Conflict‐related gender‐based violence in Khartoum, Sudan: Survivor characteristics and a locally led health system response

Abstract

OBJECTIVE: This study describes survivor characteristics, age, and reproductive status, alongside clinical consequences and the patterns of service delivery for conflict-related gender-based violence in Khartoum during active armed conflict. METHODS: This descriptive mixed-methods study included all survivors of gender-based violence who self-presented to seven designated treatment centers established by the Khartoum State Emergency Health Committee from April 1, 2023, to December 31, 2025. Quantitative clinical data were collected using standardized forms; qualitative data were gathered through in-depth interviews and counseling session narratives. RESULTS: Among 375 survivors, 168 (44.8%) were children aged <18 years, and 207 (55.2%) were adult women. A total of 178 (47.5%) survivors had documented both injuries and psychological trauma. Among adult women, unwanted pregnancy occurred in 32 (15.5%) of them; out of these 32 women, 14 recognized themselves as late comers with advanced pregnancy and delivered (n = 19, 59.4%); whereas for incomplete abortion, post-abortion care was required by the other 13 (40.6%). Physical trauma and multiple injuries were found in 67 children (39.9%). All survivors were given prophylactic antibiotics and antiretroviral prophylaxis, and 197 (52.5%) received emergency contraception. Qualitative findings suggest that some elements of violence, like repeated rape, punishment rape in front of relatives or family members, and violent death threats with firearms, were commonalities of the violence, describing a specific pattern during conflict. CONCLUSION: In Khartoum, conflict-related gender-based violence was associated with adverse physical and reproductive health outcomes and psychological morbidity, contributing to a considerable burden on children as well. Locally coordinated, survivor-centered treatment centers might represent a critical model for building trust between survivors and providers and sustaining care delivery in conflict-affected populations.