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Kane D, Kennedy KM, Eogan M. The prevalence of genital injuries in post-pubertal females presenting for forensic examination after reported sexual violence: a systematic review. Int J Legal Med 2024; 138:997-1010. [PMID: 37971512 DOI: 10.1007/s00414-023-03117-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Sexual violence is a prevalent issue in contemporary society requiring a robust forensic healthcare response. It is critically important that forensic examiners put clinical examination findings into an appropriate evidence-based context. The presence of genital injuries has been shown to increase the likelihood of successful criminal prosecution and report the crime. However, the reported rates of genital injury vary widely in published studies. AIMS AND OBJECTIVES We aim to critically evaluate and synthesize existing literature on the prevalence of genital injuries in post-pubertal females, examined following sexual violence, with a view to describing the prevalence and characteristics of genital injuries as well as the range of forensic practices employed. METHODS Three online databases (PubMed, Embase, and Scopus) were systematically searched with key terms. RESULTS Of the 1224 studies screened, 141 full-text publications met the inclusion criteria. Reported injury prevalence rates varied widely. Details pertaining to forensic examinations included in each study, such as grade of the examiner, type of examination, location of examination, and time interval from assault to examination also varied widely. Injury prevalence was highest in studies where enhanced visualization techniques were utilized. CONCLUSIONS This systematic review demonstrates that there is no universally agreed standard for documenting genital injuries in cases of sexual violence and highlights the need for standardized approaches and guidelines for assessing, documenting, and reporting these injuries. The review provides robust evidence to support a call for establishing consistent context, terminology, classification systems, and data collection methods to improve the comparability and reliability of future research findings.
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Affiliation(s)
- D Kane
- Department of Obstetrics & Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, 1, Dublin, Ireland.
- Sexual Assault Treatment Unit (SATU), Rotunda Hospital, Parnell Square, Dublin, 1, Dublin, Ireland.
| | - K M Kennedy
- School of Medicine, University of Galway, Galway, Ireland
| | - M Eogan
- Department of Obstetrics & Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, 1, Dublin, Ireland
- Sexual Assault Treatment Unit (SATU), Rotunda Hospital, Parnell Square, Dublin, 1, Dublin, Ireland
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2
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Marcos V, Seijo D, Montes Á, Arce R. Prevalence and Quantification of the Effects of Sexual Harassment Victimization of School-Aged Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 11:23. [PMID: 38255337 PMCID: PMC10814736 DOI: 10.3390/children11010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND/AIM Sexual harassment has become a serious social and public health problem in adolescents, causing adverse effects on mental health. Nevertheless, some behaviours arise that, due to their characteristics, might be misinterpreted as sexual harassment. A field study using a survey with non-probabilistic accidental sampling was designed in order to estimate the prevalence of sexual harassment victimization in the Spanish adolescent population as well as to quantify the harms. METHOD A total of 1028 Spanish adolescents, 54.3% females and 45.7% males aged 13-17 years (M = 15.21, SD = 1.03), responded to a diagnostic measure of sexual harassment victimization and an inventory measure of internalizing and externalizing mental health problems (MHPs). RESULTS The results showed a significant prevalence of diagnosed sexual harassment victimization of school-aged adolescents, 24.1%, 95% CI [0.215, 0.267], with adverse effects on internalizing and externalizing MHPs. As for the internalizing MHPs, the results exhibited moderate adverse effects on depression, anxiety, somatic burns, posttraumatic symptoms, and obsessive-compulsive symptoms, as well as mild adverse effects on social anxiety. Regarding externalizing MHPs, the results revealed moderate adverse effects on hyperactivity-impulsivity, anger control, and antisocial behaviour, as well as mild adverse effects on attention problems, aggression, and defiant behaviour. In addition, it was confirmed that sexual harassment victimization affects adolescent females to a greater extent, with the effect being significantly greater in internalizing than in externalizing MHPs. CONCLUSIONS The results obtained are discussed and future lines of research and intervention are proposed to promote the implementation of prevention and intervention programs that address this phenomenon and, in turn, improve the physical, psychological, and social well-being of adolescents.
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Affiliation(s)
| | | | | | - Ramón Arce
- Forensic Psychology Unit, Faculty of Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (V.M.); (D.S.); (Á.M.)
