The recently released 2024 Violence Against Women (VAW) Survey in Bangladesh showcases a stark reality. Conducted by the Bangladesh Bureau of Statistics and UNFPA, the survey reveals that over 70% of women have experienced intimate partner violence (IPV) in their lifetime, with 49% experiencing IPV in the past year alone. Emotional violence and controlling behaviour are the most prevalent forms of violence against women, as per the survey, with 68% of respondents reporting exposure to controlling behaviours. The survey also revealed that 8% of women with access to technology experienced tech-facilitated gender-based violence in their lifetime. Despite this, over 60% of survivors never shared their experiences with anyone. The data reflects a crisis that extends far beyond Bangladesh’s borders and affects communities across South Asia.
For survivors of gender-based violence the barriers to seeking support are systemic and deep rooted. The most common reason women did not disclose experiencing gender-based violence was that it was “unnecessary”, alongside fears of losing family honour and facing public disgrace, as per the survey. Only 14.5% women sought any form of treatment following experiences of violence in the last 12 months.
Sexual and Gender-Based Violence in South Asia
The prevalence of gender-based violence, particularly intimate-partner violence (IPV) in South Asia surpasses global averages. As per India’s latest National Family Health Survey (NFHS 5), nearly one-third of women aged 18-49 have experienced physical or sexual violence in their lifetime. Data from Nepal paints a similar picture, where one in four ever-married women have experienced spousal violence. In Sri Lanka, one in five women have experienced sexual or physical violence by an intimate partner in their lifetime, and in Bhutan two in five women experience intimate partner violence.
Sexual and gender-based violence (SGBV) and sexual and reproductive health (SRH) are inextricably linked. Health systems are critical entry points for SGBV survivors, as women access health services at multiple points, from primary care centres to hospitals to family health clinics. These touchpoints provide crucial opportunities for identifying and supporting SGBV survivors. However, survivors may delay seeking care due to a lack of privacy and confidentiality in healthcare settings. When they do access services, they may not have access to essential sexual and reproductive health services such as STI screening and treatment, HIV services, or obstetric care.
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Healthcare is often the first place where survivors try to disclose violence, but there is a tendency to notice only physical injury or sexual violence. We understand that SGBV also includes emotional abuse and coercive control. We have built comprehensive SGBV screening into every step of our services. — Dr Kalpana Apte, Director-General, the Family Planning Association of India
Integrating SGBV Response in Healthcare Systems
At the IPPF, the Integrated Package of Essential Services (IPES+), positions SGBV support as one of eight core components of sexual and reproductive healthcare, alongside contraception, safe abortion care, HIV services, STI/RTI treatment, gynaecology, prenatal care, and counselling. The IPES framework recognizes that SGBV support services cannot be siloed—a woman seeking access to contraception may be experiencing reproductive coercion; a prenatal visit may reveal intimate partner violence; an HIV test may uncover sexual abuse. By integrating first-line support including psychosocial support and referral pathways across all SRH service delivery points, IPES+ ensures that survivors can access comprehensive care regardless of their entry point into the health system.
However, it is important to operationalize this integrated approach with context-specific models that recognize SGBV support as essential to SRH services.
Service Models Across South Asia
In India, the Family Planning Association of India has been integrating SGBV screening and support into its comprehensive SRH services across clinics in the country. FPA India provides counselling and referrals to survivors, working in partnership with government agencies, one stop centres, legal aid agencies, and other NGOs to create a continuum of care for survivors.
“Healthcare is often the first place where survivors try to disclose violence, but there is a tendency to notice only physical injury or sexual violence. At FPA India, we understand that SGBV also includes emotional abuse, coercive control, psychological harm, and technology-facilitated SGBV. We have built comprehensive SGBV screening into every step of our services to ensure survivors receive the best care”, says Dr Kalpana Apte, Director-General, the Family Planning Association of India.
Across the region, the Family Planning Association of Nepal, the Population Services and Training Centre in Bangladesh, and Family Planning Association of Sri Lanka similarly embed SGBV awareness, screening, and referral into their SRH programming, ensuring that SGBV survivors are provided comprehensive support services at every step.
In Afghanistan, the resurgence of the Taliban, compounded by the collapse of formal support mechanisms, has put Afghan women and girls at a greater risk of experiencing SGBV. Healthcare facilities then often become the last refuge for survivors. The Afghan Family Guidance Association provides critical psychosocial support services amid the protracted humanitarian crisis in the country. AFGA’s Family Health Houses (FHH) provide a safe space, with trained counsellors providing psychosocial support services to Afghan women and girls.
While data on SGBV prevalence among gender-diverse populations is largely absent from national surveys, they are often at a higher risk of experiencing SGBV. Accessing affirmative and bias-free support services is especially difficult in restrictive settings. In Bangladesh, the key population clinic under the Proyojon program of the Bandhu Social Welfare Society employs a community-centred model that provides mental health counselling and care for gender-diverse communities. Bandhu’s advocacy has also contributed to the inclusion of counselling for gender-diverse individuals in mental health protocols at selected government facilities.
Respect Educate Nurture and Empower Women (RENEW) in Bhutan has built the region’s most comprehensive multi-sectoral approaches to SGBV response. RENEW’s Multi-Sectoral Task brings together health providers, police, legal services, and social workers to ensure survivors receive comprehensive, coordinated care. In 2024, RENEW launched the Rainbow Help Desk, the country's first dedicated support service for the LGBTI+ community experiencing sexual and gender-based violence, to enhance support for vulnerable communities.
“We identified, through direct community engagement, just how widespread is the violence, stigma, and discrimination against LGBTI+ individuals. They are disproportionately impacted yet remain unheard. We launched the Rainbow Help Desk, a dedicated, safe, and affirming space where LGBTI+ individuals can seek psychosocial support without fear”, adds Tshering Dolkar, Executive Director, RENEW.
Linking SRH Services with Survivor Support
The evidence is clear: SGBV support must be integrated into sexual and reproductive health services. Healthcare providers are uniquely positioned to reach survivors who might be hesitant to approach police stations or crisis centres but who will seek access to contraception, maternal health, or STI treatment services. By building provider capacity, strengthening referral networks, and creating survivor-centred approaches, the IPPF Member Associations and Collaborative Partners across South Asia, are demonstrating how to integrate SGBV support into comprehensive SRH services, ensuring survivors receive safe, confidential and compassionate support.
