Reinholdz Hanna, Palmieri Jack, Frielingsdorf Helena, Katungu Kalere Esther, Nteziryayo Heritier Gérard, Verputten Meggy, Agardh Anette
Department of Clinical Sciences, Division of Social Medicine and Global Health, Lund University, Malmö, Sweden.
Médecins Sans Frontières, Operations Centre Amsterdam, Amsterdam, Netherlands.
Confl Health. 2025 Apr 5;19(1):22. doi: 10.1186/s13031-025-00662-4.
Sexual violence is widespread in the eastern parts of the Democratic Republic of the Congo, including in the North Kivu province. Moreover, in this region survivors of sexual violence often have limited access to care and encounter a variety of barriers when seeking care and support. The aim of this study was to explore community perceptions about access to care, barriers, enablers and possible actions to improve access to care for survivors of sexual violence in North Kivu. A deeper understanding of community perceptions about access to care can guide ongoing efforts to overcome barriers and increase access to care for survivors of sexual violence.
The study utilised a qualitative design, based on focus group discussions with male and female adult community members in the study area. Previous experience of sexual violence was not a requirement. The transcripts from the discussions were analysed using manifest and latent qualitative content analysis.
A total of 18 focus group discussions were carried out. The analysis resulted in three main themes; Knowledge and misconceptions around medical consequences crucial for care seeking, Community and family attitudes playing a dual role in care seeking behaviours and Care seeking dependent on optimised healthcare facilities and sensitive staff.
Lack of correct knowledge, harmful attitudes from community and healthcare staff, and poorly adapted healthcare services constitute barriers to accessing care. Improved awareness raising around sexual violence is needed to address both lack of knowledge and misconceptions. Efforts should be made to build upon the community support models and actively work to improve community attitudes towards survivors of sexual violence. In addition, there is a need for better adapted healthcare services with improved proximity, access for different groups of survivors and respectful and well-trained healthcare staff.
性暴力在刚果民主共和国东部地区广泛存在，包括北基伍省。此外，在该地区，性暴力幸存者往往难以获得护理，在寻求护理和支持时会遇到各种障碍。本研究的目的是探讨社区对获得护理的看法、障碍、促进因素以及改善北基伍省性暴力幸存者获得护理的可能行动。深入了解社区对获得护理的看法可以指导当前为克服障碍和增加性暴力幸存者获得护理机会所做的努力。
本研究采用定性设计，基于与研究区域内成年男女社区成员进行的焦点小组讨论。是否有性暴力经历并非参与讨论的必要条件。使用显性和隐性定性内容分析法对讨论记录进行分析。
共进行了18次焦点小组讨论。分析得出三个主要主题：对寻求护理至关重要的医疗后果的知识和误解、社区和家庭态度在寻求护理行为中起双重作用、寻求护理取决于优化的医疗设施和敏感的工作人员。
缺乏正确知识、社区和医护人员的有害态度以及适应性差的医疗服务构成了获得护理的障碍。需要提高对性暴力的认识，以解决知识缺乏和误解问题。应努力建立社区支持模式，并积极改善社区对性暴力幸存者的态度。此外，需要提供更适应需求的医疗服务，包括改善就医便利性、为不同群体的幸存者提供就医机会以及配备尊重患者且训练有素的医护人员。
