Child Maltreatment in Bangladesh : Perceptions, Prevalence and Determinants

Background: Like most low- and middle-income countries Bangladesh have no prevalence data on Child Maltreatment (CM) and lack a reporting system. Objectives: The overall aims of the thesis were to generate knowledge on CM in the Bangladeshi society and to estimate the prevalence and associated risk factors. Methods: The thesis is based on four studies. In Study I children’s experiences were explored and 24 school aged children were interviewed. Qualitative content analysis was used for data analysis. In Study II 790 newspaper articles on CM from six national daily newspapers were selected during three months in 2014. Data were analysed through descriptive content analysis. Studies III and IV were cross-sectional population surveys. The International Child Abuse Screening Tool for Children (ICAST-C) was translated for data collection. Face-to-face interviews were performed during March-April 2017 with 1,416 children aged 11-17 years. In Study III the prevalence and risk factors of child physical abuse (CPA) were estimated, while in Study IV the same for child psychological abuse (CPsyA) and neglect. Results: CM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society. Vulnerable groups were young children, girls, and poor children (Study I). Physical and sexual abuse were the most common types of CM covered in the news articles. One third of the reported cases resulted in death. Boys were victims of physical abuse to a higher degree, while girls were reported as victims of sexual abuse. The identity of the victims was often disclosed (Study II). Approximately all children reported experiences of CPA and CPsyA. Neglect was less reported (Study III and IV). Boys, younger children, victim of family violence, and low maternal education were risk factors of CPA (Study III). Not living with parents, working, family size and victim of family violence were risk factors of CPsyA or neglect. More years of schooling was a protective factor (Study IV). Conclusions: The results show that almost every child in Bangladesh experience CM. The studies incorporated in this thesis contribute to the knowledge on CM in the Bangladeshi cultural context. Key words: Child Maltreatment, ICAST-C, Public Health, BangladeshLike most low- and middle-income countries Bangladesh have no prevalence data on Child Maltreatment (CM) and lack a reporting system. The overall aims of the thesis were to generate knowledge on CM in the Bangladeshi society and to estimate the prevalence and associated risk factors. The thesis is based on four studies. An explorative interview study to get children’s views on CM was the first study. A systematic analysis of newspaper content was then performed to get a societal picture of CM. The first two studies generated new research questions for the two successive studies. Study III and IV were population based cross-sectional surveys. The results show that CM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society (Study I). Boys were victims of physical abuse to a higher degree, while girls were reported as victims of sexual abuse. One third of the newspaper reported cases resulted in death. The identity of the victims was often disclosed (Study II). Almost every child in Bangladesh has experienced either physical or psychological abuse. Neglect was less reported (Study III and IV). The studies incorporated in this thesis contribute to the knowledge on CM in the Bangladeshi cultural context.Artikel 2 och 4 ingick i avhandlingen som manuskript. Nu publicerade.