For a survivor of gender-based violence (GBV), deciding to seek help can be the first difficult step towards safety and justice. But what happens after that decision?
A new assessment of GBV services in Kampala and Wakiso districts suggests that reaching a police station or health facility does not always end the ordeal.
Survivors may face long waits, confusing procedures, shortages of staff and essential supplies, limited privacy and, in some cases, requests for money to access or speed up services.
The findings come as Uganda continues to grapple with a substantial burden of sexual and GBV.
According to the Uganda Police Force Annual Crime Report 2025, police recorded 12,606 sex-related offences nationwide in 2025, down by 12.6 percent from 14,425 cases in 2024. The overall decline is encouraging, but it does not mean the problem has disappeared.
The police figures also show why the response system matters. A fall in reported cases can reflect several things, including prevention and improved interventions, but reported crime figures do not capture every incident of violence. Against that national picture, the new assessment offers a closer look at what happens when survivors actually enter the response system.
A system under pressure
The study by SEMA Uganda, Assessing Client Satisfaction in Police and Health, involved 493 GBV survivors and affected persons and 40 frontline service providers across selected police stations and health facilities in Kampala and Wakiso.
The researchers examined survivors’ experiences of timeliness, confidentiality, provider attitude, communication, referrals and the quality of assistance received.
Its central finding is not that the entire system is failing. Rather, it is a system that survivors continue to use and, in many cases, appreciate, but one that is operating under significant pressure.
Health facilities recorded an average satisfaction score of 74, compared with 68 for police stations. At health facilities, 96 percent of clients said they were adequately helped, compared with 83 percent at police stations.
Yet behind those relatively positive scores are substantial weaknesses. Only 25 percent of service providers said they had adequate resources to support survivors. Three-quarters reported shortages.
Among the items mentioned were post-exposure prophylaxis (PEP), emergency contraception, rape kits, gloves, documentation materials and private spaces for examination and counselling.
Staffing is another major problem. Seventy percent of providers said their stations or facilities did not have enough personnel dedicated to GBV.
At many police stations, one officer may be responsible for a GBV desk, while health facilities reported particularly serious shortages during nights and weekends. In other words, survivors are seeking assistance from institutions that are themselves struggling to provide it.
The cost of waiting
Time matters in GBV cases. For survivors requiring medical attention, delays can affect access to interventions. Service providers reported cases in which survivors arrived after 72 hours, when interventions such as PEP and emergency contraception become less effective.
The assessment found that the average waiting time was 42 minutes at police stations and 47 minutes at health facilities. But averages conceal sharper problems.
At Wakiso Police Station, survivors waited an average of 59 minutes, the longest among the police stations studied. Wakiso Health Centre IV and Kasangati Health Centre IV each recorded average waiting times of 51 minutes.
The report links these delays to factors including workload, high client volumes, limited staffing and case documentation. For a survivor already dealing with fear, injury, trauma or uncertainty, waiting is more than an inconvenience.
It can become another barrier to completing the process. One respondent at Wakiso Health Centre IV described the problem simply: ‘Delay in service delivery due to the large number seeking service from the same office.’
Getting through the door is only part of the journey. The assessment found that some survivors did not understand where to go or what would happen next. Others moved between offices without clear guidance, sometimes relying on fellow clients or individual staff members to explain the process.
For someone unfamiliar with police or health-facility procedures, that uncertainty can be intimidating. The problem is compounded for survivors who do not speak the dominant local language.
One respondent at Old Kampala Police Station said the officer at the gate did not know Luganda. Another survivor complained about limited privacy during consultations. These may appear to be small administrative failures, but in GBV cases they can determine whether a survivor feels safe enough to disclose what happened.
A question of money
Perhaps the most uncomfortable finding concerns informal payments. GBV services are officially supposed to be free, yet eight percent of police clients and nine percent of health-facility clients reported paying money to access or expedite services.
The assessment found that the issue was not merely financial. Clients who reported making payments recorded satisfaction scores that were 7.5 points lower than those who did not. The report identifies payment as the strongest negative influence on satisfaction and links it to erosion of trust.
That matters because GBV survivors are often approaching institutions at a moment of extreme vulnerability. The report records one survivor saying: ‘I paid the required money, but no meaningful follow-up was done on our case.’
The finding raises questions that deserve answers from the responsible institutions: What payments are being demanded? Who receives them? For which services? And why are survivors being asked to pay for services that should be free?
It would be easy to view the problem solely through the experiences of survivors. But the assessment shows that frontline workers are operating within the same strained system. Only 60 percent of the 40 providers interviewed had received formal training in handling GBV cases. Among health workers, the proportion was just 50 percent, compared with 70 percent among police respondents.
The gap is particularly significant because health workers play an important role in clinical assessment, documentation and evidence gathering. Yet there is an interesting contradiction: 95 percent of police respondents and 90 percent of health workers rated their skills as good or very good.
That confidence exists alongside shortages in training and equipment. Three-quarters of providers said they lacked adequate resources, while 70 percent said they lacked sufficient staff.
The workload is substantial. Sixty percent of providers said they handled more than five GBV cases every month, including 30 percent dealing with more than 10 cases. The message is clear: GBV is not an occasional workload for these officers and health workers. It is a routine demand on an already stretched system.
The assessment also exposes differences between groups. Female respondents reported an average satisfaction score of 75 compared with 64 among male respondents. The researchers suggest that male survivors may face stigma, limited awareness or perceived bias when seeking help.
That finding challenges the assumption that GBV response is experienced in the same way by everyone. The report also included refugees and asylum seekers, who made up five percent of respondents. It identifies language barriers, stigma, poverty and fear of retaliation as additional vulnerabilities for refugee survivors.