The Health-Sector Response to Gender-Based Violence and Sexual Reproductive Health Programmes in Commonwealth and Selected African Countries: A Mixed-Methods Systematic Review and Meta-Analysis

Abstract

The health sector needs to provide a comprehensive evidence-based response to survivors of gender-based violence (GBV). Violence against women and girls (VAWG) and GBV are one of the most prevalent forms of violence and has sexual reproductive health and rights (SRHR) impacts. This paper determines the prevalence and diversity of responses to GBV, VAWG, and SRH, and describes the interventions and associated health outcomes in the 31 Commonwealth and other selected African countries. A narrative synthesis described the diversity of interventions for GBV, VAWG, and SRHR. A meta-analysis of eligible randomised controlled trials (RCTs) was conducted to evaluate the efficacy of interventions aimed at enhancing SRHR knowledge and attitudes among adolescents, couples, and partners. We included 60 studies on GBV, VAWG and SRHR interventions. Nine studies were included in the meta-analysis. A range of education-based interventions for SRHR were implemented resulting in improved SRHR knowledge and attitudes among adolescents, couples, and partners (OR 2.47, 95% CI: 1.51–4.03). When compared with cluster RCTs (OR 2.28, 95% CI: 1.49–4.80), RCTs provided moderate evidence of improving SRHR knowledge and attitudes (OR 1.78, 95% CI: 1.14–2.77). Home-based visits, education-based interventions, one-way or two-way SMS with health education messages, and youth-friendly health services (YFHS) may all be essential for enhancing SRHR knowledge and attitudes among partners, couples, and adolescents.

1. Introduction

Gender-based violence (GBV) and sexual reproductive health and rights (SRHR) continue to pose significant public health and human rights challenges across the Commonwealth and selected African countries [1,2,3]. According to the World Health Organization (WHO), approximately one in three women globally (30%) have experienced physical and/or sexual violence by an intimate or non-intimate partner in their lifetime [4]. A WHO multi-country study on women’s health and domestic violence, conducted in 10 countries, found that between 13% and 62% of women reported experiencing physical violence at some point in their lives [5]. These statistics underscore the pervasive nature of GBV, transcending cultural, geographic, and socioeconomic boundaries.

The World Health Organization (WHO) framework defines GBV as any “harmful act perpetrated against a person, due to socially ascribed gender differences” [6]. Gender-based violence manifests in multiple forms, such as physical, sexual, psychological, and economic abuse [7,8]. Violence against women and girls (VAWG), by contrast, includes all acts of gender-based violence that result in, or are likely to result in, physical, sexual, or mental harm or suffering to women and girls specifically [9,10,11]. This includes threats, coercion, or the deprivation of liberty, whether in public or private life [10]. While GBV can affect individuals of any gender, VAWG is recognised as its most prevalent manifestation [6,12], reflecting the disproportionate burden of violence experienced by women and girls due to entrenched gender inequalities [6,12].

Both GBV and VAWG stem from unequal power relations and gender norms and commonly manifest as intimate partner violence, sexual violence, and psychological abuse [13]. The primary distinction lies in their scope: GBV encompasses violence directed at individuals of any gender, including men, boys, and gender-diverse persons when rooted in gender-based discrimination [9,10,11]. By contrast, VAWG specifically highlights the heightened vulnerability of women and girls and the profound consequences for their health, well-being, and life opportunities [14,15,16]. Accordingly, prevention and response strategies often focus on addressing harmful gender norms, supporting survivors, and promoting gender equality [17].

Gender-based violence undermines women and girls’ health, dignity, and autonomy, and often results in long-term physical and mental health consequences [18,19,20]. Simultaneously, limited access to comprehensive SRHR services such as contraceptives, safe abortion care, maternal health services, and adolescent-friendly care further exacerbates women’s vulnerabilities and reinforces structural gender inequalities [9,18,19,20,21]. Consequently, GBV is associated with physical and psychological ills as well as an overall impact on the social health of the victims and the community in terms of stigma, isolation, and rejection [22,23,24]. The physical consequences of GBV include injury, morbidity, death, the acquisition of sexually transmitted diseases—including HIV—unsafe and complicated abortion, and adverse pregnancy outcomes [21,22,25]. Psychological harm can manifest in the form of depression, post-traumatic stress disorder, increased substance abuse, and suicide [24,26]. Therefore, there is a need to understand the health-sector response to GBV, VAWG, and SRHR to address its physical, mental, and social impacts.

The health sector has an important position in preventing and treating GBV and VAWG, as well as in the protection of SRHR for women and girls [27]. Healthcare workers are uniquely positioned to identify individuals exposed to GBV, administer first-line support and care, and link them to other essential services, such as SRHR programmes [28]. The primary role of the health sector is to contribute towards secondary and tertiary prevention through early detection of GBV and VAWG and mitigation of its impacts, which can prevent poor health outcomes and the reoccurrence of violence [27]. However, the disjuncture between GBV and VAWG programmes and SRHR services continues to perpetuate the unmet healthcare needs of GBV survivors [29,30]. The multisectoral programming model recognises the rights and needs of GBV survivors as important in terms of access to supportive services, guaranteed confidentiality and safety, and the ability to determine steps for addressing GBV [31].

Sexual and reproductive health challenges account for at least 20% of the disease burden globally, especially among women of reproductive age, and 14% for men [32]. The unmet need for essential SRH services such as family planning remains high in African countries [33], where access to SRHR and utilisation by marginalised populations (i.e., women and adolescent girls) who are more vulnerable to poor health outcomes is limited [34]. Interventions aimed at syndemic factors are crucial to address GBV, VAWG, and SRHR health outcomes [35,36]. Educational and behavioural interventions have been implemented to address GBV and VAWG at individual and community levels; however, reports on violence persist [37,38,39].

This situation is antithetical to global development objectives. One of the core aims of the United Nations Sustainable Development Goals (SDGs) 2030 is to ensure gender equality and eliminate disparities across health, education, and economic sectors [40]. Therefore, generating robust evidence on the impact of policies and public health interventions to address GBV and improve SRHR outcomes is essential. Such evidence is critical for informing effective strategies, measuring progress, and holding governments and institutions accountable within the Commonwealth and across African countries. Hence, this study aimed to determine the prevalence and diversity of responses to GBV, VAWG and SRHR, as well as the associated successes and challenges in the Commonwealth and other selected African countries.

2. Methods

2.1. Approach of the Systematic Review and Meta-Analysis

We conducted the systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines [41]. We then published a protocol paper detailing the methods of the systematic review and meta-analysis in the Journal of Interactive Medical Research Protocols [35]. The protocol is registered with the International Prospective Register for Systematic Reviews (registration number: CRD42024520594).

2.2. Inclusion and Exclusion Criteria

The systematic review and meta-analysis included primary studies published on GBV, VAWG, and SRH responses/interventions, along with the associated successes and challenges in the Commonwealth and other selected African countries. The detailed inclusion and exclusion criteria used the Population, Intervention, Comparison, Outcomes, and Study (PICOS) framework [42], and this is described in the published protocol paper [35].

2.3. Online Databases and Search Strategy

We published our detailed search strategy in a protocol paper [35]. Some of the key search terms included “GBV” OR “violence” OR “VAWG” OR “sexual violence” OR “rape” and “SRHR”. We conducted additional searches using the reference lists of eligible studies and reviews on GBV, VAWG, and SRHR, as well as through the artificial intelligence tool Microsoft Copilot. Microsoft Copilot was not used as a primary source retrieval system and did not replace structured database searches. The AI-generated articles were systematically validated through a multi-step process. First, three members of the research team independently verified the 45 AI-generated articles; second, conventional database searches (e.g., PubMed, Embase) were conducted to ensure reproducibility and transparency. Thirdly, to avoid duplication and ensure relevance, the screening, study selection and eligibility assessment were conducted manually using predefined criteria. Lastly, given the known limitations of AI tools in evidence synthesis, including potential omissions and inaccuracies, AI-identified articles were not used without human validation, ensuring methodological rigour and reproducibility.

2.4. Selection and Assessment Process

2.4.1. Stage One: Title and Abstract Assessment

We initially assessed the study titles and abstracts for eligibility and included only studies focusing on GBV, VAWG, and SRH interventions in the 31 Commonwealth and other selected African countries. Additionally, the studies had to be full-text and publicly available to enable full-text screening. Three independent reviewers (EP, RN, KB) conducted the title and abstract assessment using the inclusion and exclusion criteria.

2.4.2. Stage Two: Full-Text Assessment

We used the full-text assessment to identify studies reporting on GBV, VAWG, and SRHR interventions, as well as related outcomes, barriers, and successes. Similarly, as in stage one, four independent reviewers (EP, RN, KB, PN) conducted the full-text review of the studies. In the event of any variances, we consulted a fourth reviewer (PN) for input, and the final recommendation was based on the two reviewers ‘assessment. We excluded review studies, meta-analyses, unpublished studies, and non-English studies. The PRISMA flowchart below shows the eligible studies included in this review (Figure 1).

Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) flowchart summarising the screening process for including eligible articles as of 21 July 2025. GBV: gender-based violence; SRHR: sexual and reproductive health and rights; VAWG: violence against women and girls [35].

