Abstract
ObjectivesGender-based violence is a global public health crisis, which has health, social, and economic impacts on survivors. In Ghana, responding to and preventing sexual violence on university campuses, has become a priority area. However, data are lacking on the healthcare provider response to students who have experienced sexual violence. The purpose of this study was to conduct a situational analysis to better understand the healthcare provider response to sexual violence in Cape Coast, Ghana.MethodsFirst, an observational facility assessment about healthcare services for survivors of sexual violence was conducted at two hospitals serving university students in Cape Coast, Ghana. Next, healthcare providers at the two hospitals completed: 1) a 113-item questionnaire about healthcare services, knowledge, and attitudes related to sexual violence and 2) in-depth semi-structured interviews describing their experiences providing healthcare to survivors of sexual violence. Descriptive statistics and frequencies were computed, and thematic analysis was used to analyze the qualitative data.ResultsBoth sites lacked supplies, including pre-packed rape kits, post-exposure HIV prophylaxis, and informational handouts on medications and support services for survivors. Further, healthcare providers lacked training on gender-based violence, including best practices for caring for survivors and evidence collection procedures. Providers described the clinical management for survivors of sexual violence, including providers’ role in reporting sexual violence to authorities, medical forensic exams, reproductive and sexual health services, and referral for mental healthcare. Finally, providers described a number of barriers to survivors accessing post-assault healthcare, including stigma and structural barriers, such as cost of medical supplies and lack of privacy within the healthcare facilities.ConclusionsThe current healthcare response to sexual violence in Ghana is limited by lack of supplies, knowledge, and training for healthcare providers. Personal and structural barriers may prevent survivors from accessing needed healthcare following sexual violence.
Highlights
Gender-based violence is a global public health crisis, occurring across geographic and cultural contexts
Providers described the clinical management for survivors of sexual violence, including providers’ role in reporting sexual
The current healthcare response to sexual violence in Ghana is limited by lack of supplies, knowledge, and training for healthcare providers
Summary
Gender-based violence is a global public health crisis, occurring across geographic and cultural contexts. It is estimated that 1 in 3 women will experience some form of physical or sexual violence by an intimate partner in her lifetime and one-third of adolescents report their first sexual encounter to be forced [3]. Despite the large number of victims in nearly every society, survivors of sexual violence often face numerous personal and structural barriers to accessing support and services [4]. Gender-based violence perpetrated by intimate and non-intimate partners results in significant acute and chronic health implications [3]. The consequences of gender-based violence include acute and chronic physical harm, psychological damage, increased use of health services after the assault(s), and impairment of personal relationships [5,6]. There is mounting evidence that trauma across the lifespan contributes to chronic disease [6], premature ageing, and increased morbidity and premature mortality [7]
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