By:
Gloria Seruwagi Research Uptake Manager, Baobab Research Programme Consortium
Constanza Ginestra Research and Policy Specialist,
Together for Girls
Children who have been affected by humanitarian crises are presumed to be more vulnerable to violence. However, rigorous evidence on the scale and consequences of this violence is limited.
Developing standardized approaches to quantify these is critical to promoting children’s healthy development and well-being and ending violence against children in humanitarian contexts.
The Violence Against Children & Youth Surveys (VACS) have been conducted in more than 20 countries, leading to significant positive shifts in child protection policy and practice around the world.
The Uganda Humanitarian Violence Against Children & Youth Survey (HVACS) is unique because it is the first-ever VACS to be conducted exclusively in a humanitarian setting – specifically, in all 13 of the country’s refugee settlements*. It is an extremely rigorous survey that assesses the prevalence, nature, and consequences of physical, emotional, and sexual violence against children in these settings.
Changing the game
Children living in humanitarian settings are presumed to be more vulnerable to violence, but for a long time, we had no way to measure the scale of this issue.
Until the completion of the Uganda HVACS in 2022, it was widely believed that conducting rigorous surveys in humanitarian settings was difficult—even impossible —due to contextual volatility and human and financial resource limitations.
In fact, in most VACS countries, humanitarian-affected populations were intentionally excluded. For instance, Uganda, Tanzania, and Kenya all have refugee contexts. Still, these were excluded from the VACS sample due to host governments’ concerns about how representative this data would be and whether it would skew the results.
The successful completion of the HVACS not only refuted this line of thinking but has provided a standardized approach to measuring the scale of violence against refugee children and youth and insights into how to address it.
Once the HVACS methodology was developed and implemented in Uganda, it became clear that it could be adapted to different humanitarian settings. Shortly after the first-ever HVACS was conducted in Uganda, lessons were drawn from this process to undertake a second HVACS in Ethiopia, for which data collection was completed in 2024.
Why Uganda?
Uganda has the largest share (31%) of refugees in the East and Horn of Africa – Great Lakes region, hosting over 1.7M of them. The country is considered to have one of the most compassionate refugee policies – notably being “open-door”, with provisions for refugee integration and freedom of movement, employment support, and the sharing of resources between refugee-host communities.
Additionally, Uganda has ratified key child rights treaties at the global and African levels, as well as implemented their provisions at the country level by putting in place robust legislative, policy, and institutional frameworks that guarantee the protection of children from violence.
How was the Uganda HVACS conducted?
The Baobab Research Program Consortium adapted the country-level VACS for implementation in refugee settings.
This was a crucial step towards addressing a significant research gap and ensuring that there is comprehensive, population-level data to inform a cross-sectoral response to violence against children and youth in these settings.
This work was done using the Implementation Guidance for HVACS, developed by Together for Girls, the US Centers for Disease Control and Prevention (CDC), and the International Rescue Committee with support from experts across multiple disciplines.
The HVACS was conducted in partnership with the Office of the Prime Minister (OPM), Department of Refugees**, which added another layer of political ownership and utilization uptake of the data collected. Since the lead government agency for the 2015 VACS and currently in charge of child protection in Uganda is the Ministry of Gender, Labour and Social Development, conducting the survey helped bring together these two government bodies and expand partnerships for child protection in Uganda.
Additionally, the survey implementation team worked closely with local resource persons agencies to effectively navigate personnel and mobility challenges to ensure that there was a quality, robust data collection process for the HVACS.
The team also worked closely with UNHCR and its implementing partner organizations situated in the refugee settlements to effectively navigate personnel and mobility challenges, and to ensure that there was a quality, robust response for survivors of violence identified during the HVACS.
The HVACS contains the same data as the standard country-level VACS, including the prevalence of violence, context, consequences, and access to services. It sampled females and males between the ages of 13 and 24 living in selected households in all 13 refugee settlements in Uganda.
The data were analyzed to provide:
the prevalence of violence against children/violence experienced in childhood (physical, sexual, and emotional), defined as violence occurring before age 18 years among 18-24-year-olds, and
the prevalence of violence in the past 12 months among adolescents (ages 13-17) and young adults (ages 18-24).
The HVACS includes context-specific data, including whether violence happened before or after arriving in the settlement; additional categories for perpetrators (e.g. aid workers); a module on other types of violence (family member or someone close killed, serious injury/disfigured, abduction, village attacked); disruptions to education and country of origin.
Some of the key findings of the Uganda HVACS are:
Violence affects many children and adolescents in refugee settlements in Uganda: Nearly half of females and males aged 18-24 years have experienced at least one form of violence (sexual, physical or emotional) before age 18.
Children’s first experience of each violence form often occurs subsequent to their arrival at the refugee settlement. For example, nearly three-quarters (73%) of girls and more than half (53%) of boys in the 18-24-year-old age range experienced the first incident of sexual violence after arriving at their settlement.
Children often miss school due to sexual violence. More than one-quarter (26%) of adolescent girls and more than half of adolescent boys (58%) (ages 13-17) missed school due to an experience of sexual violence.
