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Botswana's Gender-Based Violence Referral

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Botswana's Gender-Based Violence Referral 2 Botswana GBV Referral System Operations Research: End Line Report ACKNOWLEDGMENTS This report was prepared on behalf of the Ministry of Nationality, Immigration and Gender Affairs and its Gender Affairs Department by Abby Cannon, Sarah Treves-Kagan, Meghan Cutherell, Jessica Fehringer, Helen Apps, Peggie Ramaphane, and Shelah S. Bloom. All authors except Helen Apps and Peggie Ramaphane are with MEASURE Evaluation, which is funded by the United States Agency for International Development (USAID) and the United States President’s Emergency Plan for AIDS Relief (PEPFAR). Apps is with WoMen Against Rape (WAR) and was the study’s site research manager. Bloom designed the study. Cannon and Brittany Iskarpatyoti, also of MEASURE Evaluation, and Apps trained the fieldwork team and directed the data collection in Botswana. Analysis was conducted by Cannon, Treves-Kagan, and Cutherell, with support from Apps and Ramaphane. Jennifer Curran provided review and feedback during interpretation, as well as insight regarding the implementation of the Gender-based Violence Referral System Project (GBVRSP). Fehringer contributed strategic guidance on analysis and report writing and provided feedback on report drafts. We acknowledge MEASURE Evaluation’s knowledge management team for document design, editing, and production assistance. On behalf of the Ministry of Nationality, Immigration and Gender Affairs, MEASURE Evaluation thanks USAID/Botswana for its support and guidance on this project: in particular, Irene Ramatala, who provided direct technical assistance to the project, and Segametsi Duge, who provided ongoing program support and direct technical support. PEPFAR also provided funding for this project. We deeply appreciate all the providers, community members, key informants, representatives of nongovernmental organizations, and others who contributed their time and perspectives. We also thank the stakeholders for providing context and insight about the community and for their guidance in this project. We thank Elizabeth Motshubi (Gender Affairs Department), the site principle investigator of this project; Kate Scurria (formerly of the Gender Affairs Department); and Jen Curran (MEASURE Evaluation) for valuable insight, on-the-ground support, and review of this report. We thank WAR for conducting fieldwork—in particular, Peggie Ramaphane, WAR’s executive director, for her technical and logistic help. We thank the fieldworkers who collected the data: Navas Olathilwe Kamanga, Omaatla Makgetho, Lorato Masoko, Khumo Moalo, Keeme Puoetsile, Katlego Pearl Sehube, Sakaio Sesepasepe, and Thato Tshimololo; and the transcriptionists who translated and transcribed the focus groups and service provider interviews: Seopedi V.W. Baitsile, Iris Halldorsdottir, and Obonetse Lebakanyane. Mantra Solutions developed the referral information system and Orange Botswana partnered with MEASURE Evaluation for mobile connectivity. We thank MEASURE Evaluation’s knowledge management team for editorial and production services. Botswana GBV Referral System Operations Research: End Line Report 3 CONTENTS ACKNOWLEDGMENTS ............................................................................................................... 3 CONTENTS .................................................................................................................................... 4 FIGURES ......................................................................................................................................... 6 TABLES ........................................................................................................................................... 6 ABBREVIATIONS .......................................................................................................................... 7 EXECUTIVE SUMMARY .............................................................................................................. 8 Background .............................................................................................................................................................. 9 Operations Research Purpose and Questions .................................................................................................. 10 Operations Research Design, Methods, and Limitations ............................................................................... 10 Findings and Conclusions .................................................................................................................................... 11 Community Perceptions and Acceptance of GBV ..................................................................................... 11 Provider Perceptions and Handling of GBV............................................................................................... 12 RIS Uptake ........................................................................................................................................................ 13 Referral System Feedback ............................................................................................................................... 14 Key Informant Interviews .............................................................................................................................. 15 Program Implementation Findings ............................................................................................................... 15 Conclusions ....................................................................................................................................................... 19 Recommendations................................................................................................................................................. 19 PROJECT BACKGROUND........................................................................................................... 24 Gender-Based Violence Referral System Project ............................................................................................. 25 OPERATIONS RESEARCH PURPOSE AND QUESTIONS ..................................................... 29 OPERATIONS RESEARCH DESIGN, METHODS, AND LIMITATIONS ............................. 30 Study Design .......................................................................................................................................................... 30 Data Collection and Analysis .............................................................................................................................. 31 Participant Recruitment .................................................................................................................................. 31 Data Collection Tools ..................................................................................................................................... 31 Qualitative Data Analysis ................................................................................................................................ 32 Quantitative Data Analysis ............................................................................................................................. 32 Ethical Approval .............................................................................................................................................. 32 Study Sites .............................................................................................................................................................. 33 Limitations .............................................................................................................................................................. 35 FINDINGS AND CONCLUSIONS .............................................................................................. 37 Awareness and Perception of GBV and GBV Services among Community Members ............................ 41 4 Botswana GBV Referral System Operations Research: End Line Report Defining GBV and Identifying Causes ......................................................................................................... 41 GBV Acceptability ........................................................................................................................................... 42 Availability and Quality of GBV Services .................................................................................................... 45 Changes in the Previous Year ........................................................................................................................ 47 GBV Service Provider Awareness and Self-Efficacy around GBV and Provision of GBV Services ..... 49 Understanding GBV ........................................................................................................................................ 49 Comfort Handling GBV Cases That Present at Their SDP ..................................................................... 51 Collaboration and Trust among Providers ................................................................................................... 53 Feedback on GBVRSP and RIS ......................................................................................................................... 55 Key Informant Interviews ................................................................................................................................... 57 CONCLUSIONS ...........................................................................................................................
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