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3
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Mognetti B, Bo M, Berta GN, Canavese A, Castagna P, Collini F, Santa V, Salomone A, Gino S. Sexual Harassments Related to Alcohol and Drugs Intake: The Experience of the Rape Centre of Turin. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15090. [PMID: 36429806 PMCID: PMC9690951 DOI: 10.3390/ijerph192215090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
A cross-sectional study was conducted that describes the characteristics of sexual violence episodes related to the intake of alcohol and drugs observed among women that turned to the "Centro Soccorso Violenza Sessuale" (SVS) of the Sant'Anna Hospital in Turin between 1 January 2008, and 31 December 2017. Two hundred twenty-two patients were enrolled, 25 of which were minors, 141 were Italians, and most of them knew their aggressor and were raped in a private home. One hundred and fifty-five of them declared to the healthcare personnel to have taken alcoholic substances and/or drugs in conjunction with the event (86 reported having drunk alcohol, 36 having taken drugs and 33 disclosed both alcohol and drug abuse). If the woman knew her abuser, alcohol consumption was described as voluntary in more than 80% of cases, while in relation to drugs the consumption was equally voluntary or fraudulent. About 73% of women who reported having drunk alcohol just had amnesia or amnesia related to other symptoms, while amnesia was present in about 63% of women who reported only drug use. Physicians observed physical injuries on 156 women. Patients who reported to have assumed alcohol presented a significantly higher risk to suffer any physical injury and have a significantly increased risk to suffer injuries to their head and/or neck. The results obtained underline how even in Northern Italy alcohol intake represents the most widespread psychoactive substance in case of drug-facilitated sexual assault. There is therefore a need to promote education and prevention campaigns among citizens, especially among the youngest.
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Affiliation(s)
- Barbara Mognetti
- Department of Life Sciences and Systems Biology, University of Turin, via Accademia Albertina 13, 10123 Turin, Italy
| | - Marco Bo
- Hospital Medical Direction, Local Health Trust TO5, Piazza Silvio Pellico 1, 10023 Chieri, Italy
| | - Giovanni Nicolao Berta
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy
| | - Antonella Canavese
- Centro Soccorso Violenza Sessuale, Sant’Anna Hospital, City of Health and Science, Corso Spezia 60, 10126 Turin, Italy
- Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, 10126 Turin, Italy
| | - Paola Castagna
- Centro Soccorso Violenza Sessuale, Sant’Anna Hospital, City of Health and Science, Corso Spezia 60, 10126 Turin, Italy
| | - Federica Collini
- Department of Health Sciences, University of Eastern Piedmont, via Solaroli 17, 28100 Novara, Italy
| | - Veronica Santa
- Corso di Laurea Magistrale in Medicina e Chirurgia, Azienda Ospedaliera Universitaria San Luigi (Orbassano), University of Turin, v. Verdi 8, 10124 Turin, Italy
| | - Alberto Salomone
- Department of Chemistry, University of Turin, via Giuria 5, 10126 Turin, Italy
- Centro Regionale Antidoping, Regione Gonzole 10/1, 10043 Orbassano, Italy
| | - Sarah Gino
- Department of Health Sciences, University of Eastern Piedmont, via Solaroli 17, 28100 Novara, Italy
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Viana VAO, Madeiro AP, Mascarenhas MDM, Rodrigues MTP. Temporal trend of sexual violence against adolescent women in Brazil, 2011-2018. CIENCIA & SAUDE COLETIVA 2022; 27:2363-2371. [PMID: 35649023 DOI: 10.1590/1413-81232022276.14992021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to analyze the temporal trend of sexual violence (SV) reports against adolescent women in Brazil from 2011 to 2018. An ecological time series study was performed on reports of SV against women aged 10 to 19, which were available in the National Notifiable Diseases Reporting System (SINAN). Data were collected in 2020 but are related to reports filed from 2011 to 2018. The Prais-Winsten linear regression model was applied to analyze the time trend, including a calculation of the annual percentage variation (APC) and 95% confidence intervals (95%CI). We found a significant trend increase in all Brazilian regions. Although the rates in the Northern region are higher at the beginning and at the end of the analyzed time period, the reporting rates of the Southeast (APC 14.56%; 95%CI 7.98;21.54) and the South (APC 14.19%; 95%CI 6.56;22.36) showed a greater increase. The increase of SV reports in recent years shows how vulnerable adolescent women are to this type of violence, but also indicates greater improvement of violence surveillance systems. We conclude that both reporting systems and public policies aimed at tackling SV against women need to be further developed.
