routine screening for ipv in public health care settings ... · •ipv linked to both immediate and...
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Routine screening for IPV in public health care settings in Kenya Africa Regional SGBV Network Partners’ Meeting June 26-27, 2012 Mombasa, Kenya
Margaret Mak’anyengo, GBVRC, Kenyatta National Hospital
Chi-Chi Undie, Population Council
Catherine Maternowska, UNICEF/ESARO
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The IPV problem: Why screen?
• Service delivery models largely serve emergency rape or sexual assault needs, overlooking care for more chronic forms of violence (IPV)
• IPV screening is preventive
May 2, 2011: The Daily Nation NTV Reporter Sarah Kabiru’s
last words (on FaceBook) “I nid help”
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The IPV problem: Why screen?
• Failing to screen compromises quality of care
• missed opportunities to save clients from potentially life-threatening situations
• achievement of optimal RH outcomes hampered
May 16, 2011: The Daily Nation Olympian Samuel Wanjiru
“How did we miss the danger signs?”
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The IPV problem: Why screen?
May 26, 2011: The Daily Star
• IPV linked to both immediate and long-term health, social, and economic consequences
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Overall Project Goal:
to expand the access of women experiencing IPV in Kenya to comprehensive GBV services
Assess acceptability
of routine IPV screening
from client & provider
perspectives
Design IPV screening tool and provider
training curriculum for identification, response, &
referral
Assess feasibility of routine IPV screening
from client & provider
perspectives; service stats
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Methods
ANC CCC
GBVRC Youth Center
Kenyatta National Hospital
Qualitative research design
– IDIs with clients • In general (acceptability)
• compliant & non-compliant (feasibility)
– IDIs & FGDs with providers
Collection of service statistics
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Findings
• Consensus on the scale of violence among providers and clients alike
• The privileging of sexual violence over other violence forms
• Strong perception among clients that IPV survivors would be more likely to seek help in hospital settings (if asked) than with family or friends
• Youth-friendly services are critical for young IPV survivors
• Expressed need for screening in additional health care settings (pediatrics, FP clinic, Burns Center, orthopedics, mental health department, etc.)
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Conclusion
• Routine screening for IPV is acceptable to providers and clients at Kenyatta National Hospital. However, to be effective as a routine service, the system as it currently stands needs to be reinforced in specific ways (e.g., assurance of confidentiality, positive provider attitudes, and respect for clients’ rights).
• These conditions fall within expected quality of care norms associated with accredited health facilities.
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Where we are now …
Acceptability
Study
Screening tool &
training curriculum
dev’t
Sensitization of staff; Provider
training; site preparation
Feasibility Study
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A peek into a provider training session
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Influencing Opportunities Provider training: Opps to educate broadly while
doing research; awareness-raising needed throughout hospital at various staff levels
Various other, provider-identified screening areas – points to potential for scalability
WHO policy on routine IPV screening: harnessing collective of East African scholars doing similar work to disseminate evidence on IPV screening
GBVRC’s survivor in-take form now includes IPV screening questions
KNH as a strategic pilot site – potential for scalability MoH Technical Working Groups - e.g.: ASRH, FP,
Gender, Sexuality
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Challenges
• Potential for client load to greatly increase at the GBVRC as a consequence of screening, which could potentially lead to providers being overwhelmed.
• Sexual violence is more ‘sexy’: Funding for other forms of violence is lacking at KNH, while SV services are free. This inadvertently ‘normalizes’ other forms of violence.
• Funding for longer-term counseling (for other forms of violence is an issue.
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Thank you!