Beyond the 72 hours: Strengthening Care for Survivors of Violence to Secure a Better Future for Eastern Democratic Republic of Congo

In eastern Democratic Republic of Congo, ongoing conflict and displacement continue to place women, girls, and children at extreme risk of violence and has triggered an enduring humanitarian crisis. Health facilities are often overstretched, access to care is uneven, and lifesaving services for survivors are frequently disrupted by insecurity, supply shortages and limited humanitarian access.

The humanitarian crisis is also an economic crisis. Gender-based violence (GBV) costs countries an estimated 1.2 to 3.7% of GDP in lost productivity, more than most governments spend on primary education. When women and girls are injured, traumatized, or forced from their communities, they are also pushed out of the workforce, out of classrooms, and out of the economic life that is the surest path out of poverty. Protecting survivors and enabling their recovery is therefore a foundational investment in human capital, in jobs, and in the DRC's long-term development.

Within the challenging DRC context, the Stabilization and Recovery in Eastern DRC (STAR-Est) Project (project website) is strengthening essential services for survivors of violence in the three Eastern provinces that are at the epicenter of the conflict: North Kivu, South Kivu and Ituri, including through the distribution of post-exposure prophylaxis (PEP) kits.

STAR-Est is a program designed to address fragility, conflict, and violence in eastern DRC, by enhancing social cohesion, improving access to services through basic infrastructure financing, creation of economic opportunities for the most-at-risk groups, and extending services to prevent and respond to violence against women and girls. Under this project, the DRC Government, with financing from the World Bank, has engaged in a partnership with IMA World Health, the leader of global health programming for Corus International, and other service providers, namely HEAL Africa, Panzi, and the IRC, to offer critical support services for survivors of violence.

Between July 2025 and January 2026, the project strengthened supply chains, built provider capacity and training, and improved coordination across public health structures. The focus has been on responding to urgent needs and on reinforcing state-led systems that can sustain services in a highly complex operating environment.

Meeting urgent needs amid insecurity and displacement

During that time frame, insecurity intensified across North Kivu, South Kivu and Ituri provinces, driving displacement and a sharp rise in reported cases of sexual violence. Urban centers such as Goma experienced particularly high demand for survivor services, while facilities across the region faced access constraints linked to road conditions and security risks.

Changes in the U.S. funding landscape severely disrupted the procurement and last-mile delivery of PEP kits in eastern DRC, where humanitarian supply chains were already fragile due to insecurity and access constraints. As U.S. funding has historically played a significant role in supporting and coordinating services for survivors of violence, interruptions have led to stock-outs or delays at health facilities and mobile clinics. For survivors, this means reduced or delayed access to time-critical care, of which PEP kits are an essential ingredient, within the essential 72-hour window, increasing health risks and undermining survivor-centered, confidential care in conflict-affected communities.

IMA World Health has worked closely with national and provincial health authorities to maintain continuity of care for survivors, even as operating conditions continued to shift.

Ensuring access to lifesaving medical supplies

For survivors of sexual violence, timely access to PEP kits can be lifesaving. Improving availability of these essential supplies was therefore a core focus. While delays and access challenges were unavoidable in some areas, advance planning and pre-positioning helped ensure services continued where needs were most acute and the project:

• Procured and packaged 25,800 PEP kits.
• Distributed 19,000 kits to frontline health facilities, Centers of Excellence and multisectoral service centers across North Kivu, South Kivu, and Ituri.
• Introduced stock monitoring and early warning mechanisms to reduce the risk of prolonged shortages.

Supporting frontline providers to deliver integrated care

Supplies alone do not deliver care. Survivors rely on trained providers who can offer medical treatment alongside mental health and psychosocial support, often in high-pressure and resource-constrained settings. Working in partnership with the Ministry of Public Health and provincial counterparts, IMA World Health supported training aligned with updated national guidance for integrated care for survivors of violence against women and girls.

Through the project:

• 72 trainers and 414 health providers were trained in integrated medical care, mental health and psychosocial support.
• Updated training approaches combined clinical and psychosocial care within a single, coordinated framework.
• Follow-up supervision reinforced protocols and supported consistent application of standards at the facility level.

"This work is about more than delivering supplies," said Noshaba Zafar, Corus International's Global Practice Head for Community Development. "By strengthening provider capacity, data use and coordination within public systems, we are helping ensure that survivors can access timely, dignified care today while also reinforcing the systems that will sustain those services over the long term."

Together, these efforts improved both the quality of care and provider confidence in challenging operating environments.

Building toward sustained impact

The STAR-Est initiative shows how targeted investments in supply chains, provider capacity and coordination can improve essential services for survivors of violence against women and girls, even amid ongoing instability.

Beyond the immediate humanitarian emergency response, there is broad recognition by the international community that investing in pathways out of risk and violence requires integrated and holistic approaches to GBV prevention. Under STAR-Est, the government is supporting the delivery of a package of GBV prevention and response services at the community level that includes (i) medical, legal, and psychosocial services; (ii) expansion of women's economic empowerment to address poverty and food insecurity drivers of GBV; (iii) prevention activities around norm and behavior change at the individual, household and community levels; (iv) bringing services closer to survivors through partnerships with Centres of Excellence, local health centers and integrated care centers; and, (v) improving capacity of GBV service providers and local organizations.

These complementary approaches - rooted in prevention, protection, and empowerment - underscore the need to move beyond medical care alone in order to address the multiple dimensions of trauma and reinforce communities' capacity to recover in the face of pervasive, chronic violence. And the singular importance of economic livelihoods for longer-term resilience.

Jobs are the most powerful pathway out of poverty-offering not just income, but dignity, hope, and a real chance to build a better future. Violence is one of the most powerful barriers of all to women's economic participation: the cumulative impact of GBV on lost wages, absenteeism, and reduced productivity weakens families, communities, and national economies alike. The World Bank has been working with the DRC Government to progressively institutionalize violence prevention and response across the country's investment portfolio, especially in the infrastructure, education, and health sectors. Investing in the protection of women and girls and supporting their recovery is an endowment in human capital, economic growth, social cohesion, and durable peace. And this contributes to the World Bank goal of empowering women by providing 250 million with social protection support and providing capital to 80 million women and women-led businesses by 2030. Economic empowerment is a key interrupter of violence and key to the pathway out of poverty.

Jobs are the most effective way to develop economies-and they also strengthen global stability by addressing the root causes of fragility and conflict. In eastern DRC, where conflict and violence have long constrained women's participation in economic life, the work of protecting survivors and strengthening the systems that serve them is inseparable from the broader project of building an economy where women can work, lead, and thrive.