Introduction:
Children are often targets to abuse due to their vulnerability and fear to disclose the nature of abuse out of fear and absence of knowledge regarding abuse. Child abuse is a globally prevalent phenomenon. Child abuse has always been a topic often never discussed among the population; especially in the Asian region.[1] Child abuse and crimes against children has had a steady rise through the years, In India 33,098 cases of crimes against children were reported during 2011 as compared to 26,694 cases during 2010, suggesting a recent increase of 24.0 percent. Reports show that 53.22% of the abused children reported having faced one or more forms of sexual abuse.[1] Newspapers and scientific journals cater to the needs of two different kinds of population while the former is read by the general public; the latter is mostly restricted to researchers and personnel associated with the field in concern. The present study was carried out in order to find the form of reporting of child abuse in the two different mediums of information, to determine the areas of focus when reporting such incidents. Hence the study was carried out with the following objectives.
Objectives: To explore the contents of the published articles\ reports on child abuse in India from scientific journals and newspapers identifying areas and gaps for further research and program development.
Materials and Methods:
Setting: The present review was carried out in the Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry.
Study Design: Decriptive Content Analysis.
Data Collection: Published articles in scientific journals during the years 2007-2012 with free access were searched using the search engines such as ‘PubMed’ and ‘Google’. Full text articles in the Indian context were alone taken up for analysis. The key words used were ‘child abuse in (on, about) India.
Online versions of English newspapers (2007-2012) in India were accessed to find the articles on child abuse. Search engines of the corresponding newspapers and ‘Google’ were used for the search. The key words used were ‘child abuse in (on, about) India. Due to the variety of regional languages in India, articles related to child abuse from local and regional newspapers were not taken up for the analysis. In case of follow-up articles about a particular incident of abuse, the first reported incident was taken up. In cases of cross reporting i.e., reporting of the same incident by more than one newspaper the earliest published article was taken, when the date of publication of both the articles was similar, the first accessed article was considered for analysis. Articles related to child abuse like awareness, legislation, survey results were excluded. The key words used were ‘child abuse in (on, about) India.
Definitions: Standard definitions for child abuse as given by World Health Organisation was used to define child abuse in the present study.[2]
Physical Abuse: Physical abuse is the inflicting of physical injury upon a child. This may include burning, hitting, punching, shaking, kicking, beating or otherwise harming a child. The parent or caretaker may not have intended to hurt the child. It may, however, be the result of over-discipline or physical punishment that is inappropriate to the child's age.
Sexual Abuse: Sexual abuse is inappropriate sexual behavior with a child. It includes fondling a child's genitals, making the child fondle the adult's genitals, intercourse, incest, rape, sodomy, exhibitionism and sexual exploitation. To be considered ‘child abuse’, these acts have to be committed by a person responsible for the care of a child (for example a baby-sitter, a parent, or a daycare provider), or related to the child. If a stranger commits these acts, it would be considered sexual assault and handled solely by the police and criminal courts.
Emotional Abuse: Emotional abuse is also known as verbal abuse, mental abuse, and psychological maltreatment. It includes acts or the failures to act by parents or caretakers that have caused or could cause, serious behavioral, cognitive, emotional, or mental trauma. This can include parents/caretakers using extreme and/or bizarre forms of punishment, such as confinement in a closet or dark room or being tied to a chair for long periods of time or threatening or terrorizing a child. Less severe acts, but no less damaging, are belittling or rejecting treatment, using derogatory terms to describe the child, habitual tendency to blame the child or make him/her a scapegoat.
Analysis: Manual content analysis was done by the first and second authors (trained in qualitative research methods), the results were then reviewed by the third author (facilitator for qualitative research methods).mixed coding (inductive and deductive coding) of the manuscripts was done, themes and categories were assigned. First two researchers independently reviewed the content of articles\newspaper reports and decided the categories emerging from the articles and reports. Later on, the quantification of these categories was done by identifying the number of times it was reported in the reports.
Results:
In journals, our search provided us with 9 articles. The main categories derived from the analysis were Study Exclusivity, Study design, Study Setting, Study Type, Methods, Sampling, (Study participants) and Speciality undertaking study.
Among the articles from the scientific journals prevalence studies were predominant (4) followed by case reports (3) and Knowledge Attitude Practice studies (2). Five (5) articles were exclusively on child abuse, of which, three (3) were case reports and two (2) were Knowledge Attitude Practice studies. The studies were mostly conducted in the hospital setting (7). The study participants were mostly children, as case reports formed the major portion of the literature. The knowledge attitude practice studies had the mothers (in general not of abused children in specific) and medical personnel. The Pediatrics speciality had 5 articles on child abuse, followed by Dentistry (2) and Dermatology and nursing with one each.