Disclosure of violence is very low: only 17% of males and 5% of females who experienced sexual violence in childhood sought help, and 3% of females and 17% of males received help.
The first HVACS: data to action
Following the data analysis of the HVACS, policymakers and other relevant stakeholders were engaged in a ‘Data-to-Action’ Workshop to analyze the evidence and identify prevention priorities by sector based on the survey findings.
Following this workshop, the HVACS findings will feed into the next iteration of Uganda’s National Child Policy Implementation Plan in 2025.
Additionally, data from Uganda’s VACS and HVACS were used to inform some of Uganda’s commitments at the first-ever Global Ministerial Conference on Ending Violence Against Children.
After the HVACS findings captured unacceptably high rates of violence, the Baobab RPC partnered with the Ugandan Ministry of Gender, Labour and Social Development (MGLSD) to adapt and pilot a school and community-based intervention designed to promote survivor-disclosure and expand access to information and quality services relating to sexual violence through para-social worker*** involvement in screening. The intervention was successfully tested in Kiryandongo, one of the refugee settlements with the highest rates of violence, and plans for scale-up are currently underway.
Following the success of this intervention – specifically the current, vertical scale-up activities around this community-based para-social worker model – HVACS data, coupled with evaluation evidence on the model’s feasibility and effectiveness, is informing and directly supporting the review of MGLSD’s National Para-Social Workers Training Manual and development of a handbook for para-social workers as first-line responders of violence cases within their communities.
Additionally, the HVACS dataset is openly accessible to the public, and we are exploring partnerships with researchers and other interested stakeholders to maximize the use of this data to influence prevention programs and interventions, whether directly working with Baobab or through independent initiatives.
At this stage, we have partnered with practitioners, research and policy think tanks to use HVACS data in designing training and learning resources.
For example, the HVACS featured heavily on LearnVACS, a new course developed by Together for Girls, the University of Oxford’s Department of Social Policy and Intervention, the London School of Hygiene and Tropical Medicine (LSHTM) and AfriChild on using and analysing VACS data. We have also collaborated with leading academics at Makerere University in Uganda who are already using HVACS data as part of their teaching and instruction materials.
The impact of the HVACS
By filling a critical knowledge gap – on the prevalence, nature, and consequences of violence against children and youth in refugee settings – the HVACS has already influenced critical policy planning and programming and led to further research and academic use.
This rich, contextualized data has provided critical insights for programmatic and policy strategies to address violence against children and youth in humanitarian settings.
Developing a standardized approach to quantifying the scale of violence against children and adolescents in refugee settings is critical to ensuring their healthy development and well-being as the number of underage refugees continues to grow.
The first HVACS was a huge step in the right direction, and with the Ethiopia HVACS data collection being completed in 2024, we will be making new strides in protecting children and adolescents impacted by humanitarian crises.
*The survey was implemented between March and April 2022 in all 13 refugee settlements in Uganda.
The sampling frame for the 2022 Uganda HVACS included all zones – as defined by UNHCR – in all 13 refugee settlements in the country. The settlements included Adjumani in Adjumani district, Bidibidi in Yumbe district, Imvepi in Terego district, Kiryandongo in Kiryandongo district, Kyaka II in Kyegegwa district, Kyangwali in Kikuube district, Lobule in Koboko district, Nakivale in Isingiro district, Oruchinga in Isingiro district, Palabek in Lamwo district, Palorinya in Moyo district, Rhino in Madi-Okollo/Terego districts, and Rwamwanja in Kamwenge district.
**The survey was planned and implemented as a partnership between the Department of Refugees in the Office of the Prime Minister (Uganda), the United Nations High Commissioner for Refugees (UNHCR) Regional Bureau for the East, Horn of Africa, and Great Lakes Region, UNHCR - Uganda, UNHCR Implementing Partners in Uganda (Danish Refugee Council, Humanitarian Assistance and Development Services, International Rescue Committee, Lutheran World Federation, and Medical Teams International), and the Baobab RPC, comprising Population Council Inc., Population Council- Kenya, and the African Population and Health Research Center (APHRC).
The Department of Refugees in the Office of the Prime Minister (Uganda), the Baobab Research Programme Consortium, and UNHCR implementing partners guided the field implementation activities.
The U.S. Centers for Disease Control and Prevention (CDC) and Together for Girls (TfG) provided technical guidance for the survey's planning and implementation. CDC developed the original study protocols, tools, and training materials adapted for the Uganda HVACS and further provided technical guidance for electronic data collection and analysis.
***Para-social workers are a lower tier of trained social workers who are based in the community. They are not trained as psychologists, counselors, or GBV specialists but are given rigorous training to act as the first line of response at the community level when child protection cases arise. They respond to violence cases and provide referrals to the systems in place when these cases need to be escalated. The Ugandan Government fronted this model cognizant of human resource challenges in these resource-limited settings with high cases of violence. Baobab has conducted a forthcoming evaluation of this model’s effectiveness.