Barriers to accessing emergency contraception by victims of sexual assault in Addis Ababa, Ethiopia

Abstract

Background: Medical support including rape management to victims of sexual assault are not well organized and readily available
to those who require this service in Addis Ababa.
Objective: This survey aimed at examining the potential barriers to accessing emergency contraception (EC) among sexual assault
survivors in Addis Ababa, Ethiopia.
Methods: This is a quantitative and qualitative study conducted in July of 2006 in Addis Ababa, Ethiopia. The quantitative
component was a survey of all hospitals in the city using a standardized questionnaire to evaluate the provision of EC for sexual
assault victims. Since sexual assault victims often report to the police, the study included an in-depth interview with police women
who were dealing with such cases.
Results: Five public hospitals and one model clinic of the Family Guidance Association of Ethiopia (FGAE) give treatment to
victims of sexual assault in Addis Ababa. No private hospital provides treatment for such cases as the police do not refer such
cases. Though there are five public hospitals, one of them has got a model rape clinic. In the survey, most victims of sexual assault
were seen in the FGAE model clinic. This is because the police perceive that the service given by government hospitals is of poor
quality. All public hospitals provide EC, a dedicated product called ‘Postinor 2’ free of charge. The interviewed police women had
very little knowledge about EC, though they have worked for a long time with sexual assault victims. According to police women
who worked for more than six years, most victims did not come within 3-5 days after the assault. And when victims do come, they
often first visit police stations not hospitals. It was also found out that it is the police who determine as to where these victims
should get treatment.
Conclusion: Public hospitals should improve the quality of service they provide to victims of sexual assault. It is crucial to provide
health education on EC to community members and the police working with victims of sexual assault in order to ensure that patients
seek care early to prevent unwanted pregnancy and receive timely and appropriate medical certificates to legal bodies. Furthermore,
ways should be sought to increase the involvement of private hospitals in the management of victims of sexual assault in
Addis Ababa.
Keywords: Emergency contraception; legal bodies; sexual assault; gender