Childhood Sexual Violence in Indonesia: A Systematic Review

There has been relatively little research into the prevalence of childhood sexual violence (CSV) as well as the risk and protective factors for CSV in low- and middle-income countries including Indonesia. Systematic searches conducted in English and Bahasa Indonesia in this review identified 594 records published between 2006 and 2016 in peer-reviewed journals and other literature including 299 Indonesian records. Fifteen studies, including nine prevalence studies, met the quality appraisal criteria developed for this review. The review found that CSV research is scarce: Only one study included nationally representative prevalence estimates. Varying definitions for CSV, survey methods, and sample characteristics limited the generalizability of the data. The available evidence points to significant risk of sexual violence affecting both girls and boys across many geographical and institutional settings. Married adolescent girls are vulnerable to sexual violence by partners in their homes. Children in schools are vulnerable to CSV by peers and adults. Victims seldom disclose incidents and rarely seek support. In addition, early childhood experiences of trauma were strongly associated with later perpetration of sexual violence and revictimization. Limited information is available about protective factors. This review synthesizes evidence about what is currently known about CSV in Indonesia and identifies the strengths and weaknesses of the existing research. A more robust evidence base regarding CSV is required to better inform policy and justify investment into prevention programs.

Assessing large-scale violence against children surveys in selected Southeast Asian countries: A scoping review

BACKGROUND

Violence against children (VAC) is a widespread, global issue with far-reaching social and economic consequences. In recent years, VAC has received substantial international attention, resulting in government initiatives to reduce VAC, in part, by strengthening data collection and information systems.

OBJECTIVE

This scoping review was undertaken to map survey methodologies for VAC measurement in Indonesia and other Southeast Asian countries and to identify key considerations for developing both methodologically sound and culturally appropriate VAC surveys in Indonesia and similar contexts.

METHODS

The authors conducted manual and automated searches in English and Bahasa Indonesia through PubMed, global databases, and websites, and consulted with partners from the government of Indonesia and the child protection field to identify surveys conducted from 2006 to 2016 in Indonesia and Southeast Asia. The search identified 275 records, of which 11 met all inclusion criteria.

RESULTS

The 11 surveys utilized a wide range of methodologies and employed inconsistent definitions, different age ranges for respondents, and different combinations of self-administered and face-to-face modes. A majority of the studies utilized household-based sampling, did not include a qualitative component, and used a tablet for data collection.

CONCLUSION

In developing VAC surveys, researchers should consider which groups of children are excluded from the sampling frame; how qualitative data can be used to strengthen the validity of survey results; how to maximize privacy in face-to-face interviews; and whether self-administered modes are feasible and acceptable. Researchers should also ensure that the survey and research protocol undergo rigorous ethical review.

Adverse Childhood Experiences, Mental Health, and Risk Behaviors Among Men in the Solomon Islands

Compared with many parts of the world, there has been little research in Pacific Island nations into the effects of adverse childhood experiences (ACEs) on adult health. This is a significant gap for local evidence-based child protection. We describe findings from a survey of 400 men aged 18 to 70 years recruited from randomly sampled households in Honiara city, Solomon Islands. Most men reported multiple adversities during childhood (80.7% 3 or more; 46% 5 or more), such as exposure to community and domestic violence, bullying, physical maltreatment, and sexual abuse. Men with multiple ACEs had significantly lower well-being and more psychological distress, recent stressful life events, and health risk behaviors. This study reports the first observation that betel quid chewing increased as a function of multiple ACEs. In comparison with recent East Asian studies, the Solomon Islands data suggest that the collective geographic category of "Asia-Pacific" masks significant intraregional differences in childhood adversities.

The Importance of Contextual Factors in Carrying Out Childhood Violence Surveys: a Case Study from Indonesia

Nationally representative research into violence against children is necessary to understand the scale and complexity of such violence and to evaluate prevention efforts. To date, however, most countries do not have adequate data. In 2013, the government of Indonesia conducted a national Violence Against Children Survey (VACS). This was a cross-sectional household survey of male and female 13-to-24- year-olds designed to estimate physical, emotional, and sexual violence prevalence. The target was to interview at least 2580 individuals; but response rates were much lower than anticipated (females = 66.6%; males = 56.1%). Insufficient data was available across several variables and there were unexpected anomalies in obtained data. We conducted a retrospective analysis of the survey to understand impediments and to advise future national efforts in Indonesia and other low-to-middle-income contexts. Survey managers and implementers (n = 22) were interviewed online and in person. We also carried out secondary analysis of the child survey data to identify factors possibly associated with (non-)response and assessed field notes from interviewers. Culturally inappropriate timing of data-collection (during Ramadan) may have had a negative impact on household responsiveness and the availability of children at home. Face-toface interviews in households were considered to impede participation and disclosure. Survey field staff and managers expressed the need for deeper training and a more comprehensive pilot. Recommendations to improve privacy and anonymity include the use of self-administered questionnaires and school-based rather than at-home surveys. These and other findings from this case study may be useful in planning future surveys in Indonesia and similar social and cultural contexts.

Quality of Life Among Senior Citizens in Bhutan

This study explored associations between quality of life (QOL), spirituality, social integration, chronic diseases, and lifetime adversity among people aged 60 years and older in Bhutan. Adults aged 60 to 101 years (n = 337) completed face-to-face interviews. The main measure included the World Health Organization QOL questionnaire and Adverse Childhood Experiences International Questionnaire. The social relationships domain of QOL had the highest mean. Frequent back pain, memory decline, depression, mobility impairment, insomnia, and lung diseases were commonly reported and negatively related to QOL. Compared with women, men reported fewer physical and mental health problems and better QOL. Multivariate analysis revealed that cumulative health problems, psychological distress, and social connectedness contributed significantly to overall QOL. The measure of spirituality was negatively associated with QOL, which is not conclusive and suggests the need for more research especially when the influence of spiritualism is highly visible in the everyday lives of Bhutanese people. The significance of these findings is discussed in relation to care for elderly people in Bhutan.