A systematic review of the evidence on one-stop centre models for victims of gender-based violence in low- and middle-income countries: Implications for Thuthuzela Care Centres in South Africa

Gender-based violence (GBV), including intimate partner violence and sexual assault, continues to be a pervasive public health issue globally and in South Africa. One-stop centre (OSC) models have emerged internationally as integrated approaches to service delivery, designed to reduce secondary victimisation and improve access to coordinated medical, legal and psychosocial support for survivors. South Africa’s Thuthuzela Care Centres (TCCs) reflect a local adaptation of this model. However, implementation across provinces is uneven, and minimum service standards are not consistently applied. This systematic review aimed to assess the evidence from low- and middle-income countries (LMICs) on OSC models for GBV response to inform the refinement of minimum standards within the South African TCC framework. A systematic search of five electronic databases (MEDLINE, PubMed, Scopus, CENTRAL, EBSCOhost and Google Scholar) was conducted to identify peer-reviewed articles published between 2010 and 2021. The search strategy was informed by PRISMA 2020 guidelines. Narrative synthesis was conducted, using both preliminary synthesis and thematic analysis. A total of 10 studies met the inclusion criteria. Six were conducted in African countries and four in Asia. Most studies focused on the evaluation of existing OSC models ( n = 5) or the implementation of OSC services ( n = 4), with one study examining provider responses to GBV. Three major themes emerged from the synthesis: (1) strategies that enable optimal engagement with OSC models; (2) systemic and contextual barriers to access and implementation; and (3) the role of trust and relational agency in survivor–provider interactions. The findings demonstrate that while OSC models offer a promising framework for integrated GBV care, their effectiveness is mediated by relational, institutional and contextual factors. This review supports the need for national guidelines that incorporate survivor-centred principles, cross-sectoral collaboration and relational care practices to ensure equitable and effective service provision.