Evaluating the effectiveness of a mobile application to improve the quality, collection, and usability of forensic documentation of sexual violence.

BackgroundSurvivors of sexual violence deserve timely and high-quality forensic examination, evidence collection, and documentation as part of comprehensive care. However, in many countries, the quality of medical-legal documentation is severely limited. MediCapt is an innovative digital application that enables clinicians to document forensic medical evidence as well as capture and securely store forensic photographs of injuries. This study evaluated the effectiveness and usability of MediCapt to document forensic medical evidence of sexual violence.MethodsThis mixed-methods evaluation involved key-informant interviews, usability questionnaires, and forensic record reviews. Participants included clinicians, medical records personnel, information technology personnel, and health facility administrators, as well as law enforcement and legal professionals in Kenya.ResultsThe Physicians for Human Rights (PHR) data quality checklist found that using MediCapt led to significantly higher data-quality scores compared to paper-based forms. MediCapt forms scored higher on 23 of 26 checklist items. While a wide difference in quality was seen among paper-based forms, MediCapt appeared to both standardize and improve quality of documentation across sites. MediCapt strengths included data security and confidentiality, accuracy and efficiency, and supplemental documentation with photography. Weaknesses included infrastructure challenges, required technological proficiencies, and time to learn the new system. Although it is early to assess the impact of MediCapt on prosecutions, providers and law and justice sector professionals were optimistic about its usefulness. They identified MediCapt as appropriate for use with survivors of sexual violence and reported MediCapt's legibility and photography features had already been commended by the court.ConclusionMediCapt was well-received across all sectors, its use was perceived as feasible and sustainable, and it significantly improved the quality of collected forensic data. It is anticipated this improvement in forensic documentation will increase successful prosecutions, strengthen accountability for perpetrators, and improve justice for survivors

Themes from key-informant interviews, listed by frequency at baseline, endline, and total, along with illustrative quotations as relevant.

Themes from key-informant interviews, listed by frequency at baseline, endline, and total, along with illustrative quotations as relevant.</p

Semi-structured interview participants conducted during the baseline (N = 24) and endline (N = 33) assessments.

Semi-structured interview participants conducted during the baseline (N = 24) and endline (N = 33) assessments.</p

Quality of documentation in paper-based versus MediCapt forms.

Cells highlighted in gray represent the higher quality score between the two types of forms. Each item is scored from 0–2, except for Item 24, which is scored from 0–4.</p

Kenya Post-Rape Care form.

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MediCapt screenshots.

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Results of closed-response portion of the MediCapt usability questionnaire.

Results of closed-response portion of the MediCapt usability questionnaire.</p

MediCapt usability questionnaire.

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Semi-structured interview guide.

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