Piloting community-based medical care for survivors of sexual assault in conflict-affected Karen State of eastern Burma

Conflict and Health

Sandra K Krause¹  Naw Integer⁴  Eh May Htoo³  Jen A Leigh²  Catherine I Lee²  Keely Robinson²  Mihoko Tanabe¹ 

[1] Women’s Refugee Commission, 122 East 42nd Street 11F, New York, NY 10168-1289, USA;Global Health Access Program, Mae Sot, Thailand;Burma Medical Association, Mae Sot, Thailand;Karen Department of Health and Welfare, Mae Sot, Thailand

关键词: Conflict setting;    Community health workers;    Internally displaced persons;    Community-based medical care;    Reproductive health;    Sexual assault;    Burma;   

Others  :  804605
DOI  :  10.1186/1752-1505-7-12

 received in 2012-11-03, accepted in 2013-05-15,  发布年份 2013

【 摘 要 】

Background

Given the challenges to ensuring facility-based care in conflict settings, the Women’s Refugee Commission and partners have been pursuing a community-based approach to providing medical care to survivors of sexual assault in Karen State, eastern Burma. This new model translates the 2004 World Health Organization’s Clinical Management of Rape Survivors facility-based protocol to the community level through empowering community health workers to provide post-rape care. The aim of this innovative study is to examine the safety and feasibility of community-based medical care for survivors of sexual assault to contribute to building an evidence base on alternative models of care in humanitarian settings.

Methods

A process evaluation was implemented from July-October 2011 to gather qualitative feedback from trained community health workers, traditional birth attendants, and community members. Two focus group discussions were conducted among the highest cadre health care workers from the pilot and non-pilot sites. In Karen State, eight focus group discussions were convened among traditional birth attendants and 10 among women and men of reproductive age.

Results

Qualitative feedback contributed to an understanding of the model’s feasibility. Pilot site community health workers showed interest in providing community-based care for survivors of sexual assault. Traditional birth attendants attested to the importance of making this care available. Community health workers were deeply aware of the need to maintain confidentiality and offer compassionate care. They did not raise safety as an excess concern in the provision of treatment.

Conclusions

Data speak to the promising “feasibility” of community-based post-rape care. More time, awareness-raising, and a larger catchment population are necessary to answer the safety perspective. The pilot is an attempt to translate facility-based protocol to the community level to offer solutions for settings where traditional methods of post-rape care are not accessible for women and girls that need it most.

【 授权许可】

   
2013 Tanabe et al.; licensee BioMed Central Ltd.

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