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Janel Smith, MPH, RN Clinical Care for Sexual A ssault S urvivors S pecialist

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Multimedia training to strengthen clinical care capacities for sexual assault survivors and HIV/AIDS prevention in humanitarian settings. Janel Smith, MPH, RN Clinical Care for Sexual A ssault S urvivors S pecialist International Rescue Committee. Background.

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Multimedia training to strengthen clinical care capacities for sexual assault survivors and HIV/AIDS prevention in humanitarian settings

Janel Smith, MPH, RN

Clinical Care for Sexual Assault Survivors Specialist

International Rescue Committee

background
Background
  • Worldwide, an estimated 1 in 3 women will be physically or sexually abused, and1 in 5 will experience rape or attempted rape in their lifetime.*
  • The risk of HIV among women who have experienced violence may be up to 3 times higher than among those who have not.*
  • Limited access to compassionate, competent, and confidential clinical care, essential to begin a survivor’s physical and emotional healing and prevent HIV.
  • Training health care providers to strengthen the clinical response to GBV and HIV has been prioritized by humanitarian actors globally.*

*WHO, 2009

**UNHCR, 2011; USAID, 2010

evaluating the clinical care for sexual assault survivor training
Evaluating the Clinical Care for Sexual Assault Survivor training
  • Goal: Evaluate impact of training on clinician compassion, competence, and confidential care
  • Design: Comparison at pre and 3 months post-training
  • Sample: 106 clinicians in 39 health facilities in refugee camp and post-conflict settings in DRC, Ethiopia, Kenya, and Jordan
  • Method: Mixed-methods: KAP surveys, in-depth interviews, health facility checklists, participatory mapping, medical record audits
compassionate care patient rights
Compassionate care: patient rights

Before we thought they would not understand…now we give them the information…the patient has the right to accept or refuse interventions.

Doctor, Kenya

Now I know it’s not my responsibility to find sexual assault…my work is not to judge but to give treatment according to the patient’s right. Nurse, Kenya

compassionate care attitudes
Compassionate care: attitudes

They don’t come with medical problems, they come for referral… a chance of resettlement. Nurse, Ethiopia

We have the consultation to determine if it is true or false…to diagnose and guide treatment… I would ask her what she was doing, what is her occupation, if she sells sex or is married. Nurse, DRC

competent care follow up
Competent care: follow-up

We’ve found that the nurses providing the care didn’t know PEP. She [the survivor] showed us what was provided and said she was told to take them but not told what it was. GBV Manager, Ethiopia

confidential care private room
Confidential care: private room
  • Maternity is too congested and lacks privacy …it attracts a lot of onlookers…so they perceive it as not a very safe place.
  • There is now improvement in the facility, there is more privacy and confidentiality because now we are giving the services at one center.
  • Nurse, Kenya
conclusion
Conclusion
  • Limited capacity of the health care response to GBV and HIV in humanitarian settings were identified including negative attitudes among health care providers, lack of follow-up, and limited resources
  • Multimedia CCSAS training demonstrated effective at improving health care provider respect for patient rights, HIV PEP treatment initiation, and coordination of services to protect patient confidentiality
  • Additional interventions should be implemented with training to ensure a quality comprehensive health care response to GBV and HIV including long term BCC interventions, multi-sectoral coordination , and supply chain management
thank you
Thank you

Training materials in English and French: clinicalcare.rhrc.org

Contact: [email protected]

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