Characteristics of violence, timely care-seeking and perceived barriers: A cross-sectional analysis of sexual violence among displaced and resident populations in North Kivu, Democratic Republic of the Congo

INTRODUCTION

Sexual violence is highly prevalent in North Kivu, the Democratic Republic of the Congo and access to care for survivors remains challenging. This study aims to analyse characteristics of violence, barriers to care and timely access to care among survivors of sexual violence who accessed care in North Kivu following the increase of violence and displacement 2023–2024. Furthermore, it examines how violence characteristics differ between survivors with different residential status and factors associated with timely access to care and main barriers.

METHODS

This cross-sectional study uses data collected, as part of routine programme monitoring, from survivors of sexual violence who received care in three Médecins Sans Frontières programmes in North Kivu, 2023–2024. χ² tests were conducted to explore differences between residents and displaced survivors, and multivariable logistic regression models were performed to explore factors associated with timely access to care and the main perceived barriers.

RESULTS

A total of 16 712 survivors were included, of whom a majority were females (95.5%) and displaced (83.4%). Displaced survivors more commonly reported multiple assailants, violence during livelihood activities and being referred by a trained community focal point compared with residents. Lack of information and fear of social consequences were the main reported barriers to access care. Several factors, including resident status, age, assailant type and whether the assailant was armed, were significantly associated with care-seeking within 72 hours and experience of the main barriers.

CONCLUSION

This study provides new insights regarding the impact of increased violence and displacement on sexual violence characteristics and care-seeking patterns. The main barriers, lack of knowledge and fear of social consequences, call for responses which specifically address these challenges. As changes in context impact both violence and care-seeking patterns, responses to sexual violence need to be flexible to be able to meet survivors’ needs during humanitarian crises.