Background: Gender based violence (GBV) remains one of the most serious threats to the health and safety of women and girls worldwide. The problem is even more pronounced in refugee populations where women and girls are at increased risk of violence. In 2015, UNHCR reported the highest number of forcibly displaced people in recorded history. Despite growing need, there have been few rigorous evaluations of interventions aimed at primary GBV prevention and no systematic reviews of GBV prevention efforts specifically focused on refugee populations; reviews to date have primarily examined prevention of conflict related sexual violence, with very limited focus on other forms of GBV such as intimate partner violence

Methods: This study reviewed the scientific literature addressing strategies for primary prevention of GBV and their effectiveness among refugee populations over the past ten years (2006 to 2015). Narrative content analysis methods were used to extract findings related to prevention activities/programs recommended by the global humanitarian community, such as sociocultural norms change, rebuilding family and community support structures, improving accountability systems, designing effective services and facilities, working with formal and traditional legal systems, monitoring and documenting GBV, and/or engaging men and boys in GBV prevention and response.

Results: Study findings indicate that a range of GBV prevention activities recommended by the global humanitarian community are currently being applied in a variety of settings. However, there remains a limited body of evidence on the effectiveness of GBV prevention programs, interventions, and strategies, especially among refugee populations.

Conclusion: Commonly agreed upon standards or guidelines for evaluation of GBV prevention programming, and publication of evaluations conducted using these guidelines, could assist humanitarian stakeholders to build and disseminate an evidence base of effective GBV prevention interventions, programs and strategies. Evaluation of GBV prevention efforts, especially among refugee populations, must be given higher priority to justify continuation or revision of recommended GBV activities/programs being implemented in diverse humanitarian settings.

Background: Decades of civil conflict compound the challenges of food insecurity in South Sudan and contribute to persistent, high levels of child malnutrition. As efforts to prevent child malnutrition continue, there is a critical need for strategies that effectively supplement the diets of pregnant women and young children in transitional, highly food insecure settings like South Sudan.

Methods: This mixed-methods case study of four communities in South Sudan reports on the diets of children under 2 years of age and explores household-level factors including household size, intrahousehold food allocation practices, and responses to scarcity that may have significant impact on the effectiveness of strategies relying on household ration distribution to supplement the diets of pregnant women and children under 2 years of age.

Results: Participants reported experiencing increased scarcity as a result of prolonged drought and household sizes enlarged by the high volume of returning refugees. Although communities were receiving monthly household rations through a non-emergency food assistance program, most households had exhausted rations less than 30 days after receipt. Results showed that more than one half of children 12-17 months and one third of children 18-23 months consumed diets consisting of fewer than 4 food groups in the last week. Intrahousehold food allocation patterns give children first priority at meal times even in times of scarcity, yet adult women, including pregnant women, have last priority.

Discussion: These findings suggest that distribution of supplementary household rations will likely be insufficient to effectively supplement the diets of young children and pregnant women in particular. In light of the multiple contextual challenges experienced by households in transitional, food-insecure settings, these findings support recommendations to take a context-specific approach to food assistance programming, in which considerations of intrahousehold food allocation patterns and broader cultural and environmental factors inform program design. Incorporating assessments of intrahousehold food allocation patterns as part of needs assessments for food assistance and voucher or cash transfer programs may contribute to more effective, context specific programming.