Experienced by women in developed and developing countries in all regions of the world, increasing evidence shows that gender-based violence (GBV) is a systemic issue which affects all sectors of society. Gender-based violence affects the physical and emotional health of women and ultimately damages communities and societies, Unfortunately, despite the known magnitude of the problem, national leaders often fail to create and implement policy and programmatic measures needed to ameliorate the recurring phenomenon. On April 20, 2009, authors Reena Borwankar and Elisabeth Sommerfelt presented their report (co-authored with Rouguiatou Diallo), entitled Gender-based Violence in sub-Saharan Africa: A review of Demographic and Health Survey Findings and their use in National Planning. The review, published by Africa's Health in 2010 Project managed by the Academy for Educational Development and funded by USAID's Africa Bureau, (i) assessed the levels of domestic violence from comparable, nationally representative Demographic and Health Surveys (DHS) conducted between 2000-2006 from seven sub-Saharan African countries, and (ii) examined whether the evidence generated from DHS findings have informed GBV policies and programs, as reflected in the country growth and development strategies Moderated by Vivian Lowery-Derryck, Inaugural Fellow in the Advanced Leadership Initiative at Harvard University, the presentation ended with comments by Diana Prieto, Senior Gender Advisor, USAID Office of HIV/AIDS and Mark Blackden, a consultant for the International Finance Corporation.

The authors of the report focused on seven African countries with available DHS data on domestic violence - Cameroon, Kenya, Malawi, Rwanda, Uganda, Zambia, and Zimbabwe. In addition to critically reviewing the findings on domestic violence across the seven countries, the review sought to determine if countries are using compelling evidence such as the DHS findings to inform national planning around GBV, and to examine the priority level of gender-based violence in these documents. The report also considered how these documents address GBV across different sectors, such as health, justice, and education. Despite the increasing evidence-base around GBV, the authors pointed out the gap not only between this evidence actually informing policies, but also the continuing gaps in the implementation of existing policies.

The report specifically looked to National Plans of Action (NPAs) and First Generation Poverty Reduction Papers (PRSPs) to examine the DHS surveys' effects on national planning around GBV. Initiated by the World Bank and the IMF to determine the basis for debt relief and assistance, the original PRSP process has evolved so that the NPAs – also referred to as the second generation PRSPs – are more flexible and linked to a country's national strategies . The sectors that should be involved in responses to GBV (health, education, gender, justice, and law enforcement) are already involved in the development of the PRSPs and NPAs, in order that these documents lend themselves to a coordinated national response to address GBV, said Borwankar. But probably more importantly, she added, these are binding documents for the executive branch of the country. Once an issue is highlighted as a priority in these documents, it has to be taken into consideration by the Ministry of Finance in the budgeting process and is more likely to receive the required resource allocation.
The DHS surveys are nationally representative population based surveys funded by USAID since in the mid-1980's, The DHS findings for this report were drawn specifically from the domestic violence module of the survey, which asks women about their experience of violence from all perpetrators as well as violence instigated by their husbands. Women were not questioned directly if they had experienced violence, but rather asked a series of questions which develop an indicator of physical, sexual, and emotional violence, said Elisabeth Sommerfelt. The authors used information published in the respective DHS country reports and did not analyze primary DHS data. The review showed high levels of domestic violence amongst women of reproductive age in sub-Saharan Africa: about 25% of women in Malawi had experienced physical/sexual spousal violence; levels were higher in Cameroon, Kenya, Rwanda, Zimbabwe (35%-45%); and highest in Uganda (60%). Among women with spousal violence, one-quarter to one-half had experienced sexual violence.

The authors reviewed the national planning documents through word searches (on terms relevant to gender-based violence), scanning of sections pertaining to GBV such as health and education, and examination of the extent to which DHS surveys informed policies and programs in the documents. The researchers found that national planning documents did not systematically refer to gender-based violence or identify it as a priority in national planning documents. Gender-based violence was not addressed across the different sectors within the documents, and the DHS evidence did not appear to inform the policies and programs included in the national planning documents. For example, in the Cameroon PRSP, the document made a single reference to gender-based violence in a clause on the socio-legal status of women. Malawi's PRSP, on other hand, contained the strongest language about gender-based violence, identifying the issue as a priority and outlining programs and responsible organizations for carrying out these programs to provide a response to gender-based violence in different sectors of society. In general, national planning documents emphasize security and judicial sectors in responding to gender-based violence, and often do not include the public health sector as an active respondent to the issue, despite linkages between GBV and critical health issues such as HIV/AIDS and reproductive health. Furthermore, little emphasis was given to the education sections of these documents to the broader issue of gender-based violence, or specifically to issues of sexual harassment in schools.

The report suggests increasing the evidence base in gender-based violence and raising awareness of the magnitude of this issue and its detrimental implications for communities. It also encourages developing a more comprehensive multi-sectoral response to the issue of gender-based violence to increase budgetary allocations and program support in various affected sectors of society.

In her comments on "Gender-based Violence in sub-Saharan Africa", panel discussant Diana Prieto underscored the gravity of gender-based violence as a global issue and the implications of a continued lack of state involvement and policies towards domestic violence. Given that an estimated one in three or four women is affected by gender-based violence, any other problem which affected the entire population to that degree would provoke an immediate response, argued Prieto. Instead, the state contributes to men and women's widespread acceptance of gender-based violence, legitimizing inequity in families and society through a lack of criminal sanctions, protection of human and legal rights, and policies to promote access to health and education; and limited or absent resource allocation for implementation and capacity building.

Approaches towards gender-based violence often do not recognize or quantify the costs of gender-based violence to a society, added panel discussant Mark Blackden. Gender-based violence and gender equality have serious consequences not only for health, but also for unemployment, productivity and overall economic development. A cost-based analysis of gender inequality and gender-based violence might encourage stronger leadership of the issue, which is urgently needed to develop a multi-sectoral approach towards combating gender-based violence. National planners must determine how they are to rectify the weak or insufficient policy response to gender-based violence, by addressing legal inequality for women and increasing legal access and education. Leaders must also recognize the nexus between high levels of gender-based violence, gender inequality, and HIV/AIDS, and develop overt measures to tackle all three issues in different sectors of society. "I believe [gender-based violence] is fundamentally a governance issue, and it requires African leadership and engagement on this issue like we have never seen before," concluded Blackden.