Marleen Temmerman,^1,2,3,‡* Emilomo Ogbe,^2,‡ Griffins Manguro,¹ Iqbal Khandwalla,⁴ Mary Thiongo,¹ Kishor N. Mandaliya,¹ Lou Dierick,¹ Markus MacGill,⁵ and Peter Gichangi^1,2,6

Affiliations

¹ International Centre for Reproductive Health, Mombasa, Kenya

² International Centre for Reproductive Health, Ghent University, Ghent, Belgium

³ Aga Khan University, Nairobi, Kenya

⁴ Coast Provincial General Hospital, Mombasa, Kenya

⁵ Green Ink medical editing, Edinburgh, Scotland, United Kingdom

⁶ University of Nairobi, Nairobi, Kenya

The authors have declared that no competing interests exist.

‡ MT and EO are co-first authors on this work.

* E-mail: eb.tnegu@namremmet.neelram

Abstract

Marleen Temmerman and colleagues describe a model of care for people who have experienced sexual violence, set in Kenya.

Summary points

• Sexual violence (SV) is highly prevalent and a major public health problem globally. In Kenya, an estimated 32% of females and 18% of males were reported to have experienced SV before the age of 18 years.
• This paper presents a data set collected between 2007 and 2018 and describes the gender-based violence and recovery centre (GBVRC) model under which survivors of SV were cared for at a 24-hour public hospital in Mombasa, Kenya—including its development, implementation, achievements, and challenges.
• The GBVRC model is a partnership that provides (in addition to emergency healthcare) mental health support, paralegal services, and integrated cooperation with police, judiciary, local leaders, and the wider community. The Mombasa GBVRC has provided post-SV care to 6,575 people reporting SV, of whom 88% were female and over 50% were younger than 16 years. Over 90% of the perpetrators were family, neighbours, community members, or in some other way known to the survivors.
• The low rate (19%) of attendance by survivors for the second counselling visit suggests a more robust strategy is needed for follow-up—for example, by referring people back to smaller, closer health facilities. A second limitation was a lack of trained staff, although this is an expected issue in sub-Saharan Africa. There was also a low rate of legal resolution to the cases. This may be due to the need for education about the standard of evidence required by courts.
• The experiences of successful and sustainable implementation of the GBVRC model should strengthen arguments for service delivery for people experiencing SV in this and similar settings.

Link

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677296/