PURPOSE:
Accessing care to gender-based violence (GBV) services is immensely challenging anywhere in the world, but in humanitarian settings this is amplified by weakened service provision systems. In order to overcome this barrier, Médecins sans Frontières (MSF) created a midwife-led, peer sharing, co-designed community-based care approach within the organisation which was implemented in the community in three countries to improve access to care for survivors of GBV.

DISCUSSION:
We created a community-based care approach that has the ability to address prevention but simultaneously respects cultural values and beliefs in that context. Focal points (trusted women) were chosen by the community. They received training on GBV care and psychological first aid (PFA). MSF staff provide ongoing support by phone and receive referrals to an MSF supported clinic. This enabled them to provide immediate care, PFA, emergency contraception, the first doses of PEP (post-exposure prophylaxis). Currently we are in the process for the focal points to provide medication abortion in the first trimester. For referrals, MSF provides them with phone credit and a suitable referral pathway. Trust and confidentiality are at the core of this model of care.

EVIDENCE WHERE RELEVANT:
Since October 2024 a significant uptake of services was shown in one of the MSF-supported community-based care projects. Seeing before only 10 people a month for GBV care, this increased over 12 weeks into a nine-fold increase. Seventy-one percent disclosed their request for support in the first 72 hours, of which nearly 70% were under the age of 18 years.

KEY MESSAGE:
Involving the community in co-designing approaches to healthcare improves access and removes barriers in humanitarian settings. Listening to and engaging with the populations we work for is a major step in partnerships and empowerment. This is even more relevant for women and girls whose voices are often not heard. Humanitarian 2