Executive summary

Gender-based violence (GBV) is a pervasive human rights issue with public health consequences. It often goes unrecognized and unreported, is accepted as part of the "nature of things" and is shrouded in a culture of silence. Although reliable data on the prevalence of the various forms of GBV remains scarce, the Demographic and Health Surveys (DHS) program have been contributing to the growing body of evidence on one important aspect of GBV by providing national level population-based data on the prevalence, risk factors and consequences of domestic violence experienced by women.

The main purposes of this desk review are to:

1. Assess the levels of domestic violence in sub-Saharan Africa by critically reviewing the findings from available, comparable national DHS reports; and
2. Examine whether the evidence generated by these DHS findings has been used to inform policies and programs as reflected in the country growth and development strategies, such as the first and second generation Poverty Reduction Strategy Papers (PRSPs).

National response to the GBV issue should be comprehensive; thus, the review of these
national planning documents focused not only on domestic violence, but also examined GBV in its broader sense.

The second purpose of this desk review is meant to determine the extent to which governments recognize GBV as a national priority and implement a multisectoral response to tackle the issue.

The review deliberately focuses on the first and second generation PRSPs. This is because unless governments articulate their commitment to addressing GBV through well-defined policies and strategies across multiple sectors (including health, education, criminal justice, judicial, human rights, gender) in its overall growth and development frameworks, it is highly unlikely that required resources will be allocated to achieve the desired reduction in GBV in a systematic and sustainable manner. If GBV is included in a country's framework for growth and development, the Ministry of Finance must consider the budgetary implications and other relevant ministries must also address it in their programs.

This desk review presents DHS findings based on information published in the respective DHS country reports. It does not involve analyses of the primary DHS data. The desk review includes information on domestic violence from comparable DHS surveys in seven sub-Saharan African countries: Cameroon (2004), Kenya (2003), Malawi (2004), Rwanda (2005), Uganda (2006), Zambia (2001-2002), and Zimbabwe (2005-2006).

South Africa was not included in this review because in the DHS country report (1998) the structure of the questionnaire and the format of the report differ substantially from the other seven countries.

The domestic violence module that the DHS program offers to countries consists of comparable questions that have been selected based on experience within the context of the DHS program and elsewhere.

Respondents to the survey are women 15-49 years of age. In almost all countries where questions related to domestic violence were included in the questionnaire, at most, one woman in each household was asked these questions. Thus, the focus was on domestic violence as experienced by women, and primarily on violence within marriage.

The review of national planning documents is based on publicly available documents obtained through online/internet searches. The review focused on two documents for each country:

1. Poverty Reduction Strategy papers (PRSPs) referred to as "First Generation PRSPs" and
2. the more recent national planning frameworks, referred to as "Second Generation PRSPs."

Because the more recent set of documents are titled differently in every country, this desk review refers to them as National Plans of Action (NPAs). Compared to PRSPs, NPAs allow countries greater flexibility and ownership to design realistic macroeconomic frameworks linked more to their national strategies and budgets, and less to the priorities of the World Bank and International Monetary Fund.

The review focused on answering the following
three questions:

1. Is GBV addressed in the national planning documents?
2. In what sections is GBV addressed in the national planning documents and is it included in the list of priorities?
3. Have DHS findings on domestic violence informed policies and programs in the national planning documents?

The national planning documents were systematically reviewed in various ways to examine the extent to which GBV was addressed; word searches on GBV and its different forms, including domestic violence; examination of whether GBV featured in the list of priorities; examination of specific sections on health, education, gender, law and enforcement; as well as the strategies and indicators listed in the corresponding implementation matrices of the documents.

Review of DHS reports with a domestic violence module

The high quality DHS reports provide sound nationally representative quantitative information on domestic violence. The information on violence from the seven DHS reports presented in this desk review focuses on domestic violence against women inflicted by their husbands, but also provides some information about physical violence among all women. After describing types of violence (physical, sexual, emotional), differentials in the percentages of ever-marriedi women who have experienced physical and/ or sexual violence from their husbands are examined. Findings from the DHS reports are briefly described in this executive summary.