Focus AreasGender & HIV

Resources for the Clinical Management of Children and Adolescents Who Have Experienced Sexual Violence

Keywords: youth,violence and coercion,toolkits,sexual assault,orphans and other vulnerable youth,health care workers,gender-based violence (GBV),facility-level interventions,children,child protection,child health

These technical considerations and accompanying job aids serve as a guide for medical providers to address and respond to the unique needs and rights of children and adolescents who have experienced sexual violence and exploitation. These resources focus on the delivery of clinical post-rape care services and include information on establishing services tailored to the unique needs of children and adolescents, preparing for and performing a head-to-toe physical examination, conducting forensics evidence collection, and ensuring follow-up care and referrals for psychosocial and community support services. These technical considerations, developed by PEPFAR in collaboration with Together For Girls partnership, are a result of a consultative process incorporating specialized input by experienced providers and technical experts.

PDF Download Clinical Management of Children and Adolescents Who Have Experienced Sexual Violence: Technical Considerations for PEPFAR Programs (PDF, 3.5 MB)

PDF Download All 5 Job Aids (PDF, 731 KB)

Job Aids

Clinical Site Preparation and Set-Up Job Aid
Annex 4
This job aid can be used as a checklist to assist the clinical site (facility administrators and providers) in determining its readiness for an effective response to medical management of children who have experienced sexual violence and exploitation.

PDF Download Clinical Site Preparation and Set-Up Job Aid (PDF, 320 KB)

Medical Management of Child Sexual Violence and Exploitation Job Aid
Annex 8
Providers can use this job aid as a checklist reminder of what tasks should be completed when evaluating a child who has experienced sexual violence and exploitation.

PDF Download Medical Management of Child Sexual Violence and Exploitation Job Aid (PDF, 319 KB)

Clinician's Role in Evidence Collection Job Aid
Annex 9
Providers can use this job aid to determine what type of evidence should be collected, how it should be collected, and in what time frame following an incidence of sexual violence and exploitation.

PDF Download Clinician's Role in Evidence Collection Job Aid (PDF, 384 KB)

Provider's Role in Linking to Community Resources Job Aid
Annex 14
This job aid identifies community-based linkages the provider should connect the child or adolescent and caregiver/family member to, and explains the rationale behind each linkage.

PDF Download Provider's Role in Linking to Community Resources Job Aid (PDF, 453 KB)

Care Algorithm Job Aid
Annex 16
The algorithm in this annex illustrates the typical process and care considerations when sexual violence and exploitation is suspected.

PDF Download Care Algorithm Job Aid (PDF, 499 KB)

Additional Resources

Glossary of Terms
Annex 1
This includes a list of all medical terms included in Resources for the Clinical Management of Children and Adolescents Who Have Experienced Sexual Violence. (See also: Annex 1.)

PDF View Glossary (PDF, 3.5 MB)

Sexual Behavior in Young Children
Annex 2
This annex provides examples of sexual behavior in children ages 2-6 years of age. (See also: Annex 2.)

PDF View Sexual Behavior in Young Children (PDF, 3.5 MB)

Tanner Stages of Sexual Maturation
Annex 3
The Tanner scale is a scale of physical development in children, adolescents and adults. The scale defines physical measurements of development based on external primary and secondary sex characteristics. (See also: Annex 3.)

PDF View Tanner Stages of Sexual Maturation (PDF, 3.5 MB)

Understanding Informed Consent/Assentand Patients' Rights
Annex 5
It is important for the health care provider to have a basic understanding of the information necessary to relay to the patient about the choices available to them during the examination, and obtain their consent or assent to care. This annex reviews consent issues and includes a sample consent form. (See also: Annex 5.)

PDF View Understanding Informed Consent (PDF, 3.5 MB)

The "Top-to-Toe" Physical Examination
Annex 6
This annex includes step-by-step instructions for a systematic, head-to-toe physical examination of the child. (See also: Annex 6.)

PDF View Annex 6: The "Top-to-Toe Examination" (PDF, 3.5 MB)

Describing Features of Physical Injuries (WHO/UNHCR 2004)
Annex 7
This annex provides characteristics and terms to use when describing features of physical injuries. (See also: Annex 7.)

PDF View Describing Features of Physical Injuries (PDF, 3.5 MB)

Sample History, Exam Form (WHO/UNHCR 2004) and Body Maps
Annex 10
This annex provides sample medical forms and body maps that can be used during an examination. (See also: Annex 10.)

PDF View Sample History, Exam Form, and Body Maps (PDF, 3.5 MB)

Nurse's Checklist
Annex 11
Nurses can use this checklist during triage and discharge. (See also: Annex 11.)

PDF View Nurse's Checklist (PDF, 3.5 MB)

Doctor's Checklist
Annex 12
Doctors can use this checklist during an examination and to collect information on the patient's medical and forensic histories. (See also: Annex 12.)

PDF View Doctor's Checklist (PDF, 3.5 MB)

Social Worker's Checklist
Annex 13
Social workers can use this checklist during a session with a patient. (See also: Annex 13.)

PDF View Social Worker's Checklist (PDF, 3.5 MB)

Promising Practices
Annex 15
Review two promising practice examples. (See also: Annex 15)

PDF View Promising Practices (PDF, 3.5 MB)

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