Identification of gender-based violence among adult patients in the Emergency Department of Tanzania’s largest public hospital: a retrospective review

Abstract

Background: Emergency Departments (EDs) are critical for identifying and supporting victims of gender-based violence (GBV). However, data from Sub-Saharan Africa are limited, and even in high-income settings with developed EDs, identification remains poor. This study assessed the frequency of GBV identification in the tertiary ED of Tanzania's largest public hospital and described incident characteristics. Methods: This retrospective study was conducted in the ED of Muhimbili National Hospital, Tanzania, analyzing patients visits from January 2016 to December 2021. We reviewed electronic medical records of adult patients using a keyword-based search to identify complaints potentially related to GBV. A structured data sheet captured demographics, clinical data, and outcomes. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 25), with descriptive characteristics reported as percentages and means with standard deviations (SD). Results: Among 296,010 adult ED visits, 87 (0.03%) had GBV-related complaints. The mean age was 32 years (SD 14), and 86% were female. The most common form was sexual abuse (33%), followed by combined sexual and physical abuse (28%). In 21% of cases, a partner was identified as the perpetrator; in 63%, the perpetrator was unknown, refused to disclose or undocumented. Among 61 sexual assault victims, 77% were screened for Human Immunodeficiency Virus (HIV), 49% for syphilis, and 39% for hepatitis. Additionally, 46% received HIV prophylaxis, and 61% of female victims received emergency contraception. Only 14% received psychological consultation. Overall, 63% were admitted, with 84% still hospitalized after 24 h. Conclusion: GBV identification in this ED was extremely low. This likely reflects a combination of underreporting, low provider awareness, poor documentation, and the limitations of using a retrospective, keyword-based record review. A significant proportion involved sexual violence, with notable gaps in post-assault care. Strengthening GBV screening, management, and follow-up protocols in EDs is urgently needed. Future research should use prospective, robust designs.