Table 1: Content analysis of scholarly articles on Child Abuse (n=9) |
Categories |
Variables |
a3 |
b4 |
c5 |
d6 |
e7 |
Study Exclusivity |
Yes (Y) / No (N) |
Y |
Y |
N |
Y |
N |
Study design |
Quantitative (Qn) |
Ql |
Ql |
Qn |
Ql |
Qn |
Qualitative (Ql) |
Study Setting |
Hospital based (H) |
H |
H |
H |
C |
S |
Community based (C) |
Symposium (S) |
Study Type |
Case report (CR) |
Cr |
Cr |
P |
KAP |
P |
Knowledge attitude & practice (KAP) |
Prevalence (P) |
Methods |
Sample size |
1 |
1 |
661 |
50 |
NA* |
Sampling |
Case records |
Purposive |
Study pattern |
Retrospective |
Prospective |
Sampling
(Study
participants) |
Children (C) |
C |
C |
HR |
P |
C |
Parents (P) |
Medical professional(MP) |
Hospital records(HR) |
Speciality undertaking study |
Pediatrics (PED) |
PED |
PED |
PED |
NUR |
DER |
Dermatology (DER) |
Dentistry (DEN) |
Nursing (NUR) |
| * Not available |
We obtained 38 reports from newspapers. The main categories derived from the content analysis were Gender, Place, Type of Abuse, Relationship of Abuser, Setting, Indicators of Abuse, Mechanism of Reporting and Action Taken regarding the abuse.
Child abuse was found more among girls [n=35 (92.1%)] as compared to boys [n=2 (5.3%)]. The maximum cases were reported from Western part of India, [n= 15 (39.4%)] especially in Goa, followed by South [n=11 (28.9%)], North [n=8 (21.1%)] and East [n= 1 (2.6%)].
Among type of abuse, sexual abuse was more commonly reported [n=32 (84.2%)], as compared to other forms of child abuse like emotional [n=6 (15.8%)] and physical abuse [n=6 (15.8%)].The abusers were mostly people well known to the children [n=20 (52.6%)], among the other abusers were unknown persons[n=9 (23.7%)], family members constituted 21.1% (n=8) while the details of the abuser were not mentioned in one case (2.6%).The setting in which the abuse took place was mostly not mentioned[n=21 (55.3%)], among those articles where the setting was mentioned showed that most of the abuse happened at Home [n=6 (15.8%)], Institution [n=5 (13.2%)], Street [n=4 (10.5)] and during Transport[n=2 (5.3%)].
Table 2: Content analysis of scholarly articles on Child Abuse (n=9) |
Categories |
Variables |
f8 |
g9 |
h10 |
i11 |
Study
Exclusivity |
Yes (Y) / No (N) |
Y |
Y |
N |
N |
Study Design |
Quantitative (Qn) |
Ql |
Qn |
Qn |
Qn |
Qualitative (Ql) |
Study setting |
Hospital based (H) |
H |
H |
H |
H |
Community based (C) |
Study Type |
Case report (CR) |
Cr |
KAP |
P |
P |
Knowledge attitude & practice (KAP) |
Prevalence (P) |
Methods |
Sample size |
1 |
200 |
225 |
83 |
Sampling |
Random |
Random |
Random |
Study pattern |
Prospective |
Prospective |
Prospective |
Sampling
(Study participants) |
Children (C) |
C |
MP |
C |
MP |
Parents (P) |
Medical professional(MP) |
Hospital records(HR) |
Speciality undertaking study |
Pediatrics (PED) |
DEN |
DEN |
PED |
PED |
Dermatology (DER) |
Dentistry (DEN) |
Nursing (NUR) |
The manifestations of the abuse which lead to the identification was mostly physical [n= 9 (23.7%)] followed by psychological [2 (5.3%)], while in most cases this was not reported [n=27 (71.1%)].The mechanism of reporting of the incident was also not available in most articles [n=23 (60.5%)].the more common patterns of reporting were children who confided in their parents who in turn informed the authorities [n=7 (18.4%)]. The other mechanisms included parents reporting to authorities (n=4 (10.5%)], relatives reporting to authorities [n=3 (7.9%)] and neighbors reporting to authorities[n=1 (2.6%)].
The accused were mostly arrested [n =26 (68.4%)], while details were not available [n =8 (21.1%)] and investigations were in progress [n =4 (10.5%)] in other instances.
