Suscribirse

Individual and contextual determinants of early access to post-rape care: A retrospective cohort study of 4048 women in the Democratic Republic of Congo from 2014 to 2019 - 21/06/24

Doi : 10.1016/j.jeph.2024.202534 
Mugisho-Munkwa Guerschom a, b, , Ali Bitenga Alexandre c, Andro Armelle a
a Demography Institute, Paris 1 Panthéon-Sorbonne University (CRIDUP), Ecole des Hautes Etudes en Démographie, France 
b Université Evangélique en Afrique-DRC, Bukavu, Democratic Republic of the Congo (DRC) 
c ICART Research Center, Panzi Hospital and Foundation - DRC, Bukavu, Democratic Republic of the Congo (DRC) 

Corresponding author.

Abstract

Background

Armed conflict in the eastern Democratic Republic of Congo (DRC) has significantly increased the incidence of sexual violence against women. Victims who manage to access health care within 72 h of experiencing rape can receive critical preventive care to mitigate the consequences of such violence. Despite this, a disproportionately small number of victims are able to obtain medical care within this crucial time frame. This study aimed to identify both individual and contextual factors that influence the likelihood of accessing post-rape care within 72 h in the eastern DRC.

Methods

This retrospective cohort study utilized patient records from Panzi Hospital along with contextual data provided by the South Kivu Provincial Ministry of Health. It encompassed rape victims residing in South Kivu province who sought post-rape care between 2014 and 2019. To identify individual and contextual factors influencing timely access to care (within 72 h), multilevel logistic regression analysis was employed.

Results

The study included a total of 4,048 women, with 30 % being under 18 years old and 40 % married. Around 13 % accessed care within 72 h of rape. Multivariate analysis revealed that timely access to care (within 72 h) was negatively influenced by factors such as the isolation of the victim's health zone of residence (aOR = 0.29 [0.14–0.63], p = 0.002), the distance between the home health zone and the hospital (aOR = 0.75 [0.54–0.99], p = 0.041), instances of rape occurring in 2015 or earlier (aOR = 0.44 [0.34–0.57], p < 0.001), and referrals to the hospital from other health facilities or organizations (aOR = 0.78 [0.61–1.00], p = 0.049). Conversely, being single was positively associated with access to care within this critical period (aOR = 1.29 [1.03–1.61], p = 0.024). Furthermore, statistical trends indicate that the presence of Panzi partner NGOs in the victim's health zone might facilitate access to care (aOR = 1.33 [0.99–1.80], p = 0.057), highlighting an area of interest, while being internally displaced at the time of rape was associated with a trend towards reduced access to care (aOR = 0.78 [0.59–1.02], p = 0.068), underscoring the need for further research and targeted interventions.

Conclusion

To enhance access to post-rape care, our study highlights the need for strengthened collaboration with all partnering organizations and focused efforts on raising awareness, particularly among married women and their husbands. Enhancing security measures, constructing or upgrading roads to better connect major cities with currently inaccessible or isolated areas, bolstering the efforts of both local and international NGOs, and offering comprehensive reproductive health services to internally displaced women and those residing in the victims' health zones, are crucial steps toward ensuring access to post-rape care within the critical 72-hour window.

El texto completo de este artículo está disponible en PDF.

Keywords : Sexual violence, Rape, Access to health care, Conflict zones, Democratic Republic of Congo


Esquema


© 2024  The Author(s). Publicado por Elsevier Masson SAS. Todos los derechos reservados.
Añadir a mi biblioteca Eliminar de mi biblioteca Imprimir
Exportación

    Exportación citas

  • Fichero

  • Contenido

Vol 72 - N° 4

Artículo 202534- août 2024 Regresar al número
Artículo precedente Artículo precedente
  • Addressing sexual violence against women: The urgent need for global action and enhanced government engagement
  • Jérémy Khouani
| Artículo siguiente Artículo siguiente
  • Association between COVID-19 and subsequent depression diagnoses—A retrospective cohort study
  • Lee Smith, Guillermo F.López Sánchez, Marcel Konrad, Nicola Veronese, Pinar Soysal, Ai Koyanagi, Nimran Kaur, Karel Kostev

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.

¿Ya suscrito a @@106933@@ revista ?

Mi cuenta


Declaración CNIL

EM-CONSULTE.COM se declara a la CNIL, la declaración N º 1286925.

En virtud de la Ley N º 78-17 del 6 de enero de 1978, relativa a las computadoras, archivos y libertades, usted tiene el derecho de oposición (art.26 de la ley), el acceso (art.34 a 38 Ley), y correcta (artículo 36 de la ley) los datos que le conciernen. Por lo tanto, usted puede pedir que se corrija, complementado, clarificado, actualizado o suprimido información sobre usted que son inexactos, incompletos, engañosos, obsoletos o cuya recogida o de conservación o uso está prohibido.
La información personal sobre los visitantes de nuestro sitio, incluyendo su identidad, son confidenciales.
El jefe del sitio en el honor se compromete a respetar la confidencialidad de los requisitos legales aplicables en Francia y no de revelar dicha información a terceros.


Todo el contenido en este sitio: Copyright © 2025 Elsevier, sus licenciantes y colaboradores. Se reservan todos los derechos, incluidos los de minería de texto y datos, entrenamiento de IA y tecnologías similares. Para todo el contenido de acceso abierto, se aplican los términos de licencia de Creative Commons.