Barriers and facilitators to accessing post sexual-based violence health services among young women attending higher education institutions in Nigeria

Abstract

BACKGROUND: Post sexual-based violence (SBV) services are crucial for mitigating SBV-induced consequences. However, these services are reportedly rare and often underutilized, particularly by young women in Sub-Saharan Africa. This study aimed to explore the barriers and facilitators to accessing post-SBV services among young women (18-24 years) attending higher education institutions in Nigeria. METHODS: An online survey, using a piloted questionnaire, was administered to a purposive sample of 114 participants recruited from social media platforms between the 8th and 22nd March 2022. Descriptive statistics were used to summarize the study findings. RESULTS: The majority (71.1%) of the participants were between the ages of 21 and 24 years. Of the 37 participants who indicated they have had their first sexual intercourse, a quarter (9, 24.3%) indicated it was non-consensual. Also, 1 in 5 respondents did not identify SBV/abuse as abnormal. Half of the participants (50.9%) strongly agreed that a post-SBV health service should be the first place to seek care following an incident of rape, however, over half (53.2%) reported a lack of awareness of existing post-SBV health services as a key barrier affecting access. Less than half of the participants strongly agreed that healthcare workers could provide the post-SBV services highlighted in the study, including emergency contraceptives to prevent pregnancy (42.9%) and post-exposure prophylaxis (PEP) to prevent human immunodeficiency virus (HIV) (39.6%), highlighting awareness gaps. Other significant barriers included stigma, shame, and a lack of support systems. Key facilitators included assurance of confidentiality and access to free post-SBV health services. CONCLUSION: Significant barriers and facilitators affect access to post-SBV health services in Nigeria, particularly among young women. Multilevel efforts by families, civil society organizations, communities, and governments are essential to address these barriers and improve access to post-SBV health services.