Table 3: Content analysis of newspaper articles on child abuse articles (n= 38) |
| Categories |
Variables |
Number (%) |
Gender |
Female |
35 (92.1%) |
Male |
2 (5.3%) |
Not Available |
1 (2.6%) |
Place |
West |
15 (39.4%) |
South |
11 (28.9%) |
North |
8 (21.1%) |
East |
1 (2.6%) |
Type of Abuse |
Sexual |
32 (84.2%) |
Emotional |
6 (15.8%) |
Physical |
6 (15.8%) |
Relationship of Abuser |
Known |
20 (52.6%) |
Unknown |
9 (23.7%) |
Intra-familial |
8 (21.1%) |
Not Available |
1 (2.6%) |
Setting |
Not Available |
21 (55.3%) |
Home |
6 (15.8%) |
Institute |
5 (13.2%) |
Street |
4 (10.5) |
Transport |
2 (5.3%) |
Indicators of Abuse |
Not Available |
27 (71.1%) |
Physical |
9 (23.7%) |
Psychological |
2 (5.3%) |
Mechanism of Reporting |
Not Available |
23 (60.5%) |
Child -> Parents -> Police |
7 (18.4%) |
Parents -> Police |
4 (10.5%) |
Relatives -> Police |
3 (7.9%) |
Neighbours -> Police |
1 (2.6%) |
Action Taken |
Arrested |
26 (68.4%) |
Not Available |
8 (21.1%) |
Investigation In Progress |
4 (10.5%) |
Discussion:
The analysis of the journal articles showed that the articles on child abuse were mainly done in the hospital setting, predominantly case reports. Knowledge attitude practices regarding child abuse was restricted to medical personnel and mothers. Pediatric speciality is more involved in the research on child abuse. The newspaper articles showed that child abuse was more among girls. Sexual abuse was more common. The abusers were mostly members known to the victim. In most cases the manifestation of abuse which leads to the identification of the abuse has not been reported.
The Ministry of Women and Child Development, Government of India has released a comprehensive report on child abuse prevalent in India in 2007, which mentions that sexual abuse is the most common form of child abuse. Most children chose to keep quiet and do not mention about the abuse to their parents. The report also states that 50% abusers are persons known to the child or in a position of trust and responsibility. Equal percentage of both girls and boys reported facing emotional abuse.
In journal articles, majority of the articles are case reports. The majority of the articles dealing exclusively with child abuse were mainly case reports. The predominance of studies done in the hospital setting also provides limited data regarding the prevalence of the problem in the general population indicating a possible iceberg phenomenon. Studies regarding child abuse have been predominantly undertaken by the pediatric speciality, though the impact of child abuse extends to almost all areas of medicine.
In newspaper articles, the reported abuse incidents against the girl child are more as compared to the male child. Sexual abuse is reported more as compared to other forms of abuse, though other forms of abuse are also prevalent. The manifestations which lead to the identification of the abuse has not been mentioned in many of the articles, though such information would be helpful for parents and teachers to identify and compare similar situations in order to find new cases of abuse. Similar interpretation can also be made from the setting of abuse.
Recommendations: More research in the field of child abuse is necessary to create awareness among health care personnel. In India, More research\reporting is required to study the extent of problem in different settings of India, settings of abuse, quality of life of victims, parental\community education on indicators of abuse and development of support program to victim.
References:
- Ministry of Women and Child Development, Government of India (2007). Study on child abuse: India 2007.India; 2007.
- World Health Organization Report of the Consultation on Child Abuse Prevention; Geneva. 1999. Accessed on 14 Nov. 2013 Available from url:http://www.who.int/violence_injury_prevention/violence/neglect/en/
- Gupta S, Kumar A. Child Abuse: Inflicted Traumatic Brain Injury. Indian Pediatrics. 2007;44:783-784.
- Mathangi RK, Mathivanan T, Sankar J. Profile of Children Abused by Burning. Annals of Burns and Fire Disasters. 2010;23:8-12.
- Verma S, Lal N, Lodha R, Murmu L. Childhood Trauma Profile at a Tertiary Care Hospital in India. Indian Pediatrics. 2009;46:168-171.
- Sudha R. Awareness of mother about child abuse and neglect. Nursing Journal of India. 2011;102(5):100-102.
- Dhawan J, Gupta S, Kumar B. Sexually transmitted diseases in children in India. Indian J Dermatol Venereal Leprol. 2010;76:489-493.
- Kiran K. Child Abuse and Neglect. J Indian Soc Pedod Prev Dent. 2011;29:79-82.
- Kirankumar SV, Noorani H, Shivaprakash PK, Sinha S. Medical professional perception, knowledge and experience about child abuse and neglect in Bagalkot district of north Karnataka: A survey report. J Indian Sec Pedod Prev Dent. 2011;29:193-197.
- Mishra D, Arora P. Domestic Child Labor. Indian Pediatrics. 2007;44:291-292.
- Banerjee SR, Bharati P, Vasulu TS, Chakrabarty S , Banerjee P. Whole Time Domestic Child Labor in Metropolitan City of Kolkata. Indian Pediatrics. 2008;45:579-582.
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