Adapting,Sustaining and Scaling Violence against Women and Children Prevention Interventions in Low- and Middle-Income Countries: A Scoping Review on the Use of Implementation Science

Abstract

The field of violence against women and children (VAW/C) prevention has made significant progress in identifying effective strategies to prevent violence. However, there are still gaps in understanding how to sustain and scale evidence-based interventions across diverse settings. At the same time, implementation science offers approaches that could help achieve greater scale, sustainability, and equity. Despite its potential, implementation science approaches have not been fully applied to VAW/C research. To address this gap, a scoping review was conducted to identify the frameworks employed, understand the most frequently studied implementation domains, examine any specific challenges captured within the applied implementation science frameworks related to delivering survivor-centered violence prevention programming, and illuminate the role of practice-based knowledge within implementation science efforts for violence prevention programming. The review, conducted between 2023 and 2024, identified 40 VAW/C evaluation studies that included implementation or process evaluation components, with most studies published after 2020. Commonly used implementation science frameworks included the Consolidated Framework for Implementation Research (CFIR), the Exploration, Preparation, Implementation, and Sustainment (EPIS) model, and the Medical Research Council (MRC) frameworks. Key implementation domains studied were fidelity, acceptability, and feasibility. However, scale and sustainability—critical priorities for practitioners, policymakers, and donors—were only minimally addressed in the literature. In addition, there was limited focus on implementing survivor-centered practices and incorporating practice-based knowledge. The findings highlight the need for long-term collaborations between researchers and practitioners that explicitly integrate implementation science. Such partnerships could help adapt, scale, and sustain evidence-based VAW/C prevention programs more effectively while ensuring they remain survivor-centered.