A Holistic, Person-Centred Care Model for Victims of Sexual Violence in Democratic Republic of Congo: The Panzi Hospital One-Stop Centre Model of Care

Mukwege, Dennis; Berg, Marie

doi:10.1371/journal.pmed.1002156

Cited by 27 publications

(55 citation statements)

References 15 publications

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“…As a result, outcomes for mother-child dyads often include attachment difficulties; parental symptoms of PTSD are directly related to children's insecure and disorganised attachment styles (van Ee, Kleber, Jongmans, Mooren, & Out, 2016). Further, at a micro level, if women are able to access services following rape, practitioners can often attend to the most obvious concerns such as physical injury (Mukwege and Berg, 2016) . However, psychological damage can arise much later and be compounded by negative experiences in local communities, as well as displacement and migration (Laban, Komproe, Gernaat, & de Jong, 2008).…”

Section: Introductionmentioning

confidence: 99%

Mothers with children born of sexual violence: Perceptions of global experts regarding support in social care settings

Anderson

2018

Health Care for Women International

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Link to publication on Research at Birmingham portal General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law. • Users may freely distribute the URL that is used to identify this publication. • Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. • User may use extracts from the document in line with the concept of 'fair dealing' under the Copyright, Designs and Patents Act 1988 (?) • Users may not further distribute the material nor use it for the purposes of commercial gain. Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.

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Section: Introductionmentioning

confidence: 99%

Mothers with children born of sexual violence: Perceptions of global experts regarding support in social care settings

Anderson

2018

Health Care for Women International

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“…Some OSCs found that lack of high-level oversight by OSC management led to uncoordinated and delayed services (MC) 11 12 17 28 30 36 38 39. OSCs also faced challenges during transitions of ownership (such as from NGO to local government), and many felt transitions were done hurriedly and without clear instructions, resulting in poor accountability and inter-professional staff relationships (LC) 35 36 38…”

Section: Resultsmentioning

confidence: 99%

“…They frequently need to retell their stories of trauma each time they engage with a different service/sector which can contribute to secondary victimisation. The intended results of the OSC model are to increase accessibility, acceptability, quality and multisectoral coordination of care in order to reach the ultimate goal of reducing survivor retraumatisation when seeking care 15–17…”

Section: Introductionmentioning

confidence: 99%

The implementation and effectiveness of the one stop centre model for intimate partner and sexual violence in low- and middle-income countries: a systematic review of barriers and enablers

2020

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IntroductionMany low- and middle-income countries have implemented health-system based one stop centres to respond to intimate partner violence (IPV) and sexual violence. Despite its growing popularity in low- and middle-income countries and among donors, no studies have systematically reviewed the one stop centre. Using a thematic synthesis approach, this systematic review aims to identify enablers and barriers to implementation of the one stop centre (OSC) model and to achieving its intended results for women survivors of violence in low- and middle-income countries.MethodsWe searched PubMed, CINAHL and Embase databases and grey literature using a predetermined search strategy to identify all relevant qualitative, quantitative and mixed methods studies. Overall, 42 studies were included from 24 low- and middle-income countries. We used a three-stage thematic synthesis methodology to synthesise the qualitative evidence, and we used the CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach to assess confidence in the qualitative research. Meta-analysis could not be performed due heterogeneity in results and outcome measures. Quantitative data are presented by individual study characteristics and outcomes, and key findings are incorporated into the qualitative thematic framework.ResultsThe review found 15 barriers with high-confidence evidence and identified seven enablers with moderate-confidence evidence. These include barriers to implementation such as lack of multisectoral staff and private consultation space as well as barriers to achieving the intended result of multisectoral coordination due to fragmented services and unclear responsibilities of implementing partners. There were also differences between enablers and barriers of various OSC models such as the hospital-based OSC, the stand-alone OSC and the NGO-run OSC.ConclusionThis review demonstrates that there are several barriers that have often prevented the OSC model from being implemented as designed and achieving the intended result of providing high quality, accessible, acceptable, multisectoral care. Existing OSCs will likely require strategic investment to address these specific barriers before they can achieve their ultimate goal of reducing survivor retraumatisation when seeking care. More rigorous and systematic evaluation of the OSC model is needed to better understand whether the OSC model of care is improving support for survivors of IPV and sexual violence.The systematic review protocol was registered and is available online (PROSPERO: CRD42018083988).

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“…In collaboration with Panzi Hospital’s GBV division, we developed a training curriculum that complemented Panzi Hospital’s existing GBV model. The Panzi Model is a holistic person-centred care model that encompasses four pillars: medical, psychosocial, legal and socioeconomic 20. As the rural sites did not previously have access to post-rape medical kits, we added modules to the Panzi curriculum covering the following areas: HIV prevention, infection, diagnosis and treatment; HIV post-exposure prophylaxis, prophylactic treatment of other STIs and emergency contraception; how to safely administer antiretroviral drugs; side effects of post-rape medications; sensitivity to issues of violence, confidentiality, record keeping, drug security, the Prevention Pack and inventory management.…”

Section: Methodsmentioning

confidence: 99%

Delivering integrated care after sexual violence in the Democratic Republic of the Congo

et al. 2019

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In the eastern Democratic Republic of the Congo, ongoing armed conflict increases the incidence of gender-based violence (GBV) and presents a distinct and major barrier to care delivery for all survivors of GBV. A specific challenge is providing emergency contraception, HIV prophylaxis and treatment for sexually transmitted infections to all survivors within 72 hours of violence. To address the multiple barriers to providing this time-sensitive medical care, Global Strategies and Panzi Hospital implemented the Prevention Pack Program. The Prevention Pack is a pre-packaged post-rape medical kit containing antiretroviral post-exposure prophylaxis, antibiotics for treatment of sexually transmitted infections and emergency contraception. The Prevention Pack Program combines community sensitisation about post-rape medical care with the provision of Prevention Packs and the implementation of a cloud-based and Global Positioning System (GPS)–enabled inventory management system. The Panzi Hospital gender-based violence team implemented the Prevention Pack Program at Panzi Hospital and 12 rural clinics in the South Kivu Province. The data manager took GPS coordinates of each site, provided an initial stock of Prevention Packs and then called all sites daily to determine demand for post-rape care and Prevention Pack consumption. Inventory data were entered into the GPS-enabled cloud-based inventory management system. Project personnel used the consumption rate, trends and geolocation of sites to guide Prevention Pack restocking strategy. Between 2013 and 2017, a total of 8206 individuals presented for care following rape at the study sites. Of the 1414 individuals who presented in the rural areas, 1211 (85.6%) did so within the first 72 hours of reported rape. Care was delivered continuously and without a single stockout of medication across all sites. The Prevention Pack Program provided timely and consistent access to emergency contraception, HIV prophylaxis and treatment for sexually transmitted infections for rape survivors in the eastern Democratic Republic of the Congo.

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A Holistic, Person-Centred Care Model for Victims of Sexual Violence in Democratic Republic of Congo: The Panzi Hospital One-Stop Centre Model of Care

Abstract: Denis Mukwege and Marie Berg describe the One Stop Centre at Panzi Hospital in Eastern Democratic Republic of Congo that provides care for girls and women who have been raped in combination with extreme bodily harm.

Cited by 27 publications

References 15 publications

Mothers with children born of sexual violence: Perceptions of global experts regarding support in social care settings

Mothers with children born of sexual violence: Perceptions of global experts regarding support in social care settings

The implementation and effectiveness of the one stop centre model for intimate partner and sexual violence in low- and middle-income countries: a systematic review of barriers and enablers

Delivering integrated care after sexual violence in the Democratic Republic of the Congo

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