DR Congo + 1 more

Forensic documentation of sexual violence: MediCapt vs. paper forms

With the support of Elrha's Humanitarian Innovation Fund, Physicians for Human Rights (PHR) is scaling its mobile application, MediCapt, to new sites in the Democratic Republic of the Congo (DRC) and Kenya. Collaboratively designed with medical partners in the DRC and Kenya, MediCapt strengthens clinicians' capacity to document forensic evidence of sexual and gender-based violence (SGBV) and safely store and securely transmit that evidence to the justice sector, guaranteeing that many more survivors have a meaningful chance to secure justice for the harms they have suffered. Recently, PHR finalized an independent evaluation of MediCapt, which has reinforced the application's effectiveness over the commonly used paper forensic documentation forms.

The evaluation was conducted at two hospitals in Kenya that have implemented MediCapt, Naivasha County Referral Hospital and Rift Valley Provincial General Hospital. The process involved questionnaires, medical record reviews, and key informant interviews with clinicians, medical records and IT personnel, and administrators at the hospitals, as well as with law enforcement and legal professionals working on SGBV cases in Kenya. To objectively assess the quality of data collected by MediCapt versus the traditional paper forensic forms, a data quality checklist was developed.

Using the data quality checklist, the independent evaluators found that the quality of data collected using MediCapt was significantly higher than data collected using paper forms. Clinicians and other hospital personnel using MediCapt who participated in the evaluation agreed that the application is easy to use, sustainable, feasible for the settings in which they work, and acceptable to both providers and survivors. MediCapt's ability to securely store forensic evidence while also ensuring comprehensiveness and confidentiality were identified as key strengths of the application. The main challenges that the evaluation revealed relate to the time it initially requires for clinicians to fill out the MediCapt form due to the newness of the application, difficulties getting patient consent for photos, and typing proficiencies.

Overall, the evaluators concluded that:

"MediCapt appears to have been well received in Kenya across all sectors and has shown to significantly improve the quality of collected forensic data. It is anticipated that this improvement in forensic documentation will increase the likelihood of successful prosecutions, resulting in strengthened accountability for alleged perpetrators and improved access to redress and justice for survivors."

As a next step, PHR will use findings from this evaluation to inform the launch of MediCapt at HEAL Africa Hospital, our first pilot site for MediCapt in DRC. In August 2021, PHR conducted a technical assessment at HEAL Africa Hospital to evaluate their readiness to pilot MediCapt, which we followed with a successful initial training in late September 2021 to begin preparing hospital staff to use MediCapt with patients. Recently, we concluded field testing at the hospital, during which staff participated in a series of exercises to practice using MediCapt in their everyday professional settings. Throughout this initiative, PHR has provided on-site mentorship to the HEAL Africa team. Together, we have made software updates to MediCapt and strengthened the hospital's IT infrastructure to mitigate potential issues before we begin piloting the tool at the facility.

This is just one early example of how the findings of the independent evaluation of MediCapt have helped to inform PHR's work to scale the use of this innovative application. We expect to use the evaluation as a tool to build even greater interest among potential new end users. Since the evaluation was published, we have met with the hospital partners who participated in the evaluation to review the findings and discuss how they can be used to promote integration of the application into new facilities as we advance in MediCapt's scaling journey. With HIF's support, we are enthusiastic about seizing the opportunity to guide efforts to move our scaling plan forward, using this new data to shape our efforts.

Payal Shah, PHR's Director of the Program on Sexual Violence in Conflict Zones; Thomas McHale, PHR's Deputy Director of the Program on Sexual Violence in Conflict Zones