Long-term rehabilitation needs of survivors of conflict-related sexual violence in Kosovo: a scoping review of challenges and policy directions

Background More than two decades after the 1998–1999 Kosovo conflict, survivors of conflict-related sexual violence (CRSV) continue to experience profound long-term consequences across physical health, mental health, psychosocial wellbeing, economic stability, and social stigma. Despite landmark policy advances, including the 2014 legal status recognition, rehabilitation responses remain fragmented, under-resourced, and heavily dependent on the non-governmental sector. This scoping review maps the existing evidence on the long-term rehabilitation needs of CRSV survivors in Kosovo and identifies system-level barriers impeding access to comprehensive rehabilitation. Methods A scoping review was conducted following the Arksey and O'Malley framework, with reporting guided by the PRISMA extension for Scoping Reviews (PRISMA-ScR). Systematic searches were conducted in PubMed, Scopus, Web of Science, and Google Scholar, supplemented by a targeted grey literature search using systematic methods Godin et al. across institutional websites and Google Advanced Search. Records were screened against Population-Concept-Context(PCC) eligibility criteria. Data were charted using a standardized extraction form and synthesized thematically across five rehabilitation domains. Results A total of 37 sources were included: 19 peer-reviewed studies and 18 grey literature documents, including research and policy documents, government reports, non-governmental organization (NGO) reports, UN reports, and program evaluations. Sources spanned 2000–2025. Thematic synthesis identified five domains of unmet rehabilitation need: mental health and psychosocial wellbeing, physical health, legal and rights-based access, economic rehabilitation, and community reintegration. Four cross-cutting structural barriers were identified: the gap between legal recognition and substantive rehabilitation entitlements; NGO-state service dependency; stigma as a structural barrier; and unaddressed intergenerational trauma. The findings further highlight delayed accountability for CRSV as a critical constraint on rehabilitation. Conclusion Kosovo's CRSV rehabilitation landscape is characterized by substantial policy progress alongside persistent implementation gaps. Comprehensive survivor-centered rehabilitation requires institutionalization of services within the national health and social welfare system, a rights-based approach that links recognition to substantive entitlements, community-level norm change, and expanded attention to long-term and intergenerational impacts of trauma. Findings offer transferable lessons for other post-conflict settings where CRSV survivors remain underserved.