Abstract
BackgroundThe Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as ‘Chikwanekwanes’ - ‘everything under one roof’) to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country’s first Chikwanekwane in the large, urban city of Blantyre.MethodsOne hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services.ResultsAll 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. Conclusions: Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi.
Highlights
The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence
In total, 262 patients were evaluated at the Queen Elizabeth Central Hospital One-Stop Centre between August 1, 2012 and June 30, 2013
An additional 24 cases were removed as the allegation of abuse was not substantiated, and the presentation was unrelated to child sexual abuse
Summary
The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as ‘Chikwanekwanes’ - ‘everything under one roof’) to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. Prior to 2010 in Malawi, the medical, legal and social welfare agencies did not work together to assist survivors of child sexual abuse. Parents would bring their child to police who had not been trained in forensic interviewing or the need for appropriate medical examination. Some of the families were referred to the Mulambia et al BMC Pediatrics (2018) 18:145 hospital for an examination, where only 24% of the doctors could correctly interpret genital findings [3] In most hospitals they had to wait in separate lines for treatment, HIV testing and emergency contraception. The poor linkages between departments led to poor case management and children being lost to follow-up [4–7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