2.5. Quality Appraisal

The Critical Appraisal Skills Program Systematic Review (CASPSR) checklist was used to assess the type of instrument(s)/tools used and their characteristics, specifically whether the articles indicated that the reliability and construct validity of the data collection tools were established. Additionally, we assessed whether validation measures were used and extracted information on the sampling method (i.e., convenience or probability-based), whether the sample size was reported, and the response rate. The quality appraisal of the eligible studies is presented in Supplementary Table S1: Summary of study designs and instruments of the eligible studies. The risk of bias in interventional studies was assessed using the Cochrane risk-of-bias method for randomised trials. We evaluated the following domains: random sequence generation, allocation concealment, participant and staff blinding, outcome assessment blinding, inadequate outcome data, reporting bias, and other forms of bias. Three reviewers (EP, RN, KB) independently screened all eligible studies. We evaluated the titles, abstracts, and full texts of the qualifying studies against the inclusion and exclusion criteria. We used the PRISMA checklist to ensure that all the components of the systematic review were transparent and documented (Supplementary Table S2: PRISMA Checklist).

2.6. Data Reporting

The analysis is composed of narrative reporting and meta-analysis.

2.6.1. Narrative Reporting

We summarised information extracted from the full-text eligible articles in figures and tables, and the type of intervention and associated outcomes were used to describe the findings. The Results Section highlights the characteristics of the eligible studies, the types of GBV, VAWG and SRHR interventions, and associated barriers and facilitators.

2.6.2. Meta-Analysis

We conducted a meta-analysis to evaluate the efficacy of interventions aimed at enhancing SRHR knowledge and attitudes in adolescents, couples, and partners. Only studies reporting sufficiently comparable quantitative outcomes on SRHR knowledge and/or attitudes, with adequate statistical information for effect size estimation, were eligible for meta-analysis. Studies examining conceptually distinct outcomes, such as gender-based or sexual violence, were synthesised narratively due to substantial methodological and clinical heterogeneity. Among the interventions, we included module-based friendly health education, school-based SRH education, educational intervention programmes on sexual abstinence based on the health belief model, and YFHS, consisting of integrated youth-dedicated spaces and staffed by youth-friendly peers and providers, once weekly texts instructing them to study on an SRHR topic on their own, and automated two-way SMS. The primary outcome was the SRHR knowledge and attitude score, defined as the knowledge and attitudes acquired during the pre- and post-intervention assessments in both the control and intervention groups. Review Manager Software version 5.4 was used to visualise the results using odds ratios and 95% confidence intervals. We used the random Mantel–Haenszel Method because we anticipated significant heterogeneity across trials owing to the nature of interventions. We used the I² statistic to analyse heterogeneity among studies.

Furthermore, we employed the I² and Ch² subgroup difference tests to analyse heterogeneity between cluster RCTs and RCTs. I² values below 25% were considered minimal heterogeneity, whereas values above 75% were deemed considerable heterogeneity. We conducted further analysis in Stata 19 MP to assess publication bias using Egger’s and Begg’s tests.

2.7. Ethics Consideration

Ethics approval was not required since this manuscript used publicly available data in this systematic review and meta-analysis.

3. Results

3.1. Characteristics of the Eligible Studies

We included 60 studies focusing on GBV, VAWG [28,30,31,37,38,39,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82], and SRHR interventions [83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98] in this review. The characteristics of the studies are summarised in Table 1 and Table 2. The sample sizes of the eligible studies ranged from 31 to 30,563 participants. Ages ranged from 13 to 65 years. The study population was mainly women, followed by men, adolescent girls, young women, healthcare providers, and survivors. South Africa and Kenya were the highest producers of GBV, VAWG, and SRHR, followed by India. Countries such as Uganda, Ethiopia, Rwanda, Tanzania, and Ghana contributed four studies each, while the United Kingdom and Malawi contributed three and two studies, respectively. Most of the studies were randomised controlled trials (RCTs) (n = 18), followed by cluster RCTs (n = 16), mixed-methods studies (n = 7), and qualitative studies comprising in-depth interviews, focus group discussions, etc. (n = 7). The geographical distribution of the eligible studies reporting on GBV, VAWG, and SRHR interventions was across the 31 Commonwealth and other selected African countries. Most of the studies emanated from East Africa (n = 34), followed by Southern Africa (n = 14), and Asia (n = 13). The least contributing regions were West Africa (n = 5), Central Africa (n = 1), Europe (n = 4) and North America (n = 1).

Table 1. Characteristics of the eligible studies focusing on GBV and VAWG interventions in the Commonwealth and selected African countries.

