Obuvumu: Improving Health Service Uptake for Survivors of Sexual Violence

Obuvumu：提高性暴力幸存者的医疗服务利用率

基本信息

批准号：
10360735
负责人：
Massy Mutumba
金额：
$ 23.97万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-02-01 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10360735
关键词：
Address Africa South of the Sahara Age Alcohol consumption Behavior Behavioral Model Caring Child Chronic stress Communities Country Decision Making Development Drug usage Economic Development Economic Factors Economics Education Emergency treatment Ensure Exposure to Female Financial cost Forcible intercourse Fright Future Goals HIV Health Health Services Health Services Accessibility Health care facility Income Individual Injury Intervention Interview Investments Knowledge Language Lead Life Marital Status Mental Depression Mental Health Methodology Methods National Institute of Mental Health Outcome Perception Phase Population Process Prophylactic treatment Public Health Qualitative Research Recommendation Reporting Reproductive Health Research Research Personnel Resources Risk Behaviors Safety Services Sexually Transmitted Diseases Social Development Social Network Structure Survivors Testing Time Trauma Trust Uganda United States United States National Institutes of Health Unwanted pregnancy Utility Theories Violence Visit Vulnerable Populations Woman base care seeking design effective intervention effective therapy emergency contraception experience experimental study follow-up global health health service use improved innovation low income country medical supply physical conditioning preference psychologic recruit reproductive self esteem service uptake sexual coercion sexual risk taking sexual violence social norm social stigma sociodemographic variables therapy design uptake user centered design violence victimization

项目摘要

PROJECT SUMMARY High numbers of women experience sexual violence (SV) in Uganda, and this includes violence from intimate and non-intimate partners. Studies of past year violence have revealed that three out of four females were exposed to at least one type of SV: one out of four are victims of sexual coercion, and one out of four have experienced forced sex. Experiencing SV has harmful effects on physical and mental health including: unwanted pregnancy, physical injury, risky behaviors, sexual risk-taking behaviors exposing women to sexually-transmitted infections, chronic stress, depression, low self-esteem and lack of control over reproductive choices. The negative impacts of SV can be mitigated by health services providing timely and effective interventions that target injury management and psychological support. However, health services for victims of SV in Uganda, and much of sub-Saharan Africa (SSA), are vastly underutilized to the extent that nine out of 10 females who experience SV never seek care. Many factors contribute to limited uptake of health services in Uganda and elsewhere in SSA for SV survivors, including psychological, cultural, economic, and other factors, such as fear and stigma. Further, health services for victims often lack sufficiently qualified staff and medical supplies, and confidentiality cannot be ensured. In the absence of timely and effective treatment, high rates of SV result in serious psychological and physical consequences at a population level and compromise future social and economic development. Thus, there is a strong need for research that will generate knowledge that may be used to improve health service utilization for survivors of SV. The proposed Obuvumu (meaning “courage” in Luganda – a local Ugandan language) study in Uganda innovates and addresses this need through the following specific aims: Aim 1: Conduct formative qualitative research to inform a discrete choice experiment (DCE) that will generate systematic information on health service utilization for female survivors of SV in Uganda; Aim 2: Using a DCE approach, assess the factors that influence women’s decisions to seek services after experiencing SV among; and Aim 3: Based on findings from the DCE, apply user-centered design principles to co-design an intervention that addresses barriers and preferences identified in Aims 1 and 2. If warranted, findings from this R34 will be used to inform an R01 application to test the intervention. Ultimately, study findings may help inform efforts to increase rates of reporting SV, and improve reproductive health, mental health and related health outcomes for women in Uganda, and more broadly in low-resource countries in SSA and other regions where rates of SV are high. Relatedly, the long-term goal of the proposed research is to inform the future development of culturally appropriate, feasible, acceptable and effective interventions to increase health service utilization among female survivors of SV.

项目概要在乌干达，大量女性遭受性暴力 (SV)，其中包括来自亲密伴侣的暴力对过去一年的暴力行为的研究表明，四分之三的女性遭受过暴力。至少接触过一种类型的 SV：四分之一是性胁迫的受害者，四分之一是性强迫的受害者经历过强迫性行为会对身心健康产生有害影响，包括：意外怀孕、身体伤害、危险行为、使妇女遭受危险的性行为性传播感染、慢性压力、抑郁、自卑和缺乏控制生殖选择的负面影响可以通过及时提供卫生服务来减轻。针对伤害管理和心理支持的有效干预措施。乌干达和撒哈拉以南非洲 (SSA) 的大部分地区的 SV 受害者都没有得到充分利用，以至于九个患有 SV 的女性中有十分之一从未寻求治疗许多因素导致健康状况有限。在乌干达和SSA其他地方为SV幸存者提供服务，包括心理、文化、经济和此外，受害者的卫生服务往往缺乏足够合格的工作人员。和医疗用品，并且在没有及时有效的治疗的情况下，保密性无法得到保证。 SV 的高发生率会在人口层面造成严重的心理和身体后果，因此，迫切需要进行相关研究。生成可用于改善 SV 幸存者的医疗服务利用率的知识。 Obuvumu（乌干达当地语言卢干达语的意思是“勇气”）乌干达的研究创新和这通过以下具体目标满足需求：目标 1：开展形成性定性研究为离散选择实验（DCE）提供信息，该实验将生成有关卫生服务的系统信息乌干达女性 SV 幸存者的利用情况；目标 2：使用 DCE 方法评估影响因素影响女性在经历 SV 后寻求服务的决定；以及目标 3：基于调查结果来自 DCE，应用以用户为中心的设计原则来共同设计一种干预措施，以解决障碍和目标 1 和 2 中确定的偏好。如果有必要，本 R34 的调查结果将用于告知 R01 最终，研究结果可能有助于为提高死亡率的努力提供信息。报告 SV，并改善妇女的生殖健康、心理健康和相关健康结果乌干达，以及更广泛的撒哈拉以南非洲资源匮乏国家和其他 SV 发生率较高的地区。相关地，拟议研究的长期目标是为文化的未来发展提供信息采取适当、可行、可接受和有效的干预措施，提高女性卫生服务利用率 SV的幸存者。