#16DaysofActivism 2021 Blog Series
Written by Lindsey Green, Suzanne Kidenda, Roseline Muchai and Brett D. Nelson
The survivor-centered approach to addressing sexual violence seeks to empower the survivor by prioritizing their rights, needs, and wishes, and ensuring they have access to appropriate, accessible, and quality services. This approach is central to how the Physicians for Human Rights (PHR) Program on Sexual Violence in Conflict Zones pursues our work to improve the quality of forensic documentation of sexual violence and, thereby, to ensure justice and accountability for these crimes.
MediCapt is a mobile application created by PHR to help clinicians securely document forensic medical evidence of sexual violence. The app was created through a participatory, collaborative design process with PHR’s partners in Kenya and the Democratic Republic of the Congo to ensure the final product addressed their specific needs and challenges.
MediCapt promotes a survivor-centered approach by standardizing methods of evidence collection, reducing errors in documentation, and ensuring more complete collection of evidence to support prosecutions. The tablet-based application enables clinicians to document assault cases digitally, capture photographs of injuries sustained, and store and transmit information across different sectors securely.
Assessing effectiveness and usability of MediCapt
A recent PHR study funded by the SVRI and World Bank Gender-based Violence Development Marketplace Award evaluated the effectiveness and usability of MediCapt in improving the forensic evidence collection process and the quality of documentation, and identified obstacles and strategies to scaling up this digital tool. This research will help determine whether MediCapt facilitates a survivor-centered approach to documentation.
Through a mixed-methods evaluation, PHR sought to answer these guiding questions. Methods included (a) a quantitative assessment using a data quality checklist to assess the completeness of MediCapt records versus traditional paper-based Post-Rape Care forms, (b) a usability questionnaire, and (c) semi-structured interviews with MediCapt end-users from the health, law enforcement, and judicial sectors.
Improving survivors’ access to quality care in low resource settings
Our findings showed that not only does MediCapt standardize and improve the quality of documentation, it is also easy to use and is acceptable to both providers and survivors, making it a feasible and sustainable tool in low-resource settings.
“The benefits we are able to see is that we have efficiency,” said a participating nursing administrator. “…. It’s like work has become easy to perform.”
“I know that the quality of documenting cases has improved, [and] thus, [the] overall benefit to the patient,” said one evaluation respondent. Another pointed out that MediCapt “has improved patient care, by ensuring that all key parts of the form [are] filled, such as the psychological assessment, referrals and laboratory tests. This has contributed to the holistic care of the survivors.”
These results suggest that MediCapt can provide survivors with key elements of survivor-centered care —accessibility and quality.
A survivor-centered solution
Additionally, though it is too early to assess the impact of MediCapt on survivors’ access to justice, providers and law enforcement professionals were optimistic about its usefulness in securing justice and accountability for survivors.
“In one case, because I had completed the psychological assessment clearly [with MediCapt], the magistrate was able to use it to provide a ruling,” said an evaluation participant. “I was … told that was a well-completed form, which I believe worked to the advantage of the survivor.”
The justice sector in Kenya has been very receptive to the use of MediCapt and has called for more widespread use of the app and its integration into the police and court systems.
Our evaluation findings all point to MediCapt as an effective, survivor-centered approach to responding to sexual violence. Identifying opportunities for future growth and scaling is a key priority for MediCapt as we seek to strengthen accountability for alleged perpetrators and improve access to redress and justice for survivors.
For more information read more at https://phr.org/issues/sexual-violence/
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Lindsey Green, program officer, Program on Sexual Violence in Conflict Zones, Physicians for Human Rights (PHR). Lindsey conducts research on sexual violence and other human rights violations perpetrated against the Rohingya minority in Myanmar after August 2017 and provides support for capacity development and network building at PHR. She has worked on program implementation, evidence generation, and knowledge sharing at the Friedman School for Nutrition Science and Policy at Tufts University, Mercy Corps, Pathfinder International, and Dartmouth College. She holds a masters’ degree in sustainable international development from Brandeis University and has a BA from Beloit College.
Suzanne Kidenda, program officer, Program on Sexual Violence in Conflict Zones, Physicians for Human Rights. Suzanne leads in the design, initiation, implementation, and monitoring of capacity development and network projects in Kenya. She also manages the advancement of mental health and psychosocial projects related to the program. Suzanne holds a post-graduate degree in development studies from the Catholic University of Eastern Africa and a BA in psychology from the United States International University in Nairobi.
Roseline Muchai, monitoring and evaluation consultant, Program on Sexual Violence in Conflict Zones, Physicians for Human Rights (PHR). Roseline has been the country lead evaluator for baseline and end line assessments for MediCapt. Roseline is a core team member for clients that include Global Fund, Gavi, the Vaccine Alliance, and the UN agencies where she conducts varied grants monitoring, spot checks, and assessments. Roseline holds a master’s degree in project planning and management from the University of Nairobi and a bachelor of business management degree from Kenya Methodist University. She holds various certificates in monitoring and evaluation and is a member of the Evaluation Society of Kenya (ESK).
Brett D. Nelson
Brett D. Nelson, monitoring and evaluation consultant, Program on Sexual Violence in Conflict Zones, Physicians for Human Rights (PHR). Brett is an associate professor and global health pediatrician at Massachusetts General Hospital and Harvard Medical School. Working with organizations such as PHR, the Centers for Disease Control and Prevention, UNICEF, Médecins Sans Frontières (Doctors Without Borders), and others, Brett has been involved in human rights research, clinical care, and program management in dozens of low- and middle-income countries. He directs Harvard Medical School’s course on global health and serves as editor of the leading textbook on clinical global health.