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Affiliation(s)
- Vera Alice Oliveira Viana
- Programa de Pós-Graduação em Saúde e Comunidade, Universidade Federal do Piauí. Av. Frei Serafim 2280, Centro. 64000-020 Teresina PI Brasil.
| | - Alberto Pereira Madeiro
- Programa de Pós-Graduação em Saúde e Comunidade, Universidade Federal do Piauí. Av. Frei Serafim 2280, Centro. 64000-020 Teresina PI Brasil.
| | - Márcio Dênis Medeiros Mascarenhas
- Programa de Pós-Graduação em Saúde e Comunidade, Centro de Inteligência e Agravos Tropicais, Emergentes e Negligenciados. Teresina PI Brasil
| | - Malvina Thaís Pacheco Rodrigues
- Programa de Pós-Graduação em Saúde e Comunidade, Centro de Inteligência e Agravos Tropicais, Emergentes e Negligenciados. Teresina PI Brasil
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Barbara G, Albertini V, Tagi VM, Maggioni L, Gorio MC, Cattaneo C, Parazzini F, Ricci E, Buggio L, Kustermann A. Characteristics of Sexual Violence Against Adolescent Girls: A 10 Years' Retrospective Study of 731 Sexually Abused Adolescents. Int J Womens Health 2022; 14:311-321. [PMID: 35273451 PMCID: PMC8901429 DOI: 10.2147/ijwh.s343935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/04/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Sexual violence against young girls is a pervasive multifaceted phenomenon which embraces several different forced sexual acts, including attempted and/or completed rape, sexual coercion and harassment, and sexual contact with force or threat of force. The aim of this study is to evaluate the characteristics of sexual violence in adolescent girls, by a retrospective analysis of 731 consecutive cases of sexually abused girls. Materials and Methods We analyzed demographic characteristics, risk factors for rape, and the eventual subsequent presence and type of ano-genital lesions. Results We found that sexual violence with penetration was perpetrated in 591 (80%) cases. Vulnerability factors related with a major risk of rape were age >17 years old and consumption of alcohol and/or other drugs. About 196 (55%) victims had at a least one genital lesion. Conclusion A prompt identification of red flags of sexual violence may help physicians in suspecting and managing cases of sexual assault in adolescent girls, even in the absence of typical lesions.
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Affiliation(s)
- Giussy Barbara
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Valentina Albertini
- Department of Emergencies, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Lidia Maggioni
- Department of Biomedical Science, Legal Medicine Section, University of Milan, Milan, Italy
| | - Maria Carlotta Gorio
- Department of Clinical and Biomedical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Cristina Cattaneo
- Department of Biomedical Science, Legal Medicine Section, University of Milan, Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Elena Ricci
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Laura Buggio
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Kustermann
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Barbara G, Buggio L, Micci L, Spinelli G, Paiocchi C, Dridi D, Cetera GE, Facchin F, Donati A, Vercellini P, Kustermann A. Sexual violence in adult women and adolescents: a narrative review. Minerva Obstet Gynecol 2022; 74:261-269. [PMID: 35147019 DOI: 10.23736/s2724-606x.22.05071-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sexual violence is a widespread phenomenon, as it has been estimated that about 35.6% of women have experienced some forms of sexual abuse, with variable prevalence estimates worldwide. Sexual violence has remarkable negative consequences on women's health and quality of life, with a specific harmful impact on women's psychological well-being and sexuality. In this narrative review, we provide an overview on the phenomenon of sexual violence against adult women and adolescents, discussing its associated multiple negative consequences with a specific focus on clinical and sexological aspects. ''Women centered care'' and a multidisciplinary approach appear of pivotal importance when working with sexual violence survivors. Woman should be engaged in all the clinical activities as equal partners in the decision-making process, and should be supported by multiple and different professional figures (i.e. gynecologists, psychologists, sexologists, forensic medical doctors, lawyers) working within the framework of a cooperative integrated model.
