Improving The Availability & Use of SGBV Services in Kananga Project in Central Kasai, DRC

Sexual- and gender-based violence (SGBV) is a widespread phenomenon in the Democratic Republic of Congo (DRC). In 2017, Médecins Sans Frontières (MSF) launched the Kananga project to provide emergency medical assistance to people affected by the Kamwina Nsapu conflict in the Central Kasai. To adjust to the evolving context in 2020, MSF initiated the “decentralization initiative” which: aimed to 1) Improve access to SGBV care, including contraception and abortion care; and 2) Build staff capacity to provide holistic medical support to survivors at the health center level. From April 2022 to March 2023, MSF piloted the decentralization initiative at the Kamuandu Health Center (CSK) in the Tshikula Health Zone. Before the decentralization initiative, the CSK did not formally integrate post-sexual violence care.

In 2022, the Stockholm Evaluation Unit (SEU) commissioned a two-phase developmental evaluation of the decentralization initiative. Conducted from July to November 2022, Phase 1 assessed the design, planning, and prospective implementation of the decentralization initiative.

This Phase 2 evaluation, which is the focus of this report, was carried out in June 2023 and assessed the results of the implementation and handoff of the decentralization. We employed a concurrent mixed-methods approach combining desk review, secondary analysis of routine data from the CSK, case study methodology of the CSK, and 18 semi-structured interviews with providers (n=4), survivors (n=5), MSF staff (n=7), and external stakeholders (n=2). We analyzed the primary qualitative data for content and themes using inductive and deductive techniques and computed descriptive statistics to analyze secondary quantitative data. We addressed the primary evaluation questions through seven criteria: relevance, Coherence, efficiency, effectiveness, impact, sustainability, and gender and human rights mainstreaming.