Care-seeking patterns and timely access to care among survivors of sexual violence in North Kivu, the Democratic Republic of the Congo: a retrospective file-based study

Figures & data

Table 1. Sex and age group of survivors of sexual violence accessing care in MSF programmes in Mweso and Walikale, DRC, 2014–2018.

		Age
Year	Sex	0–9	10–19	20–29	30–39	40–49	≥50	Missing data^a	Total
2014	Female	14	195	232	154	66	30		691
	Male	0	4	12	7	8	1		32
	Total	14	199	244	161	74	31		723
2015	Female	24	153	186	144	88	30		625
	Male	0	0	11	10	1	0		22
	Total	24	153	197	154	89	30		647
2016	Female	20	248	309	287	116	52		1032
	Male	1	6	8	8	1	1		25
	Total	21	254	317	295	117	53		1057
2017	Female	25	316	377	291	124	50	1	1184
	Male	0	6	8	8	1	2		25
	Total	25	322	385	299	125	52	1	1209
2018	Female	24	281	402	202	90	20		1019
	Male	1	10	9	6	3	0		29
	Total	25	291	411	208	93	20		1048
2014–2018	Female	107	1193	1506	1078	484	182	1	4551
	Male	2	26	48	39	14	4	0	133
	Total	109	1219	1554	1117	498	186	1	4684

^aData concerning age of survivor missing.

Table 2. Healthcare facilities offering sexual violence care with MSF support and survivors of sexual violence accessing care in those facilities in Walikale and Mweso, North Kivu, DRC 2014–2018.

	Number of MSF supported healthcare facilities with sexual violence care provision				Number of survivors of sexual violence accessing care
Year		Health Centres	Hospitals	Tumaini (specialised sexual violence clinic)	Health Centres	Hospitals	Tumaini (specialised sexual violence clinic)
2014	Walikale	3	1	0	24	4	0
	Mweso	4	1	2^a	161	0	534
	Total	7	2	1	185	4	534
2015	Walikale	3	1	0	26	44	0
	Mweso	5^b	1	1	167	0	410
	Total	8	2	1	193	44	410
2016	Walikale	4^c	1	1^d	45	194	46
	Mweso	5	1	2^e	220	0	552
	Total	9	2		265	194	598
2017	Walikale	4	1	1	32	0	77
	Mweso	5	1	2	293	0	807
	Total	9	2	3	325	0	884
2018	Walikale	4	1	1	9	0	37
	Mweso	11^f	1	2	384	0	618
	Total	15	2	3	393	0	655
2014–2018	Walikale				136	242	160
	Mweso				1225	0	2921
	Total				1361	242	3081

^aOne of them only January to August.

^bOne of them only in December.

^cOne of them only September–December.

^dOnly November–December.

^eOne of them only April–December.

^fSix of them only March–December.

Table 3. Referral pathways for survivors of sexual violence accessing care in different type of healthcare facilities in MSF programmes in North Kivu, DRC, 2014–2018.

	Tumaini		Health Centre		Hospital		Total
	n	%	n	%	n	%	n	%
Referral pathway
Self-referral	1459	47.22%	902	66.77%	14	5.83%	2375	50.74%
Health promotion team	803	25.99%	5	0.37%	0	0.00%	808	17.26%
Community health worker	195	6.31%	117	8.66%	15	6.25%	327	6.99%
Community	366	11.84%	49	3.63%	0	0.00%	415	8.87%
Psychosocial staff	76	2.46%	105	7.77%	0	0.00%	181	3.87%
Family member	35	1.13%	20	1.48%	29	12.08%	84	1.79%
Mobile clinic	3	0.10%	3	0.22%	25	10.42%	31	0.66%
Local authorities	71	2.30%	62	4.59%	154	64.17%	287	6.13%
Partner	0	0.00%	3	0.22%	2	0.83%	5	0.11%
Other	82	2.65%	85	6.29%	1	0.42%	168	3.59%

Table 4. Timing of care seeking among survivors of sexual violence accessing care in different healthcare facilities within MSF programmes in Walikale and Mweso, DRC, 2014–2018.

	Percentage of total survivors accessing care
Days between sexual violence incident and receiving care	Mweso				Walikale				Total
	Tumaini	Health Centre	Hospital	Total	Tumaini	Health Centre	Hospital	Total	Tumaini	Health Centre	Hospital	Total
0–3	70.55%	86.45%	-	75.25%	23.67%	46.03%	18.83%	26.78%	67.98%	82.68%	18.83%	69.72%
4–5	7.61%	3.18%	-	6.30%	1.78%	3.17%	10.46%	5.99%	7.29%	3.18%	10.46%	6.27%
6–30	11.04%	6.20%	-	9.61%	13.61%	18.25%	41.00%	26.97%	11.18%	7.33%	41.00%	11.59%
31–90	5.76%	2.78%	-	4.88%	15.38%	10.32%	22.18%	17.23%	6.29%	3.48%	22.18%	6.29%
91–180	2.57%	0.82%	-	2.05%	8.28%	12.70%	5.44%	8.05%	2.88%	1.92%	5.44%	2.74%
>180	2.47%	0.57%	-	1.91%	37.28%	9.52%	2.09%	14.98%	4.37%	1.41%	2.09%	3.40%

Table 5. Association between age, sex and referral pathways and access to care within 3 days of a sexual violence incident among survivors accessing care in MSF programmes in Walikale and Mweso, DRC 2014–2018.

	Bivariable logistic regression				Multivariable logistic regression
Dependent variable:		95% CI		p-value	Adjusted OR	95% CI		p-value
Accessing care within 3 days after the sexual violence incident	OR	lower	upper			lower	upper
Independent variable:
Age
=>50	ref				ref
0–9	2.903	1.743	4.833	<0.001	3.375	1.931	5.897	<0.001
10–19	2.379	1.740	3.253	<0.001	2.067	1.476	2.895	<0.001
20–29	3.310	2.426	4.515	<0.001	2.907	2.081	4.061	<0.001
30–39	2.603	1.898	3.570	<0.001	2.213	1.576	3.107	<0.001
40–49	1.859	1.322	2.615	<0.001	1.597	1.108	2.301	0.012
Sex
Female	ref				ref
Male	2.846	1.725	4.696	<0.001	2.679	2.673	1.592	4.489
Referral pathway
Self-referral	ref				ref
Health promotion team	1.125	0.934	1.353	0.214	1.169	0.969	1.410	0.104
Community health worker	1.071	0.82	1.397	0.615	1.161	0.887	1.520	0.277
Community	0.783	0.624	0.982	0.034	0.791	0.629	0.995	0.045
Psychosocial staff	1.022	0.724	1.442	0.903	1.028	0.726	1.456	0.876
Family member	0.282	0.182	0.438	<0.001	0.285	0.180	0.450	<0.001
Mobile clinic	0.086	0.035	0.211	<0.001	0.097	0.039	0.239	<0.001
Local authorities	0.089	0.066	0.121	<0.001	0.091	0.066	0.123	<0.001
Partner	0.239	0.04	1.433	0.117	0.243	0.039	1.509	0.129
Other	1.477	0.999	2.184	0.051	1.566	1.054	2.326	0.026

Hosmer and Lemeshow test for goodness of fit of multiple logistic regression model; p-value 0.595. Bold indicates significant values (p-value < 0.05). OR = Odds Ratio, CI = Confidence Interval.