Characteristics, medical management, and outcomes of gender-based violence survivors in Neno, Malawi: a cross-sectional study
Understanding who experiences gender-based violence—and how health facilities can strengthen survivor care in rural Malawi.
Abstract
Abstract
Background: There is limited research describing survivors of gender-based violence (GBV) in Malawi. This study examined characteristics, medical management, and outcomes of GBV survivors presenting at health facilities in Neno district, Malawi.
Methods: We conducted a retrospective cross-sectional study, using facility-based GBV registers at 14 health facilities in Neno district, Malawi. We categorized all variables and used frequencies and percentages. We used Chi-square and Fisher exact to test the association between sexual abuse and other variables.
Results: Of 465 GBV survivors, 59.1% were sexually abused, and 56.8% sought help within 72 h after the incident. The majority of survivors were female (n = 413, 88.8%), unmarried (n = 334, 71.8%), and aged 18 years or younger (n = 282, 60.6%). Psychological and trauma counselling was provided to 85.6% and 84.1% of survivors, respectively. Of 275 SGBV survivors, 74.9% tested HIV negative, and 25.8% (n = 71) tested Venereal Disease Research Laboratory (VDRL) positive. Of the 33 eligible women, 40% tested pregnancy positive. Only 26.6% of the eligible 275 SGBV survivors received STI prophylaxis, and 47.1% of the eligible 85 SGBV survivors received post-exposure prophylaxis (PEP). Emergency contraception was given to twelve of 29 eligible women. We found an association between sexual abuse and reporting to the health facility within or after 72 h, age of the victim, sex of the victim, marital status, and referral to social welfare (p < 0.001).
Conclusions: GBV survivors district-wide were mainly at or below 18 years of age, female, and unmarried. A majority of the survivors were sexually abused, and over half of the survivors reported cases within 72 h of the incident taking place. Our study demonstrates that providing standard, and coordinated GBV care in a rural setting is possible. Improvements to documentation tools is needed to enhance follow-up interventions.
Keywords: Gender-based violence; Medical management; Neno, Malawi; Sexual violence; Survivor characteristics; Survivor outcomes.