AIDSTAR-One | CASE STUDY SERIES                                                                                           ...
AIDSTAR-One | CASE STUDY SERIESdifficulty achieving an erection. The discussion also                          development....
AIDSTAR-One | CASE STUDY SERIESFigure 1: HIV Prevalence by Sex and Age Group, and Female to Male Prevalence Ratios in Swaz...
AIDSTAR-One | CASE STUDY SERIESwomen and men but maintains the dual systemof legislation that recognizes both traditional ...
AIDSTAR-One | CASE STUDY SERIES                                                                            others. However...
AIDSTAR-One | CASE STUDY SERIESresponse to GBV. An asset of SWAGAA’s approach                                 prevention, ...
AIDSTAR-One | CASE STUDY SERIESdialogues. While there is traditional reluctance to discuss intimatedetails of sexuality in...
AIDSTAR-One | CASE STUDY SERIES                                 Counseling: SWAGAA provides face-to-face individual and gr...
AIDSTAR-One | CASE STUDY SERIESFigure 2. Types of Abuse Reported by Counseling Clients, Fiscal Year 2010 (N = 1,753)Source...
AIDSTAR-One | CASE STUDY SERIES                                  The network developed a referral directory (2010) and wil...
AIDSTAR-One | CASE STUDY SERIESrelationships with independent attorneys who agree                the country have faciliti...
AIDSTAR-One | CASE STUDY SERIES                                     indicators relating to the type of abuse, location of ...
AIDSTAR-One | CASE STUDY SERIES                                                                           Engaging men as ...
AIDSTAR-One | CASE STUDY SERIESaccording to SWAGAA’s program director, is to            expenses, which affect the organiz...
AIDSTAR-One | CASE STUDY SERIESThe 2009/2010 annual report indicates that433 adult men reported abuse, representing 28perc...
AIDSTAR-One | CASE STUDY SERIESIncreasingly, SWAGAA sees the need to build the             a deeper understanding of the c...
AIDSTAR-One | CASE STUDY SERIESREFERENCES                                                       Swaziland Action Group Aga...
AIDSTAR-One | CASE STUDY SERIESACKNOWLEDGMENTS                                     RECOMMENDED CITATIONThe authors would l...
AIDSTAR-One’s Case Studies provide insight into innovative HIV programs and approachesaround the world. These engaging cas...
AIDSTAR-One Swaziland Action Group Against Abuse (SWAGAA)
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AIDSTAR-One Swaziland Action Group Against Abuse (SWAGAA)

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Entrenched gender inequality is a major contributor to Swaziland's HIV prevalence rate, which in turn, hinders poverty reduction and national development activities. For the past ten years, the Swaziland Action Group Against Abuse (SWAGAA) has been addressing the links between the HIV epidemic, gender-based violence (GBV), and human rights. Although SWAGAA was initially formed to provide counseling services to survivors of GBV, it has expanded its programs to better meet the needs of the community.

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AIDSTAR-One Swaziland Action Group Against Abuse (SWAGAA)

  1. 1. AIDSTAR-One | CASE STUDY SERIES February 2012Swaziland Action Group AgainstAbuseAddressing Gender-based Violence within theContext of HIV S ome 60 men are gathered in the Kagogo (Grandmother) Centre, a space created for children orphaned due to HIV but also used for local meetings, in a small community in Swaziland’s northern Hhohho District. Men and teenage boys, most in western clothes and a few in traditional attire, are sitting together on wooden benches and plastic chairs. They listen to a woman whose business attire marks her as a city dweller. She SWAGAA uses familiar images to introduce charged topics—sex, violence, and HIV. Later, the youth are dismissed as the conversationSwaziland Action Group AgainstAbuse logo. turns to topics that fathers do not want their unmarried sons to hear about. “It is not like the old days when you could treat a woman like one of your prize cows—you can’t just poke her and say ‘let’s go,’” says the woman. She is an education officer with the Swaziland Action Group Against Abuse (SWAGAA),1 and she intends to challenge prevailing norms about gender roles and sexuality. As she talks, she sensitizes the men to notions about women’s rights to sex that is consensual as well as respectful of needs that may be different than men’s. Within a few minutes, the men are rapt with attention. Many are nodding and want to talk. Everyone laughs when one man likens a woman to a car that needs to be warmed up before you can drive it. An older man, dressed in traditional Swazi dress, says that each ofBy Diane Gardsbane and his four wives has different needs. The men talk about how to best satisfy a woman and how to deal with male-sensitive issues, such asSizakele Hlatshwayo 1 Funded by the U.S. President’s Emergency Plan for AIDS Relief through the U.S. Agency for International Development, among other donors.AIDSTAR-OneJohn Snow, Inc.1616 North Ft. Myer Drive, 11th Floor This publication was produced by the AIDS Support and Technical Assistance ResourcesArlington, VA 22209 USA (AIDSTAR-One) Project, Sector 1, Task Order 1.Tel.: +1 703-528-7474 USAID Contract # GHH-I-00-07-00059-00, funded January 31, 2008.Fax: +1 703-528-7480 Disclaimer: The author’s views expressed in this publication do not necessarily reflect the views of the United Stateswww.aidstar-one.com Agency for International Development or the United States Government.
