Table 5.
Thematic synthesis of barriers and enablers of the OSC model to implementation and achieving intended results
| Output level | Outcome level | ||
| Increased staff trainings on trauma-informed care | B: Increased healthcare worker time constraints M | Accessibility | E: Community awareness raising activities L |
| B: Harmful staff attitudes on IPV/SV H | E: Focal person to assist user with navigation of OSC L | ||
| B: Staff burnout L | E: Affordable medical services and support L | ||
| Reduced number of survivor interview | E: Standardised policies and procedures M | E: Minimised points of care for survivors L | |
| B: Lack of standardised policies and procedures M | B: Transportation cost M | ||
| B: Inadequate training on trauma-informed care and OSC operations H | B: Lack of rural access M | ||
| B: Unclear, uncontextualised or unavailable OSC policies and procedures M | B: Lack of services on night and weekends H | ||
| B: Out-of-pocket user costs H | |||
| B: Long wait times M | |||
| B: Lack of community awareness H | |||
| B: Navigation challenges within facility L | |||
| Reduced number of survivor interviews | E: Standardised policies and procedures M | Acceptability | B: Hostile and sceptical community beliefs L |
| B: Lack of standardised policies and procedures M | B: Non-representative staff L | ||
| B: Inadequate training on trauma-informed care and OSC operations H | |||
| B: Unclear, uncontextualised or unavailable OSC policies and procedures M | |||
| More services provided at one place and all hours | E: Available, on-site psychosocial services and support M | Quality | E: Sensitive staff attitudes and behaviours L |
| B: Lack of basic medical supplies, facility equipment, survivor comfort items H | E: Sensitive staff referrals L | ||
| B: Insufficient staff H | E: Champion, dedicated OSC staff leaders M | ||
| B: Lack of psychosocial services H | B: Failure to provide health information L | ||
| B: Lack of security at OSC L | B: Harmful behaviours of healthcare staff towards survivors L | ||
| B: Lack of designated budgets and budget transparency L | B: Mistreatment by police H | ||
| B: Unsustainable, donor-dependent funding sources M | B: Lack of staff knowledge on IPV/SV M | ||
| B: Operation costs not feasible in many low-resource settings M | B: Lack of long-term support and follow-up M | ||
| B: Compromised confidentiality and privacy H | |||
| B: Lack of child friendly environments L | |||
| Increased evaluations and research | B: Poor data management systems H | Multisectoral coordination | E: Strong interprofessional staff relationships L |
| B: Lack of oversight and supervision M | E: Regular interagency meetings M | ||
| B: Lack of facility-level monitoring mechanisms H | B: Weak multi-sectoral networks H | ||
| B: Unclear staff roles L | |||
| B: Fragmented services M | |||
| B: Poor transfers of management L | |||
| B: Lack of information sharing between sites L | |||
| B: Weak referral networks H | |||
| B: Unclear responsibilities of implementing partners M | |||
| B: Ineffective advisory committees L | |||
H indicates high-confidence evidence. M moderate-confidence evidence. L low-confidence evidence. F, indicates enabler. E, indicates enabler.
IPV, intimate partner violence; OSC, one stop centre; SV, sexual violence.