University of Oslo, Norway.
Oslo and Akershus University College of Applied Sciences, Norway.
J Interpers Violence. 2020 Mar;35(5-6):1415-1441. doi: 10.1177/0886260517696863. Epub 2017 Mar 17.
Child sexual abuse (CSA) is a major global health challenge. Extant literature in Kenya indicates an alarming rate of sexually abused minors presenting to poorly equipped health facilities with untrained health providers for post rape care. National guidelines on management of sexual violence have been in existence since 2004; however, little is known on the impact of these guidelines on post rape care provision to minors. Therefore, the study aims to assess the knowledge, attitudes, and practices of health providers with regard to post rape care provision in a Kenyan District health facility. The study used a triangulation of different qualitative methods: review of 42 health records of minors seeking post rape care, 15 in-depth interviews, and informal conversations with health providers. Findings indicate that the Kenyan national guidelines on management of sexual violence were nonexistent in the health facility. Consequently, health providers possessed limited knowledge on post rape care administration. The limited knowledge translated to poor collection and preservation of evidence, inadequate psychosocial support, and clinical care. In addition, rape myth attitudes and religious beliefs contributed to survivor blaming and provider hesitance in provision of legal abortion care, respectively. To facilitate provision of quality post rape care, policy makers and health institutions' managers need to avail protocols in line with evidence-based best practices to guide health providers in post rape care administration. In addition, there is need for rigorous training and supervision of health professionals to ensure better service provision.
儿童性虐待(CSA)是一个全球性的重大健康挑战。肯尼亚现有的文献表明,大量遭受性虐待的未成年人前往装备简陋、医护人员未经培训的卫生机构寻求强奸后护理,这令人震惊。自 2004 年以来,肯尼亚就已经存在关于性暴力管理的国家指南;然而,对于这些指南对未成年人性虐待后护理服务的提供的影响,人们知之甚少。因此,本研究旨在评估肯尼亚地区卫生机构的卫生提供者在提供强奸后护理方面的知识、态度和实践情况。本研究采用了不同定性方法的三角测量法:对 42 名寻求强奸后护理的未成年人的医疗记录进行了审查,对 15 名进行了深入访谈,并与卫生提供者进行了非正式交谈。研究结果表明,肯尼亚国家性暴力管理指南在该卫生机构中并不存在。因此,卫生提供者对强奸后护理管理的知识有限。这种有限的知识导致证据收集和保存不足、心理社会支持不足以及临床护理不足。此外,强奸谬论态度和宗教信仰分别导致幸存者受到指责以及提供者在提供合法堕胎护理方面犹豫不决。为了促进提供高质量的强奸后护理,政策制定者和卫生机构管理人员需要提供符合循证最佳实践的协议,以指导卫生提供者进行强奸后护理管理。此外,需要对卫生专业人员进行严格的培训和监督,以确保更好的服务提供。