"Other patients are really in need of medical attention" - the quality of health services for rape survivors in South Africa

dc.contributor.authorChristofides, Nicola J
dc.contributor.authorJewkes, Rachel K
dc.contributor.authorWebster, Naomi
dc.contributor.authorPenn-Kekana, Loveday
dc.contributor.authorAbrahams, Naeema
dc.contributor.authorMartin, Lorna J
dc.date.accessioned2018-01-11T13:33:49Z
dc.date.available2018-01-11T13:33:49Z
dc.date.issued2005
dc.date.updated2017-11-06T13:17:31Z
dc.description.abstractObjective: To investigate in the South African public health sector where the best services for rape survivors were provided, who provided them, what the providers’ attitudes were towards women who had been raped and whether there were problems in delivering care for rape survivors. Methods: A cross-sectional study of facilities was carried out. Two district hospitals, a regional hospital and a tertiary hospital (where available) were randomly sampled in each of the nine provinces in South Africa. At each hospital, senior staff identified two doctors and two nurses who regularly provided care for women who had been raped. These doctors and nurses were interviewed using a questionnaire with both open-ended and closed questions. We interviewed 124 providers in 31 hospitals. A checklist that indicated what facilities were available for rape survivors was also completed for each hospital. Findings A total of 32.6% of health workers in hospitals did not consider rape to be a serious medical condition. The mean number of rape survivors seen in the previous six months at each hospital was 27.9 (range = 9.3–46.5). A total of 30.3% of providers had received training in caring for rape survivors. More than three-quarters of regional hospitals (76.9%) had a private exam room designated for use in caring for rape survivors. Multiple regression analysis of practitioner factors associated with better quality of clinical care found these to be a practitioner being older than 40 years (parameter estimate = 2.4; 95% confidence interval (CI) = 0.7–5), having cared for a higher number of rape survivors before (parameter estimate = 0.02; 95% CI = 0.001–0.03), working in a facility that had a clinical management protocol for caring for rape survivors (parameter estimate = 2; 95% CI = 0.12–3.94), having worked for less time in the facility (parameter estimate = -0.2; 95% CI = -0.3 to -0.04) and perceiving rape to be a serious medical problem (parameter estimate = 2.8; 95% CI = 1.9–3.8). Conclusion: There are many weaknesses in services for rape survivors in South Africa. Our findings suggest that care can be improved by disseminating clinical management guidelines and ensuring that care is provided by motivated providers who are designated to care for survivors.
dc.identifierhttp://dx.doi.org/10.1590/S0042-96862005000700009
dc.identifier.apacitationChristofides, N. J., Jewkes, R. K., Webster, N., Penn-Kekana, L., Abrahams, N., & Martin, L. J. (2005). "Other patients are really in need of medical attention" - the quality of health services for rape survivors in South Africa. <i>Bulletin of the World Health Organization</i>, http://hdl.handle.net/11427/26805en_ZA
dc.identifier.chicagocitationChristofides, Nicola J, Rachel K Jewkes, Naomi Webster, Loveday Penn-Kekana, Naeema Abrahams, and Lorna J Martin ""Other patients are really in need of medical attention" - the quality of health services for rape survivors in South Africa." <i>Bulletin of the World Health Organization</i> (2005) http://hdl.handle.net/11427/26805en_ZA
dc.identifier.citationChristofides, Nicola J., Jewkes, Rachel K., Webster, Naomi, Penn-Kekana, Loveday, Abrahams, Naeema, & Martin, Lorna J.. (2005). Other patients are really in need of medical attention: the quality of health services for rape survivors in South Africa. Bulletin of the World Health Organization, 83(7), 495-502. https://dx.doi.org/10.1590/S0042-96862005000700009
dc.identifier.ris TY - Journal Article AU - Christofides, Nicola J AU - Jewkes, Rachel K AU - Webster, Naomi AU - Penn-Kekana, Loveday AU - Abrahams, Naeema AU - Martin, Lorna J AB - Objective: To investigate in the South African public health sector where the best services for rape survivors were provided, who provided them, what the providers’ attitudes were towards women who had been raped and whether there were problems in delivering care for rape survivors. Methods: A cross-sectional study of facilities was carried out. Two district hospitals, a regional hospital and a tertiary hospital (where available) were randomly sampled in each of the nine provinces in South Africa. At each hospital, senior staff identified two doctors and two nurses who regularly provided care for women who had been raped. These doctors and nurses were interviewed using a questionnaire with both open-ended and closed questions. We interviewed 124 providers in 31 hospitals. A checklist that indicated what facilities were available for rape survivors was also completed for each hospital. Findings A total of 32.6% of health workers in hospitals did not consider rape to be a serious medical condition. The mean number of rape survivors seen in the previous six months at each hospital was 27.9 (range = 9.3–46.5). A total of 30.3% of providers had received training in caring for rape survivors. More than three-quarters of regional hospitals (76.9%) had a private exam room designated for use in caring for rape survivors. Multiple regression analysis of practitioner factors associated with better quality of clinical care found these to be a practitioner being older than 40 years (parameter estimate = 2.4; 95% confidence interval (CI) = 0.7–5), having cared for a higher number of rape survivors before (parameter estimate = 0.02; 95% CI = 0.001–0.03), working in a facility that had a clinical management protocol for caring for rape survivors (parameter estimate = 2; 95% CI = 0.12–3.94), having worked for less time in the facility (parameter estimate = -0.2; 95% CI = -0.3 to -0.04) and perceiving rape to be a serious medical problem (parameter estimate = 2.8; 95% CI = 1.9–3.8). Conclusion: There are many weaknesses in services for rape survivors in South Africa. Our findings suggest that care can be improved by disseminating clinical management guidelines and ensuring that care is provided by motivated providers who are designated to care for survivors. DA - 2005 DB - OpenUCT DP - University of Cape Town J1 - Bulletin of the World Health Organization LK - https://open.uct.ac.za PB - University of Cape Town PY - 2005 T1 - "Other patients are really in need of medical attention" - the quality of health services for rape survivors in South Africa TI - "Other patients are really in need of medical attention" - the quality of health services for rape survivors in South Africa UR - http://hdl.handle.net/11427/26805 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/26805
dc.identifier.vancouvercitationChristofides NJ, Jewkes RK, Webster N, Penn-Kekana L, Abrahams N, Martin LJ. "Other patients are really in need of medical attention" - the quality of health services for rape survivors in South Africa. Bulletin of the World Health Organization. 2005; http://hdl.handle.net/11427/26805.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Forensic Medicine and Toxicologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceBulletin of the World Health Organization
dc.source.urihttp://www.who.int/bulletin/en/
dc.subject.otherRape [rehabilitation]
dc.subject.otherHealth services
dc.subject.otherQuality of health care
dc.subject.otherAttitude of health personnel
dc.subject.otherForensic medicine
dc.subject.otherHealth care surveys
dc.subject.otherCross-sectional studies
dc.subject.otherSouth Africa
dc.title"Other patients are really in need of medical attention" - the quality of health services for rape survivors in South Africa
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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