  2. 2. AIDSTAR-One | CASE STUDY SERIESdifficulty achieving an erection. The discussion also development. Women are disproportionatelytouches on the need for condoms—generally not affected by HIV, representing 59 percent of thoseused in stable partnerships in Swaziland—and the infected. These rates include 12 percent of allrelationship between HIV and forced sex. women aged 15 to 19, 38 percent of women aged 20 to 24, and almost half (49 percent) of womenAs the conversation unfolds, there is evidence aged 25 to 29 (Central Statistics Office andboth of men’s increasing understanding of MEASURE Demographic and Health Survey 2007).women’s rights, as well as of significant remaining Figure 1 shows HIV prevalence disaggregated bychallenges to shift gender norms that prioritize male sex and age, with male and female ratios (NERCHAdominance. In later discussion, everyone agreed n.d.).that getting men to openly discuss their sexualrelationships in a staunchly patriarchal society is a There is no routine screening for gender-basedsignificant accomplishment of the male dialogues, violence (GBV) by health providers in Swazilandbut the road to achieving gender equality between to provide statistical data relating to the incidencemen and women is a long one. or prevalence of GBV. However, a national population-based household study on violence against children (mostly girls) and young women,Background for which SWAGAA was a key stakeholder in implementing, revealed an epidemic of sexualA small, land-locked country of only 17,200 square assault against girls. The study, which included datakilometers (World Atlas 2010)2 and approximately from more than 1,200 girls and women aged 13 to1.2 million people (United Nations Department for 24, found that approximately one in three femalesEconomic and Social Affairs 2009), the Kingdom experienced sexual violence as a child and moreof Swaziland has the world’s highest rates of than half of these incidents are not reported toHIV infection. Twenty-six percent of adults 15 to anyone, notably because most of those interviewed49 years of age are HIV-positive, with women said they did not know the violence was wrong.representing 59 percent of those infected. In addition to sexual violence, 1 in 4 reported thatSwaziland is ranked as a lower middle income they experienced physical violence and 3 in 10country; however, 40 percent of the wealth is were emotionally abused as a child (United Nationscontrolled by only 10 percent of the population, and Children’s Fund [UNICEF] 2007). Further results of69 percent of the population lives below the poverty the study demonstrated significantly increased risksline (United Nations Country Team 2009). for health-related issues for girls who experienced sexual abuse before age 18, including depression,Entrenched gender inequality is cited as a major suicidal thoughts and attempts, unwanted andcontributor to the country’s HIV prevalence rate complicated pregnancies, sexually transmitted(National Emergency Response Council on HIV and infections, sleep disorders, and smoking andAIDS [NERCHA] 2010; U.S. Agency for International alcohol use (Reza et al. 2009).Development [USAID] Swaziland 2010). In turn,both HIV prevalence and gender inequality are Human trafficking brings together issues of humanobstacles to poverty reduction and national rights, GBV, and HIV transmission. Swaziland is a source, destination, and transit country for women, girls, and boys who are trafficked to or2 This is slightly larger than Connecticut in the United States and is simi-lar in size to Kuwait and Fiji. from neighboring countries of Mozambique and2 AIDSTAR-One | February 2012
  3. 3. AIDSTAR-One | CASE STUDY SERIESFigure 1: HIV Prevalence by Sex and Age Group, and Female to Male Prevalence Ratios in Swaziland, 2007Sources: Central Statistics Office and MEASURE Demographic and Health Survey 2007; recreated from NERCHA n.d.South Africa (U.S. Department of State 2010). umcwasho, wearing of headgear and tassels thatPressure from the U.S. Government was a factor signify a virgin, as a major strategy for combatingin increasing efforts by the Swazi Government to HIV. While supported by some as an effective useaddress trafficking, and in 2010 U.S.$100,000 was of traditional beliefs and customs, others maintainmade available to SWAGAA for anti-trafficking that this strategy placed the responsibility foractivities. controlling the epidemic on women and girls and reinforced the prevailing perception that women and girls are the “vectors” of HIV.Policy Environment Swaziland is a signatory to the Convention on the Elimination of all Forms of Discrimination AgainstSwaziland is Africa’s only remaining absolute Women, the Convention on the Rights of the Child,monarchy, with a king who is popular but more the Millennium Development Goals, the Southernknown for his extravagance and traditional Africa Development Community Gender Protocol,polygamy than for his social policy and and several other international human rights treatiesdevelopment. Swaziland has been slow to put in that promote gender equality. A new constitution,place concrete policies that effectively address adopted in 2005,3 provides for equal rights ofthe gender dimensions of the HIV epidemic. Asan example, in 2001, King Mswati III supported a 3 Swaziland had been without a constitution since 1973, when King Sob-ban on premarital sex for girls and young women huza II abolished the constitution adopted at independence as unwork-and reintroduced the traditional “chastity vow” and able for Swazis. Swaziland Action Group Against Abuse: Addressing Gender-based Violence within the Context of HIV 3
  4. 4. AIDSTAR-One | CASE STUDY SERIESwomen and men but maintains the dual systemof legislation that recognizes both traditional and Program Descriptioncivil law. Marriage, child custody, property rights, SWAGAA’s organizational mission centers onand inheritance laws remain largely covered by eradicating GBV and promoting human rights fortraditional law and custom, which strongly reflect all Swazi citizens. Strategies for achieving thispatriarchal norms and practices. vision include advocacy, services, and activities to improve GBV policy, prevent violence, and provideThe Deputy Prime Minister’s Office houses both care, support, and access to justice to survivorsthe Gender and Family Unit and the National of GBV. SWAGAA is the only organization inChild Coordination Unit. These units were placed Swaziland whose primary work is to address GBV,within the Deputy Prime Minister’s Office to raise and both government and civil society call on thethe profile of human rights and gender equality organization frequently for technical assistance,at a national level. Gender focal points were expertise, and assistance to survivors. When storiesappointed in every ministry as a way of mobilizing of shocking abuse, such as the rape of infants andand coordinating anticipated programs and children, reach