Child abuse and neglect in the Jaffna district of Sri Lanka – a study on knowledge attitude practices and behavior of health care professionals

Abstract

BackgroundVictims and perpetrators of child abuse do not typically self-report to child protection services, therefore responsibility of detection and reporting falls on the others. Knowledge on child protection is essential for the first contact person and such information is sparse in research literature originally coming from Sri Lanka. Anecdotally, several cases of child abuse have been missed out at the first contact level. Therefore we undertook this survey to assess the knowledge, attitudes towards child protection and the experiences of medical officers, nursing officers and social workers on child protection.MethodThis was a descriptive analytical study carried out in hospitals and the community during March–October 2016. An anonymous content validated self-administered questionnaire was used as the study instrument. Knowledge, Attitude, Practices and Behaviour were assessed via multiple choice questions and responses according to Likert score. Three anonymised case records were given as case vignettes to be studied by the participants and their responses were also recorded on the questionnaire.ResultsAmong the 246 responders 156 (63.4%) were doctors. All groups of professionals identified the forms of child abuse correctly and the social indicators of child abuse was correctly identified in 152 (61.7%). Majority failed to identify the features of the perpetrator. Majority of the professionals showed a favourable response in attitude when dealing with child maltreatment. 153 (62%) had suspected child abuse in their career and 64% of them had reported it to the authority. Fifty two (21%) had attended a training workshop on child abuse and 65.8% of the responders were not satisfied with their knowledge. 229(93%) of them indicated that they wanted some form of education on child maltreatment. The Knowledge, Attitude and Behaviour towards child abuse were significantly good on people with experience in the field of Paediatrics and Judicial Medical work, when compared to those who did not have the experience in these two fields. (p value< 0.01).ConclusionAlthough the knowledge among health professionals regarding child abuse and care was satisfactory, further areas need reinforcement. The attitude was more positive, the behavior and practices on child maltreatment needed reinforcement via workshops and continuing medical education.

Knowledge and Attitude Regarding Child Abuse Among Primary Healthcare Physicians and Interns in Al Qassim, Saudi Arabia

“…This did not seem to disagree with our results, as we observed that specialty significantly influences the knowledge score, with pediatricians exhibiting lower knowledge scores than doctors in other specialties. However, our results contradict the report by Sathiadas et al, who found that the knowledge, attitude, and behavior of healthcare professionals toward child abuse were significantly good among respondents within the pediatric specialty [ 18 ]. Similarly, we also noted that physicians with children have significantly better KA scores than those without children.…”

“…The study showed that the main obstacles to reporting such cases were the fear of misdiagnosis and the fear of separating the children from their families with a lack of knowledge about the reporting process [ 8 ]. Sathiadas et al [ 18 ] reported that although healthcare professionals demonstrated good overall knowledge, 65.8% of physicians were unsatisfied with their knowledge and expressed the desire for some form of education on child maltreatment to further their understanding. AlBakr et al [ 16 ] reported that the overall knowledge among all primary healthcare physicians in Al-Khobar City in the Eastern Region of Saudi Arabia about child abuse was significantly higher among those aged 36-40 years, which aligned with our findings related to the age of the respondents.…”

Shadows of Conflict in Northern and Eastern Sri Lanka: Socioeconomic Challenges and a Way Forward

“…while some of the increases in reporting may be due to a greater availability of helpdesks, fieldlevel research also confirmed perceptions that a growing number of children are facing issues of malnutrition, abuse, and abandonment. In addition, reports of child abuse, neglect, and exploitation are likely underreported, in part because of sociocultural factors (Sathiadas, Viswalingam, and Vijayaratnam 2018).…”

Social Representations of nurses on the approach to children and adolescents who are victims of violence

“…A number of studies (11)(12)(13)(14)(15) point out relevant factors that permeate the intervention by nurses in cases of violence in the pediatric and adolescent population, such as the reason for the silence established in the family, the fear coming from the professionals for having doubts about tangible problem solving, definition of care protocols and flows, professional training, lack of resoluteness by the child protection agencies and lack of institutional and governmental support to deal with these families (16) .…”