This GBV Assessment Template is a structured field tool for rapidly collecting information on gender-based violence risks, patterns, and response capacity in a displaced or crisis-affected community. It guides assessment teams to document basic assessment details (dates, location, team, translation), profile the affected population (age/sex breakdown, displacement setting, religion/ethnicity/languages), and capture both formal and informal reports of sexual violence and exploitation (including where incidents occurred and who reports are made to). The template then examines the broader protection environment—community perceptions of safety, priority threats, types of violence reported, availability of shelters, and whether SV/SEA is integrated into protection assessments/monitoring—followed by detailed sections on health response (access, barriers, clinical rape management protocols, privacy and confidentiality), psychosocial response (services, referrals, barriers, record confidentiality), coordination and referral systems (GBV coordination body, focal points, protocols, standardized data/reporting), and key environmental risk factors linked to GBV such as site planning and vulnerable groups, fuel collection and food security, and WASH infrastructure and safety features (lighting, separation, locks, women’s participation in committees).

Table of Contents

1. Assessment Details (dates, location, team, translation/translator)

2. Population of Displaced Community
   2.1 Displacement pattern and living arrangement (camp vs host community)
   2.2 Religious affiliations and estimated percentages
   2.3 Tribes/ethnic groups and estimated percentages
   2.4 Languages spoken and estimated percentages

3. Formal and Informal Reported Cases of Sexual Violence
   3.1 Time since emergency/displacement
   3.2 Reported cases by authority (police, health, community/religious leaders, NGOs, others)
   3.3 Where incidents occurred (pre-displacement, transit, camp/community, host community, other)
   3.4 Informal reports of sexual abuse/exploitation (including peacekeeping forces)
   3.5 Presence/access of armed actors and related reports

4. Safety and Security
   ...

5. Sexual Violence Health Response
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6. GBV Psychosocial Response
   ...

7. GBV Coordination
   ...

8. Shelter and Site Planning
   ...

9. Fuel Collection and Food Security
   ...

10. Water and Sanitation (WASH)
    ...