Clinical Care of Victims of Interpersonal Violence and Rape in Tanzania: A Qualitative Investigation

Abstract

Introduction: Africa has high rates of interpersonal violence and rape, although little is known about how these cases are handled in the clinical setting. Methods: We enrolled 121 health care professionals and students in Tanzania from the fields of midwifery, nursing and medicine, and conducted 18 focus group discussions stratified by both professional and clinical experience. Two clinical scenarios were presented across all groups and participants were asked to give their opinions on how the hospital they worked in would manage the cases. Case 1 focused on how to address a case of an injured woman beaten by her husband (and whether the perpetrator would be reported to the police). Case 2 focused on how to handle a rape victim who is brought to the hospital by the police. Results: Participants considered both cases as emergencies. There was a similarity in the clinical care procedures across both scenarios. This included building rapport with the patient, prioritization of the medical care, history taking, and referring to other specialties for follow-up. Participants differed in how they would handle the legal aspects of both cases, including whether and how to best follow mandated reporting policies. Providers wondered if they should report the husband in case study 1, the criteria for reporting, and where to report. Providers displayed a lack of knowledge about resources needed for sexual violence victim and the availability of resources. Conclusion: These findings indicate that cases of intimate partner violence and rape are likely to be under-reported within hospitals and clinics in Tanzania. Health care providers lack training in their required obligations and procedures that need to be followed to ensure victim's safety. The findings confirm that there is a need for health care students in Tanzania (and possibly Africa) to receive comprehensive training in how to handle such cases.

A Participatory Comic Book Workshop to Improve Youth-Friendly Post-Rape Care in a Humanitarian Context in Uganda: A Case Study

“… 12 HCP training needs for working with SGBV survivors have also been identified in Kenya 14 and Tanzania. 11 In Kenyan humanitarian 13 and non-humanitarian 10 contexts, SGBV survivors reported concerns regarding HCP confidentiality and fears of community stigma. 13 A recent study with women sexual violence survivors from Somalia and Syria noted the need for additional research to understand sexual violence stigma in health care.…”

“…8,9 Further information on effective strategies to train HCPs in humanitarian contexts is required to ensure youth-friendly post-rape care experiences. 9 The need for youth-friendly post-rape care training with HCPs has been identified in East African contexts, 10,11 including within conflictaffected regions. 3,12,13 A study with HCPs from conflict-affected Gulu District in Uganda found that inadequate training opportunities and policies within health facilities contributed to a lack of confidence when working with SGBV survivors.…”

Not Lost in Translation: The Use of Standardized Patients Technology among Health Professional Students in Tanzania

“…Healthcare providers (HCPs) play a critical role in accessing and delivering SRH services. While HCPs face facility-level challenges to highquality care, such as a lack of private rooms to ensure privacy and confidentially, high volumes of patients, scheduling issues, and a lack of specific SRH services and equipment (Mgopa et al, 2021c), studies demonstrate that individuallevel factors such as the religious and cultural background of HCPs may also impact care delivery (Mgopa et al, 2021b). Many patients have reported SRH services being inaccessible due to a lack of confidentiality, privacy, discrimination, stigma, and negative attitudes toward HCPs (Ross et al, 2021).…”