the media, there is an expectationinitiatives. Problems yet to be resolved include the that SWAGAA will speak out as the country’scumbersome infrastructure of the Deputy Prime conscience.Minister’s Office, which slows processes andefficiency, and the practice of appointing low-level SWAGAA was founded and registered in 1990 asindividuals with limited authority and decision- a volunteer-operated, grassroots NGO to providemaking abilities as gender focal points. counseling services to survivors of family violence and sexual abuse. Today, the organization hasAmong the recent positive developments is the 2010 22 staff positions (although some are vacant) andNational Gender Policy, which has been 13 years several full-time volunteer positions, a headquartersin the making. The new policy is expected to guide in Manzini, Swaziland’s largest urban area, andthe attainment of the gender equality provided by five satellite counseling sites, including one in eachthe constitution. Gender mainstreaming is officially of Swaziland’s four regions where field volunteersencouraged by the government in national strategic are utilized for outreach. As a way of maximizingdocuments. limited capacity, SWAGAA maintains a presence in 24 communities, selected based on a numberYet it has taken more than 10 years of work by of criteria, including high rates of GBV as reportedgender equality advocates to finally get a Sexual to SWAGAA. A toll-free phone line has operatedOffences and Domestic Violence Bill approved by since 2000. A new children’s counseling space atParliament. The bill, approved in October 2011, the headquarters’ office site was recently developedcurrently awaits senate ratification. The original and completed.version of the bill was criticized as being tooprogressive and generated heated discussions SWAGAA has been addressing the linkagesabout Swazi “culture versus gender equality.” The between the HIV epidemic and GBV for almost afinal bill is a compromise, with some contentious decade, and it integrates education and counselingissues given attention, although not as strongly as on HIV throughout its programs and services.advocates would hope for. SWAGAA does not provide shelter but refers4 AIDSTAR-One | February 2012
  5. 5. AIDSTAR-One | CASE STUDY SERIES others. However, SWAGAA has never had a single “There is always an assumption large donor provide sustained core support, and that when a [horrifying] case of the NGO’s sustainability often (and presently) appears precarious. Most Swazis, including those abuse is reported in the paper working for other NGOs, government agencies, and that SWAGAA will always say donors, say that SWAGAA is part of the “fabric of something. If we don’t, someone Swaziland” and feel assured the organization will never be allowed to “go under” for lack of finances. will write in to the paper and say, Yet for SWAGAA staff, there is constant worry ‘Why is SWAGAA quiet?’” about being able to make ends meet. –SWAGAA staff member While SWAGAA was founded to provide services to female survivors of GBV, new programs and activities that expand the reach of the organizationsurvivors to three independently run shelters were developed in response to needs expressedfor women and children that generally allow a by community members during baseline studiessix-month stay while providing services to help and community assessments—an approach thewomen gain economic independence.4 One of organization consistently uses to identify needsSWAGAA’s successes is the role it has played in and gaps in services. Community assessments,raising national consciousness about GBV and for example, led SWAGAA to integrate HIV withinhuman rights, particularly notable within the context all of its programs. This integration was based onof entrenched patriarchal power structures. It is stories that women told about GBV and HIV, andcommon to hear that “SWAGAA is a household predated the current attention by donors and othername,” that “SWAGAA” is synonymous with agencies. Assessments also pointed to the strong“GBV” and “children’s rights,” and that, because of need for an increasing emphasis on engaging menSWAGAA, parents no longer have the right to beat and boys, preventing GBV, developing a referraltheir children, even in small communities outside network to increase the capacity to meet survivors’the NGO’s targeted areas. needs, and implementing a more strategicSWAGAA is funded by a variety of donor sources,although not by the Swaziland Government, eventhough government institutions refer GBV survivorsto SWAGAA. Donors include private individualand corporate donations, local and internationalfoundations, Canadian Crossroads International,the European Union, Irish Aid, United Nationsagencies, the U.S. President’s Emergency Planfor AIDS Relief (PEPFAR) through USAID, and SWAGAA4 These are currently undocumented; however, the Deputy Prime Minis-ter’s Office is working on a mapping exercise to better identify existing A small reception area for clients awaitingresources. services. Swaziland Action Group Against Abuse: Addressing Gender-based Violence within the Context of HIV 5
  6. 6. AIDSTAR-One | CASE STUDY SERIESresponse to GBV. An asset of SWAGAA’s approach prevention, human rights, trafficking in persons,has been its engagement with traditional leaders and the role of GBV as a driver in the HIVand power structures at the community level to epidemic. Other interventions, often implementedgarner support for programs, typically a first step in collaboration with other agencies, have includedfor working in a targeted area. Ongoing programs training for police, prosecutors, health providers,include the following. government agencies, and NGOs.Lihlombe Lekukhalela (LL; “A Shoulder School sensitizations: These peer-basedto Cry On”): This is a child protection initiative programs have been used to increase awarenesscreated by the Government of Swaziland and of abuse and promote HIV prevention throughUNICEF that several organizations, including abstinence. In SWAGAA’s 24 target communities,SWAGAA, have adopted. SWAGAA oversees three students per school are trained as peerthe LLs in 15 of its 24 target communities. Local educators, along with a teacher peer supporter, involunteer “child protectors” are provided training a two-and-a-half–day workshop. Male and femaleon how to identify children experiencing sexual, peer educators in turn train groups of 25 students,emotional, or physical abuse; support children and until every student in the school has receivedfamilies; and provide needed referrals to advocacy, training.legal, and medical services. “Child protectors,” whoare both male and female community volunteers, The male involvement initiative: Thisvisit homes to develop rapport with families and program, with the theme “Men for Change,” wasspot behaviors that might indicate abuse. They launched in 2006 in response to a communityare also known in the community as “go-to” adults