Child physical and sexual abuse in Dammam, Saudi Arabia: A descriptive case-series analysis study

Child Sexual Abuse Studies in Arab Societies: A Systematic Review and Directions for Future Research

Although child sexual abuse (CSA) is acknowledged as a worldwide social phenomenon, less is known about CSA within Arab societies. The current systematic literature review was designed to highlight the empirical knowledge on CSA in Arab societies. Guided by PRISMA principles, key databases were searched, with no time limit, for studies meeting the inclusion criteria. Fifty-seven studies were identified. The majority focused on the prevalence of CSA in various Arab societies around the world, with a wide range of rates reported. It is important to stress two main barriers addressed by the included studies. The first relates to the issue of taboo and the forbidden discussion of sexual content. The second is ethical, in which the researchers expressed their fear of creating emotional distress for their participants. A small group of studies examined parents' perceptions of CSA and the need for parents' involvement in the protection of their children. Another small group of studies focused on professionals' perceptions and experiences in contending with CSA, as well as their distress, conflict, and urgent need for support and guidance. The conclusions from the systematic literature review emphasized the enormous challenge of conducting studies on CSA in Arab societies and the urgent need to advance this research while also including children and adult survivors, whose perceptions and experiences are currently understudied. Moreover, the discussion stresses the need to adopt an intersectionality paradigm in future studies to advance the improvement of CSA policy and practice.

Parents' Knowledge and Perception of Child Abuse and Neglect in the Eastern Province of Saudi Arabia

Background

Child maltreatment is a crucial issue worldwide that has negative consequences for children and their families. Inability to distinguish between traditional corporal punishment and abuse is part of the problem.

Objectives

To assess parents' knowledge and perception of child maltreatment and investigate the factors that influence their awareness.

Materials and Methods

This cross-sectional study recruited parents with at least one child aged <18 years. Data were collected using a self-administrated online questionnaire. Participants were categorized into two groups based on the median knowledge score.

Results

A total of 447 participants completed the questionnaire, of which 62% were female and the average age was 37 years. Almost two-thirds of the respondents (60.6%) consider child abuse and neglect (CAN) to be a common problem in Saudi Arabia. Only 53% had good knowledge of CAN, and more than one-third were unaware of the hotline number available to report any CAN. Almost half of the participants did not consider refusing childhood immunization or smoking in front of children to be a form of CAN. Logistic regression showed that higher education and family income levels were significantly associated with good knowledge (P = 0.013 and 0.003, respectively).

Conclusions

While most parents consider CAN to be a common problem in Saudi Arabia, they do not have adequate knowledge of what constitutes emotional abuse and neglect. These findings highlight the need for community-based education programs to increase parents and caregivers' awareness of child rights.

Medico-legal history taking from the victims of sexual assaults: the role of nurse examiners

Background

Sexual assault examiners provides comprehensive health care to victims of sexual assault. Communication with the victim is important to collect relevant information from the victims. Ineffective communications can cause re-victimization and hamper the medico-legal evidence collection.

Main text

This article aims to orient the novice examiner and nurses to the prerequisites of medico-legal history collection, techniques of building trust, establishing rapport, ensuring privacy and confidentiality, taking consent, communicating effectively with the victims of sexual assault, and components of medico-legal history collection.

Conclusions

Novice examiners and nurses need to be trained in collecting medico-legal history and evidence. The examiners who conduct the examination should be dedicated to delivering compassionate and high-quality care to individuals who have disclosed sexual assault.

Child abuse and neglect in a rapidly developing country: Parents' perspectives

Purpose:

To identify parental awareness and knowledge regarding child abuse and neglect in the State of Qatar.

Methods:

A cross-sectional study using a questionnaire was conducted at Hamad Medical Corporation, the only tertiary pediatric hospital in the State of Qatar at the time of the study. Parents of children of all ages were offered a questionnaire that included demographic details, parental knowledge, and awareness of child abuse and neglect.

Results:

300 questionnaires were completed (response rate = 95%). More than 70% of parents were older than 30 years of age, 60% of them were females, and 66% were college graduates. The majority of the participants stated their familiarity about child abuse, and 6% witnessed morbidity or mortality due to child abuse in the society. Despite the identified laws, only 50% of the parents were aware of laws restricting child abuse. In regards to children with special needs, only 16% of the participants agreed that disabled children are at a higher risk of abuse compared to healthy children, while 33% were neutral and 52% disagreed. In addition, one-fifth of the respondents stated that hitting is discipline, while 63% disagreed. Almost one-third of the respondents agreed that hitting hands and buttock or hitting with soft objects is acceptable form of discipline. Unexpectedly, one-quarter of participants stated that it is okay to hit a child as long as no damage incurs. As for verbal abuse, around one-third of parents stated that yelling is not a form of child abuse, and that yelling does not affect growth and development. Comparing both corporal and verbal abuse, approximately 70% of parents stated that yelling is less harmful than hitting. In terms of child neglect, around half of the respondents agreed with the statement “Leaving a child (<5 years) unattended at home is a form of neglect,” while 42% were neutral. Finally, approximately 50% of the participants believed that it is okay to depend on nannies in assisting their children in eating and using the bathroom.

Conclusion:

Parents residing in the State of Qatar believe that they have a good knowledge regarding child abuse and neglect. However, this study shows many deficiencies in parental knowledge of child abuse and neglect. Parents’ attitudes and perceptions are considered indispensable targets for community health intervention.

