The health sector response to gender-based violence and sexual reproductive health programs in the Commonwealth and selected African countries : protocol for a mixed methods systematic review and meta-analysis

Abstract

BACKGROUND : The intertwining nature of gender-based violence (GBV) and violence perpetrated against women and girls (VAWG), as well as sexual and reproductive health rights (SRHR), underlines the urgent need for the health sector to enhance the coordination of services to improve health outcomes. Importantly, GBV and VAWG are intricately linked to a spectrum of SRHR challenges, ranging from unintended pregnancies to severe maternal, gynecological, and mental health outcomes. Cumulative GBV had a more significant effect on abortion risk than associated variables. Recognizing the interplay between GBV, VAWG, and SRHR highlights the necessity for a comprehensive health sector response. A systematic review of the health sector response to GBV, VAWG, and SRHR will be conducted to understand the extent and array of health facility–based coordinated responses to GBV, VAWG, and SRHR; lessons learned; and successes and challenges in the Commonwealth and selected African countries. OBJECTIVE : We aim to understand the context of GBV, VAWG, and SRHR by conducting a comprehensive review of health sector responses in different national, cultural, and socioeconomic contexts, and we aim to share best practices, experiences, and lessons learned. METHODS : A mixed methods systematic review will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. The population, intervention, comparison, and outcome framework will be applied to screen and select relevant sources guided by the inclusion and exclusion criteria. The review will include relevant research papers published in the last 15 years and conducted in the 24 Commonwealth and 7 selected African countries. Electronic databases to be searched will include PubMed, Google Scholar, Science Direct, EBSCOhost, Web of Science, Embase, PsycINFO, Cochrane, CINAHL, Index Medicus for the Eastern Mediterranean Region, and POPline. RESULTS : Ethics approval will be waived as the study will use data in the public domain. The project has been commissioned by the Commonwealth Secretariat (2022-2025). The database search, data screening, and data extraction process for the review will be completed by September 2025. A manuscript will be submitted to a peer-reviewed international journal by November 2025. The initial online database searches, citations of eligible studies, and Microsoft Copilot identified 38,200 studies focusing on GBV, VAWG, and SRHR interventions. To date, 60 studies have been found eligible for inclusion in the review. The majority of these studies were conducted in eastern Africa (n=34), South Africa (n=14), and Asia (n=13). Evidence generated from this review will be made available through journal publications, seminars and workshops with key stakeholders, ministries of health, and local and international conferences. CONCLUSIONS : The study will generate evidence to inform recommendations on addressing and mitigating the effects of GBV and VAWG on SRHR outcomes and coordinated services in the health sectors of Commonwealth and selected African countries.