assessment that returned feedback that menfor children in need. When children are identified and boys must be engaged if SWAGAA is towho have been abused, or who are orphaned be effective in achieving its goals. Canadianand made vulnerable by the impact of HIV, they Crossroads International supported the training,are provided opportunities to talk with a volunteer which included a study tour to Canada for the(given a “shoulder to cry on”) and referred to police, initiative’s first coordinator. The project is introducedlegal, and medical services, and other appropriate to communities by engaging the chief, the chief’sproviders. In addition, the LLs sponsor community inner council, and other influential males who aredialogues on GBV and HIV awareness and part of the traditional community power structure,prevention, and training to build the capacity of local with activities following once the men understandtraditional structures to respond to child abuse. the project (see Box 1).Education for prevention: Education Facilitators have been trained in all 24 SWAGAAprograms are central to SWAGAA’s approach. target communities. They organize men’s dialoguesThese include school sensitizations,5 girls’ as opportunities for men to come together toempowerment clubs, the LL initiative, the male discuss topics relating to gender norms. Theengagement initiative, and awareness campaigns. project’s focus is to engage men as partners inIn 2009 and 2010, more than 20,000 women, men, ending GBV. In 2009 and 2010, a total of 1,053 menand children were reached by these education were reached.programs through messages about GBV and HIV5 The term “sensitization” is used to refer to awareness raising activities, SWAGAA has been experimenting with bringingincluding short trainings or briefings. unmarried boys and young men into the male6 AIDSTAR-One | February 2012
  7. 7. AIDSTAR-One | CASE STUDY SERIESdialogues. While there is traditional reluctance to discuss intimatedetails of sexuality in their presence, SWAGAA hopes to reach the BOX 1: INTRODUCINGyounger generations to instill values of gender equality. One way of MALE INVOLVEMENTdoing this while keeping with traditional practices is to have the boys TO COMMUNITIESjoin the first part of the session where the discussion is kept moregeneral. 1. Provide sensitization on GBV at a regional chief’sOther activities of the male involvement initiative have included a meeting.Father’s Day campaign event, bringing 2,000 men together in oneplace, and a “Man of the Year” competition in collaboration with the 2. Address the localnational newspaper to recognize a man who displays attributes such chief’s inner council, theas respecting his female partner’s rights to be an equal in decision bandlancane.making and never using violence of any kind.Girls’ empowerment clubs: These clubs, adapted for Swaziland 3. Select two men from thefrom the Zimbabwe-based Girl Child Network, promote school-based local community to becomeweekly gatherings where girls can discuss topics of importance to volunteer facilitators.them, including sexuality, abuse, and HIV, while building confidence,assertiveness, and leadership capacity. A female teacher is recruited 4. Provide technicaland trained to serve as volunteer club coordinator at each school. knowledge and leadershipShe helps club members set their own agenda and determine skills to facilitators in aactivities within the parameters of the key issues. three-day workshop using materials from the Sonke Gender Justice Network in South Africa, internationally known for engaging men and boys in GBV and HIV prevention. Diane GardsbaneOne of the male dialogue participants. Swaziland Action Group Against Abuse: Addressing Gender-based Violence within the Context of HIV 7
  8. 8. AIDSTAR-One | CASE STUDY SERIES Counseling: SWAGAA provides face-to-face individual and group BOX 2: ESCAPING counseling in six locations and phone counseling through the national THE CYCLE OF toll-free line. In addition, SWAGAA provides psychosocial support ABUSE counseling, for GBV as well as other issues, for male, female, and juvenile inmates within the government’s correctional facilities. One of SWAGAA’s many stories of success includes SWAGGA’s staff includes both male and female counselors who work counseling a woman who with clients of the same and opposite sex. Counselors are trained came to discuss what through an annual two-week in-house program and receive on-the- she believed were false job training by accompanying a seasoned counselor. Additional in- accusations by her daughter service training, both in-house and external to SWAGAA, supplements that she was being raped staff expertise. Within its current Strategic Framework 2010–2013, by her father, the client’s the organization emphasizes the provision of comprehensive support husband. Counseling services to survivors. The role of counseling is to provide a safe space services helped the woman and to support and empower clients, help them to prevent further abuse, move from denial to and describe possible strategies to achieve economic security (see Box acceptance, and helped her 2). identify a way to create a microenterprise business to In fiscal year 2009/2010, a total of 1,753 clients received face-to-face support her household—her counseling services in all six locations. Quality counseling is maintained need for financial support by limiting the number of clients per counselor. Figure 2 provides a was a primary reason she breakdown of the types of abuse reported by these clients. While the was afraid of reporting majority of women and men report experiencing emotional abuse, for the the abuse to the police. 22 percent of clients who were children, more report sexual abuse than Recently, the client was ill any other form of abuse, and almost all were female. and tested positive for HIV. SWAGAA arranged for The intake process for clients who receive face-to-face counseling her to have help with her includes asking if they know their HIV status, although clients are not business so that she can pressured for disclosure. Clients who do not know their status are continue to make a living. encouraged to go for HIV testing and counseling services. All clients receive some counseling on HIV by SWAGAA, including referral to –SWAGAA counselor partner support groups for those who are HIV-positive and counseling on prevention strategies for those who are HIV-negative or do not know their status. Of 1,606 clients who were asked about their status, 214 (13 percent) were HIV-positive, 447 (28 percent) were negative, 688 (43 percent) did not want to disclose their status, and 257 (16 percent) did not know their status. For survivors of sexual assault who reported the assault within 72 hours, SWAGAA follows the initial counseling with a referral to the Family Life Association of Swaziland (FLAS) for emergency contraception and post-exposure prophylaxis (PEP). FLAS, an International Planned Parenthood Federation affiliate, is a provider of comprehensive sexual and reproductive health services that integrates family planning and HIV8 AIDSTAR-One | February 2012
