An audit to detect gender-based violence victim-survivors and to improve their referral care pathways in a primary care clinic’s emergency centre in Cape Town, South Africa: A narrative report

Abstract

Background: South Africa’s population experiences high rates of gender-based violence (GBV), with primary care emergency centres (ECs) often being the first point of contact for victim-survivors of violence. The ability of these centres’ staff to identify survivors of abuse plays a critical role in connecting them to a multidisciplinary network of support services. During 2025, a medical intern expressed his frustration with a community health centre’s lack of readily available guides to refer GBV victim-survivors for psychosocial support. Once, it was established that his perception was shared by other clinicians, the family physician of the facility agreed to work with the intern to ‘do a situational analysis audit and fix the problem’.
Methods: The folders of the first 100 adults over 18 years old who presented to the EC with injuries in 2025 were reviewed between June and August for identification of physical and nonphysical abuse plus whether their management included appropriate referral for psychosocial support.
Results: Roughly a quarter were GBV, with most being women. Perpetrators were largely known individuals. For sexual violence, the standard management guidelines were followed, and appropriate medico-psychosocial referrals were made. For non-sexual assaults, such referrals were sparse. Where medico-legal action was taken, it tended to be patient initiated.
Conclusion: These findings pointed to missed opportunities to provide legislated care for abused victims.
Contribution: A flowchart, in line with South Africa’s National Strategic Plan for GBV, was produced to close the gaps. Its generic design will allow for wider use at the primary level.