and the Population Council collaborated on an operations research study designed to improve services for survivors of gender-based violence (GBV). Specifically, the study tested the feasibility of police provision of emergency contraception (EC). It also hypothesized that the intervention could strengthen GBV services at both police and health facilities through an increased emphasis on multisectoral collaboration. Based on the study’s findings, national scale-up of this program has been widely endorsed. The following recommendations are offered to guide such scale-up: ensure that a dedicated EC pill is available through the public sector; incorporate police provision of EC into provincial and national policies and guidelines; integrate EC services into the national victim support unit training curriculum and offer MOH certification; refine the EC provision training curriculum in conjunction with the MOH; integrate EC into the national training curriculum for all police officers; assign dedicated health sector staff to support police EC providers; and develop innovative approaches to overcoming transport constraints

Mitigating the consequences of sexual violence in Zambia by decentralizing emergency medical responses to police victim support units: Report on the feasibility of police provision of post-exposure prophylaxis for HIV (PEP) in Zambia

The Zambian Ministry of Home Affairs (housing the Zambia Police Service); the Ministry of Health, the Ministry of Community Development, Mother and Child Health; and the Population Council collaborated on operations research studies to increase provision of emergency medical care to survivors of sexual violence via the Zambia Police Services (ZP). Recognizing the need to strengthen linkages between the police and the health sector and following up on the lessons learned from earlier models of police delivery of emergency contraception, this feasibility study was designed to: determine if victim support unit (VSU) officers could be trained to safely and effectively provide post-exposure prophylaxis (PEP) to sexual violence (SV) survivors, explore ways to improve linkages and referrals between the ZP and hospital providers, and raise community awareness about SV and increase prompt reporting of cases to participating VSUs. The study confirms that Zambian police officers can effectively and correctly provide SV survivors with a three-day starter pack of PEP and refer them to health services for follow-up. However, the study also highlights issues needed to improve program effectiveness

The prevention and management of HIV and sexual and gender-based violence: Responding to the needs of survivors and those-at-risk

The Population Council seeks to understand the social, economic, political, and physical context of risks for sexual and gender-based violence and HIV. Among the top priorities of Council research are supporting and evaluating efforts to prevent violence and HIV, including creating safe spaces for adolescent girls, and working with men and boys to change gender norms within the community; and comprehensively responding to the needs of survivors (including those who are HIV-infected) by strengthening health systems and integrating services. The purpose of this guide is to provide practical guidance on the steps necessary to establish and strengthen sexual violence (SV) services within existing public health facilities, improve linkages to other sectors, and engage local communities around issues of sexual violence. It includes tips, resources, and tools that will help partners and stakeholders design, implement, and evaluate SV programs

Assessing the feasibility of police initiation of HIV post-exposure prophylaxis for sexual violence survivors in Lusaka, Zambia

[Extract] Globally, more than 1 in 3 women have experienced physical or sexual violence (SV) from intimate partners or SV from non-partners [1]. Furthermore, over 10% of all girls are estimated to have experienced a forced sexual act, with the highest rates of SV against girls found in sub-Saharan Africa [2].\ud \ud Although public recognition of SV is growing in Zambia, reliable data on the nature and extent of such violence is limited. Approximately 20% of Zambian women aged 15 to 49 have experienced some form of sexual violence; however, this is likely underestimated due to underreporting [3]. Previous research in Zambia suggests that exposure to SV is equally pervasive among adolescent girls [4,5].\ud \ud The risks associated with SV, especially among young women, are numerous. Immediate health consequences include unwanted pregnancy, physical trauma, mental distress and acquisition of HIV and other sexually-transmitted infections. The linkage between sexual and gender-based violence (SGBV) and risk of HIV has been well documented in Africa and is especially pronounced in countries with high HIV prevalence, such as Zambia [3,6-8].\ud \ud Growing awareness of these negative consequences of SGBV led the Government of Zambia to develop a set of national guidelines for the management of SGBV, highlighting the need for a response system linking the health, police, and social services sectors. A critical component of this response is the prevention of HIV infection in SV survivors through the provision of preventive anti-retroviral therapy, or HIV post-exposure prophylaxis (PEP). The initial dose of PEP must be taken within 72 hours of exposure to HIV [9].\ud \ud Given the time sensitivity of PEP and the fact that police and health services are often the first points of contact for SV survivors, strong coordination between these two sectors is central to the effective medical management of SV cases in Zambia [10]. Building on the results of previous research in Zambia, which demonstrated that trained Victim Support Unit (VSU) police officers could effectively administer the emergency contraception pill to SV survivors, the Population Council, Zambia Police Service, and Ministry of Health aimed to assess the feasibility of having trained VSU police officers safely and effectively provide a PEP starter dose to SV survivors with immediate referral to comprehensive medical services [10].\u