Factors associated with perceptions of child sexual abuse and lack of parental knowledge: a community-based cross-sectional study from the Eastern Province of Saudi Arabia

BACKGROUND

Child sexual abuse (CSA) has serious consequences that can affect the physical, social and mental health of a child. In the last two decades, concern about CSA has increased around the world including Saudi Arabia.

OBJECTIVE

Evaluate factors associated with parental perceptions and knowledge of CSA.

DESIGN

Cross-sectional survey.

SETTINGS

Primary health care clinic.

SUBJECTS AND METHODS

Simple random sampling was used to select participants. The main tool for data collection was a self-administered questionnaire.

MAIN OUTCOME MEASURES

Factors associated with knowledge and perceptions of CSA.

SAMPLE SIZE

400.

RESULTS

Most respondents (69%) had good knowledge of the signs of sexual abuse in children. For perception scores, statistically significant variables were age (P=.004), educational level (P=.005), income (P less than .001), number of wives (P=.004), number of male children (P=.021), and number of female children (P=.027). For knowledge scores, statistically significant variables were income (P=.008), number of wives (P less than .005), number of male children (P=.003) and number of female chil.dren (P less than .003). Logistic regression showed that the older age group was significantly associated with a good perception score (P less than .046).

CONCLUSIONS

Risk factors for parental lack of knowledge and poor perception associated with CSA are poverty and low education. Protective factors included the older parent age, size of the family and families with more than one wife. Education should be designed for parents and the community to increase the knowledge and perception of CSA.

LIMITATIONS

Single-center study and short study period.

CONFLICT OF INTEREST

None.

Prevalence of Sexual Abuse Among Secondary School Students in Saudi Arabia

Child sexual abuse (CSA) is a public health problem that has been found to be linked to negative health outcomes. Data on CSA in Saudi Arabia are limited, and there are many gaps in research in this field. The aim of this study is to examine the prevalence of sexual abuse among children in Saudi Arabia. A cross-sectional, national survey (N = 16,010) utilizing International Society for Prevention of Child Abuse and Neglect Child Abuse Screening Tool Children's Version was conducted at secondary high schools in Saudi Arabia. Participant's mean age was 16.8 ± 0.9 years, and 50.8% were boys. Sixteen percent of the participants reported exposure to any type of CSA during their lives. Boys and those who lived with step-parent were more likely to be sexually abused compared to those who didn't (p < .05). Ordinary least squares regression analysis revealed that gender was the predictor significantly associated with CSA. Evidence-based prevention programs targeting mainly the high-risk groups should be implemented.

Study of Cases of Child Sexual Abuse Referred for Medico-Legal Examination in Cairo and Giza, Egypt,2007-2011

Child sexual abuse is a complex problem that results in detrimental effects on its victims. This study aimed to investigate the pattern of child sexual abuse in cases referred for medico-legal examination in Cairo and Giza governorates in the period between 2007-2011. The study included 813 cases of child sexual abuse. Female gender was more predominant than male gender (52.8%, 4.29 cases), and adolescents were the most frequent age group identified as victims of sexual abuse (43.8%, 356 cases). All perpetrators were male and most of them were persons outside the victims' families (89.9%, 731 cases). It was recommended to teach and encourage children to tell their caregivers if they have been assaulted and to educate parents and caregivers on how to respond when the child discloses sexual abuse.

Child maltreatment between knowledge, attitude and beliefs among Saudi pediatricians, pediatric residency trainees and medical students

Background

Child maltreatment is not included in Saudi medical schools and pediatric residency curriculums, which might limit knowledge and spread misconceptions. Additionally, physicians might have different attitudes regarding reporting child abuse and neglect. In this study, we hypothesize that medical students and pediatric trainees have limited knowledge, oblivious attitude and misbeliefs regarding child maltreatment in comparison to experienced pediatricians. But, medical students and trainees might hold higher motives and willingness to learn about child maltreatment and their consequences.

Methods

A self reported questionnaire was distributed after a pilot study to include pediatricians, pediatrics trainees and medical students in all main areas of pediatrics services: pediatrics wards, pediatrics outpatient clinics, critical care and pediatrics emergency.

Results

In disregard to their level of training, medical students and physicians believed that child maltreatment happens within the kingdom and is common. They were familiar with the child maltreatment definition, although only one third thought it is subject to culture sensitivity. However, experienced physicians were more knowledgeable especially about neglect. Moreover, female participants were more likely to report despite being more skeptical of readiness of Saudi law system to deal with cases of maltreatment. In general, knowledge about reporting was clearly deficit at all levels. Fortunately, all participants requested and were enthusiastic to receive further training.

Conclusion

Saudi medical students, pediatrics trainees and pediatricians have good basic knowledge, positive attitude and willingness to learn more to provide a safe environment for children in Saudi Arabia. However, knowledge in regards to reporting child maltreatment is a major observed defect. Still, further education and training are needed to combat CAN in Saudi Arabia.

•

Despite disagreement of culture impact on CAN definition, it was well known.

•

Experienced physicians were the most knowledgeable about CAN especially neglect.

•

Most participants lacked knowledge regarding reporting of CAN.

•

All participants expressed need to further training to deal with cases of CAN.