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Affiliation(s)
- Giussy Barbara
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy - .,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy -
| | - Laura Buggio
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laila Micci
- Gynecological Emergency Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gaia Spinelli
- Gynecological Emergency Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Paiocchi
- Gynecological Emergency Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dhouha Dridi
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia E Cetera
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Federica Facchin
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Agnese Donati
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paolo Vercellini
- Gynecological Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessandra Kustermann
- Gynecological Emergency Unit and SVSeD, Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Syukriani Y, Noviandhari A, Arisanti N, Setiawati EP, Rusmil VK, Dhamayanti M, Sekarwana N. Cross-sectional survey of underreported violence experienced by adolescents: a study from Indonesia. BMC Public Health 2022; 22:50. [PMID: 34998387 PMCID: PMC8742168 DOI: 10.1186/s12889-021-12427-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Global studies on adolescent victims of violence require serious attention due to the possibility that underreported cases may be higher than official records indicate. Since Indonesia expects to witness a demographic bonus, extensive research is needed to strengthen early detection, case handling, and prevention. Here, we report the outcomes of a survey on physical, verbal, and sexual violence experienced by adolescents in West Java, an Indonesian province inhabited by 18% of the country's total population. METHODS We conducted a cross-sectional survey in 2017 using the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool for Children (ICAST-C) questionnaire for detecting child abuse; an expert panel translated, simplified, and validated it based on a theoretical framework that combines paediatrics, public health, and medicolegal perspectives. We aimed to cover a large sample size and explore three types of violence (physical, verbal, and sexual) that have high evidentiary value in the forensic context. The respondents were adolescents in the first and second grades of middle school (12 to 14 years old) and high school (15 to 17 years old) in seven cities/municipalities in the province, selected through several stages of simple random sampling (N = 3452). We analysed the samples through univariate (percentage), odds ratio (OR), comparison, correlation, and correspondence analyses. RESULTS The results showed that 78.7% of the adolescents experienced violence in 2017, comprising those who encountered at least one incidence of physical violence (43.1%), verbal violence (12.2%), and sexual violence (4.5%). Data overlap includes 14.3% who experienced one type of violence in 2017, 7.4% who experienced two forms of violence, and 1.4% who underwent all three kinds of violence. The offenders were mainly adolescents across all types of violence, except for being forced to engage in sexual intercourse. Several victims of sexual violence did not state who the offenders were. Further, several characteristics showed a higher chance of experiencing violence than other characteristics, especially for adolescents who were still in middle school and those who lived only with their mothers. Correspondence analysis suggested subtle differences between characteristics. CONCLUSION We expect this study to help identify risk and protective factors that are essential to strengthening early detection efforts, decisive medicolegal examinations, case handling, and policy-making.
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Affiliation(s)
- Yoni Syukriani
- Department of Forensic and Legal Medicine, Faculty of Medicine, Universitas Padjadjaran, Jalan Raya Bandung-Sumedang KM 21, Jatinangor, Sumedang, Bandung, West Java, 45363, Indonesia.
| | - A Noviandhari
- Department of Children Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - N Arisanti
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - E P Setiawati
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - V K Rusmil
- Department of Children Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - M Dhamayanti
- Department of Children Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - N Sekarwana
- Department of Children Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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Arisukwu O, Igbolekwu C, Adebisi T, Akindele F. Perception of domestic violence among rural women in Kuje. Heliyon 2021; 7:e06303. [PMID: 33665453 PMCID: PMC7907773 DOI: 10.1016/j.heliyon.2021.e06303] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/02/2021] [Accepted: 02/12/2021] [Indexed: 11/15/2022] Open
Abstract
Domestic violence has become a global social problem affecting women and girls across different socio-demographics and culture. Often times a greater attention is paid to the experiences of urban women and girls to the detriment of their counter parts in rural areas who constituted major victims. The study explored the experiences, awareness and perception of domestic violence among rural women in Kuje, Nigeria. A total of 130 respondents were selected using stratified and simple random sampling technique. In-depth interview was conducted on 13 women and market leaders across Kuje. The findings revealed that 43.8% of the respondents fall within 30 years and above age bracket, 26.9% had non-formal education, 67.7% were Christians, while 56.2 % were married A total of 97.7% of the respondents were aware of domestic violence, while 43.8% linked domestic violence to early marriage. There is a significant relationship between level of education and perception of what constituted domestic violence among the respondents. Qualitative data revealed that culture and family affected expectations and treatment of women in rural Nigeria. The study concluded that domestic violence affects women and girl child negatively, and recommended that a more vigorous advocacy campaign against it should be intensified through mass media, family, community and religious leaders. Government should intensify efforts on free and compulsory education to empower the populace and reduce poverty among families.
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Affiliation(s)
- Ogadimma Arisukwu
- SDG 16, Peace, Justice and Strong Institutions, SDG 10, Reduced Inequality, Department of Sociology, Landmark University, Omu-Aran Kwara, Nigeria
| | - Chisaa Igbolekwu
- SDG 10, Reduced Inequality, Department of Sociology, Landmark University, Omu-Aran Kwara, Nigeria
| | - Tunde Adebisi
- SDG 16, Peace, Justice and Strong Institutions, Department of Sociology, Landmark University, Omu-Aran Kwara, Nigeria
| | - Favour Akindele
- SDG 10, Reduced Inequality, Department of Sociology, Landmark University, Omu-Aran Kwara, Nigeria
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