RESUMEN
BACKGROUND: The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as 'Chikwanekwanes' - 'everything under one roof') to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country's first Chikwanekwane in the large, urban city of Blantyre. METHODS: One hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services. RESULTS: All 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. CONCLUSIONS: Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi.
Asunto(s)
Abuso Sexual Infantil/terapia , Centros Comunitarios de Salud/organización & administración , Adolescente , Niño , Abuso Sexual Infantil/diagnóstico , Protección a la Infancia , Centros Comunitarios de Salud/normas , Consejo , Femenino , Humanos , Aplicación de la Ley , Malaui , Masculino , Evaluación de Procesos y Resultados en Atención de Salud , Desarrollo de Programa , Calidad de la Atención de Salud , Maltrato Conyugal/terapia , Población Urbana , Adulto JovenRESUMEN
Participants in the 2018 ERS summer schools of adult and paediatric respiratory medicine describe their experiences http://ow.ly/MV7Q30m5SkW.
RESUMEN
In this article, child sexual abuse in low-income settings is reviewed, including the extent of the problem, the way children present, and how they should be managed. Liaising with other agencies, training in all aspects of sexual abuse and creating an environment that is conducive to good care by all groups involved is essential. Technical details of medical examination are not covered as appropriate guidelines are accessible.