Abstract
IntroductionIn 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.MethodsWe 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.ResultsThe 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.ConclusionAvailability 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.
Highlights
In Zimbabwe, there is a gap between sexual violence (SV) survivors' health care needs versus the existing facilities
Sexual violence is a widespread problem in sub-Saharan Africa [8], and Sub-Saharan African countries are increasingly responding to sexual violence with a range of legislative and healthcare interventions [9]
Inputs Injected into the Sexual Gender Based Violence (SGBV) Program: The program adequately received targeted resources as far as guidelines, IEC materials registers, HIV test kits and fuel were concerned
Summary
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. In Harare city, the SGBV program follows the Ministry of Health and Child Care (MOHCC) national protocol on care for survivors of SGBV It offers free medical care, HIV testing and counselling, screening and referrals for psychological, psychosocial and legal support. In the light of these issues, we here consider the question "why is the 58% of the SV survivors not accessing quality post-rape services promptly?" We broadly evaluated the performance of the programme and assessed the inputs, processes, outputs and outcomes of the program
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