Sexual Health

The Health Sector Response to Gender-Based Violence and Sexual Reproductive Health Programs in the Commonwealth and Selected African Countries: Protocol for a Mixed Methods Systematic Review and Meta-Analysis.

TL;DR

A mixed methods systematic review protocol is described to examine health sector responses to gender-based violence, violence against women and girls, and sexual and reproductive health rights in 24 Commonwealth and 7 selected African countries, with 60 studies identified as eligible for inclusion to date.

Key Findings

Initial database searches identified 38,200 studies focusing on GBV, VAWG, and SRHR interventions across multiple electronic databases.

  • Searches were conducted across 11 electronic databases including PubMed, Google Scholar, Science Direct, EBSCOhost, Web of Science, Embase, PsycINFO, Cochrane, CINAHL, Index Medicus for the Eastern Mediterranean Region, and POPline
  • Microsoft Copilot was also used in addition to traditional database searches
  • The review covers research published in the last 15 years
  • The review covers 24 Commonwealth countries and 7 selected African countries

To date, 60 studies have been found eligible for inclusion in the review.

  • The majority of eligible studies were conducted in eastern Africa (n=34)
  • South Africa contributed 14 eligible studies (n=14)
  • Asia contributed 13 eligible studies (n=13)
  • Studies were screened using the population, intervention, comparison, and outcome (PICO) framework guided by inclusion and exclusion criteria

Cumulative GBV was found to have a more significant effect on abortion risk than other associated variables.

  • This finding is cited in the background as evidence of the interlinking nature of GBV and SRHR outcomes
  • GBV and VAWG are described as linked to unintended pregnancies, severe maternal, gynecological, and mental health outcomes
  • This finding is used to justify the need for a comprehensive health sector response integrating GBV and SRHR services

The review protocol follows PRISMA-P guidelines and is registered with PROSPERO (CRD42024520594).

  • A mixed methods systematic review design was chosen to accommodate diverse study types
  • Ethics approval was waived as the study uses data already in the public domain
  • The project was commissioned by the Commonwealth Secretariat for the period 2022-2025
  • Database search, data screening, and data extraction are planned to be completed by September 2025, with manuscript submission by November 2025

The review aims to examine the extent and array of health facility-based coordinated responses to GBV, VAWG, and SRHR across different national, cultural, and socioeconomic contexts.

  • The review will cover 24 Commonwealth and 7 selected African countries
  • The study seeks to identify lessons learned, successes, and challenges in health sector responses
  • The review intends to share best practices, experiences, and lessons learned across contexts
  • Evidence will be disseminated through journal publications, seminars, workshops, and local and international conferences

What This Means

This paper describes the protocol (the detailed plan) for a large systematic review examining how health systems in Commonwealth countries and selected African nations respond to gender-based violence (GBV) and its connections to sexual and reproductive health. The researchers plan to analyze existing published studies to understand what kinds of health facility programs exist, what has worked, and what challenges remain. So far, their database searches have turned up 38,200 potentially relevant studies, of which 60 have been confirmed eligible for in-depth analysis, with the largest share coming from eastern Africa, South Africa, and Asia. This research suggests that GBV and sexual and reproductive health issues are deeply intertwined — for example, the paper notes that cumulative exposure to GBV is more strongly linked to abortion risk than other factors, and that GBV is associated with unintended pregnancies, complications during pregnancy, gynecological problems, and mental health impacts. By systematically gathering and analyzing evidence from many countries and contexts, the review aims to identify best practices and generate recommendations that health ministries and policymakers can use to better coordinate services for people affected by GBV. The full review is still in progress, with data extraction expected to be completed by September 2025 and final results published shortly thereafter. Once complete, findings will be shared with health ministries, policymakers, and stakeholders through publications and conferences. This kind of synthesis is important because it can help countries learn from each other's experiences and avoid reinventing solutions that have already been tested elsewhere.

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Citation

Phaswana-Mafuya R, Phalane E, Zungu N, Musekiwa A, Ramalepe L, Bagg K, et al.. (2025). The Health Sector Response to Gender-Based Violence and Sexual Reproductive Health Programs in the Commonwealth and Selected African Countries: Protocol for a Mixed Methods Systematic Review and Meta-Analysis.. JMIR research protocols. https://doi.org/10.2196/67571