Health Consequences Responses and Prevention Strategies of Sexual Violence among Survivors in Selected Hospitals

Abstract

Sexual violence (SV) is a serious public health problem with profound immediate and long-term impact on physical, social and mental health, both immediately and many years after the assault. While women and girls are the most visible survivors of sexual violence, they are far from being the only ones who suffer it. Children of both sexes constitute a large proportion of abused survivors. Adult men and the handicapped are minority groups who are also affected but often neglected in research and interventions. Rape occurs every half hour in Kenya. The nature and health consequences of sexual violence are not well understood and documented. Whereas there are some studies conducted on sexual violence there is a clear gap on the investigation of health consequences, responses and prevention strategies. The aim of this study was to investigate health consequences, responses and prevention strategies of SV among survivors in coait: ..Provincial General Hospital, Nairobi Women Hospital and Nyanza Provincial GeneralHospital. This was a cross-sectional study where both qualitative and quantitative methods were used to collect data. Two hundred and eighty survivors were interviewed, focus group discussions held and observation done. Data were analysed using Predictive Analytics Software (PASW) version 17 and summarized using frequency tables and bar charts. Chi- square test was used to determine relationships between variables. The 95% confidence intervals were estimated by maximum likelihood ratio. Multivariate logistic regression was then used to establish the relationship between several independent variables and dependent variable. The results indicated that, 55.4% of those who were sexually abused were minors «18 years) compared to 44.6% who were adults. More females (84.3%) than males (15.7%) were abused. The result showed that, survivors were violated under various circumstances including perpetrators or survivors home (50%), while walking home alone (38%), carjacked (9%) and work place (3%). The study revealed that, sexual violence was committed while the perpetrators or survivors were in the state of drunkenness (38%), being alone (32%), during darkness or night (29%), insecurity (27%) and lured with money (18%) The study revealed that, survivors (77%) suffered health consequences as a result of sexual violence. The study established that, among survivors who suffered health -consequences due to SV, there was no significant differences in the proportions of minors and adults (p=0.772), females and males (p=0.637), unmarried and married (p=0.426), those with different levels of education (p=0.813) and those in different occupations (p=0.813). The study revealed that, of the 215 (77%) SV survivors who suffered health consequences, 67% of them had psychological trauma, 35% physical injuries, 27% gynaecological disorders, 18% STls, 15% HIV, 10% gastrointestinal disorders and 8% unwanted pregnancies. Majority of the survivors acknowledged the existence of individual based approaches (62%), community based efforts (68%), healthcare responses (82%) and legal and policy reform (80%) as responses and prevention strategies to SV. Success of some responses and strategies was associated with individuals involvement, community participation and people working together to fight SV. Failure of responses and strategies was ascribed to poverty, ignorance, lack of commitment from the individual, low attitude in implementing, evidence interfered with and cases delayed in court. Findings from this study are useful for all individuals working with survivors, including victim advocates, community health workers, and policy makers.