Author, Year	Setting and Country	Participant Characteristics	Study Design and Sample Size	Sample Size	Outcome Measured
Dunkle et al., [43]	Seven districts of Rwanda, spread across the Eastern, Northern and Western provinces	Couples living together or married for at least 6 months prior to enrolment; partners aged between 18 and 49 years old. One member of the couple had to be active in village savings and loan association	Randomised controlled trial	28 sectors, 828 women and 821 men in the intervention group, 832 women and 830 men in the control group	Primary outcomes were perpetration (for men) or experience (for women) of past-year physical/sexual IPV at 24 months post-baseline; secondary outcomes were IPV-related, help-seeking behaviour, children witnessing IPV in the household, beliefs about IPV and community engagement, mental health; exploratory outcomes were economic, parenting, and health-related
Islam et al., [44]	Bangladesh	Midwives providing remote telemedicine services, national and district level managers, and service users—pregnant or postpartum Muslim women, 20–29 years old involved in the telemedicine programme	Case study using mixed methods	8 midwives, 10 managers and 13 sub-district hospitals	GBV screening, counselling, and referral for GBV
Saggurti et al., [38]	India, Mumbai	Women 18–40 years old, contending with a history of IPV and/or husband’s drunken behaviour, resided with her husband in the area of study for a period of 2 months or more; reported that her husband engaged in heavy drinking	2-armed cluster randomised control trial	13 clusters, 220 women	Marital conflict (arguments with husband in past 3 months), marital IPV (physical or sexual violence from husband in past 3 months), and marital sexual coercion (husband forcing sex at last sex)
Gibbs [45]	eThekwini municipality, South Africa	Young people in urban informal settlements	Mixed-methods evaluation	n = 232 young people	Past 3-month experience of sexual IPV among women. Male attitudes towards gender norms and economic empowerment
Leight et al., [46]	Rural Gurague Zone in southern Ethiopia	Men, women, and couples	4-armed cluster randomised control trial	64 villages (kebels), 1344 women in each intervention arm	Women’s past-year experience of physical IPV and secondary IPV
Chaudhury et al., [47]	Rural Southern Kayonza District, Rwanda	Families affected by caregiver HIV—at least one adult HIV-positive caregiver living in the household; at least one school-aged child (7–17 years)	Randomised control trial	82 families total for control and intervention; 93 children and 61 caregivers’ intervention arm, 77 children and 62 caregivers	Primary outcomes: child outcomes Secondary outcomes: IPV and alcohol use among caregivers
Conroy et al., [48]	Zomba district Malawi	Married couples living with HIV, 18 years or older	Pilot randomised control trial	78 married couples (156 individuals); 39 couples in the control group and 39 in the intervention group	Couple conflict and violence, improved relationship dynamics
Doyle et al., [49]	Karongi, Musanze, Nyaruguru and Rwamagana districts, Rwanda	Couples, men, and women. Men between the ages of aged 21–35 years, married or cohabitating, expectant and/or current fathers of children under five years	Randomised control trial (2-arm multi-site)	575 couples in the intervention arm (575 men and 575 women), 624 couples in the control arm (624 men and 624 women)	Primary outcomes: experience of physical and sexual IPV, women’s attendance and men’s accompaniment at ANC, modern contraceptive use, and partner support during pregnancy
Kilburn et al., [50]	Mpumalanga, South Africa	Young women, 13–20 years old, enrolled in high school	Randomised control trial	2448 young women, 1225 treatment group and 1223 control group	IPV and causal pathways
Parcesepe et al., [51]	Mombasa, Kenya	Women 18 years and older	Randomised control trial	818 women (410 intervention arm and 408 control arm)	Recent violence (physical violence, verbal abuse, and being robbed) from paying and non-paying sex partners and engagement in sex work in the past 30 days
Matthews et al., [52]	Western Cape, South Africa	School-going adolescent girls	Cluster randomised control trial	42 schools (20 intervention—1748 girls; 22 control—1703 girls)	IPV victimisation, IPV perpetration
Agde et al., [53]	Hadiya Zone, Ethiopia	Pregnant women	Cluster randomised control trial	16 clusters, 8 intervention and 8 control; 432 pregnant women	IPV during pregnancy
Kalokhe et al., [54]	Pune, India	Married couples, 18 years or older, married for less than a year	Randomised control trial-pilot study	Groups of 3 to 5 married couples assigned to intervention or control arm, non-random assignment	Preliminary efficacy in preventing IPV; mental health among women
Addo-Lartey et al., [55]	Central region of Ghana	Women 18 to 49 years and men 18 years and above	Randomised control trial (Mixed-methods unmatched cluster)	82 households per cluster	Incidence of IPV in the past year, mental health and indicators of violence against women
Matseke & Peltzer [56]	Mpumalanga, South Africa	Pregnant women aged 18 years and older	Pre-post intervention	160 women	IPV incidence
Wagman et al., [57]	Rakai, Uganda	Both males and females of all ages	Mixed-methods process evaluation	1407 participants; 824 women and 583 men	IPV reduction
Haberland et al., [37]	Nairobi, Kenya	Women attending ANC; first visit aged 15 to 49 years	Randomised control trial (2-armed)	698 women	IPV-related knowledge
Settergren et al., [39]	Tanzania, Mbeya region	Women in the households aged 15 to 49 years	Cluster randomised control trial	12 clusters, 656 women in the intervention arm and 642 in the control arm	Recent experience of IPV utilisation of GBV services
Kuo et al., [58]	South Africa	Teenage school-going boys aged 15 to 17 years	Pilot randomised control trial	282 boys; 141 in the intervention school and 141 in the control school	IPV frequency and endorsement of IPV supportive attitudes
Starmann et al., [31]	Kampala, Uganda	Couples	Cluster randomised control trial	n = 929,358 women and 571 men	Relationship quality and less violence.
Jewkes et al., [59]	South Africa	Grade 8 students, girls, and boys	Cluster randomised control trial (3 arm)	24 clusters	Incidence of IPV, severe IPV and non-partner rape
Ogum Alangea et al., [60]	Ghana	Men 18 years and older, women 18–49 years	Randomised control trial	2000 women and 2126 men	IPV, severity of IPV experiences of women and perpetration by men
Javalkar et al., [30]	India	Female sex workers aged 18 years and above	Cluster randomised control trial	47 villages for the intervention arm, 620 FSWs	IPV incidence, associated factors
Ranney et al., [61]	Kenya	Patients’ mean age:15.9 years with 50% younger than 14 years old; predominantly female and single	Retrospective study	n = 321	Feasibility of GBV intervention; knowledge of GBV intervention
Rees & Joyner [62]	South Africa	Health workers, women, and health managers	Qualitative evaluation. Semi-structured interviews and focus group discussions		IPV services
Joyner & Mash [63]	South Africa	Primary healthcare providers, managers, academics, NGO leaders	Qualitative Focus groups and key informant interviews	n = 114	IPV screening and management
Joyner & Mash [64]	South Africa	Women experiencing IPV seeking primary care, health workers, and managers	Key informant interviews and focus group discussions	Inquiry group consisted of 4 nurses, 1 doctor and 1 qualitative researcher.	IPV screening
Matseke, Peltzer, Mlambo [65]	South Africa	Pregnant women experiencing partner violence	Cross-sectional study	n = 1502	IPV factors
Odero et al., [66]	Nyanza Province, Kenya	Service providers	Qualitative	A total of 90 men and women participated in 9 focus group discussions and 20 in-depth interviews.	IPV services
Turan et al., [67]	Kenya	Pregnant women seeking ANC, clinic staff, and community volunteers.	Mixed methods. Cross-sectional study, focus group, and in-depth interviews.	2 focus groups and 25 in-depth interviews with healthcare workers and community members.	IPV services and risk assessment
Colombini et al., [68]	Malaysia	Healthcare providers, policy makers and key informants in 7 hospital facilities.	Qualitative	74 semi-structured interviews were conducted; 12 key informants	GBV interventions
Quiroga & Terrón-Caro, [69]	Lamu, Kenya	Women			GBV interventions
Mutisya et al., [70]	Kenya	Pregnant women aged 18–45 years seeking ANC services in the selected health facilities, being in the first or second trimester of pregnancy and having a positive GBV score	Quasi-experimental design	n = 288, n = 144 in each arm	Mental health
Nathane-Taulela, [28]	7 provinces of South Africa North West, Mpumalanga, Gauteng, Free State, KwaZulu-Natal, Limpopo	Women	Mixed-methods design that included qualitative and quantitative components	n = 191	Knowledge of GBV/femicide interventions
Daruwalla et al., [71]	Mumbai, India	Women or men aged 18–65 years	Cluster randomised control trial	48 informal settlement (slum) clusters, each of 500 dwellings; 24 clusters allocated randomly to receive the intervention and 24 to control	Primary outcomes: physical or sexual domestic violence, and prevalence of emotional or economic domestic violence, control, or neglect; secondary outcomes: disclosure of violence to support services, community tolerance of violence against women and girls, prevalence of non-partner sexual violence, and mental health and well-being
Knettel, [72]	Cape Town, South Africa	Women initiating ARVs	Randomised control trial (pilot trial of ImpACT) intervention	A total of 64 eligible participants were enrolled in the trial, and 32 were randomly assigned to the ImpACT	Sexual trauma and HIV care
Uysal et al., [73]	Nairobi, Kenya	Women and girls seeking contraceptive services	Randomised control trial (matched-pair cluster control trial)	Three clinics in the intervention group and three clinics in the control group	Reduction in reproductive coercion and intimate partner violence
Le Port et al., [74]	Rural, Senegal	Adolescent girls and young women aged 14 to 34. It was done in March 2020 in 14 villages	Process evaluation involving individual semi- structured interview, observations of screening sessions and post-screening discussions	100 participants consisting of men, women, adolescent girls, village chiefs and implementers	GBV, SRH and MCH social norms
Norbu & Zam, [75]	Bhutan	Healthcare workers comprising medical doctors, nurses, health assistants, clinical officers, and basic health workers across, policymakers and programme managers	Not specified	n = 660 healthcare workers	GBV outcomes, i.e., prevalence, reporting, and services
Thomas et al., [76]	Urban or peri- urban Kampala and Wakiso Districts of Uganda	Healthcare service providers, with median age of 36 years, offering post-GBV care to clients	30 in-depth interviews with providers implementing GBV screening and/or referral.	67% of respondents were female and 57% were counsellors	GBV screening and referral, i.e., knowledge, skills, attitudes,
Kapiga et al., [77]	Mwanza city, Tanzania	Women taking part in a microfinance loan scheme in Mwanza city, north-western Tanzania, in collaboration with BRAC, an established microfinance provider in Tanzania.	Randomised control trial (cluster)	485 in the intervention group; 434 in the control group	Physical or sexual intimate partner violence
Colombini et al., [78]	Malaysia	In-depth interviews with key informants from governmental and non-governmental organisations	Policy analysis of legal, policy and regulatory framework documents, and in-depth interviews with key informants	20 interviews with key informants	GBV intervention
Sikder et al., [79]	Bangladesh, Brazil, Nepal, Rwanda, Sri Lanka	Health providers, policymakers, service users (survivors)	Synthesised from 30 documents (11 publications + 19 programme reports)	Five countries	Health systems response on violence against women
Sohal et al., [80]	United Kingdom	Women aged 16 years and above registered at general practices	A segmented regression interrupted time series analysis	144 general practices	Healthcare response to domestic violence and abuse
Olum et al., [81]	Kenya	Sexual violence survivors	Retrospective cross-sectional study	3122 girls/women and 384 boys/men	Sexual violence reporting
Warren-Gash et al., [82]	London, United Kingdom	Males and females attending outpatient clinics	Observational cross-sectional and retrospective cohort analysis	n = 10,158 participants	Screening for domestic violence

Table 2. Characteristics of the eligible studies focusing on SRH interventions in the Commonwealth and selected African countries.

Author, Year	Setting and Country	Participant Characteristics	Study Design and Sample Size	Sample Size	Outcome Measured
Alekhya et al., [83]	Urban areas of Odisha, India	Adolescent girls	Randomised control trial (cluster)	Eight schools	SRHR education
Temmerman et al., [84]	Mombasa, Kenya	Survivors and perpetrators of violence		Total sample of 6575, of which n = 5837 were females and n = 738 were males	HIV and SRH service outcomes psychological care legal
Millani et al., [85]	Tanzania	Adolescents’ mean age was 15 ± 1.869 with 57.5% females	Randomised controlled trial (double-blinded clustered)	n = 660 adolescents	SRHR education
Baku et al., [86]	Ghana	Parents of adolescent girls aged 26 to 63 years	Randomised control trial (cluster)	n = 145	Sexual education; sexual abstinence
Friedberg et al., [87]	Kenya	Female and male adolescents	Two-year randomized controlled trial	n = 3263 female and n = 828 male	GBV and mental health
Boti Sidamo et al., [88]	Ethiopia	First-year students	A quasi-experimental study	A total of 832 and 820 students participated in a baseline and post-test respectively	Sexual and reproductive health education practice, receptive penetrative sex, comprehensive knowledge of HIV/AIDS, and attitude on HIV/AIDS
Boku et al., [89]	Guji Zone, Ethiopia	Adolescents	Cluster randomised controlled trial	759 adolescents among 15 intervention and 15 control clusters; intervention group (n = 375) and control group (n = 384)	SRHR knowledge and prediction
Ampt et al., [90]	Kenya	Female sex workers	Development and qualitative study	n = 42	SRH behaviour change constructs, SRH intervention feasibility and acceptability
Constant et al., [91]	Cape town, South Africa	Healthcare providers registered as nurses and those experienced in providing medical abortion	Randomised controlled trial	469 participants received standard abortion care, and 234 women were allocated to receive the intervention	Out-of-clinic self-assessment of abortion outcome, i.e., ongoing pregnancies or the need for vacuum aspiration or extra misoprostol; provider’s assessment of the need for manual vacuum aspiration or additional misoprostol at follow-up
de Tolly & Constant [92]	South Africa	Women	Randomised control trial	In the RCT, 234 women were randomised to the intervention group	Feasibility and efficacy of mobile-phone-based medical abortion services
Aiken et al., [93]	Republic of Ireland and Northern Ireland	Women living in the Republic and Northern Ireland	Population-based study	1000 women who underwent self-sourced medical abortion through Women on Web (WoW)	Successful medical abortion outcomes, care-seeking for symptoms of potential complications and adverse events after self-sourced medical abortion through online telemedicine
Gichangi et al., [94]	Kwale County, Kenya	Men and women aged 18–24 years	Randomised controlled trial (three-arm, unblinded)	740 participants (n = 255 intervention; n = 249 contact and n = 236 control)	Delivery of SRH information using technology (SMS) and contraception-related myths and misconceptions
Harrington et al., [95]	Public hospitals in the Kisumu and Siaya counties of western Kenya	Female participants attending the antenatal clinic, aged 14 years and above, pregnant, with an estimated gestational age of 28 weeks or more and a reported HIV-negative status	Randomised controlled trial (unblinded)	260 women were randomised into the to 2-way SMS or control and 103 male partners were enrolled.	Current self-reported use of a highly effective contraceptive (HEC) method at 6 months postpartum
Lemani et al., [96]	Lilongwe, Malawi	Sexually active women aged < 30 years who had never used a modern FP method	A cluster randomised trial	30 health surveillance assistant (HAS) and family planning client	53% of the young women were counselled by the 15 HSAs who received couples counselling training, and 47% were counselled by the 15 HSAs who did not
Levy et al., [97]	Kenya	Pregnant adolescent girls, adolescent mothers (ages 10–19) and their infants (0–24 months) between March 2018 and February 2019	Quasi-experimental design	n = 384	Health and social service uptake among pregnant adolescent girls and adolescent mothers
Macharia et al., [98]	Kibra, Kenya	Adolescents aged 15 to 19 years residing in Kibra, Kenya, who had to have access to a phone and be available for the 3-month follow-up visit	Randomised controlled trial	Intervention group: n = 146 Control group: n = 154	Provision of on-demand SRH information
Yakubu et al., [99]	Northern Ghana	Adolescent girls aged 13–19 years	Cluster randomized control trial	363 adolescent girls	Sexual abstinence
Rosenberg et al., [100]	Malawi	Adolescent girls and young women aged 15–24 years	A Quasi-Experimental Cohort Study	n = 1000	Youth friendly health services

