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the police department piloted Gender and Children’s Desks at police stations in Dar es
Salaam in an attempt to offer more “woman-friendly” services. Gender and Children’s
Desks, staffed by male and female police officers, provide private locations for discussing
sensitive matters—including GBV—and officers frequently offer escort services (for example,
to the hospital), represent survivors in court, and may also provide temporary shelter at the
police station or to a female police residence. However, the program has only recently
expanded to districts beyond Dar es Salaam. Access for rural women remains limited.
4. Health Sector
Tanzania’s public health system, administered by the MoHSW, is also decentralized.
Community Health Workers (CHWs) operate at the village level; however, they are
generally considered to only provide advice for maternal and child health issues. They were
not mentioned in relation to formal GBV services during the course of this research. 21 Health
dispensaries provide the most basic level of care, and can assist a survivor with first aid for
minor injuries. Most often they will refer GBV cases to a higher-level health facility with
more comprehensive services. Health centers offer the next level of care and can treat a
wider range of injuries, for example, those requiring incisions and drainage. While District
Hospitals offer both inpatient and outpatient care and some basic laboratory testing,
comprehensive services for GBV survivors are available only at selected health centers,
District Designated Hospitals (DDH), District Hospitals, as well as referral hospitals.
Depending on the capacity of the facility and the availability of supplies, these services can
include post-exposure prophylaxis (PEP), HIV and STI screening and treatment, collection of
forensic evidence, and counseling for cases of sexual assault. For physical injuries resulting
from GBV, survivors will receive medical management of their injuries, including stitches,
antibiotics, and wound dressing, and, in rare cases, counseling. Survivors who report GBV
will be required to obtain a PF3 before they receive this care. However, a woman can choose
not to report that her injuries were due to violence and will still be able to receive the
necessary services.
In contrast to government-supported health facilities, private clinics and hospitals are not
authorized or mandated to complete PF3 forms. As a result, their capacity to respond to
cases of GBV is very limited. This is a serious constraint, given that an estimated one-third
of health services in Tanzania are provided outside of the public system. The range of
services provided by NGOs, FBOs, and other private organizations that operate health
facilities varies according to the mandate of each organization and the specific center. In
addition, Tanzania also has several Voluntary Counseling and Testing (VCT) centers that
provide services for GBV survivors. However, to date, GBV has not yet been systematically
integrated into these facilities. 22
According to the Tanzania Service Provision Assessment (SPA) conducted in 2006, the
number of medical personnel (including doctors and assistant medical officers) per 10,000
21 No CHWs were interviewed for this study.
22 While no independent VCT centers were interviewed for this study, interviews with hospital-based
providers who offer VCT highlighted the importance of including GBV-related services in VCT.
Help-Seeking Pathways and Barriers for Survivors of GBV in Tanzania March 2013
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