Analysis of health and support services for survivors of child sexual abuse in Kenya: Lessons for Malawi
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Introduction Child abuse is a severe and devastating issue not only in Africa but all over the world. It is an infringement of fundamental human rights and a threat to achieving Sustainable Development Goals 3 and 4. goal three, target 3.5, aims to reduce premature mortality from non-communicable diseases by one-third by 2030 through promoting mental health and well-being and prevention treatment of adverse mental effects. SDG 4. target 4,2 ensures that all girls and boys have equal access to high-quality early childhood development, care, and pre-primary education to be prepared for primary school. However, sexually abused children may not attend school due to psychological effects (shame). The consequences for mental health can be as profound as the physical impact and can last a long time. However, over the years, there is growing evidence that childhood sexual abuse survivors who experienced supportive care following disclosure of the abuse have been found to have fewer psychological symptomatology relative to those who received no support. Unfortunately, in Malawi, such services are limited, under-resourced, and challenging to access. Understanding the barriers and challenges of supportive services delivery and access will better inform efforts to improve access for survivors of child sexual abuse in Malawi. Method The search strategy used Online English Published peer-reviewed articles and relevant reports. The search focused only on access to psychological care or management of survivors of child sexual abuse and challenges associated with access to such services. The online search used scientific databases like PubMed, Scopus, CINAHL, Psych Info, and Google scholar to retrieve articles using controlled vocabulary and free-text terms like (a) child sexual abuse OR assault OR violence AND care OR management; (b) challenge OR barriers; and (c) Kenya and Malawi (E) mental health care, support, or services Results In Kenya, psychological care is provided through one-stop centers. There are different types of one-stop center models for survivors of child sexual abuse, namely hospital-based centers owned by a facility or run by NGOs. Malawi has mostly adopted facility-based hospital-owned services for SCSA. Challenges to access are associated with the economy, education, society and culture, and the health system. Education barriers are lack of awareness about sexual children's health, society and culture stigma, and patriarchal norms and bars SCSA access to care while the long distance to the facility has been reported as the main challenge in most studies. Therefore, multisectoral interventions should be committed to reducing the challenges at all levels in improving access to support services for survivors of child sexual abuse Conclusion Multi-sector collaboration efforts are required for individuals, families, communities, and society. Efforts to reduce the access burden should target improving awareness of child sexual abuse and decentralizing support services at community levels.