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.