Distribution of Published Studies per Five-Year Period

The publications were mainly available for the period 2011–2015 (n = 29), compared with 2016–2020 (n = 21) and 2021 to date (n = 16) (Figure 2). In the years 2016 (n = 7), 2020 (n = 2020), and 2023 (n = 2023), more studies reporting on “GBV, VAWG, and SRHR” were published. However, fewer studies were published in 2011, 2025, and 2017. There was a decline in publications between 2023 and 2025. This might reflect a publication lag and an incomplete indexing of recent studies, rather than a complete reduction in research activity, as delays between manuscript submission and publication can extend over several months or longer.

Figure 2. Number of studies on GBV, VAWG, and SRHR by year.

3.2. Narrative Results

3.2.1. Cultural Approaches to GBV and VAWG Control

The interventions implemented to address GBV and VAWG in the Commonwealth and other selected African countries were culturally and socially diverse, ranging from interventions that challenged patriarchal norms [37,38,39,54], addressing gender equality by engaging men and women [49,53,58]; strengthened communities by tackling inherent social and economic dynamics [31,48,50,51,77]; and promoted women’s empowerment and survivor support programmes [55] (Table 3) to interventions that aimed to address power relations, change harmful social norms and beliefs through education and community engagement, and promote an equitable and gender-sensitive community.

Table 3. Summary of studies reporting on cultural approaches to GBV and VAWG control.

Author, Year	Country	Approach	Main Findings
Haberland et al., [37]	Nairobi, Kenya	Challenging patriarchal norms	“Women who experienced IPV, were more likely to: Disclose violence to their counselor than women receiving standard care (32% vs. 7%, p < 0.001), Talking with their counselor made a positive difference (aOR 2.9; 95% CI 1.8, 4.4; p < 0.001) and; They felt more confident in how they deserved to be treated (aOR 2.7; 95% CI 1.7, 4.4; p < 0.001).”
Saggurti et al., [38]	India	Challenging patriarchal norms	RHANI Wives intervention “showed reductions in marital conflict (RR 0.4; 90% CI, 0.1–0.9; p = 0.06) and marital sexual coercion (RR 0.2; 90% CI, 0.05–0.9; p = 0.08)”. However, the intervention did not show reduced association with IPV.
Settergren et al., [39]	Mbeya Region, Tanzania	Challenging patriarchal norms	The comprehensive health facility- and community-based programme contributed 15% reduction, but the effect was not statistically significant. The programme led to increased utilisation of GBV services at health facilities: n = 1427 GBV visits versus n = 489 visits in the intervention groups versus control group.
Kalokhe et al., [54]	Pune, India	Challenging patriarchal norms	Couples-based intervention: No reported physical or sexual IPV events in either group. “Fewer incidents of psychological abuse in intervention group (3/17, 18%) versus counterparts (4/16, 25%) at 3-month follow-up. No significant improvement in the mental health of female in the intervention group and declines in the control group (change in mean General Health Questionnaire-12 score: −0.13 in intervention vs. 0.13 in controls; p = 0.10)”.
Doyle et al., [49]	Karongi, Musanze, Nyaruguru and Rwamagana districts, Rwanda	Gender equality	Gender-transformative Bandebereho couples: Women in the intervention group versus those in the non-intervention group reported “Lower odds of past-year physical (OR 0.37, p < 0.001) and sexual IPV (OR 0.34, p < 0.001); Greater attendance (IRR 1.09, p < 0.001) and male accompaniment at antenatal care (IRR 1.50, p < 0.001); Women and men in the intervention group reported: less child physical punishment (women: OR 0.56, p = 0.001; men: OR 0.66, p = 0.005); Greater modern contraceptive use (women: OR 1.53, p = 0.004; men: OR 1.65, p = 0.001); Higher levels of men’s participation in childcare and household tasks (women: beta 0.39, p < 0.001; men: beta 0.33, p < 0.001) and; Less dominance of men in decision-making”.
Agde et al., [53]	Ethiopia	Gender equality	Couple-based violence-prevention education (CBVPE) in reducing IPV during pregnancy in rural areas: “Reduction in IPV during pregnancy from 39.4% at baseline to 13.0% at endline (p < 0.001). Women in the intervention group were less likely to report: any IPV (aOR = 0.259; 95% CI 0.161–0.417); psychological IPV (aOR = 0.249; 95% CI 0.153–0.406); physical IPV (aOR = 0.282; 95% CI 0.162, 0.490) and sexual IPV (aOR = 0.338; 95% CI 0.172, 0.661) during pregnancy compared to the control group.”
Kuo et al., [58]	South Africa	Gender equality	Schools championing a safe South Africa: “Attempted acts of any sexual violence perpetration reduced from 49% (95% CI: 40%, 58%) at baseline to 25% (95% CI: 17%, 33%) at 1 month, with a percentage difference of 22% (95% CI: 11%, 32%; p < 0.001)”.
Kapinga et al., [77]	Mawanza City, Tanzania	Partner engagement and empowerment	Social empowerment intervention and finance scheme: “Women in the intervention arm were less likely to report physical intimate partner violence (aOR 0.64, 95% CI 0.41–0.99; p = 0.043) and were less likely to express attitudes accepting of intimate partner violence (0.45, 0.34–0.61; p < 0.0001) or beliefs that intimate partner violence is a private matter (0.51, 0.32–0.81; p = 0.005) or should be tolerated (0.68, 0.45–1.01; p = 0.055)”.
Conroy et al., [48]	Zomba, Malawi	Partner engagement and empowerment	Mlambe relationship-strengthening programme: “At 10- and 15-month follow-up visits, Couples in the intervention arm showed greater increases in couple communication, unity, sexual satisfaction, intimacy, and trust (Cohen’s d ranged from 0.36 to 0.56; p < 0.05) as compared to those in Enhanced Usual Care arm at both 10 and 15 months follow ups”. “Intervention couples also reported reduction in physical and emotional IPV (Cohen’s d ranged from 0.33 to 0.49; p < 0.05)”. “Women reported significantly greater improvements in relationship quality than men, except for sexual satisfaction (p < 0.05), and greater declines in physical IPV than men (p < 0.05)”.
Kilbur et al., [50]	South Africa	Partner engagement and empowerment	Conditional cash transfer programme: “The intervention interacted with mediators of violence leading to larger reductions in IPV risk compared to the total effect of the CCT on any physical IPV [RR 0.66, CI(95%):0.59–0.74]”. “The largest reductions under no sexual debut [RR 0.57, CI(95%):0.48–0.65] or under no sexual partner in the last 12 months [RR 0.53, CI(95%):0.46–0.60]”.
Parcesepe et al., [51]	Mombasa, Kenya	Partner engagement and empowerment	Alcohol harm-reduction intervention: “The alcohol intervention was associated with significant decreases in physical violence from paying partners at 6 months post-intervention (0.45 (0.23, 0.85) and verbal abuse from paying partners immediately post-intervention (0.54 (0.36, 0.82) and 6-months post-intervention (0.59 (0.38, 0.92)”. “Women in the intervention arm had lesser odds of engaging in sex work immediately post-intervention and 6-months post-intervention”.
Starmann et al., [31]	Uganda	Community engagement	SASA! community mobilisation programme: “Communication materials and mid media channels generated awareness and knowledge, while the concurrent influence from interpersonal communication as well as changes in behaviour”.
Ogum Alangea et al., [55]	Central Region of Ghana	Women’s empowerment and survivor support programmes	Rural response system: “Intervention versus non-intervention group: higher odd of reporting sexual violence (aOR = 0.259; 95% CI 0.161–0.417)”.

