The experiences of Nicaraguan health care professionals' encounters with victims of sexual violence

Abstract: Background  Sexual violence against women and adolescents is widespread in Nicaragua, a country which also has one of the highest rates of adolescent pregnancies in Latin America. Research shows that adolescent pregnancy is often in correlation with sexual violence. Health care services have an important role in the detection, prevention and treatment of victims of sexual violence. Yet research on Nicaraguan health care professionals’ views and practices regarding sexual violence is scarce.  Aim  The aim of this study was to explore how the Nicaraguan health care system approaches the issue of health care towards victims of sexual violence. What are Nicaraguan health care professionals’ views and practices regarding the health care towards victims of sexual violence? To what extent is the steering document La Norma being applied in the Nicaraguan health care system?  Methods  A qualitative interview study with six health care professionals was conducted and data was interpreted with a qualitative content analysis.  Findings  Health care workers express strong commitment for their professions and a willingness to attend to the victims of sexual violence. However, views and practices not in accordance with La Norma were found, such as gender stereotypes among health care professionals about adolescent girls becoming pregnant mainly due to recklessness on their side. This constitutes a barrier against regarding adolescent pregnancy as a possible indicator of sexual violence. There is a clear connection with gender as it is young women and girls that are affected. This attitude is negative for the detection and treatment of victims of sexual violence and consequently for the protection of these patients’ right to the highest attainable health.  Conclusion  Health care practices and views of health care professionals are often not consistent with the steering document La Norma. Increased resources including education and more time with patients would strengthen nurses’ work and improve the medical attendance to sexual violence victims, thus contributing to a rights-based approach to sexual and reproductive health. Implementation of steering documents regarding the attention to sexual violence in the health care services also needs to improve. Future studies should further examine the implementation and monitoring process of steering documents, including budget resources.