A review and evaluation of multi-sectoral response services ('one-stop centers') for gender-based violence in Kenya and Zambia

i The Population Council confronts critical health and development issues—from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees. Askew. 2012. ―A review and evaluation of multi-sectoral response services (‗one-stop centers') for gender-based violence in Kenya and Zambia.‖ Nairobi, Kenya: Population Council. iii ACKNOWLEDGMENTS This report is based on a study funded by the Eastern and Southern Africa Regional Office of the United Nations Children's Fund. We are indebted to the administration of all the health facilities and one-stop centers that formed a part of this study, as well as to all the study's interviewees. We also gratefully acknowledge the varied contributions of several individuals toward the initiation and/or completion of the study, including: vi EXECUTIVE SUMMARY While data are very limited on sexual and gender-based violence (SGBV) in Africa i , estimates suggest that SGBV is a major health, human rights, and development issue in the region, as it is globally. Approximately half of the women aged 15-49 (48%) in Zambia have experienced physical violence, and one in five women have experienced sexual violence (Zambia DHS, 2007). In Kenya, 39% of women aged 15-49 have ever experienced physical violence since the age of 15, and one in five (21%) reported sexual violence. Given complicated stigma and reporting issues, it is likely that these national Demographic and Health Surveys (DHS) underestimate the true prevalence and incidence of violence. Children are not immune to this epidemic. A global school-based survey found that 31% of girls and 30% of boys aged 13-15 in Zambia had been forced to have sex (Brown et al., 2009). Results of the study based on responses from males and females aged 18 to 24 indicate that lifetime exposure to childhood violence is exceedingly and unacceptably high in Kenya. Nearly one in three females and one in five males experience at least one episode of sexual violence before reaching age 18 – an experience that can shape their futures in terms of their attitudes towards violence, their adoption of risky behaviors and …