Case Advocates Help Survivors Reach Services

Expert's Take

Case Advocates Improve Uptake of Violence Against Children Services Across Different Service Delivery Points in Public Health Facilities

By Lina Digolo, LVCT Health

The uptake of health services by child survivors of violence is a growing challenge, especially in sub-Saharan Africa. A major factor contributing to this is the inability of health care workers to provide extra support in facilitating referral to and linkage of the child survivors across the various service delivery points. LVCT Health, a civil society organization in Kenya, sought to explore the acceptability of using lay health workers trained as case advocates to escort child survivors of violence to various referral points within two public health facilities in Kenya.

Best Practices/Promising Program

The case advocates were identified by the hospital administration from a pool of interns (university students and recent graduates) who were attached to each health facility. They were taken through a three-day training aimed at equipping the case advocates with basic information on violence against children, including types: the guiding principles for providing services to a child survivor of violence, how to communicate with children, and how to provide supportive referrals. 

Medical clinic in Kenya, dealing with Maternal, Neonatal and child health.

Post-training, the case advocates were stationed at the outpatient departments and tasked with escorting all child survivors and their caregivers through the various service delivery points. Each case worker was attached to an LVCT mentor for continued support offered during monthly face-to-face meetings. Perceptions of the usefulness of case advocates were assessed using in-depth interviews with the children and interviews and focus groups with caregivers.


The use of case workers to support child survivors of violence was acceptable to children, caregivers, and health workers. Caregivers and child survivors reported that the case advocates were useful in fast-tracking access to services, easing the movement through health facilities, and helping them communicate their issues to the different service providers. 

Portrait of Maasai woman. Kenya.

Health workers reported improved timeliness and completeness of services due to the involvement of the case advocates. Overall, the intervention led to an increase in the number of child survivors who received comprehensive services from the two health facilities during the study period.

Key considerations for improving access to comprehensive services by child survivors of violence are as follows:

  • Identification of individuals who can work as escorts for child survivors across the different service delivery points
  • Training and continuous mentor-ship of the lay workers

Learn More:

This spotlight was pulled from “What Works to Prevent Sexual Violence Against Children,” a systematic review of proven solutions and best practices to prevent and respond to sexual violence against children and youth (SVAC). The review was completed in collaboration with a group of experts and allied organizations and highlights evidence-based solutions from around the world. Read the whole set of #SVSolutions Program Spotlights here.

Dr. Lina Digolo

  • Author: Dr. Lina Digolo, LVCT Health, Nairobi, Kenya
  • Organization: LVCT Health
  • Strategy: Response & Support Services
  • Location: Nairobi, Kenya

Read More Solutions Spotlights

The SASA! Initiative

About the Program The SASA! initiative in Uganda is one example of a social norms community mobilization program, widely considered good practice for social norms interventions. SASA! seeks to change community attitudes, norms, and behaviors around gender, violence, and the risk of and vulnerability to HIV infection among women. Premised on the ecological model of [...]

Criminal Justice Response to Sexual Violence in Guatemala

About the Program The International Justice Mission (IJM) recently celebrated a decade of work in Guatemala, fighting to end sexual violence. Data from IJM’s program in Guatemala suggest that a criminal justice response to sexual violence against children can be improved significantly, leading to an increase in sexual violence crimes reported to the authorities.   Along with community-based awareness [...]

Prevention in Education Settings: A Case Study on the Good School Toolkit

About the Program A Raising Voices study found that 60% of children in Uganda regularly experienced violence at school. To combat this, they created a holistic and cost-effective program focused on decreasing violence in schools. The Good School Toolkit is effective in reducing staff violence against children in Ugandan primary schools. A Raising Voices study [...]