Factors associated with loss follow-up at University Teaching Hospital among female victims of sexual violence in Lusaka: A prospective Cohort study

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Kawimbe, Bambala Alexander
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Introduction: Up to 20% of Zambian women between 15 and 49 years of age have experienced some form of sexual violence. Despite a growing public recognition of gender-based violence (GBV) and its attendant health consequences, less than 50% of survivors ever reach a health facility and of these, less than 60% complete their prescribed follow-up care, which includes return at 1 week, 1 month and 3 months etc depending on the case. There is currently no reliable data to know who or why there is such a huge loss to follow-up. Methods: A prospective cohort study of all survivors of sexual violence in Lusaka, presenting to University Teaching Hospital (UTH) between June and September 2012, to determine factors associated with failure to return for review. File review was conducted after three months of being seen to assess care received at the hospital and adherence to follow-up. Results: A total of 158 eligible survivors were seen out of which 115 patient files were analyzed and the following data relate to these 115. Survivors of sexual assault were mainly teenagers between 13 and 19 years of age (n = 83, 72.2%), single (n = 106, 92%), unemployed (n = 109, 94.8%) and with no income (n = 93, 81.6%). The perpetrator was known to his victim in most cases (n = 98, 85.2%) and usually considered a friend or relative (n = 62, 61.4%). Almost half of the survivors were threatened or injured (n = 51, 45.1%) but injuries requiring treatment were uncommon (n = 2, 11.8%). A large number of survivors (n=99, 86.1%) did not come for review at 3 months and were deemed lost to follow-up while 16 (13.9%) returned for follow-up. The odds of being lost to follow-up were significantly increased in survivors that knew the assailant and in survivors whose files did not show that an appointment for review was given. Marital status [OR 0.41, 95% CI 0.16 – 1.05] and average monthly income [OR 0.69, 95% CI 0.37 – 1.30] were not significantly associated with loss to follow-up. Conclusion: Loss to follow up at UTH among survivors of sexual violence in Lusaka was high and associated with knowing the assailant and not being given an appointment for review by the attending doctor.
Sex crimes-Zambia , :Abused women-Zambia