Sithole Zvanaka, Gombe Notion Tafara, Juru Tsitsi, Chonzi Prosper, Shambira Gerald, Nsubuga Peter, Tshimanga Mufuta
MPH Programme, Department of Community Medicine, University of Zimbabwe, Zimbabwe.
City Health Directorate, Harare, Zimbabwe.
Pan Afr Med J. 2018 Nov 22;31:200. doi: 10.11604/pamj.2018.31.200.14791. eCollection 2018.
In Zimbabwe, there is a gap between sexual violence (SV) survivors' health care needs versus the existing facilities. Harare city started Sexual Gender Based Violence (SGBV) project in 2011, with the aim to reduce SV morbidity.Only 592 (42%) of 1425 SV survivors reported for medical services within 72 hours in 2015. HIV post-exposure prophylaxis (PEP) is effective within 72hours of post exposure. We evaluated the program performance in Harare city.
We conducted a process-outcome evaluation using a logic model. We purposively recruited all eight SGBV sites and key informants. We randomly selected 27nurses into the study. Interviewer-administered questionnaires and checklists were used to collect data. To generate frequencies, means and proportions we used Epi info 7.
The program adequately received inputs except for counselling rooms (1/8). About 4285 survivors were recorded from 2013-2016. Of these, 97% were counselled, 93% received HIV test, 41% reported to the clinic within 72hrs of post-rape, and 12% received PEP. About 16% of the total survivors were followed up. The programme failed to meet its targets on decentralised sites (8/10), awareness campaigns(16/32) and sensitisation activities(16/32). About 500(12.5%) IEC materials were distributed. All 96-targeted supervisory visits were achieved. Two ofeight district supervisors were trained. Majority of health workers (25/35) citedlack of awareness as major reasons for underperformance.
Availability of resources did not translate to program performance. Most survivors were not reporting to the clinic timeously due to the low level of awareness of the programme to the community, hence were not protected from getting HIV through PEP. The programme was not well disseminated, as most supervisors were not trained. Following this evaluation, we distributed150 IEC materials to each of the eight facilities. A follow-up study on outcomes of clients referred for services and training of district officers were recommended.
在津巴布韦，性暴力（SV）幸存者的医疗保健需求与现有设施之间存在差距。哈拉雷市于2011年启动了基于性别的暴力（SGBV）项目，旨在降低性暴力的发病率。2015年，1425名性暴力幸存者中只有592人（42%）在72小时内寻求医疗服务。艾滋病毒暴露后预防（PEP）在暴露后72小时内有效。我们评估了哈拉雷市该项目的执行情况。
我们使用逻辑模型进行了过程-结果评估。我们有目的地招募了所有八个SGBV站点和关键信息提供者。我们随机选择了27名护士参与研究。通过访谈者管理的问卷和清单收集数据。我们使用Epi info 7生成频率、均值和比例。
除咨询室（1/8）外，该项目充分获得了投入。2013年至2016年期间记录了约4285名幸存者。其中，97%的人接受了咨询，93%的人接受了艾滋病毒检测，41%的人在强奸后72小时内到诊所就诊，12%的人接受了PEP。约16%的幸存者接受了随访。该项目在分散站点（8/10）、提高认识运动（16/32）和宣传活动（16/32）方面未能达到目标。分发了约500份（12.5%）信息、教育和宣传材料。完成了所有96次目标监督访问。八名地区监督员中有两名接受了培训。大多数卫生工作者（25/35）将缺乏认识作为表现不佳的主要原因。
资源的可用性并未转化为项目绩效。由于社区对该项目的认识水平较低，大多数幸存者没有及时到诊所就诊，因此无法通过PEP预防感染艾滋病毒。该项目传播不力，因为大多数监督员没有接受培训。经过此次评估，我们向八个设施各分发了150份信息、教育和宣传材料。建议对转介接受服务的客户的结果进行后续研究，并对地区官员进行培训。
