Background: Sexual and gender-based violence (SGBV), including rape and child sexual abuse, remains a significant challenge
in post-conflict northern Uganda. Many victims have never sought help. Consequently, the scale of the problem is not known,
and SGBV victims’ injuries, both psychological and physical, remain hidden and unresolved.

Objectives: We aimed to explore whether health workers in rural Reproductive Health Services (RHS), following specific training,
could provide a valuable resource for SGBV screening and subsequent referral to targeted services.

Methods: Our project had three elements. First, RHS workers were trained to use a questionnaire to screen subjects for past
SGBV. Second, the screening questionnaire was used by RHS workers over a 3-month period, and the data collected were analysed
to explore whether the screening approach was an effective one in this setting, and to record the scale and nature of the
problem. Third, victims detected were offered referral as appropriate to hospital services or to a dedicated SGBV ActionAid
shelter.

Results: Of 1656 women screened, 778 (47%) had suffered SGBV: 123 rape, and 505 non-sexual violence. 1,254 (76%) had been
directly or indirectly affected by conflict experiences; 1066 had lived in internally displaced persons camps. 145 (9%) requested
referral to Gulu SGBV Shelter; 25 attended the shelter and received assistance, and 20 others received telephone counselling.

Conclusion: Undetected SGBV remains a significant problem in post-conflict northern Uganda. RHS workers, following specific
training, can effectively screen for and identify otherwise unrecognised survivors of SGBV. This matters because without
ongoing detection, survivors have no opportunity for resolution, healing or help.

Keywords: SGBV; resource-poor setting; Screening.