What Works for Women and Girls

worked with women’s groups, radio and others to distribute information pamphlets toover 14,000 and trained nurses at 15 primary health care clinics to include informationon sexual violence and services during health talks for patients waiting for services. Theproject took place in a rural hospital with a 450-bed district hospital that functions asa referral site for post-rape care. Interviews were conducted with 109 rape survivors,50 providers and 334 hospital charts were reviewed. Two day training for healthcareworkers and other service providers was implemented in 2005. A designated roomfor treating patients who have been sexually assaulted can reduce delays and increaseprivacy (Kim et al., 2007a; Kim et al., 2009a). (Gray III) (violence, rape, pregnancy, counseling,providers, South Africa)Between 2002 and 2007, a standard of care and a simple post-rape care system wasdeveloped in Kenya, resulting in 784 survivors of rape accessing services. Client exitinterviews conducted with survivors or their guardians in 2005 indicated a high levelof satisfaction with post-rape services. In 2002, a situation analysis was conducted. In2003, there was no policy, no coordination, no confidential spaces for treatment, noservice delivery mechanisms for post-rape services in Kenya and PEP was not offered.Formal counseling for sexual trauma did not include HIV testing. Starting in 2003,a standard of care, post-rape algorithms and counseling protocols were developed.Training that included knowledge, skills and values clarification was conducted withclinicians, lab personnel and trauma counselors. Post-rape kits were developed to facilitatethe collection of evidence. Services were provided through VCT and casualty department.Services were advertised within public health services. A universal data formbecame acceptable for legal presentation in Kenyan courts. Since 2006, indicators forpost-rape care have been incorporated into national planning. By June 2007, 13 postrapefacilities in Kenya delivered services to over 2,000 adults and children with 96%of those eligible initiating PEP at presentation. The cost of providing post-rape care wasestimated at US$27 per patient, similar to costs for VCT (Kilonzo et al., 2009a). (GrayIII) (violence, rape, pregnancy, counseling, providers, Kenya)A project in Kenya with AMPATH instituted provision of occupational PEP and nonoccupationalPEP between 2001 and 2006, during which 446 patients sought PEP. Ofthese 446 patients, 91 sought PEP for occupational exposure. Of the 72 patients whopresented for occupational exposure and tested HIV-negative, 69 completed PEP. Ofthe 296 patients who presented for non-occupational exposure and tested HIV-negative,only 104 completed PEP. Numerous reasons were advanced as contributing to high lossto follow-up in non-occupational cases, such as multiple stops, fees, and confidentialityconcerns (Siika et al., 2009). (Gray III) (post-exposure prophylaxis, Kenya)Following the introduction of comprehensive post-rape care services, the reporting ofrape was ten times higher in the following three months at Thika District Hospital inKenya (Taegtmeyer et al., 2006). (Gray V) (violence, rape, providers, Kenya)WHAT WORKS FOR WOMEN AND GIRLS305