Prevention and Response to Sexual Exploitation and Abuse (PRSEA) in Emergencies: Beneficiary Experiences from a Cholera Outbreak Response in Kadoma City, Zimbabwe, 2024″

Introduction Sexual Exploitation and Abuse (SEA) is a fundamental failure to protect the vulnerable by those in power. The heightened vulnerability of individuals during public health emergencies contributes to a significant increase in reported SEA cases worldwide. PRSEA is essential to safeguarding survivors and offering support that prevents further exploitation or abuse. Kadoma City was one of the most affected areas in Zimbabwe that reported cholera cases in 2024. This study assessed the beneficiaries’ knowledge and experiences of SEA during the outbreak response. Methods We conducted a mixed methods study in Kadoma City. The study population were beneficiaries who received hygiene kits during the response from January to July 2024. A sample size 371 was calculated using Dobson’s formula. Data were collected using an interviewer-administered questionnaire, and a focus group discussion guide. Beneficiaries were selected from the cholera linelist. Analysis was done using Epi Info 7™ and thematic analysis for qualitative data. Results We interviewed 371 beneficiaries of which, 300 (81%) were females. Two hundred and ninety (78%) of them attained a secondary education (Form 1-4). Twenty-six (9%) females and 9 (13%) males had high SEA knowledge (p=0.3005). Seven (2%) respondents reported knowing a sexual relationship between a responder and a beneficiary. Three (1%) reported being sexually exploited and five (1%) reported being sexually abused during the response. Barriers to reporting SEA mentioned included fear 318 (86 %), slander 119 (32%) and perpetrator victimization 90 (24%). Respondents preferred to report SEA anonymously 247 (67%) and 158 (43 %) using toll-free lines. Conclusion Beneficiaries’ knowledge of SEA was limited. Fear was the main reporting barrier. Anonymous reporting was the preferred reporting method. We recommend integrating PRSEA mainstreaming into outbreak response activities. Addressing barriers to reporting through awareness-raising campaigns. Establishing robust accountability mechanisms for holding perpetrators accountable. Expansion of confidential reporting options.