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Impact of Sexual Assault Response Education on Knowledge of Post-Assault Health Services among Female University Students in Nigeria

Abstract

Sexual assault is an important public health and gender-based violence concern that may have serious physical, psychological, sexual, and reproductive-health consequences for affected individuals. Female university students may face risks of sexual assault in various settings, while limited knowledge of available post-assault health services may contribute to delayed or missed access to appropriate care. Post-assault healthcare may include medical assessment, treatment of injuries, prevention or management of sexually transmitted infections, HIV post-exposure prophylaxis where clinically indicated, emergency contraception where appropriate, psychological support, forensic examination where available and desired, and referral to relevant protection and support services. However, fear, stigma, shame, uncertainty about confidentiality, misconceptions about available services, and limited awareness of where and when to seek care may prevent survivors from accessing appropriate services. Sexual assault response education provides an opportunity to improve students' understanding of post-assault healthcare and available support pathways. Against this background, this study investigates the impact of sexual assault response education on knowledge of post-assault health services among female university students in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Theory, and Social Ecological Model. The Health Belief Model explains how students' perceptions of the seriousness of sexual assault consequences, perceived benefits of timely healthcare, perceived barriers, self-efficacy, and cues to action may influence knowledge and potential healthcare-seeking responses. Health Literacy Theory emphasizes students' ability to obtain, understand, evaluate, and use reliable information about available post-assault health services. The Social Ecological Model highlights the influence of individual, interpersonal, institutional, community, healthcare-system, and broader social factors on awareness of and access to post-assault services. Collectively, these theoretical perspectives provide a suitable framework for explaining how sexual assault response education may influence knowledge of post-assault health services among female university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise female undergraduate and postgraduate students aged 18 years and above enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, academic levels, and eligible students. Sexual assault response education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, knowledge of immediate safety measures, availability and timing of medical assessment, management of physical injuries, sexually transmitted infection prevention and treatment, HIV post-exposure prophylaxis where indicated, emergency contraception where appropriate, pregnancy-related care, forensic examination and evidence preservation where available and desired, psychological first aid and counselling, confidentiality and informed consent, referral pathways, survivor-centred care, reporting options, emergency contacts, available university health services, hospitals, sexual-assault referral centres, and other relevant support services. Knowledge of post-assault health services will be assessed using indicators such as students' ability to identify appropriate healthcare services following sexual assault, recognize the importance of timely medical assessment, identify services for injury management, understand the purpose and time-sensitive nature of HIV post-exposure prophylaxis where clinically indicated, recognize the availability of emergency contraception where appropriate, identify sexually transmitted infection services, understand options for psychological support, recognize the role of forensic services where available and desired, identify appropriate referral pathways, and recognize the importance of confidentiality and survivor consent. Data will be collected using structured questionnaires, standardized knowledge assessment tools, case-based scenarios, university health-service information, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, prior exposure to sexual-assault information, awareness of university and community health services, and baseline knowledge of post-assault care. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of sexual assault response education on knowledge of post-assault health services. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that sexual assault response education has a significant positive impact on knowledge of post-assault health services among female university students in Nigeria. Students exposed to structured, evidence-based, survivor-centred, and practical education are expected to demonstrate greater knowledge of available post-assault health services than students without comparable exposure. Education may improve students' understanding of the importance of seeking timely medical assessment, injury care, HIV post-exposure prophylaxis where clinically indicated, emergency contraception where appropriate, sexually transmitted infection services, psychological support, and other relevant healthcare and referral services. Case scenarios and practical information about where to seek help may improve students' ability to identify appropriate services during an emergency and reduce misconceptions about confidentiality and available care. However, stigma, fear of judgement, concerns about confidentiality, limited availability of specialized services, financial barriers, inadequate referral systems, misinformation, and fear of reporting may reduce the effectiveness of education alone. The study therefore expects accessible, confidential, survivor-centred, trauma-informed, and sustained sexual assault response education, supported by functional post-assault healthcare and referral systems, to contribute significantly to improved knowledge of post-assault health services among female university students in Nigeria. The study is expected to contribute to the literature on sexual assault response, post-assault healthcare, gender-based violence, women's health, sexual and reproductive health, adolescent and young adult health, health education, health literacy, trauma-informed care, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, universities, university health centres, hospitals, sexual-assault referral services, healthcare professionals, counsellors, gender-based violence response organizations, student support services, development partners, and policymakers regarding strategies for improving awareness of post-assault healthcare. The study will also provide evidence-based recommendations for integrating sexual assault response education into university health programmes, strengthening awareness of time-sensitive post-assault services, improving university referral pathways, increasing confidentiality and survivor-centred care, training healthcare and student-support personnel, improving access to psychological and medical services, and developing sustainable campus-based programmes that ensure female university students are informed about appropriate post-assault health services across Nigeria.

Keywords: Sexual assault response education, post-assault health services, female university students, sexual assault, gender-based violence, survivor-centred care, sexual and reproductive health, health education, health literacy, trauma-informed care, Nigeria, public health.