Improving quality of care for female rape survivors in Scottish Livingstone Hospital, Molepolole, Botswana
Thesis (MFamMed)--Stellenbosch University, 2019.
ENGLISH SUMMARY : Background Although rape is prevalent in Botswana, there has not been any published research undertaken to improve the quality of care for female rape survivors in our clinical setting. Improving the quality of care for female survivors of rape is therefore of importance, not only because of the short and long term health related benefits, but also with regard to policy implementation, improvements of structural needs as well as upskilling of health care providers. Aim The aim of the study was to improve the quality of care for female rape survivors in Scottish Livingstone Hospital, Botswana. Setting The setting is Scottish Livingstone Hospital, Molepolole Botswana. Methods This study was a qualitative cycle, using the normal steps of performing an audit of clinical practice at baseline from December 2016 to May 2017. Planning and implementation of changes was conducted from August 2017 to December 2017 and a re-audit to detect improvements in the quality of care was performed from January to June 2018. Results One hundred and twenty four patient records were audited, comprising of sixty two patient records at baseline audit and re-audit. Although the mean age of the victims was 23 years, the age category with the highest incidence of rape ranged from 12 years to 20 years constituting 47% of total number of patients’ records. During the baseline audit, only one out of ten structural standards was met. However, at re-audit, eight structural standards were fully compliant and one partially compliant to current structural standards out of a total of ten. Although none of the process standards were met during both the baseline audit and re-audit, statistically significant improvements in performance (p <0.05) was shown in six out of ten criteria. Conclusion The quality of care for female rape survivors is suboptimal in our setting. However, simple interventions to improve structure in place for patients and upskilling the entire practice team to align care to current international standards can improve the overall quality of healthcare provided to patients.
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