Citation

Stark L, Mutumba M, Ssewamala F, Brathwaite R, Brown DS, Atwebembere R, Mwebembezi A. BMJ Open 2024; 14(8): e081663.

Copyright

(Copyright © 2024, BMJ Publishing Group)

DOI

10.1136/bmjopen-2023-081663

PMID

39107025

Abstract

INTRODUCTION: Sexual violence is a significant public health concern with severe physical, social and psychological consequences, which can be mitigated by health service utilisation. However, in Uganda and much of sub-Saharan Africa, these services are significantly underused, with 9 out of 10 survivors not seeking care due to a range of psychological, cultural, economic and logistical factors. Thus, there is a strong need for research to improve health service utilisation for survivors of sexual violence.

METHODS AND ANALYSIS: The proposed study seeks to address the underutilization of health services for female survivors of sexual violence using a discrete choice experiment (DCE). The study will be conducted in the greater Masaka region of southwestern Uganda and target adult female survivors of sexual violence. We will first undertake qualitative interviews with 56 survivors of sexual violence to identify the key attributes and levels of the DCE. In order to ensure a sufficiently powered sample, 312 women who meet inclusion criteria will be interviewed. Our primary analysis will employ a mixed (random parameters) logit model. We will also model the role of individual-specific characteristics through latent class models. ETHICS AND DISSEMINATION: The study protocol was reviewed and approved by the following ethics review boards in Uganda and the USA: the Uganda Virus Research Institute (UVRI), the Uganda National Council for Science and Technology (HS2364ES), Washington University in St Louis and the University of Michigan. Our methods conform to established guidelines for the protection of human subjects involved in research. Our dissemination plan targets a broad audience, ranging from policymakers and government agencies to healthcare providers, academic communities and survivors themselves.

Language: en

Keywords

Humans; Adult; Female; Qualitative Research; Behavior; Research Design; Health Services; Patient Preference; Uganda; *Patient Acceptance of Health Care/psychology/statistics & numerical data; *Sex Offenses/psychology; *Survivors/psychology; Choice Behavior; SEXUAL MEDICINE