Evaluation of sexual and gender-based violence program in Harare City, Zimbabwe, 2016: a descriptive cross-sectional study

Abstract

Introduction 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. Methods 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. Results 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. Conclusion 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.

Interventions in sexual and reproductive health services addressing violence against women in low- and middle- income countries: a mixed-methods systematic review

“…Of the 26 studies, 18 were from sub-Saharan Africa, 28 31–34 38 42 45–47 49 52–54 56 57 59 60 three from the Middle East, 40 55 58 three from South Asia, 29 39 50 and two from South America. 30 35 Twelve quantitative evaluations were randomised controlled trials (RCTs), 32 34 35 38 40 47 50 52 55 58–60 six were uncontrolled before-after (UBA) studies, 29 30 39 42 46 54 six cross sectional studies, 31 45 49 53 56 57 and one was a controlled before-after evaluation (CBA). 28 Nine qualitative evaluations were components of mixed-methods studies: three embedded in RCTs, 38 44 51 two carried out alongside UBA studies, 30 54 three alongside cross-sectional studies, 49 56 57 and one standalone qualitative study.…”

“…Most interventions took place in antenatal care (ANC) services (n=11), 29 34 35 39 40 45 47 50 55 56 58 followed by HIV testing and treatment (n=8), 32 33 38 46 52 57 59 60 services for victims of sexual violence (n=5), 28 31 42 53 54 and family planning (n=2). 30 49 The SRH services were provided in primary care (n=15), 30 32–34 39 40 46 47 49 52 53 55 56 58 59 hospital (n=7), 29 35 38 42 45 50 57 and across both (n=4). 28 31 54 60 Included studies used different definitions and measures of VAW.…”

Aspectos Epidemiológicos Da Leishmaniose Visceral No Estado Do Piauí No Período De 2015 a 2018

“…No que tange aos periódicos, a maior parte dos artigos foram publicados em revistas de saúde (SITHOLE et al, 2018;VANDENBERGHE et al, 2018;VIEIRA et al, 2016;COLOMBINI et al, 2013;JINA;JEWKES;CHRISTOFIDES;LOOTS, 2013;AMEELE et al, 2013). As revistas específicas da área de violência contra a mulher, saúde da mulher e ginecologia e obstetrícia tiveram um artigo cada respectivamente (BOWS, 2018; AMIN;…”

“…Do direcionamento dos estudos, três dos oito estudos avaliaram serviços de saúde que prestam assistência à pessoa em situação de violência sexual (SITHOLE et al, 2018;VANDENBERGHE et al, 2018;AMEELE et al, 2013), três atitudes e concepções dos trabalhadores (BOWS, 2018;AMIN;BURANOSKY;CHANG, 2017;COLOMBINI et al, 2013) e dois investigaram o processo de trabalho com foco no uso de protocolo em capacitação dos trabalhadores (VIEIRA et al, 2016 Apesar de a atenção à pessoa em situação de violência sexual ser considerada de boa qualidade, lacunas importantes são apontadas no processo de trabalho, como por exemplo a necessidade de conscientização sobre a oferta desta atenção aos grupos vulneráveis (VANDENBERGHE et al, 2018;BOWS, 2018;AMEELE et al, 2013), efetiva supervisão e auditoria dos profissionais, amplo apoio psicossocial e monitoramento ininterrupto dos sobreviventes (VANDENBERGHE et al, 2018), desenvolvimento de estratégias para uma efetiva comunicação (AMIN;BURANOSKY;CHANG, 2017;COLOMBINI et al, 2013), são apontados como pontos nevrálgicos da atenção.…”

“…; JINA; JEWKES; CHRISTOFIDES; LOOTS, 2013).Quanto à avaliação da assistência à saúde dispensadas às sobreviventes da violência sexual, evidenciou-se que a disponibilidade de recursos materiais não está diretamente associada ao desempenho do programa. Apesar do repasse de insumos satisfatório, acompanhamento das usuárias, descentralização do site, campanhas de conscientização e atividades de sensibilização, capacitação dos trabalhadores, não tiveram cem por cento de suas metas alcançadas(SITHOLE et al, 2018) …”