Background: Healthcare providers play an important role in responding to violence against women. The healthcare providers have an important role as expert witness in trials related to sexual violence. In India, several policy and legal reforms like MoHFW guidelines and Criminal Law Amendment have been done to establish a sensitive response to survivors of sexual violence. However, several gaps continue to exist in health systems' response in cases of sexual violence. To fill this gap, this paper presents the findings from a tertiary health facility which has implemented evidence-based standardized guidelines for providing care to sexual violence survivors.

Methods: The study was carried out in the OBGY department of a tertiary public health facility of Aurangabad, Maharashtra. The findings are based on the analysis of medicolegal records of 78 cases of sexual violence which came to hospital over a period of 6 months. The information about the profile of survivors, nature of violence, health consequences and compliance to standardized guidelines for medico-legal care was assessed. Additionally, the study also presents findings from in- depth interviews with trained doctors to understand their experiences of providing care and testifying in court in cases of sexual violence.

Results: About 42% of survivors were adult and majority of them gave history of violence from a known abuser (83%). In 82% cases, the survivors reported penetrative sexual violence. The analysis of records indicated sensitive medico-legal care in form of operationalization of informed consent in all cases, collection of relevant samples for evidence collection (93%), and mention of irrelevant comment on hymen in 10 cases. The interviews with providers indicated the need to sensitize police and judges about relevance of medical evidence.

Conclusion: Inservice training of HCPs and system level changes are essential for sensitive medico-legal care.

Keywords: HCPs; Medico-legal care; Provider; Sexual violence.

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背景： 医疗保健提供者在应对针对女性的暴力事件中扮演着重要角色。他们在与性侵犯相关的法庭案件中作为专家证人也具有重要作用。印度已经通过卫生部和家庭福利司（MoHFW）指南以及刑事法律修正案等政策和法律改革，建立了对性侵幸存者的敏感响应机制。然而，在处理性暴力事件时，医疗系统中仍然存在一些不足之处。为了解决这些问题，本文介绍了在一个实施了基于证据的标准化指南以提供性侵犯受害者护理的三级医疗机构的研究成果。

方法： 该研究在马哈拉施特拉邦奥兰加巴德的一家三级公共医疗设施的妇产科部门进行。研究结果基于6个月内前来医院的78例性暴力案件中的法医记录分析得出。评估了受害者概况、暴力性质、健康后果以及遵循为性侵犯幸存者提供法医护理的标准指南的情况。此外，该研究还呈现了对经过培训的医生进行深入访谈的结果，以了解他们在处理性侵犯案件时提供的护理和在法庭作证的经验。

结果： 约42%的受害者是成年女性，并且大多数受害者报告来自熟人的虐待（83%）。在82%的情况下，幸存者报告了侵入性性暴力。记录分析表明，在所有情况下都实施了知情同意操作、收集相关样本用于证据收集（93%），并且有10例中提到与处女膜无关的评论。提供者的访谈显示需要让警察和法官了解医学证据的相关性。

结论： 医务人员在岗培训以及系统层面的变化对于提供敏感的法医护理至关重要。

关键词： HCPs；法医护理；提供者；性侵犯。