3.2.2. Challenging Patriarchal Norms

Haberland et al. [37] included an intervention focused on addressing IPV and power dynamics among intimate partners and their impact on women’s health in Kenya. The intervention empowered healthcare providers through IPV training and screening, client messaging on IPV and power dynamics, and the provision of a counsellor to facilitate timely referrals and follow-ups for IPV-related services. Women who received IPV/power-enhanced counselling had greater IPV knowledge compared to women in the control group, although the difference was borderline significant after controlling for covariates (p = 0.051). A household- and community-focused intervention addressing marital conflict by building women’s skills to negotiate and find resources in India reported that women in the intervention group were likely to disclose their IPV status and follow up on referrals for IPV services [38]. The marital conflict challenges were mainly sexual relationships, financial and family pressures, and the husband’s use of alcohol. Intention-to-treat analyses did not show reductions in IPV, but significant changes were observed for marital conflict (RR 0.4; 90% CI, 0.1–0.9) and marital sexual coercion (RR 0.2; 90% CI, 0.05–0.9) [38].

A cluster randomised trial evaluated a comprehensive mHealth facility and community-based programme delivered through the HIV/AIDS programme platform to reduce GBV and improve care for survivors in Tanzania [39]. The likelihood of reporting GBV decreased over time in the absence of the intervention (time effect OR = 0.71, 95% CI: 0.57–0.89), but the intervention’s effect on GBV remained significant. At the community-wide level, the GBV intervention was reported to have improved GBV knowledge and fostered community-oriented strategies to tackle GBV. In India, Kalokhe et al. [54] implemented a couples-based primary prevention intervention for IPV that included relationship dynamics, self-esteem, SRHR components, and IPV-related norms. Married women in both the intervention and non-intervention arms reported no cases of IPV.

3.2.3. Addressing Gender Equality by Engaging Men and Women

Doyle et al. [49] implemented a “gender-transformative Bandebereho couples” intervention to promote male engagement in reproductive and maternal health and violence prevention. Women in the intervention arm reported reduced past-year physical (OR 0.37, p < 0.001) and sexual IPV (OR 0.34, p < 0.001) and greater ANC attendance (IRR 1.09, p < 0.001) and male accompaniment at ANC visits (IRR 1.50, p < 0.001). “Schools Championing Safe South Africa” is an intervention that seeks to address sexual violence perpetration and HIV/STI risk behaviour among teenage boys by implementing corrective programmes that address harmful social norms and risky behaviour [58]. The programme showed a reduction in attempted acts of any sexual violence perpetration at baseline (95% CI: 40%, 58%) and at one-month follow-up (95% CI: 17%, 33%). However, this change was not observed at six months (47–43%; p = 0.446). Another study in Ghana explored a rural response system to tackle the incidence of all forms of violence against women and violence perpetrated by men, as well as to preserve women’s human rights through state and community-based structures [53]. The response system also showed improved knowledge of violence, changes in behaviour at the individual and community level towards gender equality and violence, social norms, and support for victims/survivors.

3.2.4. Strengthening Partner Engagement and Communities by Tackling Inherent Social and Economic Dynamics

Social protection programmes, such as cash transfers, have been promoted as part of GBV and VAWG prevention [50]. The provision of conditional cash transfers delayed early sexual debut and reduced the number of sexual partners among school-going girls aged 13–20 years in South Africa. An alcohol intervention implemented in Kenya was associated with a reduction in physical abuse by paying clients among female sex workers [51]. Starmann et al. [31] assessed the role of a community mobilisation approach in preventing IPV and HIV, as well as women’s acceptance of new behaviours concerning IPV in Uganda. Interpersonal communication, community-based change agents, and social networks were linked to improved IPV awareness and knowledge, as well as behaviour change. The combination of community mobilisation components, reflection on people’s lived experiences, and context-specific support from local change agents can facilitate behavioural change towards violence within communities. An “economic and relationship-strengthening intervention” for addressing alcohol use and violence among married couples living with HIV in Malawi reported significant decreases in physical and emotional IPV (“Cohen’s d ranged from 0.33 to 0.49; p < 0.05”) in the intervention arms [48]. Women reported improvements in relationship quality and declines in physical IPV compared to men (p < 0.05). The intervention comprised incentivised savings accounts, financial literacy and relationship education, and couples counselling sessions to build relationship skills. Similarly, Kapinga et al. [77] described the positive impact of microfinancing in addressing IPV cases, norms, and behaviours in Tanzania.

3.2.5. Promoting Women’s Empowerment and Survivor Support Programmes

Some studies have shown no effect or have shown increased risk among women in the intervention arm. For example, women who received intervention on couple-based violence-prevention education had higher odds of reporting IPV than their counterparts (aOR = 0.259; 95% CI 0.161–0.417) [55].

3.2.6. Interventions for Prevention and Control of GBV/VAWG

Twenty-three studies described the GBV interventions and their associated outcomes [30,31,37,38,39,46,47,48,49,50,51,54,56,58,59,60,70,72,77,87]. The interventions ranged from educational (n = 20 studies) to behavioural (n = 8 studies) to telehealth (n = 4 studies) and were aimed at preventing and controlling GBV and related health outcomes (Table 4). Additionally, economic interventions through microfinancing, cash transfers, and telehealth were also implemented to address GBV. These interventions were implemented at individual, group, facility, and community levels.

Table 4. Interventions for the control of GBV, VAWG and SRHR improvement.

Author	GBV and VAWG Interventions	Category and Level	Summary of the Findings
Haberland et al. [37]	The intervention included training and support for HIV counsellors, a take- home card for clients, and an on-site IPV counsellor.	Educational; individual	Women experiencing IPV were more likely to disclose their experience and had confidence in treatment
Kilburn et al. [50]	Conditional cash transfer (CCT) targeted to poor girls in high school	Economic; individual	The intervention mediated factors that could lead to IPV risk rather than IPV outcomes; CCT delayed sexual debut and decreased the number of sexual partners
Parcesepe et al. [51]	Alcohol harm-reduction intervention	Behavioural; individual	Decreased physical and verbal violence from paying partners and reduced the odds of engaging in sex work
Saggurti et al. [38]	Reducing HIV among non-infected wives: an intervention on marital conflict and intimate partner violence	Mixed—rural, education, and economic; individual	Reduced marital conflict and sexual coercion among women
Settergren et al. [39]	Comprehensive health facility- and community-based programme delivered through the HIV/AIDS platform	Educational facility and community	Lower odds of reporting GBV experience, increased use of GBV services at the facility level and improved access to SRH services, such as HIV testing
Starmann et al. [31]	SASA! a community mobilisation approach for preventing HIV and violence against women	Educational; community	Awareness and knowledge and changes in behaviour
Leight et al. [46]	Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples	Behavioural; individual group	Men: reduced frequent past-year alcohol and increase in khat; women: an increase in symptoms of moderate depression
Chaudhury et al. [47]	Family-based intervention	Behavioural	Reductions in alcohol use and IPV among caregivers
Conroy et al. [48]	Economic and relationship-strengthening intervention to address alcohol use and HIV treatment adherence for couples	Mixed—economic and behavioural; individual	Reduced IPV and improved relationship quality; women reported a lower relationship quality and reduced physical IPV than men
Doyle et al. [49]	Gender-transformative Bandebereho couples’ intervention to promote male engagement in reproductive and maternal health and violence prevention	Behavioural; individual	Women reported reduced past-year physical and sexual IPV; improved attendance and male accompaniment at antenatal care; both women and men reported less child physical punishment; men reported increased modern contraceptive use; higher levels of men’s participation in childcare and household tasks; and ess dominance of men in decision-making
Agda et al. [53]	Couple-based violence-prevention education	Educational; couple	Reduced IPV during pregnancy; reporting on IPV during pregnancy, there was reduced psychological, physical, and sexual violence during pregnancy
Kuo et al. [58]	Schools Championing Safe South Africa is an intervention to prevent sexual violence perpetration and HIV/STI risk behaviour among teenage boys	Behavioural; school	Short-term reduction in sexual violence perpetration
Jewkes et al. [59]	Skhoskho-school intervention to prevent gender-based violence	Educational; school	Girls had no changes in IPV experience and incidence of non-partner rape
Alangea et al. [60]	Rural response system (RRS) intervention, which uses community-based action teams to prevent IPV by raising awareness and supporting survivors	Educational; community	Reduced physical IPV prevalence, no effect on the violence perpetrated by men, lower emotional IPV, reduced women’s depression scores and reports of male partner controlling behaviour
Javalkar et al. [30]	Samvedana Plus multilevel intervention to reduce violence and increase condom use	Behavioural; community	Decreased acceptance of IPV, increased awareness of self-protection strategies, and increased solidarity of sex workers around issues of IPV
Mutisya, Ngure, Mwachari [70]	Psychosocial intervention to reduce gender-based violence and antepartum depressive symptoms in pregnant women	Behavioural; individual	The difference between the psychosocial intervention and the usual antenatal care group in the total IPV and physical violence: no difference in proportion of women reporting other acts of GBV by intimate and non-intimate partners post-intervention, and lower mean depression scores in the intervention arm compared to non-intervention arm
Knettel et al. [72]	Improving AIDS care after trauma (ImpACT)—a counselling intervention aimed at reducing the negative impact of sexual trauma and HIV	Educational; individual	Women reported feelings of shame, sadness, and anger that led to social isolation, mistrust, and damaged relationships; motivation to continue with long-term HIV care; and clearer understanding of barriers and facilitators to ARV adherence
Kapiga et al. [77]	Microfinance loan	Economic; individual	“Women reporting past-year physical or sexual intimate partner violence were less likely to express attitudes accepting of intimate partner violence or beliefs that intimate partner violence is a private matter or should it be tolerated”
Islam et al. [87]	Telemedicine programme	Telehealth; facility	Over 6917 women were screened for GBV, 223 received counselling and 34 referrals were made; increase in the frequency of GBV experiences over time following the implementation of the telemedicine programme
Kalokhe et al. [54]	Ghya Bharari Ekatra (GBE), a couples-based primary prevention intervention for IPV among newly married couples	Educational and behavioural; couple	No reported physical or sexual IPV events in either group, fewer incidents of psychological abuse in GBE participants at 3-month follow-up, and improvement in the overall mental health of female intervention participants
Matseke & Peltzer [56]	Training community workers on IPV for pregnant women	Educational; community	The mean danger assessment score of 6.0 before intervention fell significantly to 2.8 after 3 months
Wagman et al. [82]	The Safe Homes and Respect for Everyone (SHARE) intervention for preventing Intimate partner violence and HIV infection	Educational; individual	Two-thirds of those who participated in SHARE felt it influenced behaviour change related to IPV
Author, Year	SRHR Interventions	Category and Level	Summary of the Findings
Alekhya et al. [83]	School-based sexual and reproductive health education	Educational; school	Positive change in knowledge, attitude, and practices pertaining to SRH; improved awareness of different methods of contraception, and increased awareness of STIs/RTIs
Boku et al. [89]	School-linked module-based friendly health education on SRH	Educational; school	Overall, SRH knowledge and confidence increased overtime
Gichangi et al. [94]	Informational SRH text messages on demand	Telehealth and Educational; individual	Reduced the number of myths and misconceptions on SRH
Harrington et al. [95]	2-way short message service (SMS) with a nurse on postpartum contraceptive use	Telehealth and educational; individual	Improved postpartum contraceptive use; male participation also improved contraceptive use
Lemani et al. [96]	Couples counselling training for community health workers	Educational; community	Trained health surveillance assistants improved the uptake of family planning; couples counselling increased male involvement and uptake on family planning, i.e., condoms or dual methods.
Levy et al. [97]	Home-visiting programme	Educational; individual	Increased use of modern family planning; pregnant adolescent girls gave birth under a skilled healthcare professional
Macharia et al. [98]	Unstructured supplementary service-data-based mhealth app for SRH information	Telehealth and educational; individual	Improved SRH knowledge, i.e., identification of STI, seeking STI services and decision-making
Millanzi et al. [85]	Problem-based pedagogy + reproductive health lesson materials	Educational; individual	Hybrid PBP was associated with higher soft skills for safe sexual behaviours
Sohal et al. [80]	Reproductive health text-messaging programme	Telehealth and educational; individual	Unidirectional and interactive interventions lowered the odds of self-reported pregnancy for sexually active participants; no changes in reproductive health outcomes overall
Rosenberg et al. [100]	“Youth-friendly health services, consisting of integrated youth-dedicated spaces and youth-friendly peers and providers”	Youth-friendly health services	YFHS models improved access to HIV testing, condoms, and hormonal contraception than SOC models
Boti Sidamo et al. [88]	Adolescents’ SRHR access and utilisation of services	Behavioural	Lack of SRH literacy, lack of outreach activities, and integration of SRHR information in health facilities often hamper adolescents
Yakubu et al. [99]	Comprehensive sex education programme “comprising lessons on susceptibility and the severity of teenage pregnancy, personal and community values, female reproductive system, contraceptives and decision-making”	Educational; individual	Improved sexual abstinence and the knowledge of adolescents on pregnancy prevention among the intervention group

