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Every Hour Matters


Challenge Summary

This challenge is seeking to reduce barriers to post-rape care for vulnerable girls and women, including streamlining care and increasing knowledge of and access to post-rape care services including PEP (post-exposure prophylaxis) and emergency contraception. 

Challenge Status: This challenge is now closed. Please see the Winners Page for information on the winning submission. 

Prize amount: $75,000


In Collaboration With: Together for Girls & PAGW

Together for Girls is a global public-private partnership dedicated to ending violence against children, with a focus on sexual violence against girls. To address this horrific human rights violation and public health problem, Together for Girls brings together the expertise and resources of many of the strongest organizations working globally in development, public health, and children and women’s rights to collaborate with national governments and civil society.



Globally, the incidence of rape and sexual assault amongst girls, women and children is alarmingly high. Adolescent girls are at particular risk; in some countries one in three girls report a sexual assault before the age of 18. Millions are subjected to sexual assault and rape, yet the data show that very few seek potentially life-saving post-rape care services.

Barriers such as fear, stigma, and lack of awareness of time-sensitive medical needs and available services, lead to both low reporting rates and care-seeking. These barriers disproportionately impact girls, young women and children. 

The Violence Against Children Surveys (VACS) – led by the Centres for Disease Control (CDC) as part of the Together for Girls partnership – show that less than 5% of children who experience sexual violence seek services. Globally, national governments have made good progress in scaling up post-rape care services. However, survivors, particularly in resource-limited settings, continue to experience many barriers to accessing these services. 

As a response, Together for Girls launched Every Hour Matters – a global advocacy campaign - to raise awareness and spark action around the critical need for post-rape care. The campaign amplifies a critical, but little-known message: every hour matters for survivors of sexual assault. While counselling support and care are critical, survivors have 72 hours (ideally 24 hours), to receive post-exposure prophylaxis (PEP) to prevent HIV infection and 120 hours to receive emergency contraception to prevent unwanted pregnancy.



The Challenge

Positive Action Challenges, in collaboration with Together for Girls and Positive Action for Girls and Women (PAGW) is seeking innovative solutions to remove barriers to post-rape care in resource limited settings, with particular applicability in DREAMS countries (Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe). Proven or innovative solutions may be submitted for consideration.

Challenge statement: Identify a solution that increases awareness about the critical post-rape care timelines related to post-exposure prophylaxis (72 hours) and emergency contraception (120 hours) and leads to a significant increase in up-take of post-rape care services. Solutions must demonstrate an understanding of the availability of post-rape care services in the local context/healthcare systems targeted, and must be able to demonstrate an increase in uptake of services in these contexts.

Success measures for increased up-take of post-rape care services may include:

  • Streamlined care: increased knowledge of location and availability of post-rape care services in local context (especially DREAMS countries)
  • Reduction in ‘time-to-care’: more girls and women accessing services and care within 72 hours of an incidence of rape
  • Awareness: increased knowledge of the benefits of quickly accessing post-rape care, including PEP and EC, among key populations, including providers
  • Reduction in HIV transmission and unintended pregnancy rates in the community




In addition to the below criteria, solutions must demonstrate an understanding of the availability of post-rape care services in the intended country of implementation. The best entries will also explain how solutions can complement, leverage and/or scale-up existing post-rape care services within local health systems, while proving effective across different age groups. All solutions must apply to resource limited settings, with a particular focus on applicability in DREAMS countries (Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe).

  • People Centred: Entries may focus on a process, technology or other method but the ultimate benefit must be measurable in terms of impact on people’s lives. Must ensure privacy, demonstrate an ability to not perpetuate stigma and discrimination associated with HIV and enhance active community participation in solution development.
  • Replicable: Entries can be replicated and adapted by others at low cost to ensure broader implementation and uptake as quickly as possible in similar settings.
  • Scalable: Entries must demonstrate how they can be scaled beyond pilot programmes to large scale responses that can be implemented at greater/national scale.
  • Affordable: Entries must demonstrate affordability (low-cost or no-cost to the end users) within resource limited settings or other similar settings as detailed in the individual challenges.
  • Sustainable: Entries must demonstrate how they are implementable in the longer term (beyond the lifecycle of prize funding) using the resources that already exist or which can be incremental to existing service delivery.
  • Achieving substantive change: Successful entries are expected to change the thoughts, processes and other barriers that prevent people living in resource limited settings from receiving the best care possible within the resources (financial and other) available, demonstrating a clear benefit to the people and systems targeted.



Executive Director, International AIDS Society, Geneva; IAS non-voting Governing Council member; IAS non-voting Executive Committee officer.


Senior Programme Manager, International Development and UK Prizes, Centre for Challenge Prizes, Nesta, London.


Divison Chief: Applied Innovation, U.S. Global Development Lab, USAID




    Click Apply Now to access the PAC Community portal where you can register or log in to start an application. Once registered you can connect with fellow solvers to share ideas, find collaborators and work on applications.
    Submit a Concept Note to provide a summary of your innovation. You can seek input/feedback from other community members or submit right away. Concepts are shortlisted to progress to the next stage by the PAC team based on the challenge criteria.
    The best eligible Concept Notes are invited to submit a Full Application. This stage requires more detail about the development and implementation of your innovation. This is the final stage for applicants before the judging process begins.

For more detail, see How it Works.