Whether marginalized populations, such as adolescents, LGBTQ+ people, migrant workers, and sex workers are included in health services can be a “litmus test” of our progress towards universal health coverage (UHC), said Sivananthi Thanenthiran, Executive Director of Asian-Pacific Resource and Research Centre for Women (ARROW). Thanenthiran spoke at a recent Wilson Center event with the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) Department of Sexual and Reproductive Health and Research about the importance of engaging stakeholders in sexual and reproductive health (SRH) to achieve UHC for all. In SRH services, the most marginalized and most vulnerable populations are often left out, she said. When engaging stakeholders, representatives from these groups must be included to ensure equity in healthcare services.

After enduring sexual violence in the DRC conflict, Steven Kighoma fled to Uganda where he became an activist with the NGO, Men of Hope Refugee Association, supporting male victims of conflict-related sexual violence. The experiences of male victims include rape, being forced to watch family members being raped, being beaten on the genitals, and enduring other kinds of abuse. Compounding their trauma, men who have suffered sexual violence in the region are often seen as not properly masculine and face homophobic violence and criminalization, regardless of their sexual orientation. In addition, they face exclusion from survivor support services which assume that only women face sexual violence.

The biggest challenge is “the ignorance of the government, the medical institutions, the community, not knowing a male victim of sexual violence exists,” says Kighoma. “There is a confusion when you talk about male victims of sexual violence. People confuse it with homosexuality.”

“From birth, from almost from cradle to grave, girls have been seen as some sort of baggage,” said Shamsa Suleiman, Project Management Specialist for Gender and Youth at the U.S. Agency for International Development (USAID), Tanzania. Suleiman spoke at a recent Wilson Center event with USAID MOMENTUM Country and Global Leadership about balancing power dynamics to achieve equity for all women and children in maternal, child, and adolescent health, and family planning. Home should be a safe space, said Suleiman. But for many girls, it no longer is. To escape the poverty and pressures at home, including early marriage and other forms of gender-based violence, some girls leave, said Suleiman. “Girls are trying to escape the safe spaces.”

According to the World Health Organization, 1 in 3 women in the world will experience physical or sexual violence during their lifetime. Intimate partner violence is the most common form of violence, impacting an estimated 641 million women worldwide. Lockdowns and disruptions in access to support services due to the COVID-19 pandemic have exacerbated the prevalence of gender-based violence (GBV).

“One hundred thirty-seven women are killed by a family member every day,” said Beth Schlachter, Executive Director of Family Planning 2020. “That’s a staggering statistic.” She spoke at a recent Wilson Center event about gender-based violence (GBV) in conflict and humanitarian settings in partnership with CARE, the International Rescue Committee (IRC), Save the Children, and the Women’s Refugee Commission. The event was a part of a Wilson Center series recognizing the United Nation’s “16 Days of Activism Against Gender-Based Violence” and commemorated our friend and colleague, Jennifer Schlecht.

When Mwanahamisi Abdallah’s mother announced plans to marry her off to a stranger, the 14-year-old Tanzanian girl burst into tears. She had no desire to marry—especially after learning the man already had three wives. Remembering advice from a teacher, she phoned authorities to intervene. They blocked the wedding and eventually delivered Mwanahamisi from her village in southeastern Lindi region to a girls’ shelter in Dar es Salaam.