Alangea et al. [55] implemented a “Rural Response System intervention—Community-Based Action Teams”—and reported reduced physical and emotional IPV among women. The women reported reduced male controlling behaviours and lower levels of depression (difference in difference (DID) = −2.7 (−3.3–1.0), p = 0.002; DID = −4.8 (−8.0–1.5), p = 0.005; respectively). However, the intervention had no effect on violence perpetrated by men. A multilevel intervention among sex workers, their intimate partners, and communities was initiated to reduce IPV and to encourage condom use [54]. That study reported increased awareness of self-protection strategies (aOR = 1.73, 95% CI = 1.04–2.89, p = 0.035) and solidarity of sex workers around IPV issues (aOR = 1.69, 95% CI = 1.02–2.82, p = 0.042).

An alcohol harm-reduction intervention was assessed among female sex workers aged 18 years and above in an HIV prevention drop-in centre in Mombasa, Kenya [37]. The intervention was associated with reduced physical (OR = 0.45, 95% CI = 0.23–0.85, p = 0.01) and verbal abuse (OR = 0.59, 95% CI = 0.38–0.92, p = 0.02) at six months post-intervention. Starmann et al. [31] also reported IPV awareness and knowledge, as well as behavioural changes, using a community mobilisation approach.

Economic interventions such as microfinancing and conditional cash transfers (CCTs) were found to be effective in reducing IPV incidence among young women and adolescent girls [46,50,77]. CCTs were associated with delayed sexual debut or a reduced number of sexual partners, leading to larger reductions in IPV risk [RR 0.66, CI (95%): 0.59–0.74] [50]. A randomised controlled trial piloted a mixed economic and relationship-strengthening intervention among 78 married couples living with HIV and reporting unhealthy alcohol use in HIV care clinics in Malawi [46]. The couples in the intervention group reported a significant decrease in physical and emotional IPV at 10- and 15-month follow-up visits when compared with those in enhanced universal care (Cohen’s d ranged from 0.33 to 0.49; p < 0.05). Additionally, women reported a greater decline in physical IPV than men (p < 0.05). The intervention included the incentivising of savings accounts, financial literacy and relationship education, and couples counselling sessions to build relationship skills [46]. In Tanzania, Kapinga et al. [77] evaluated the effect of a violence-prevention strategy among women participating in a group-based microfinance scheme. Women in the intervention arm had lower odds of reporting IPV (aOR 0.64, 95% CI 0.41–0.99; p = 0.04), were less likely to express accepting IPV attitudes (0.45, 0.34–0.61; p < 0.0001) and were less likely to hold the belief that IPV was a private matter (0.51, 0.32–0.81; p = 0.005) or that it should be accepted (0.68, 0.45–1.01; p = 0.06).

Some studies have reported the impact of GBV interventions on SRHR outcomes. For instance, Doyle et al. [49] reported improved attendance at ANC, use of contraception, and partner support during pregnancy in a gender-transformative couples’ intervention. Additionally, sexual, and emotional IPV were lower [49]. Haberland et al. [37] assessed that training and support for HIV counsellors, a take-home card for clients, and an on-site IPV counsellor could address violence and increase the uptake of HIV testing services during antenatal care. Among women experiencing IPV, higher odds of disclosing violence to their counsellor than women receiving standard care were observed (32% vs. 7%, p < 0.001). Women in the intervention arm reported that counsellors had a positive influence on them (aOR 2.9; 95% CI 1.8, 4.4; p < 0.001) and felt more confident in how they deserved to be treated (aOR 2.7; 95% CI 1.7, 4.4; p < 0.001) during their ANC visits. “Couple-based violence-prevention education” was implemented to mitigate IPV outcomes among pregnant women in rural Ethiopia [55]. The intervention enhanced the reporting of IPV, and women reported fewer cases of emotional, psychological, physical, and sexual violence during pregnancy. Pregnant women attending the prevention of mother-to-child transmission of HIV services in primary healthcare facilities in South Africa were provided with an IPV intervention that comprised training on safety behaviours, strategies for dealing with the abuse, and referral services [47]. The women reported a significantly lower mean danger assessment score (6.0 at baseline versus 2.8 after intervention at three months). The “Improving AIDS Care after Trauma (ImpACT)” programme was piloted among 64 women initiating HIV treatment in Cape Town, South Africa, and a positive psychological impact on symptoms associated with sexual trauma was observed [59].

Moreover, the women were encouraged to continue with long-term HIV care. Nevertheless, no change was observed in GBV reports, with a similar number of GBV cases reported by the intervention and non-intervention groups of pregnant women taking part in a psychosocial intervention that aimed to reduce GBV and antepartum depressive symptoms [30]. Similarly, Settergen et al. [39] reported no change in reported GBV experiences in a comprehensive health-facility- and community-based programme delivered through the HIV/AIDS services. However, the programme improved the utilisation of GBV services by survivors in the facility, and they were more likely to include the provision of an HIV test (55.3% vs. 19.6%, p = 0.002).

3.2.7. SRHR Interventions

Two main categories of SRHR interventions were identified: educational interventions and a combination of telehealth and education [74,80,83,85,88,89,96,97,98,99,100] (Table 4). Gichangi et al. [94] used telehealth to send messages about contraception-related myths and misconceptions to young people. Both the intervention and control groups reported similar proportions of young people who believed the myths and misconceptions. Most of the women who received educational SMS reported increased contraceptive use compared to their counterparts: 70% versus 57%, p = 0.04 [94]. Similarly, adolescents who received SMS messages about SRHR information had higher knowledge scores, were able to make informed decisions about SRH services, identified STIs, and were more likely to seek treatment [85]. Alekhya et al. [83] assessed the effect of SRH education among adolescent girls in urban India and reported improved SRH knowledge, awareness of different contraceptive methods (51 (10.9%) to 337 (87.1%), p < 0.001), and STIs/RTIs awareness (177 (38.2%) to 371 (96.1%), p < 0.001) in the intervention group. A school-lined module-based friendly health education programme was effective in improving the SRH knowledge score, (375) 73.3%, vs. (384) 66.5%%, p < 0.001, 95% CI, (0.05–0.08) [89]. The increase in SRHR knowledge in the intervention group was mediated by improved access to SRHR information, knowledge, and compassionate care. A team-focused approach of home visits increased the uptake of modern family planning from 39% at baseline to 64% at end line (p < 0.001) among those living with HIV and HIV-vulnerable pregnant adolescent girls and adolescent mothers in Kenya [97]. A youth-friendly health-services model led to increased use of SRHR services among adolescent girls and young women in Malawi [98].

