Screening for sexual violence against children in humanitarian settings: a feasibility study of a para-social worker-led intervention in Uganda

Abstract Background Sexual violence against children (SVAC) is an acknowledged concern in humanitarian settings; yet, effective, tested interventions to support disclosure and access to care remain limited. This study assessed the feasibility of implementing SVAC screening, referral protocols, and service provision, in a bid to rectify these limitations within two primary schools in Uganda’s Kiryandongo Refugee Settlement. Methods A mixed-methods concurrent triangulation design was used to implement and assess the feasibility of a seven-month intervention (April–October 2024) in two primary schools. Para-Social Workers, trained under Uganda’s Ministry of Gender, Labour and Social Development, screened Primary 6 and 7 pupils, aged 11 to 35 years old, for SVAC. Older pupils (Primary 6–7) were selected for their perceived capacity to engage on the topic. Survivors received school-based psychological first aid and were referred to additional services as needed. Results The intervention demonstrated strong demand and acceptability among the target populations. All 831 eligible pupils assented to intervention participation, and the majority (96%, n = 794) ended up actually participating in the screening exercise. Of these, 82% ( n = 653) disclosed experiencing SVAC, with 100% receiving care. In contrast, in the absence of screening in the 12-month period before the intervention, only 16 pupils in the same primary schools disclosed experiencing SVAC and obtained care. Stakeholders – including parents, teachers, government, and humanitarian actors – expressed strong support for expanding the model, while pupils reported high levels of satisfaction with the intervention. Conclusions Proactive SVAC screening in schools within humanitarian settings is both feasible and holds promise for effectively identifying and supporting child and adolescent survivors of sexual violence. The intervention significantly increased disclosure and service uptake and was well received by all stakeholders. Findings support the adaptation and cautious scale-up of this model in similar, carefully selected and adequately resourced, crisis-affected contexts.