of violence on Health Workers
levels of crime and violence have increased the workload of
public and private sector trauma services, taken up resources
necessary for the treatment of other conditions and also adversely
affected staff security and public access. The high levels
of crime and violence nationally also complicate a wide range
of public services, mostly rendered by local authorities.
study with the Institute of Criminology at the University
of Cape Town is currently capturing the diverse effects
of such violence on service delivery in the health sector
at institutional, interpersonal and individual levels. Preliminary
research observations have been published in Trauma Review,
Vol 8, No 2, December 2000.
of medico-legal services in Gauteng, South Africa
evaluation was commissioned to ascertain the current status
of medico-legal services in Gauteng against the Health Department's
stated objectives and various other stakeholders'
views of how the service could and should function. This
project was initiated in 2000 following recommendations
that emerged from the ISHS's Rape Surveillance Project,
which was conducted in collaboration with the Gauteng Health
Department's Directorate of Medico-Legal Services from 1994-1998.
scope of the evaluation project includes an assessment
of the structure (resources/input), process (activities)
and outcome (effectiveness/output) of after-care services
for adult rape survivors at 26 medico-legal centers
in Gauteng. The evaluation framework included a focus on
issues related to the availability, accessibility, quantity,
quality/effectiveness and acceptability of the services.
The analysis of qualitative data obtained suggests that
the current system of service provision at medico-legal
clinics in Gauteng remains flawed in many respects.
Although the medico-legal
system is increasingly engaged in developing and improving
service provision at district and regional levels, these
reform efforts have not been consistently applied
across the province. Consequently, minimum standards of
care are not being met, with problems of access, charges
of insensitive treatment of rape survivors, incompetent
documentation of medico-legal evidence, lack of resources,
inadequate training, disparities across clinics and weak
inter-sectorial collaboration being the leading concerns
affecting the quality of care provided to rape survivors.
University of the Western Cape, Tel: +27 21 959-2732
Copyright © 1999-current