3.3. Meta-Analysis Results

Only nine studies that included the main outcome, namely SRHR knowledge and attitude scores, were included in the meta-analysis. Then, nine studies, including RCTs and cluster RCTs with a total of 5058 participants, were included in the meta-analysis. Among them, seven were cluster RCTs [80,83,85,89,94,96,99] and two were RCTs [96,98]. Among them, roughly 78.8% (3986/5058) were adolescents aged 10 to 24 years and the rest were aged from 25 to 30 years. Only three studies included both sexes [85,89,94]. In total, 56% (1697/3029) were females and 44% (1332/3029) were male. Interventions included a pedagogy and school-based SRHR education and belief model [89,98,99]; text messages with SRH information [80,85,94,95]; YFHS, consisting of the same Sexual Offences Court (SOC) services in integrated youth-dedicated spaces and staffed by youth-friendly peers and providers to improve SRH [98]; and visits to women from their catchment areas at their homes, counseling them on SRH [97,99]. Among studies included in the meta-analysis, the intervention duration varied from seven weeks [94] to seven months [89].

Our findings showed that interventions implemented in the Commonwealth and selected African countries—including educational interventions, one- or two-way SMS containing SRHR messages, home-based visits, and YFHS—significantly improved SRHR knowledge and attitudes among adolescents, couples, and partners (OR = 2.47, 95% CI: 1.51–4.03) (Figure 3). The overall meta-analysis demonstrated considerable heterogeneity across studies (I² = 92%, τ² = 0.49, χ² = 94.28, df = 8, p < 0.00001), indicating substantial variability in intervention effects beyond chance. Therefore, a random-effects model was considered appropriate for pooling the results.

Figure 3. Forest plot of interventions improving sexual reproductive health and rights knowledge and attitude in adolescents, couples, and partners.

In the subgroup analysis, cluster randomised controlled trials demonstrated a greater improvement in SRHR knowledge and attitudes (OR = 2.68, 95% CI: 1.49–4.80), with considerable heterogeneity (I² = 94%), whereas individually randomised controlled trials showed a smaller but statistically significant effect (OR = 1.78, 95% CI: 1.14–2.77) with no observed heterogeneity (I² = 0%). The studies by Alekhya et al. [83] and Millanzi et al. [85] reported the largest intervention effects, with ORs of 7.60 (95% CI: 4.55–12.69) and 10.27 (95% CI: 6.86–15.39), respectively. The test for subgroup differences showed no statistically significant difference between cluster RCTs and individually randomised trials (χ² = 1.20, p = 0.27; I² = 16.6%), indicating that study design did not significantly modify the intervention effect. Publication bias was unlikely based on Egger’s test (Z = 0.83, p = 0.405) and Begg’s test (Z = 0.10, p = 0.917).

Assessing the risk of bias, 78% of trials effectively reported random sequence generation, only 22.2% minimised allocation concealment and the blinding of participants and personnel, 11.1% reported effective control of outcome blinding, 100% minimised attrition and reporting biases, and other biases, mainly contamination bias, was reported in three cluster randomised controlled trials.

4. Discussion

The systematic review and meta-analysis determined the diversity of GBV, VAWG and SRHR interventions. It also described the interventions and associated health outcomes in the Commonwealth and other selected African countries. We included 60 studies reporting on GBV, VAWG and SRHR interventions. Different categories of GBV, VAWG and SRHR responses were identified, including educational, behavioural, economic, technological, as well as mixed interventions delivered at individual, facility, and community levels. The education-based intervention, using one or two-way SMS, contained a health education message, home-based visits, and YFHS, improved SRHR knowledge and attitude in adolescents, couples, and partners (OR 2.47, 95% CI: 1.51–4.03). When compared to cluster RCTs (OR 2.28, 95% CI: 1.49–4.80), RCTs revealed moderate evidence in improving SRHR knowledge and attitudes (OR 1.78, 95% CI 1.14–2.77). Four studies reported on interventions focusing on alcohol reduction, education, and awareness in addressing violence against women or violence perpetuated by men [30,47,56,57]. Substance misuse is a well-known driver of GBV and VAWG as well as other forms of violence [101,102]. Women carry the greatest burden of substance use, constituting 25–27% of the 296 million people that use drugs globally [103]. Conroy et al. [48] reported lower rates of physical IPV and quality relationship due to an “economic and relationship-strengthening intervention” that focused on reducing alcohol use and violence among married couples living with HIV in Malawi. Interventions for addressing GBV and VAWG should focus on specific risk factors that perpetuate GBV such as “alcohol reduction strategies” as it has a demonstrable potential effect in addressing hostile environments and facilitators that drive violence [30,47,56,57]. Moreover, GBV survivors have higher odds of using substance misuse as a coping strategy [104,105]. Also, causal links have been established between substance use and poor SRHR outcomes such as HIV/STI risk, especially among vulnerable women and girls, commonly described as “substance abuse, AIDS and violence syndemic” [106,107].

About four included studies focused on female sex workers [30,31,51,54], a population that experiences heightened vulnerability to violence due to intersecting social, legal, and economic factors [108,109]. While interventions such as the alcohol harm-reduction programme evaluated by Parcesepe et al. [51] demonstrated reductions in physical violence and verbal abuse from paying partners, these findings should be interpreted within the broader structural environment in which sex workers operate. Specifically, violence against sex workers is often shaped by the criminalisation or partial criminalisation of sex work, police harassment and abuse, stigma and discrimination in healthcare settings, economic marginalisation, and limited access to legal protections [110,111]. These structural conditions may increase exposure to violence while simultaneously creating barriers to reporting abuse and accessing health, legal, and social services.

Similarly, the studies by Javalkar et al., [30] highlighted the high prevalence of intimate partner violence among female sex workers and demonstrated the influence of gendered power dynamics, alcohol use, client violence, and financial dependence within intimate relationships. Although the Samvedana Plus intervention improved awareness of self-protection strategies, reduced the acceptance of violence, and strengthened collective solidarity among sex workers, it did not significantly reduce intimate partner violence outcomes, suggesting the limitations of interventions that primarily target individual and interpersonal factors in the absence of broader structural change [30]. These findings underscore the need to conceptualise sex workers as a population with distinct structural needs rather than simply a subgroup of women affected by GBV. Emerging evidence suggests that health-sector interventions are likely to be most effective when complemented by structural approaches that address stigma and discrimination, strengthen legal and social protections, improve access to survivor-centred healthcare, and promote enabling environments that support safety, autonomy, and human rights [112,113].

Multilevel interventions are needed to address GBV and its impact on SRHR to advance the realisation of the SDGs, especially SDGs 3, 5 and 10. The narrative analysis suggests that tailored gender-transformative interventions, including all genders and couples, can be effective at positively deconstructing the entrenched gender inequalities and the associated health-related behavioural outcomes [30,43,45,46,47,55,56,57,59,60,70,72,77,87]. A review and meta-analysis in low- and middle-income countries showed that community and group-based interventions have the potential of addressing GBV and other forms of violence [62].

The use of telehealth was effective in improving access to SRH information, improving SRH knowledge for better decision-making, especially among the youth [82,84,90]. In developing countries, telehealth faces unique challenges of access and availability, given the context of the technological divide in the digital age, and the potential for scale-up and sustainability may be limited [114,115]. Gender-based violence and VAWG interventions have shown positive impacts on outcomes related to SRHR outcomes such as STIs, family planning, and maternal health [95,96,98]. Couple-based interventions that raise awareness about IPV during pregnancy and its consequences have the potential to eliminate gender norms and power dynamics [44,62,72]. In most developing countries, GBV screening and management are not part of routine healthcare; this is a missed opportunity for meeting the needs of the victims [116,117]. Gender-based violence interventions that mitigate the impact on SRHR outcomes, including HIV transmission and virological suppression, are important, especially among women with a history of trauma in high-risk settings [95,96,98]. Financial literacy and stability were associated with delayed engagement in sexual relationships and having fewer sexual partners, leading to less exposure to IPV. The latter is known to be protective against STIs such as HIV, which is disproportionately higher among young women and adolescent girls [51,55,57]. Associations between poverty and women’s increased risk of intimate partner violence have been observed [61].

