BACKGROUND
This article shares the learnings of Médecins Sans Frontières (MSF)’s experience of adapting its sexual violence care training for its staff and missions in the Middle East and North Africa (MENA) region in 2019. It explores some of the implications of MENA operational and sociocultural specificities for MSF’s training approach, as well as theoretical and practical aspects of working in sexual violence response in specific settings and addressing contextual structural barriers to survivors’ accessing such services. It contributes to sharing knowledge among practitioners about adapting a sexual violence training approach for different contexts.

METHODS
Methods employed included a scoping review of literature; qualitative data collection via consultations with MENA organisations and interviews with MSF experts and staff working in Yemen, Palestine, Syria, Lebanon, Jordan, Turkey and Greece; collaborative content adaptation and issue integration; translation in Arabic and proofreading; testing of training modules in different settings; and feedback integration.

RESULTS
The adaptation work shows the importance of context and suggests that culturally and contextually adapted training bears potential for effectively strengthening staff members’ survivor-centered skills and attitudes, as well as technical knowledge and skills in care provision. The revision process shows that the overall approach of the training is constitutive to its effectiveness since the approach to – in addition to the substance of – most core principles and elements bears the potential to make training more acceptable and effective in encouraging staff reflectivity on local existing social and gender norms and their own beliefs and attitudes.

CONCLUSIONS
The article concludes that capacity-building efforts alone must not be overestimated in their ability to mobilize change in complex settings but highlights their potential to catalyze change if embedded in institutional longstanding efforts involving operational strategies, political advocacy and organizational culture. The process represents a first step which needs to be further tested, evaluated and continuously fed by MSF practice-based knowledge and dialogue with other organizations around response and training approaches and practices

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Adapting Médecins Sans Frontières (MSF)’s sexual violence care training approach to Middle Eastern contexts: what does this mean in practice?