The importance of the indicator in public health: Sexual violence or rape is an important public health burden affecting the sexual, reproductive and mental health of survivors. Mitigating the health impacts of this violence and providing access to health and other referral services is important. Comprehensive health care to be provided according to WHO guidelines includes provision of PEP within 72 hours of the rape, emergency contraception within 120 hours of the rape, STI prophylaxis and first line support or psychological first aid.
Definition:
Percentage of countries reporting on the availability of service delivery points that provide the following appropriate medical and psychological care and support for women and men who have been raped or experienced incest, in accordance with the recommendations of the 2013 WHO guidelines Responding to intimate partner violence and sexual violence against women.
The numerator includes the number of countries that respond yes to: three or more of the following items/questions:
Do you have service delivery points that provide the following appropriate medical and psychological care and support for women and men who have been raped and experienced incest, in accordance with the recommendations of the WHO’s 2013 guidelines, Responding to intimate partner violence and sexual violence against women
a. First line support or what is known as psychological first aid Yes/No
b. Emergency contraception to women who see services within five days: Yes/No
c. Safe abortion if a woman is pregnant as a result of rape, in accordance with national law: Yes/No
d. STI and HIV post-exposure prophylaxis (within 72 hours of sexual assault) as needed: Yes/No
The denominator includes the number of countries that report on question 115 to the UNAIDS global AIDS monitoring NCPI questionnaire Part A &/or Question 35 NCPI questionnaire Part B. Responses from Part B should be used when the responses from Part A are not reported. If there are discrepancies in any responses between Part A and Part B, the discrepancy should be resolved/validated.
Associated terms:
Appropriate psychological care and support: includes as per WHO guidelines the provision of first line support or psychological first aid (i.e. counselling and psychosocial support involving non-judgmental response, safety planning, and referrals for social support).
Appropriate medical care: includes provision of HIV PEP within 72 hours, STI post-exposure prophylaxis, emergency contraception within 5 days of exposure and safe abortion in accordance with national law.
Disaggregation:
At the global level, this data can be disaggregated by WHO region or income levels of the countries.
It may also be useful to report the data disaggregated by type of item/service that is included in the post-rape care - i.e. to see percentage of countries providing: HIV PEP and STI prophylaxis (item 115 or 35 d); emergency contraception (item 115 or 35 b); safe abortion in accordance with national laws (item 115 or 35 c); first line support/psychological care (item 115 or 35 a).
Method of measurement
Count the number of service delivery points that have trained health providers and that are offering survivors of sexual assault with post-rape care services that includes: HIV PEP within 72 hours of exposure and STI post-exposure prophylaxis, emergency contraception within 5 days of exposure, safe abortion in accordance with the national law and first-line support or psychological first aid (i.e. counselling and psychosocial support involving non-judgmental response, safety planning, and referrals for social support).
Method of estimation:
N/A
Method of estimation of global and regional aggregates:
The indicator does not provide any indication of service delivery coverage. Therefore, it puts in the same grouping countries that may have only 1 service delivery points with those that have multiple service delivery points. It also does not provide any indication of accessibility of these service delivery points or of quality of services provided by these service delivery point. Comparing the responses to this question in the NCPI part A (i.e. question 115) and Part B(i.e. question 35) which is filled out by NGOs might serve as a proxy for accessibility of services.
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