An assessment of health sector guidelines and services for treatment of sexual violence in El Salvador, Guatemala, Honduras and Nicaragua.

In Central America, approximately 12% of women report ever having been forced to have sex by an intimate male partner, and sexual violence by others is also a frequent experience. All Central American countries are signatories to human rights agreements that oblige States to ensure access to comprehensive health services for victims of sexual violence, but there is limited information as to whether these agreements have been translated into policy and practice. This article critically examines health sector guidelines for the treatment of sexual violence in El Salvador, Guatemala, Honduras and Nicaragua, and reports on an assessment of services in 34 private- and public-sector facilities in the four countries. Overall, policies were consistent with international agreements and included guidance on detection and documentation of violence, forensic examination, treatment, referral and follow-up care. However, only a small proportion of women who experience sexual violence actually seek care. The challenge facing all four countries is to turn policy into practice. Screening practices were inconsistent, and policies needed to indicate more clearly the roles and responsibilities of health care providers and forensic specialists. Finally, women's right to privacy and confidentiality in reports of cases to legal authorities needed further consideration, as well as the importance of providing all services at a single location.