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One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo

BACKGROUND: Outcomes of sexual violence care programmes may vary according to the profile of survivors, type of violence suffered, and local context. Analysis of existing sexual violence care services could lead to their better adaptation to the local contexts. We therefore set out to compare the Mé...

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Autores principales: Loko Roka, Jerlie, Van den Bergh, Rafael, Au, Sokhieng, De Plecker, Eva, Zachariah, Rony, Manzi, Marcel, Lambert, Vincent, Abi-Aad, Elias, Nanan-N’Zeth, Kassi, Nzuya, Serge, Omba, Brigitte, Shako, Charly, MuishaBaroki, Derick, Basimuoneye, Jean Paul, Moke, Didier Amudiandroy, Lampaert, Emmanuel, Masangu, Lucien, De Weggheleire, Anja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4203825/
https://www.ncbi.nlm.nih.gov/pubmed/25329482
http://dx.doi.org/10.1371/journal.pone.0111096
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author Loko Roka, Jerlie
Van den Bergh, Rafael
Au, Sokhieng
De Plecker, Eva
Zachariah, Rony
Manzi, Marcel
Lambert, Vincent
Abi-Aad, Elias
Nanan-N’Zeth, Kassi
Nzuya, Serge
Omba, Brigitte
Shako, Charly
MuishaBaroki, Derick
Basimuoneye, Jean Paul
Moke, Didier Amudiandroy
Lampaert, Emmanuel
Masangu, Lucien
De Weggheleire, Anja
author_facet Loko Roka, Jerlie
Van den Bergh, Rafael
Au, Sokhieng
De Plecker, Eva
Zachariah, Rony
Manzi, Marcel
Lambert, Vincent
Abi-Aad, Elias
Nanan-N’Zeth, Kassi
Nzuya, Serge
Omba, Brigitte
Shako, Charly
MuishaBaroki, Derick
Basimuoneye, Jean Paul
Moke, Didier Amudiandroy
Lampaert, Emmanuel
Masangu, Lucien
De Weggheleire, Anja
author_sort Loko Roka, Jerlie
collection PubMed
description BACKGROUND: Outcomes of sexual violence care programmes may vary according to the profile of survivors, type of violence suffered, and local context. Analysis of existing sexual violence care services could lead to their better adaptation to the local contexts. We therefore set out to compare the Médecins Sans Frontières sexual violence programmes in the Democratic Republic of Congo (DRC) in a zone of conflict (Masisi, North Kivu) and post-conflict (Niangara, Haut-Uélé). METHODS: A retrospective descriptive cohort study, using routine programmatic data from the MSF sexual violence programmes in Masisi and Niangara, DRC, for 2012. RESULTS: In Masisi, 491 survivors of sexual violence presented for care, compared to 180 in Niangara. Niangara saw predominantly sexual violence perpetrated by civilians who were known to the victim (48%) and directed against children and adolescents (median age 15 (IQR 13–17)), while sexual violence in Masisi was more directed towards adults (median age 26 (IQR 20–35)), and was characterised by marked brutality, with higher levels of gang rape, weapon use, and associated violence; perpetrated by the military (51%). Only 60% of the patients in Masisi and 32% of those in Niangara arrived for a consultation within the critical timeframe of 72 hours, when prophylaxis for HIV and sexually transmitted infections is most effective. Survivors were predominantly referred through community programmes. Treatment at first contact was typically efficient, with high (>95%) coverage rates of prophylaxes. However, follow-up was poor, with only 49% of all patients in Masisi and 61% in Niangara returning for follow-up, and consequently low rates of treatment and/or vaccination completion. CONCLUSION: This study has identified a number of weak and strong points in the sexual violence programmes of differing contexts, indicating gaps which need to be addressed, and strengths of both programmes that may contribute to future models of context-specific sexual violence programmes.
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spelling pubmed-42038252014-10-27 One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo Loko Roka, Jerlie Van den Bergh, Rafael Au, Sokhieng De Plecker, Eva Zachariah, Rony Manzi, Marcel Lambert, Vincent Abi-Aad, Elias Nanan-N’Zeth, Kassi Nzuya, Serge Omba, Brigitte Shako, Charly MuishaBaroki, Derick Basimuoneye, Jean Paul Moke, Didier Amudiandroy Lampaert, Emmanuel Masangu, Lucien De Weggheleire, Anja PLoS One Research Article BACKGROUND: Outcomes of sexual violence care programmes may vary according to the profile of survivors, type of violence suffered, and local context. Analysis of existing sexual violence care services could lead to their better adaptation to the local contexts. We therefore set out to compare the Médecins Sans Frontières sexual violence programmes in the Democratic Republic of Congo (DRC) in a zone of conflict (Masisi, North Kivu) and post-conflict (Niangara, Haut-Uélé). METHODS: A retrospective descriptive cohort study, using routine programmatic data from the MSF sexual violence programmes in Masisi and Niangara, DRC, for 2012. RESULTS: In Masisi, 491 survivors of sexual violence presented for care, compared to 180 in Niangara. Niangara saw predominantly sexual violence perpetrated by civilians who were known to the victim (48%) and directed against children and adolescents (median age 15 (IQR 13–17)), while sexual violence in Masisi was more directed towards adults (median age 26 (IQR 20–35)), and was characterised by marked brutality, with higher levels of gang rape, weapon use, and associated violence; perpetrated by the military (51%). Only 60% of the patients in Masisi and 32% of those in Niangara arrived for a consultation within the critical timeframe of 72 hours, when prophylaxis for HIV and sexually transmitted infections is most effective. Survivors were predominantly referred through community programmes. Treatment at first contact was typically efficient, with high (>95%) coverage rates of prophylaxes. However, follow-up was poor, with only 49% of all patients in Masisi and 61% in Niangara returning for follow-up, and consequently low rates of treatment and/or vaccination completion. CONCLUSION: This study has identified a number of weak and strong points in the sexual violence programmes of differing contexts, indicating gaps which need to be addressed, and strengths of both programmes that may contribute to future models of context-specific sexual violence programmes. Public Library of Science 2014-10-20 /pmc/articles/PMC4203825/ /pubmed/25329482 http://dx.doi.org/10.1371/journal.pone.0111096 Text en © 2014 Loko Roka et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Loko Roka, Jerlie
Van den Bergh, Rafael
Au, Sokhieng
De Plecker, Eva
Zachariah, Rony
Manzi, Marcel
Lambert, Vincent
Abi-Aad, Elias
Nanan-N’Zeth, Kassi
Nzuya, Serge
Omba, Brigitte
Shako, Charly
MuishaBaroki, Derick
Basimuoneye, Jean Paul
Moke, Didier Amudiandroy
Lampaert, Emmanuel
Masangu, Lucien
De Weggheleire, Anja
One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo
title One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo
title_full One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo
title_fullStr One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo
title_full_unstemmed One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo
title_short One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo
title_sort one size fits all? standardised provision of care for survivors of sexual violence in conflict and post-conflict areas in the democratic republic of congo
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4203825/
https://www.ncbi.nlm.nih.gov/pubmed/25329482
http://dx.doi.org/10.1371/journal.pone.0111096
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