Rape prevention efforts are hampered by a chronic lack of adequate epidemiological and surveillance data. Information on identifying factors such as the who, when, where and how of rape is needed to inform the design of effective intervention programmes. Results from a demonstration Rape Surveillance Project show that records of rape cases presenting at three medico-legal clinics provide a valuable source for the epidemiological surveillance of rape. From January 1996 to December 1998 a surveillance questionnaire was completed for rape victims presenting at the Hillbrow, Lenasia South, and Chris Hani Baragwanath Medico-Legal Clinics in Gauteng. Analysis of the data suggests which women are most at risk for being raped, by whom they are raped, the areas where attacks most often occur, and the day and time when rapes are mostly committed. Despite the limited database and difficulties with generalizing findings beyond the three clinics, it is apparent that surveillance procedures have enormous import for sexual violence prevention and intervention. Implications for prevention strategies, aftercare, policy formulation, and future research are discussed. Methodological issues and institutional constraints are also discussed with a view to strengthening and developing such information management systems.
In this paper the authors extend the predominantly etic analysis of the Soweto Community Health Centre System's macrostructural and managerial factors presented in Part 1 (Seedat & Nell, this issue), to an emic analysis at the microlevel of interpersonal processes and practices among nursing staff. Content analysis of interviews with 18 nurses one year after they had completed a psychological skills-training programme revealed five key constraints on the development of nurse autonomy and integration of psychological with biomedical treatment modalities: (1) Dichotomization of biomedical and psychosocial treatment modalities;(2) Inadequately explained instructions; (3) Contradictions between official roles and organizationally determined powerlessness; (4) Time-limited effects of psychological skills training on patient referral patterns; and (5) Invasion of nurse-patient boundaries by superiors. Positive effects of training were evident in only two areas: (a) Improved conflict resolution skills in relationships with family and peers; and (b) Attempts at self-initiated application of psychological skills during routine treatment of patients. The findings are discussed in relationship to the wider organization, and in particular the attitudes and actions of matrons toward nursing staff. This suggests that in the absence of organizational changes to reduce the ambiguity of role definitions and power relationships between nurses, matrons, doctors and management, the development of holistic and empowering primary health care cannot prosper. In conclusion, some suggestions are presented as to the nature of these changes at the conceptual and organizational levels of primary health care provision.In hierdie artikel brei die outeurs uit op die analise vannuit 'n buite-perspektief van makrostrukturele en bestuursfaktore in die Soweto Gemeenskapsgesondheidsentrumstelsel wat in Dee1 1 aangebied is (Seedat & Nell, hierdie uitgawe), en beskryf 'n 'inwendige' analise van die interpersoonlike prosesse en praktyke van verpleegpersoneel. lnhoudsanalise van onderhoude met 18 verpleegsters 'n jaar nadat hulle 'n sielkundige vaardighede opleidingsprogram voltooi het, het vyf belangrike beperkende faktore op die ontwikkeling van verpleegsteroutonomiteit en die integrasie van biomediese en psigo-sosiale behandelingsmodaliteite aan die lig gebring: (1) Dichotomisasie van biomediese en psigo-sosiale behandelingsmodaliteite; (2) Onvoldoende verduideliking van instruksies; (3) Teenstrydighede tussen amptelike rolle en organisatoriesbepaalde magsloosheid; (4) Tydbeperkte invloed van sielkundige vaardigheidsopleiding op pasientverwysings patrone; en (5) Binneval van verpleegster-pasient grense deur hoofde. 'n Positiewe invloed van die opleiding was slegs op twee gebiede merkbaar: (a) Verbeterde konflikoplossingsvaardighede in verhoudings met familie en gelykes; en (b) Pogings tot self-ge'inisieerde aanwending van sielkundige vaardighede gedurende roetine behandeling van pasiente. Hierdie bevindinge word bespreek met verwysing na die breere ...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.