Wangamati Cynthia Khamala, Combs Thorsen Viva, Gele Abdi Ali, Sundby Johanne
Department of Community Medicine, Faculty of Medicine, University of Oslo.
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
Int J Womens Health. 2016 Jul 1;8:249-59. doi: 10.2147/IJWH.S108316. eCollection 2016.
Child sexual abuse is a global problem and a growing concern in Sub-Saharan Africa. It constitutes a profound violation of human rights. To address this problem, Kenya has established the Sexual Offences Act. In addition, Kenya has developed national guidelines on the management of sexual violence to grant minors access to health care. However, little is known about the experiences of sexually abused minors when they interact with the health and legal system. Accordingly, this study uses a triangulation of methods in the follow-up of two adolescent girls. Health records were reviewed, interactions between the girls and service providers were observed, in-depth interviews were conducted with the girls, and informal discussions were held with guardians and service providers. Findings indicated that the minors' rights to quality health care and protection were being violated. Protocols on postrape care delivery were unavailable. Furthermore, the health facility was ill equipped and poorly stocked. Health providers showed little regard for informed assent, confidentiality, and privacy while offering postrape care. Similarly, in the justice system, processing was met with delays and unresponsive law enforcement. Health providers and police officers are in grave need of training in sexual and gender-based violence, its consequences, comprehensive postrape care, and sexual and reproductive health rights to ensure the protection of minors' rights. Health administrators should ensure that facilities are equipped with skilled health providers, medical supplies, and equipment. Additionally, policies on the protection and care of sexually abused minors in Kenya require amendment.
儿童性虐待是一个全球性问题，在撒哈拉以南非洲地区日益受到关注。它构成了对人权的严重侵犯。为解决这一问题，肯尼亚制定了《性犯罪法》。此外，肯尼亚还制定了性暴力管理国家指南，以使未成年人能够获得医疗保健服务。然而，对于遭受性虐待的未成年人在与卫生和法律系统互动时的经历，人们知之甚少。因此，本研究采用三角测量法对两名少女进行跟踪调查。查阅了她们的健康记录，观察了她们与服务提供者之间的互动，对她们进行了深入访谈，并与监护人及服务提供者进行了非正式讨论。研究结果表明，未成年人获得优质医疗保健和保护的权利正在受到侵犯。缺乏强奸后护理服务的相关协议。此外，医疗机构设备简陋、物资匮乏。卫生服务提供者在提供强奸后护理时很少考虑知情同意、保密和隐私问题。同样，在司法系统中，案件处理存在延误，执法部门反应迟钝。卫生服务提供者和警察急需接受关于性暴力和基于性别的暴力、其后果、全面强奸后护理以及性健康和生殖健康权利方面的培训，以确保保护未成年人的权利。卫生管理人员应确保医疗机构配备技术熟练的卫生服务提供者、医疗用品和设备。此外，肯尼亚关于保护和照顾遭受性虐待未成年人的政策需要修订。
