Provision of Sensitive Medico-Legal Care to Sexual Violence Survivors in a Tertiary Public Health Facility of Maharashtra
J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):152-158. doi: 10.1007/s13224-024-02042-z. Epub 2024 Aug 17.
ABSTRACT
BACKGROUND: Healthcare providers play an important role in responding to violence against women. The healthcare providers have an important role as expert witness in trials related to sexual violence. In India, several policy and legal reforms like MoHFW guidelines and Criminal Law Amendment have been done to establish a sensitive response to survivors of sexual violence. However, several gaps continue to exist in health systems’ response in cases of sexual violence. To fill this gap, this paper presents the findings from a tertiary health facility which has implemented evidence-based standardized guidelines for providing care to sexual violence survivors.
METHODS: The study was carried out in the OBGY department of a tertiary public health facility of Aurangabad, Maharashtra. The findings are based on the analysis of medicolegal records of 78 cases of sexual violence which came to hospital over a period of 6 months. The information about the profile of survivors, nature of violence, health consequences and compliance to standardized guidelines for medico-legal care was assessed. Additionally, the study also presents findings from in- depth interviews with trained doctors to understand their experiences of providing care and testifying in court in cases of sexual violence.
RESULTS: About 42% of survivors were adult and majority of them gave history of violence from a known abuser (83%). In 82% cases, the survivors reported penetrative sexual violence. The analysis of records indicated sensitive medico-legal care in form of operationalization of informed consent in all cases, collection of relevant samples for evidence collection (93%), and mention of irrelevant comment on hymen in 10 cases. The interviews with providers indicated the need to sensitize police and judges about relevance of medical evidence.
CONCLUSION: Inservice training of HCPs and system level changes are essential for sensitive medico-legal care.
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