A community-based intervention for improving health-seeking behavior among sexual violence survivors: a controlled before and after design study in rural Tanzania.
A community-based intervention for improving health-seeking behavior among sexual violence survivors: a controlled before and after design study in rural Tanzania.
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DOI：
10.3402/gha.v8.28608
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发表时间：
2015
影响因子：
2.6
通讯作者：
Axemo P
中科院分区：
文献类型：
--
作者：
Abeid M;Muganyizi P;Mpembeni R;Darj E;Axemo P
尽管全球都承认性暴力是对人权的侵犯，但有证据表明，性暴力在所有社会都是一个普遍存在的问题。在低收入和中等收入国家，有希望的社区干预研究有限。这项研究评估了以社区为基础的干预措施的影响，重点是提高社区的知识，降低社会对暴力侵害妇女行为规范的接受度，目的是预防和应对性暴力。用于提高认识的战略包括电台节目、信息、教育宣传材料和与当地领导人举行的倡导会议。干预发生在坦桑尼亚的莫罗戈罗地区。评估采用准实验设计，包括基线(2012年)和终点(2014年)的横断面调查，调查对象为18-49岁的男性和女性。主要结果衡量标准是卫生机构报告的强奸案件数量以及社区对性暴力的了解和态度。在干预期间，卫生机构报告的强奸事件数量增加了50%以上。在研究期间，两地对性暴力知识的知晓率显著增加(干预区从57.3%上升到80.6%，对照区从55.5%上升到71.9%；p<；0.001)，两地干预的净效果有统计学意义(6.9，95%CI0.2-13.5，p=0.03)。干预区大部分态度指标均有明显改善，而对照区未见明显改善。然而，当比较两个领域时，干预对最终评估中接受态度的总分没有显著影响(−2.4，95%CI：−8.4~3.6，p=0.42)。即使在短期干预后，干预对性暴力知识和态度的一些指标也有影响。这一发现使公共卫生从业者认识到综合战略在实现变化方面的重要性。
Despite global recognition that sexual violence is a violation of human rights, evidence still shows it is a pervasive problem across all societies. Promising community intervention studies in the low- and middle-income countries are limited. This study assessed the impact of a community-based intervention, focusing on improving the community's knowledge and reducing social acceptability of violence against women norms with the goal to prevent and respond to sexual violence. The strategies used to create awareness included radio programs, information, education communication materials, and advocacy meetings with local leaders. The intervention took place in Morogoro region in Tanzania. The evaluation used a quasi-experimental design including cross-sectional surveys at baseline (2012) and endline (2014) with men and women aged 18–49 years. Main outcome measures were number of reported rape cases at health facilities and the community's knowledge and attitudes toward sexual violence. The number of reported rape events increased by more than 50% at health facilities during the intervention. Knowledge on sexual violence increased significantly in both areas over the study period (from 57.3 to 80.6% in the intervention area and from 55.5 to 71.9% in the comparison area; p<0.001), and the net effect of the intervention between the two areas was statistically significant (6.9, 95% CI 0.2–13.5, p=0.03). There was significant improvement in most of the attitude indicators in the intervention area, but not in the comparison area. However, the intervention had no significant effect on the overall scores of acceptance attitudes in the final assessment when comparing the two areas (−2.4, 95% CI: −8.4 to 3.6, p=0.42). The intervention had an effect on some indicators on knowledge and attitudes toward sexual violence even after a short period of intervention. This finding informs the public health practitioners of the importance of combined strategies in achieving changes.