Objective. Pregnant women are especially vulnerable to adverse outcomes related to HIV infection and gender-based violence (GBV). We aimed at developing a program for prevention and mitigation of the effects of GBV among pregnant women at an antenatal clinic in rural Kenya. Methods. Based on formative research with pregnant women, male partners, and service providers, we developed a GBV program including comprehensive clinic training, risk assessments in the clinic, referrals supported by community volunteers, and community mobilization. To evaluate the program, we analyzed data from risk assessment forms and conducted focus groups ( groups) and in-depth interviews ( ) with healthcare workers and community members. Results. A total of 134 pregnant women were assessed during a 5-month period: 49 (37%) reported violence and of those 53% accepted referrals to local support resources. Qualitative findings suggested that the program was acceptable and feasible, as it aided pregnant women in accessing GBV services and raised awareness of GBV. Community collaboration was crucial in this low-resource setting. Conclusion. Integrating GBV programs into rural antenatal clinics has potential to contribute to both primary and secondary GBV prevention. Following further evaluation, this model may be deemed applicable for rural communities in Kenya and elsewhere in East Africa. 1. Introduction Gender-based violence (GBV) is a major source of preventable mortality and morbidity for women globally [1–3]. In Kenya, 47% of ever-married women report having ever experienced emotional, physical, and/or sexual violence from their spouse—among the highest rates in the world [4, 5]. Violence towards pregnant women in Kenya is estimated to be 13.5% [6], a higher prevalence than many conditions routinely screened for during pregnancy [7]. Global research suggests that when pregnant women experience GBV, there is a higher likelihood of miscarriage [3, 8], premature labor [9], low birthweight [8, 10, 11], and infant death [12]. Demographic Health Survey data from Kenya suggests that experiencing lifetime GBV is associated with child stunting and under-2 mortality [12]. GBV is also a driver of the global HIV epidemic, particularly in sub-Saharan Africa where women are disproportionately at risk of both GBV and HIV infection. GBV increases risk of HIV acquisition [13, 14], and HIV-positive women are more likely to experience GBV than their HIV-negative counterparts [15]. Pregnant women are especially vulnerable to the intersecting risks and adverse outcomes related to HIV infection
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