  9. 9. AIDSTAR-One | CASE STUDY SERIESFigure 2. Types of Abuse Reported by Counseling Clients, Fiscal Year 2010 (N = 1,753)Source: recreated from SWAGAA 2010, 11.services for adults and youth. In turn, FLAS clients DNA kits by the end of October 2011, in line withare told about SWAGAA and offered a referral to the Ministry’s objective to increase uptake of PEPSWAGAA when abuse is revealed. services.SWAGAA has been instrumental in strengthening Case management: Individuals and familiesthe health sector’s response (clinics and hospitals) with complex needs are provided case managementto rape by incorporating providers into the referral services (203 clients were served in the 2009/2010network and by supporting the development of a fiscal year, an increase from 175 the previous year).national training manual for clinical management This entails identifying a survivor’s short- to long-of sexual violence cases. While there is a national term needs and providing mechanisms to meetprotocol for the provision of PEP, the awareness those needs, such as emergency food, shelter,and capacity of health facilities to provide PEP clothing, and medical attention, including accessacross the country are still limited. In 2007, 432 to PEP for HIV prevention, and follow-up; survivorspeople were provided PEP at the 22 health facilities also have access to protection and legal aid. Thisthat were equipped at that time to provide PEP care may involve referral to other service providers;services. for example, SWAGAA does not provide shelter but works with independently run shelters. SWAGAASWAGAA is part of the national PEP technical also finds housing for orphans and vulnerableworking group, led by the Ministry of Health, children, and helps women to develop opportunitieswhich recently trained personnel from 47 health for income generation. There are no shelter facilitiesfacilities on the collection of DNA evidence and specifically for survivors of trafficking in Swaziland.administration of PEP, and reviewed data collectiontools to ensure effective monitoring of the PEP SWAGAA convenes a network of organizationsprogram. These facilities were slated to receive working on related issues on a regular basis. Swaziland Action Group Against Abuse: Addressing Gender-based Violence within the Context of HIV 9
  10. 10. AIDSTAR-One | CASE STUDY SERIES The network developed a referral directory (2010) and will be creating BOX 3: PLANNING guidelines and tools to formalize and improve the entire referral process SUSTAINABLE as a next step. SERVICES SWAGAA is considering strategies to ensure sustainable management Case management is of clients’ needs given financial constraints (see Box 3). costly and challenging to do well, given the lack Self-help groups: Community self-help groups are a SWAGAA of adequate resources. strategy to reach rural women at the community level with strategies to Going forward, SWAGAA prevent violence and increase economic security. SWAGAA provides believes that a strategic training and organizational support to help women organize income- response to complex generating cooperatives that build savings and loan associations for survivor needs will include members. SWAGAA uses the groups for dialogues about issues that defining a comprehensive, include GBV and HIV, and encourages the development of informal multi-sectoral package of support groups among women. Women from one self-help group said services, defining protocols that the presence of their group in the community has helped to reduce and monitoring processes, the incidence of GBV. and developing tools and guidelines to support service Legal services for access to justice: The legal unit provides delivery. Key to successful women with GBV-specific legal needs including legal counseling and delivery will be a strong information, assistance and representation for peace-binding orders, partner referral network interdictions, divorce, custody, property rights, and restraining orders, and an effective national among others. To maximize limited resources, SWAGAA creates coordinating mechanism for GBV. –SWAGAA Executive Director Diane Gardsbane Self-help group stripping and cutting sisal to make salve marketed throughout Swaziland.10 AIDSTAR-One | February 2012
  11. 11. AIDSTAR-One | CASE STUDY SERIESrelationships with independent attorneys who agree the country have facilities to allow children to beto provide services at a greatly reduced, fixed fee. interviewed in private, if requested by a prosecutor.SWAGAA’s lawyer will draft papers and liaise withthe client to facilitate the private attorneys’ work and Monitoring and Evaluation andkeep costs down. Currently, three outside attorneys Surveillance Systems: SWAGAA has beenaccept cases from SWAGAA. working to establish an effective monitoring and evaluation system within a context of limitedThe legal unit also provides court preparation for resources. Community assessments are conductedchildren, women, and sometimes men to help them as needed and programmatic statistics areunderstand the judicial process and how to present recorded. SWAGAA plans to develop indicatorsthemselves in court. and tracking mechanisms to be able to measure program impact.SWAGAA is developing a Court Watch Program.As part of this program, SWAGAA staff have There is no routine surveillance in Swaziland tobeen given permission to sit in court to observe provide data relating to the incidence or prevalencecourtroom attitudes and behavior, with the goal of of GBV; however, a unique initiative in the Southernmaking recommendations for improvements toward Africa region is the development of the nationalrecognition of survivors’ rights, gender equity in surveillance system that collects data about GBVthe courtroom, and adherence to legal standards survivors who report abuse. All referral partnersrelating to GBV cases. collect monitoring data with agreed-on commonCommunications and advocacy: Advocacyis a cornerstone of SWAGAA’s work. The “We were banging on people’sorganization was centrally involved in advocating doors—demanding change—wefor the Sexual Offences and Domestic ViolenceAct, the People Trafficking and People Smuggling didn’t just sit in our offices. It(Prohibition) Act of 2009, as well as numerous other was speaking to individuals ininitiatives to reform laws and policies relating to decision-making positions anddomestic violence and child protection. SWAGAAplays a convening role with partners, calling them the police. We took survivors withtogether on a regular basis, and currently chairs us to tell their stories. We went tothe Gender Consortium, an advocacy group of communities and to schools. Usingapproximately 17 organizations that are members of case studies—true stories wherethe Coordinating Assembly for Non-GovernmentalOrganizations. we changed the names—was most effective in breaking through theSWAGAA has played a significant role in denial.”advocating for child-friendly courts, with onecourt functioning in the country’s capital city of –Nonhlanhla Dlamini, Member ofMbabane for several years, and a second court Parliament and former SWAGAAopening with support from UNICEF in Nhlangano Executive Directorin the Shiselweni District. Some courts throughout Swaziland Action Group Against Abuse: Addressing Gender-based Violence within the Context of HIV 11
