Professors Receive Center for African Studies Loogman Grant

Dr. Alison Colbert, PhD, APRN-BC, FAAN, and Dr. Kathleen Sekula, PhD, PMHCNS-BC, FAAN, FAAFS and Noble J. Dick Endowed Chair in Academic Leadership, received the Center for African Studies Loogman Faculty Research Grant to study interpersonal violence (IPV) against women in Kenya. In Kenya, as is the case globally, IPV is a significant health problem. A 2020 study published in Public Health estimated that 39% of women experienced IPV in their lifetime. The research suggested that marital violence is a normal part of a woman’s life and often goes grossly underreported. Alarmingly, studies also have found that 1 in 4 women in Kenya have experienced rape.

Currently, the healthcare system in Kenya cannot adequately support the number of women suffering from this widespread violence. The sheer amount of cases has overwhelmed the healthcare system there, and the type of care these women need is not possible without specialized training. Forensic nursing is a critical element in forming a comprehensive response to this problem. Despite significant efforts from the country’s nursing authority to make the necessary changes to combat this problem, no real progress has been made in developing a forensic nursing program. 

When Dr. Sekula received an email from doctoral nurse, Irene Mageto, Clinical Mental Health and Forensic Nursing Specialist, who is from Kenya, she was inspired to seek funding to help look into this glaring issue. After meeting with Dr. Mageto, Dr. Sekula was encouraged to work with other nurses from Kenya to help them move forward in respect to patient care of IPV and sexual assault victims. Her goal was to help establish a forensic nursing practice in Kenya, but funding was hard to come by. Dr. Sekula and her co-PI, Dr. Colbert, would spend the next two years searching for a grant for their research.

Finally, in 2023 their efforts paid off, and they received the Loogman Faculty Research Grant. Plans were immediately put into motion. Working directly with the Aga Khan University’s School of Nursing and Midwifery (AKU-SONAM), Dr. Sekula and Dr. Colbert looked to address the need for adequately trained nurses in Kenya. They realized that forensic nursing training and education in Kenya would have different challenges than here in the US. She noted that “In Kenya, the roles of men and women are different in some ways from men and women in the US. As we collaborate with our Kenyan colleagues, we will work with these nurses who teach at the AKU-SONAM to prepare educators to provide the training needed to undergraduate and graduate nurses with the knowledge required to specialize in forensics, specifically in Kenya.” 

Another challenge Dr. Sekula and Dr. Colbert will face is the stigma surrounding IPV and rape as well as ingrained gender norms and economic conditions in Kenya that will complicate the delivery of services for victims, including identifying those who need care. Their proposed research seeks to better understand the educational and practice landscape in Kenya regarding the delivery of healthcare services for IPV victims.

The need for a study of this kind has been necessary for some time. As mentioned, a previous effort was made by the country’s nursing authority to address the forensic nursing shortage but no substantive progress was made in implementing training to fulfill this role. Dr. Sekula attributed the lack of progress to financial difficulties. Noting that “While researchers who conducted the needs assessment identified what was required in schools of nursing to achieve their goals, the financial support was not available to make the necessary changes. Subsequently, no means of acquiring those funds has been identified by the Kenyan government or nursing authority.” 

Dr. Sekula cited that the number one action the Kenyan government could take right now to improve healthcare for women is “to provide nurse educators with the support they need to improve their knowledge and practice as forensic nurses and then support the role of forensic nurses in hospitals and clinical systems. This would require a major change in the healthcare systems in Kenya. There is an urgent and unmet need for an adequately trained healthcare response to IPV, and in order to make a difference in caring for these patients, we must prepare nurses in the area of forensic nursing.” Through their research, Dr. Sekula and Dr. Colbert hope to discover, through a survey of nurse educators and practicing nurses in Kenya, what the most critical needs are in providing healthcare to victims as well as what the current state of forensic nursing care actually is in Kenya. 

The greatest challenge to this goal will, of course, be distance. Luckily, the US and Kenyan teams are able to use Zoom, a platform everyone became proficient in during the pandemic, to meet regularly. Through these meetings, they will determine how to best survey clinical nurses and educators and then eventually meet in person at the fall 2023 International Association of Forensic Nurses conference to discuss current and future initiatives for the project. By the conference, they hope to have a plan in place to move forward and take action. Dr. Sekula admits that “There are many variables in Kenya that can impact the outcome of this study, including economic conditions, social structure inequalities and conflict-related violence that could result in a lack of concern for women who are victims of abuse.” Despite the challenges, the team hopes to affect real change through their research initiative.

At the end of their project, Dr. Sekula and Dr. Colbert, as well as their Kenyan colleagues, hope to have completed their mixed methods study by analyzing the results of the survey and determining resources available to provide healthcare services to individuals, communities and families affected by violence. They also hope to identify the barriers to facilitators who would help those affected by violence. Dr. Sekula hopes “This study will serve as a foundation for future initiatives to enhance the education of nursing students in Kenya by supporting nurse educators in gaining the knowledge necessary to provide forensic education.”

At Duquesne University’s School of Nursing, our faculty recognizes the importance of nurses as changemakers throughout the world and how, through the proper education and care, huge differences can be made to a population. Our Spiritan mission drives us to use our bigger ideas and goals to improve the world around us.