Our results in both meta-analysis and narrative synthesis have shown that pedagogy and school-based education and belief models, text messages with SRHR information, YFHS, and counselling were effective interventions to increase SRHR knowledge and attitude in adolescents, couples, and partners in the Commonwealth and selected African countries [80,83,85,89,94,96,99]. Similarly, a systematic review and meta-analysis including twenty-seven studies highlighted that school-based sex education interventions can be effective in promoting positive sexual health behaviours [118]. Other studies also reported that school-based interventions improved contraceptive use among adolescents [85,99]. The SMS intervention should be implemented as an intervention package to improve knowledge and reduce risk in developing sexual and health-related challenges among adolescents [80,95,98]. Home-based visits, when combined with counselling and personalised information, may be an effective technique for improving SRHR knowledge and attitude, particularly among adolescents and other vulnerable groups [97]. Interventions such as mHealth, coupled with the effectiveness of youth-friendly health services, could integrate both strategies to improve access to and the utilisation of SRHR services in future interventions [80,88,95,98]. Our findings may play an important role in informing interventions seeking to improve SRHR knowledge and attitude in adolescents, couples, and partners in the Commonwealth and selected African countries. However, the results from cluster randomised controlled trials should be taken in the context of multiple limitations due to potential bias and high heterogeneity between studies. The two randomised controlled studies found moderate evidence that automated two-way SMS comprised a health education message and a behaviour modification framework designed to promote SRHR knowledge and attitude [95,98]. Furthermore, our study revealed a minimal probability of publication bias, as shown by the calculated Egger test and Begg’s test.

A multisectoral approach, including governments, non-governmental, and healthcare providers, should prioritise the uptake of evidence-based interventions to mitigate GBV and associated health outcomes [27,31,32]. Collaboration among healthcare providers, community organisations, and policymakers is vital to overcoming systemic barriers, cultural barriers, resource constraints, and syndemic factors of health, ultimately minimising GBV [28,29,31,32,118,119].

5. Strengths and Limitations

The review provides relevant information, documentation, and in-depth analyses of GBV, VAWG and SRHR practices and experiences. It was carried out by a team of researchers with expertise and experience in health system responses to violence against women and global health. The inclusion of diverse sources (e.g., peer-reviewed publications, grey literature, mixed-methods design) across different databases provided an opportunity for the selection of the most relevant studies. We used the PRISMA guidelines to ensure consistency of the methodology and to guide the collection of information and material. We adapted a WHO framework to assess a range of GBV, VAWG and SRHR dimensions on facility-based responses to ensure comparability between countries and regions as much as possible. The review search focused on peer-reviewed publications and searches of secondary sources. We acknowledge the broad definition of GBV, its interpretation, and the variable measurement of GBV and IPV in respective countries. A range of studies may have social desirability bias as they relied on self-reported responses to sensitive questions of GBV. The review focused on the last 15 years (2014–2024). We excluded older articles and reports that could have been significant from the review.

The review should be interpreted within the relevant context and has several limitations. First, the review focused on health-sector responses to GBV, VAWG, and SRHR interventions and therefore primarily included studies evaluating health, behavioural, educational, community, and service-delivery approaches. As a result, structural interventions such as legal reform, decriminalisation policies, social protection programmes, labour protections, and broader policy-level interventions were not a primary focus of the review and were outside the eligibility criteria used to identify studies.

Consequently, the limited discussion of structural interventions should not be interpreted as evidence of their ineffectiveness or lack of importance. Rather, it reflects the specific focus of this review on health-sector interventions and service responses to GBV, VAWG and SRHR. Nevertheless, some of the included studies highlighted the influence of broader structural determinants, including poverty, gender inequality, stigma, discrimination, social exclusion, and unequal power relations, on both the risk of violence and access to care. These findings suggest that health-sector interventions alone may be insufficient to address the complex drivers of violence without complementary action across legal, social, economic, and policy domains. The meta-analysis shows evidence suggesting that healthcare-based interventions may contribute to improvements in GBV and SRHR outcomes. However, these findings are moderated by methodological limitations observed across several studies, including incomplete reporting of response rates, non-probability sampling approaches, potential attrition bias, and limited information regarding blinding and outcome assessment. Therefore, the implications of these intervention should be interpreted within context.

Secondly, the review focused primarily on studies of women and girls and did not identify eligible studies specifically addressing GBV experienced by LGBTQ+ populations, including transgender and gender-diverse individuals. Although the definition of GBV encompasses violence experienced based on gender identity and sexual orientation, no included studies specifically focused on LGBTQ+ populations. The review was primarily designed to examine health-sector responses to GBV, VAWG, and SRHR programmes among women and girls, and therefore the findings should not be interpreted as representative of the experiences or health-sector needs of LGBTQ+, and other gender-diverse populations. Consequently, the findings should not be generalised to these populations, whose experiences of violence, barriers to care, and intervention needs may differ substantially.

Thirdly, the review did not include other gender identities such as transgender people/women and women who use drugs; therefore, the conclusion of the paper should be interpreted within the inclusion context. Substance misuse is a well-known determinant of GBV and VAWG as well as other forms of violence. Future studies should focus on understanding the interventions that can be incorporated to address the role of substance misuse in alleviating GBV and VAWG among individuals who use drugs. Some studies evaluated GBV that may have occurred long ago, while others did not specify the period in which the incident occurred. This systematic review focused on responses to GBV, VAWG and SRHR by a diverse range of stakeholders. The variability in intervention delivery is also acknowledged.

Fourthly, the review was restricted to the inclusion of articles written in English, which may have introduced a language bias, particularly in French-speaking countries. The decision was based on the constraints related to translation and resource availability. While English-based publications capture a substantial proportion of globally indexed research, excluding non-English publications may lead to the omission of relevant local evidence and perspectives. Consequently, the findings of this study may underrepresent research from French-speaking countries and should be interpreted within this limitation. Future reviews should consider multilingual search strategies to enhance inclusivity and diversity.

Lastly, it is important to note that the review may not include all health-sector responses to GBV, VAWG and SRHR in the Commonwealth countries. Still, attempts have been made to use diverse sources and cross-validate these to ensure that many initiatives are captured. The assessment focused on health system responses to GBV, VAWG and SRHR. It should be noted that there are structural variations in the healthcare systems across different countries. Countries are at varying levels of development and integration of GBV, VAWG, and SRHR services in the health sector. It is not easy to compare them in some respects. The review is based on information available in the public domain.

6. Future Research

Future reviews focus on the following:

• Understanding the effectiveness of structural and policy-level interventions, including legal and regulatory reforms, social protection mechanisms, economic empowerment programmes, and other multisectoral approaches that address the underlying determinants of violence. Such evidence would complement the findings of the present review and contribute to a more comprehensive understanding of how health-sector responses can be strengthened through broader societal and institutional reforms.
• Evaluating multilevel strategies that address the social, economic, policy, and legal determinants of violence affecting sex workers.
• Understanding the interventions that can be incorporated to address the role of substance misuse in alleviating GBV and VAWG among individuals who use drugs. Some studies evaluated GBV that may have occurred long ago, while others did not specify the period in which the incident occurred.
• Explicitly examining interventions and service responses targeting LGBTQ+ populations to strengthen the evidence base and inform more inclusive GBV prevention and response strategies. The absence of lesbian, gay, bisexual, transgender, queer+ (LGBTQ+)-specific studies limits the comprehensiveness of the review and highlights an important area for future research. This omission is particularly relevant within many Commonwealth and African contexts where stigma, discrimination, and restrictive legal environments may increase vulnerability to violence and create barriers to accessing health and support services. Consequently, the effectiveness, accessibility, and appropriateness of health-sector responses for LGBTQ+ populations remain inadequately understood within the evidence synthesised in this review.

7. Conclusions

This paper revealed a wide range of GBV, VAWG, and SRHR interventions implemented across the Commonwealth and selected African countries. The evidence presented provides insights that can inform policies and programmes. By examining 60 studies, this work highlights the effectiveness and ineffectiveness of diverse educational, behavioural, economic, and technological approaches delivered at multiple levels to reduce GBV/VAWG. Promising interventions for SRHR include education-based approaches, such as SMS messaging, youth-friendly health services, and home visits, which have been shown to improve SRHR knowledge and attitudes. Evidence on GBV/VAWG, however, indicates that multi-layered, gender-transformative strategies tailored for both men and women are needed to address deep-rooted gender inequalities and to achieve sustainable health outcomes. It is also important to note that context matters as much as intervention type. In countries where VAWG is inconsistently criminalised, marital rape exemptions persist, or survivors lack legal recourse, health-sector interventions will face structural headwinds regardless of design. In this context, legal and policy reform is a precondition, not just a parallel track, for achieving population-level impact.

Evidence on LGBTQ+ people and sex workers were notably sparse, reflecting both under-inclusion in studies and, in some countries, criminalisation or stigmatisation that constrains research and service access. We therefore cannot draw the same evidence-based conclusions for these groups. This itself is a finding, pointing to a need for tailored programme design rather than assumptions extrapolated from mainstream GBV, VAWG and SRHR evidence. Despite limitations in the trial designs of some studies, our findings support integrating GBV, VAWG, and SRHR approaches to reduce GBV and enhance SRHR. This is particularly pertinent given the technological and resource challenges faced by the developing world.

Taken together, these findings suggest a tiered set of priorities: (i) scale education- and service-based SRHR interventions where infrastructure allows; (ii) pair GBV/VAWG programming with legal/structural reform in contexts where enforcement or legal gaps undermine health-sector efforts; and (iii) invest specifically in evidence generation and inclusive service design for LGBTQ+ people and sex workers before generalising existing recommendations to them. A coordinated multisectoral effort (involving governments, healthcare providers, and community organisations) that is sequenced and population-specific rather than uniform is most likely to unlock the full potential of integrated GBV, VAWG, and SRHR interventions in advancing “SDGs 3 (Good Health and Well-Being), 5 (Gender Equality) and 10 (Reduced Inequalities)”.