  12. 12. AIDSTAR-One | CASE STUDY SERIES indicators relating to the type of abuse, location of abuse, victim LEVERAGING and perpetrator identity, and services and referrals provided. SWAGAA’S CAPACITY Monthly meetings are held where each organization reports on BY BUILDING A data collected, and the data is then consolidated into a national NETWORK OF surveillance report. PROVIDERS While there is no baseline for comparison, SWAGAA reports an Major strategies: increase of reporting on GBV based on anecdotal evidence. There is also growing support in communities for activities, such as • Quarterly meetings of campaigns for prevention of violence against women, which promote partners to facilitate changes in norms relating to violence against women and children. knowledge sharing, building of expertise in GBV, and networking among partners What Worked Well • Naming and mentoring of partner focal points to build Boldly speaking out: According to Cebile Manzini-Henwood, expertise SWAGAA Executive Director, SWAGAA’s success initially was largely based on the willingness of a few to speak out. She states: • Publication of a referral directory and distribution to When SWAGAA was first established by a group of Swazi all partners women, many of whom had been affected by violence, it was the first organization in Swaziland to boldly address the problem of • Development of national GBV, let alone women’s rights. A shock factor that rippled through multi-sectoral guidelines for society was created and continues to prevail when people think management of GBV about SWAGAA. It was a group of women with few resources, who took a stand to challenge the status quo, and who refused • Development of a national to allow things to continue the way they did. The initial work is surveillance system to what led to the reputation the organization has today—even if track reports of GBV by all the backlash was immeasurable! History, or rather ‘herstory’ was partners made. • Moving from providing Engaging survivors: Early organizational strategies may be the all direct services to a key to SWAGAA’s achievements in creating widespread awareness coordination and capacity of GBV. According to Member of Parliament Nonhlanhla Dlamini, building role. one of the former Executive Directors of SWAGAA, critical factors of early success were deep passion for the cause, perseverance in the face of adversity, the role of survivors who spoke out about their stories, and the strong support of the media, nurtured through meetings, training, and collaboration. These strategies continue to be useful today. Engaging the media: One of SWAGAA’s significant strategies from the beginning was engaging the media as partners, laying a12 AIDSTAR-One | February 2012
  13. 13. AIDSTAR-One | CASE STUDY SERIES Engaging men as partners: Working with men to achieve a more gender-equitable society has been critical to SWAGAA’s recent progress. As Programmes Manager Nelly Dlamini-Mtshali notes: “It is very important, especially in a patriarchal society. They don’t know how to share the power—or even what you mean by sharing the power. What they see is ‘you want to take this from me.’” SWAGAA uses a “man-to-man” approach, helping men reflect about their notions Diane Gardsbane of masculinity and engaging them as partners in GBV prevention. Among the changes since SWAGAA began to proactively engage men is aSWAGAA’s Programmes Manager Nelly Dlamini-Mtshali more open stance within communities for messagesexplains services. about GBV. Ultimately, it is hoped that men will be equally capable of taking a stand against GBV and raising awareness of HIV within their families andgroundwork that created a sustained relationship communities.that is still evident today. Early in SWAGAA’sdevelopment, staff held meetings with the editor Multiple partnerships: SWAGAA works inof each media house and took the time to learn close collaboration with civil society organizations,how the media works. SWAGAA continues to work government, United Nations agencies, and donorswith editors to understand and appreciate the to accomplish its mission and objectives. Partnerscomplexities of GBV, and provide training to help include Women and Law in Southern Africathe media become more sensitive to the needs of (Swaziland chapter); FLAS; Save the Children;those who survived violence. In turn, the media the Deputy Prime Minister’s Office, including theoften alerts SWAGAA about reports of abuse. As Gender Unit, the National Children’s Coordinationthe media prints newsworthy and important stories, Unit, and the Social Welfare Department; theSWAGAA acknowledges them with awards. Swaziland Police Domestic Violence Unit; Government Correctional Services; United NationsPartnering with community leaders: agencies, including UNICEF, the UN PopulationAll SWAGAA community programs begin with a Fund, and the UN Development Programme;presentation and sensitization on the issue to the and donors including PEPFAR. This increaseschief’s inner council. Official acceptance at this efficiency or resource use, and helps SWAGAAtraditional level allows the program to function and maintain its close focus on supporting survivors ofis typically the source for volunteers who staff the GBV.programs at local levels. Expanding organizational capacitySWAGAA’s work at the community level, particularly by building a broad-based network ofschool sensitizations, has promoted widespread providers: SWAGAA has placed a strongawareness and education about GBV and children’s emphasis on developing a network of partners thathuman rights, and provided SWAGAA with high can provide GBV services, including services tovisibility and virtually universal name recognition children, as a strategy to leverage its own capacitythroughout the country. to serve all GBV survivors in Swaziland. The goal, Swaziland Action Group Against Abuse: Addressing Gender-based Violence within the Context of HIV 13
