Improving access to care for survivors of gender-based violence through task sharing with non-physician providers in Ethiopia: experience from a pilot project

Background Gender-based violence (GBV) is a pervasive public health and human rights issue in Ethiopia, characterized by high prevalence and limited access to care. Systemic barriers, including stigma, a shortage of trained providers, and the centralization of services in hospitals located in major cities, significantly hinder timely support for survivors. Care is typically delivered by a small number of gynecologists and obstetricians, further constraining access. This pilot project aimed to evaluate the effectiveness of task sharing, delegating GBV care to trained non-physician providers, in addressing these gaps at two health centers in Ethiopia. Methods This pilot project employed an implementation research approach to evaluate the operational and technical feasibility and effectiveness of task sharing in GBV care at two health centers in Ethiopia. Fourteen mid-level providers (health officers, midwives, and nurses) received comprehensive training in medical evaluation, psychosocial support, and legal referrals. The project included baseline facility assessments, structured training, ongoing mentorship, and community engagement. Data were collected through service records, client satisfaction interviews, and stakeholder consultations. Results Over one year, 45 survivors of GBV received comprehensive care, with 66.7% presenting within 72 hours of the incident. Sexual violence was the most frequently reported form, accounting for 66.7% of cases. Trained providers delivered key services, including HIV testing (95.6%), emergency contraception and post-exposure prophylaxis for HIV (46.7%), sexually transmitted infection prophylaxis (44.4%), and psychosocial support (93.3%). Legal service linkages were established for 84.4% of survivors, and only three cases (6.7%) required referral to higher-level facilities. Client satisfaction was high, with over 90% of respondents reporting positive care experiences. Stakeholders expressed strong support for scaling up the intervention. These findings underscore the effectiveness of the task-sharing approach in expanding access to essential, survivor-centered GBV care. Conclusion and lessons learned Task sharing proved feasible and effective in decentralizing GBV care, improving accessibility, and reducing referral burdens. Key lessons include the importance of structured training, continuous mentorship, and multi-sectoral collaboration. This model offers a scalable solution to enhance GBV care in low-resource settings.