刚果民主共和国北基伍省性暴力幸存者的就医模式及及时获得医疗服务情况:一项基于档案的回顾性研究

Care-seeking patterns and timely access to care among survivors of sexual violence in North Kivu, the Democratic Republic of the Congo: a retrospective file-based study.

作者信息

Reinholdz Hanna, Agardh Anette, Verputten Meggy, Byenda Joseph, Frielingsdorf Helena

机构信息

Department of Clinical Sciences, Division of Social Medicine and Global Health, Lund University, Malmö, Sweden.

Public Health Department, Médecins Sans Frontières, Amsterdam, Netherlands.

出版信息

Glob Health Action. 2024 Dec 31;17(1):2336708. doi: 10.1080/16549716.2024.2336708. Epub 2024 Apr 25.

Abstract

BACKGROUND

Sexual violence is widespread in war-torn North Kivu province in the Democratic Republic of the Congo (DRC). Timely access to care is crucial for the healing and wellbeing of survivors of sexual violence, but is problematic due to a variety of barriers. Through a better understanding of care-seeking behaviours and factors influencing timely access to care, programmes can be adapted to overcome some of the barriers faced by survivors of sexual violence.

OBJECTIVE

The aim of this study was to describe demographics, care-seeking patterns and factors influencing timely care-seeking by survivors of sexual violence.

METHODS

Retrospective file-based data analysis of sexual violence survivors accessing care within two Médecins Sans Frontières (MSF) programmes supporting the Ministry of Health, in North Kivu, DRC, 2014-2018.

RESULTS

Most survivors (66%) sought care at specialised sexual violence clinics and a majority of the survivors were self-referred (51%). Most survivors seeking care (70%) did so within 3 days. Male survivors accessing care were significantly more likely to seek care within 3 days compared to females. All age groups under 50 years old were more likely to seek care within 3 days compared to those aged 50 years and older. Being referred by the community, a family member, mobile clinic or authorities was significantly associated with less probability of seeking care within 3 days compared to being self-referred.

CONCLUSION

Access to timely health care for survivors of sexual violence in North Kivu, DRC, is challenging and varies between different groups of survivors. Providers responding to survivors of sexual violence need to adapt models of care and awareness raising strategies to ensure that programmes are developed to enable timely access to care for all survivors. More research is needed to further understand the barriers and enablers to access timely care for different groups of survivors.

摘要

背景

性暴力在饱受战争蹂躏的刚果民主共和国(DRC)北基伍省广泛存在。及时获得医疗护理对于性暴力幸存者的康复和福祉至关重要,但由于各种障碍,这一过程存在问题。通过更好地了解寻求护理行为以及影响及时获得护理的因素,可以调整相关项目,以克服性暴力幸存者面临的一些障碍。

目的

本研究旨在描述性暴力幸存者的人口统计学特征、寻求护理模式以及影响其及时寻求护理的因素。

方法

对2014年至2018年期间在刚果民主共和国北基伍省支持卫生部的两个无国界医生组织(MSF)项目中接受护理的性暴力幸存者进行基于档案的回顾性数据分析。

结果

大多数幸存者(66%)在专门的性暴力诊所寻求护理,且大多数幸存者是自行前往(51%)。大多数寻求护理的幸存者(70%)在3天内这样做了。与女性相比,接受护理的男性幸存者在3天内寻求护理的可能性显著更高。与50岁及以上的人相比,50岁以下的所有年龄组在3天内寻求护理的可能性更高。与自行前往相比,由社区、家庭成员、流动诊所或当局转诊与在3天内寻求护理的可能性显著降低相关。

结论

在刚果民主共和国北基伍省,性暴力幸存者及时获得医疗护理具有挑战性且在不同幸存者群体之间存在差异。应对性暴力幸存者的医疗服务提供者需要调整护理模式和提高认识策略,以确保制定相关项目,使所有幸存者都能及时获得护理。需要更多研究来进一步了解不同幸存者群体及时获得护理的障碍和促进因素。

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