  14. 14. AIDSTAR-One | CASE STUDY SERIESaccording to SWAGAA’s program director, is to expenses, which affect the organization’s capacitymove from a role as the sole provider of GBV for continuous quality service delivery.services in the country to coordinator of multi-sectoral and multi-agency service provision. Slow policy response: SWAGAA has greatly increased public awareness of GBV, slowly bringingSWAGAA initiated quarterly meetings of partners, about incremental changes in social norms relatingincluding police, legal, social welfare, and medical to gender inequity, and the government has adoptedservice providers, to provide an opportunity a new gender policy. Yet the policy environmentfor sharing of expertise and knowledge across in Swaziland remains difficult, as evidenced bysectors, building the expertise of partner NGOs the challenges in getting the Sexual Offences andand government providers in addressing GBV, Domestic Violence Bill passed.networking among partners, and developing areferral directory. Partners have named a focal point Limited internal capacity: SWAGAA facesthat SWAGAA can target for mentoring on GBV, serious challenges to its capacity to provide theand memorandums of understanding with specific most needed services. Infrastructure needs includeNGOs, such as FLAS, formalize services to be such basic items as a dedicated computer for theprovided to GBV survivors. monitoring and evaluation officer, and funds to conduct formal program evaluations. WhereasSWAGAA is also coordinating the development SWAGAA was once characterized by staffof national multi-sectoral guidelines for the longevity, today, few staff members have worked formanagement of GBV cases. SWAGAA for more than two years. Staff morale has declined with anxiety about job security and salary scales. Training needs include ensuring that all staffChallenges have good knowledge of international best practices in GBV, including issues relating to trafficking inSustainability of funding: While government, persons, a new area of concern for SWAGAA, andcivil society, and ordinary citizens place a very high men as clients.value on SWAGAA’s contribution to the country,funding is a constant challenge. For example, Serving men as clients: While engagingwhen SWAGAA’s budget grew from no designated men as partners to eliminate GBV has been afunds for work on trafficking in 2009 to $100,000 good practice, serving men as clients raisesin 2010, the organization’s budget for counseling questions that may not have been sufficientlyservices—the organization’s initial raison d’être— considered. Adult males comprised 22 percentwas reduced by the same amount. This raises the of clients in fiscal year 2001-2002, 25 percent inquestion of whether priorities to address trafficking fiscal year 2008-2009 (SWAGAA 2009), and 28come at the expense of domestic and sexual abuse percent in fiscal year 2009-2010 (SWAGAA 2010).programming. Interview participants said that Staff report that counseling is provided both toSWAGAA is taken for granted by many partners— men who say they are victims of abuse and towith an assumption that the organization will perpetrators. Perpetrators receive one-on-onealways be “bailed out” financially. Unfortunately, the anger management counseling; when the client isconstant funding uncertainty is affecting not only repentant and the couple wants to remain together,staff morale, but also the availability of resources, couples counseling and communication skillespecially for operational and administrative building is provided.14 AIDSTAR-One | February 2012
  15. 15. AIDSTAR-One | CASE STUDY SERIESThe 2009/2010 annual report indicates that433 adult men reported abuse, representing 28percent of all adult reports of abuse. While therehas been insufficient research to determine theextent of abuse suffered by men, some researchand considerable anecdotal data indicate that itis uncommon for women to establish the kind ofcoercive control over men that defines domesticviolence (Larance 2007; Pence and Das Dasgupta2006; Reed et al. 2010). The number of menreporting abuse to SWAGAA is high, and is raising Diane Gardsbanequestions about how to properly screen a man’sreport of abuse. For example, a man can beconvincing of his role as a victim, when SWAGAAcan later discover that he was the initial perpetrator. Members of a Lihlombe Lekukhalela.Some women report that after putting up withabuse for many years, they have begun to strikeback. SWAGAA, like many other GBV programs,is continuing to consider how to address these Use survivors’ voices to combat denialchallenging issues. and to determine needs: Denial that abuse occurs among families in one’s own community is a global issue. Having women who can tell theirChallenges with prioritization: SWAGAA stories can break this denial. In addition, includinghas been successful in generating public awareness women who have experienced abuse among staff,that GBV is a thread woven through every aspect board members, and volunteers is a good practiceof Swazi society. However, this success has pulled for programming and evaluation.the organization in many different directions. Asa result, many of SWAGAA’s programs serve a Use assessment to determine needs:cross-section of the population, including those who Situational analyses and baseline assessmentsmay not be directly affected by GBV. SWAGAA’s help to identify what is already working and what isrecent strategic planning process highlighted this not, and specifies gaps that can be filled. Questionsdichotomy, and the new strategic plan will more to ask include the following: What structuresclearly prioritize services to those most in need, are in place to provide support and service towith the additional priority, discussed previously, of women? Who are the key partners? How canbuilding the capacity of other agencies to address programs coordinate services? How can the linksGBV. between HIV and GBV prevention and services be improved?Recommendations Develop a national coordinating mechanism for GBV: SWAGAA sees theThe SWAGAA experience supports several lack of a national coordinating agency for GBV inrecommendations for other programs, as well as for Swaziland as a factor that limits the effectivenessits own continued development. and synergy of programming and partnerships. Swaziland Action Group Against Abuse: Addressing Gender-based Violence within the Context of HIV 15
