A mixed-methods assessment of sexual and gender-based violence in eastern Democratic Republic of Congo to inform national and international strategy implementation

Int J Health Plann Manage. 2013 Jul-Sep;28(3):e188-216. doi: 10.1002/hpm.2144. Epub 2012 Oct 29.

Abstract

Context: National and international strategies were implemented in eastern Democratic Republic of Congo (DRC) to address sexual and gender-based violence (SGBV).

Objectives: The objective was to assess community attitudes of SGBV and health facility capacity to address SGBV in eastern DRC.

Design and setting: The design and setting are as follows: a cross-sectional, population-based cluster survey of 998 adults in eastern DRC territories, a convenience sample of 27 adults using semi-structured directed interviews, qualitative data from 37 focus groups conducted in three health zones, assessment of 64 health facilities and a comparative analysis of SGBV strategies.

Main outcome measures: The main outcome measures opinions regarding SGBV prevention and justice and health facility capacity to address SGBV.

Results: The majority of respondents favored the legal system over community mediation to obtain justice for SGBV. However, 61.1% (95% CI, 51.8-70.5%) of SGBV survivors reported being forced to accept community mediation. Among SGBV survivors, 81.2% (95% CI, 74.5-87.8%) reported no available mental health care. Less than half of all respondents reported access to a hospital, clinic or pharmacy. The analyses and facility assessment reinforce the need to improve SGBV care.

Conclusions: Mixed methodologies point to the complexities of addressing SGBV, assess key elements of SGBV prevention, justice and response, and may ultimately inform national and international strategies.

Keywords: Democratic Republic of Congo; community mediation; conflict; justice; sexual gender-based violence.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cluster Analysis
  • Community Health Workers
  • Cross-Sectional Studies
  • Democratic Republic of the Congo
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Internationality
  • Male
  • Qualitative Research
  • Sex Factors
  • Sex Offenses / prevention & control*
  • Social Justice
  • Violence / prevention & control*
  • Young Adult