Barriers and Pathways to Healthcare Access Among Women Survivors of Gender Based Violence in Turkana County, Kenya

Abstract

Gender-based violence is a pervasive public health and human rights issue. In Kenya, over 40% of women have experienced physical mistreatment and 14% sexual assault. In Turkana County, the GBV rate stood at 42% in 2024, higher than the national average of 34%. The study aimed to determine the barriers and pathways to healthcare access among women survivors of GBV in Turkana County. Specifically, it sought to identify types of GBV experienced by survivors seeking care, assess barriers faced in accessing healthcare services, and examine steps taken by survivors in seeking care. A cross-sectional descriptive mixed-methods study was conducted at Lodwar County Referral Hospital and Kakuma Sub-County Hospital. Purposive sampling targeted 73 women GBV survivors attending the facilities. Client exit interviews provided quantitative data and a Focus Group Discussion generated qualitative data. Data were analyzed using R software; findings presented in tables, graphs, and narratives. The study found that 97% of respondents experienced physical, psychological, or sexual harm due to GBV. Major barriers included patriarchal cultural norms (99%), corruption and associated costs (96%), lack of formal referral networks (90%), financial constraints (67%), and fear of stigma or intensified abuse (62%). While 80.8% first sought care at healthcare facilities, only 49.3% did so immediately. Single survivors had 87% lower odds (OR=0.127, p=0.012) and Muslim survivors 90% lower odds (OR=0.102, p=0.010) of seeking immediate help. The model explained 23% of the variance in immediate help-seeking behavior. Qualitative data highlighted community leaders and village elders as initial contact points in many cases. The study concluded that GBV is highly prevalent in Turkana County. Survivors face significant socio-cultural, economic, and systemic barriers that delay or prevent timely healthcare access. It therefore recommends; provision of free GBV services, anti-corruption measures, strengthened referral networks, stigma reduction, family engagement, and targeted interventions for single and Muslim survivors.