  16. 16. AIDSTAR-One | CASE STUDY SERIESIncreasingly, SWAGAA sees the need to build the a deeper understanding of the complex issuescapacity of partner organizations to address GBV relating to GBV.as a way to meet growing needs, as awareness ofabuse increases in Swaziland. There is a sense that Leverage cultural assets: SWAGAA’s abilityreplicating a mechanism such as NERCHA for GBV to work so closely at grassroots levels and to gainwould support higher levels of service coordination, the legitimacy and respect required to broachas well as the development and coordination of sensitive topics in communities is to a large extentmulti-sectoral structural interventions that can related to its willingness to work with traditionalultimately impact the social and behavioral norms leaders. Rather than attempting to circumvent thethat promote GBV. traditional sector because they are often perceived as conservative and likely to object to the promotionAdvocate for a national budget for GBV: of new gender norms, SWAGAA staff have beenIn Swaziland, the absence of a reasonable national actively involved in engaging traditional leadersbudget for the Gender Unit, the National Children’s and fostering their commitment for the fight againstCoordinating Unit, and other government agencies all forms of abuse and GBV. Where appropriate,tasked with addressing gender inequity limits the efforts to leverage key cultural assets such as theability of these entities to do the work even with traditional sector to make them part of the solutioncommitted staff. A recommendation is to ensure can only strengthen and deepen programming.a sufficient national budget specifically for GBV.In addition, strengthening awareness of linkagesbetween GBV and HIV should lead to the allocation Future Programmingof some funds within HIV programs to also coverGBV interventions. SWAGAA developed a strategic plan for 2010 to 2013 that will streamline services andGenerate and use evidence: The international focus limited resources on five priority areas:evidence base on effective interventions for prevention of GBV, care and support for survivors,GBV remains thin. A key recommendation is to access to justice, financial sustainability, andincorporate monitoring and evaluation into all institutional strengthening. This approach isprograms. In addition, it is critical to identify funding intended to emphasize measurable objectivesto support an infrastructure with the capacity to and achievements, rather than focus on individualsupport evidence gathering from the beginning, so activities. Defining a comprehensive package ofthat data can be easily collected, analyzed, and services for women and an effective way to deliverreported, and the results used to improve programs. these services, including a strong referral network,SWAGAA has successfully used community is considered a major priority going forward.assessments and routine monitoring data as the Drawing on the success and popularity of its Girls’basis of program development, along with research Empowerment Clubs, the organization is currentlystudies. For example, SWAGAA supported a developing a similar initiative to work with boys tosignificant study by UNICEF on child sexual abuse, establish healthy gender norms. Administratively,A National Study on Violence Against Children and the focus will be on financial sustainability andYoung Women in Swaziland (2007), which provided institutional strengthening. g16 AIDSTAR-One | February 2012
  17. 17. AIDSTAR-One | CASE STUDY SERIESREFERENCES Swaziland Action Group Against Abuse. 2009. Swaziland Action Group Against Abuse: AnnualCentral Statistics Office and MEASURE Report 2008/2009. Manzini, Swaziland: SWAGAA.Demographic and Health Survey. 2007. SwazilandDemographic and Health Survey 2006-07: Swaziland Action Group Against Abuse. 2010.Preliminary Report. Mbabane, Swaziland: Central Swaziland Action Group Against Abuse: AnnualStatistics Office, and Calverton, MD: MEASURE Report 2009/2010. Manzini, Swaziland: SWAGAA.DHS, Macro International. United Nations Children’s Fund. 2007. A NationalLarance, L. Y. 2007. When She Hits Him: Why the Study on Violence Against Children and YoungInstitutional Response Deserves Reconsideration. Women in Swaziland. Geneva, Switzerland:Violence Against Women Newsletter 5(4):10–19. UNICEF.National Emergency Response Council on United Nations Country Team. 2009.HIV and AIDS. n.d. The National Multi-sectoral Complementary Country Analysis. Mbabane,Strategic Framework for HIV and AIDS 2009–2014. Swaziland: UNDP. Available at www.undp.org.Mbabane, Swaziland: The Kingdom of Swaziland. sz/index.php?option=com_docman&task=doc_ details&gid=202&Itemid=67 (accessed JanuaryNational Emergency Response Council on HIV 2012)and AIDS. 2010. Swaziland National Social andBehaviour Change Communication Strategy United Nations Department for Economic and2009–2014. Mbabane, Swaziland: The Kingdom of Social Affairs. 2009. World Population Prospects:Swaziland. The 2008 Revision. New York, NY: Department for Economic and Social Affairs.Pence, E., and S. Das Dasgupta. 2006. Re-Examining “Battering”: Are All Acts of Violence U.S. Agency for International DevelopmentAgainst Intimate Partners the Same? Duluth, MN: Swaziland. 2010. Swaziland: HIV/AIDS HealthPraxis International, Inc. Profile. Mbabane, Swaziland: U.S. Agency forReed, E., A. Raj, E. Miller, and J. G. Silverman. International Development.2010. Losing the “Gender” in Gender-BasedViolence: The Missteps of Research on Dating and U.S. Department of State. 2010. Trafficking inIntimate Partner Violence. Violence Against Women Persons Report 2010 - Swaziland. Available at16(3):348–354. www.unhcr.org/refworld/docid/4c1883c323.html (accessed May 2011)Reza, A., J. Breiding, J. Gulaid, et al. 2009. SexualViolence and Its Health Consequences for Female World Atlas. 2010. “Map of Swaziland.” AvailableChildren in Swaziland: A Cluster Survey Study. at www.worldatlas.com/webimage/countrys/africa/Lancet 373:1966–1972. sz.htm (accessed December 2010) Swaziland Action Group Against Abuse: Addressing Gender-based Violence within the Context of HIV 17
  18. 18. AIDSTAR-One | CASE STUDY SERIESACKNOWLEDGMENTS RECOMMENDED CITATIONThe authors would like to thank all of the Gardsbane, Diane, and Sizakele Hlatshwayo. 2012.SWAGAA staff, particularly Cebile Manzini- Swaziland Action Group Against Abuse: AddressingHenwood, SWAGAA Executive Director, and Gender-based Violence within the Context of HIV.Nelly Dlamini-Mtshali, SWAGAA Programmes Case Study Series. Arlington, VA: USAID’s AIDSManager; Natalie Kruse-Levy, U.S. Agency for Support and Technical Assistance Resources,International Development Gender Focal Point; as AIDSTAR-One, Task Order 1.well as the many representatives of government,United Nations agencies, and nongovernmental Please visit www.AIDSTAR-One.com fororganizations that took the time to meet with additional AIDSTAR-One case studies and otherthem. The authors owe a special thank you to the HIV- and AIDS-related resources.community groups they visited and interviewed,including a self-help women’s group, a LihlombeLekukhalela meeting, and men participating in amale dialogue session. Thanks also to the U.S.President’s Emergency Plan for AIDS Relief GenderTechnical Working Group for their support andcareful review of this case study.18 AIDSTAR-One | February 2012
  19. 19. AIDSTAR-One’s Case Studies provide insight into innovative HIV programs and approachesaround the world. These engaging case studies are designed for HIV program planners andimplementers, documenting the steps from idea to intervention and from research to practice.Please sign up at www.AIDSTAR-One.com to receive notification of HIV-related resources,including additional case studies focused on emerging issues in HIV prevention, treatment,testing and counseling, care and support, gender integration and more.

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