Lifetime and past-year prevalence of children’s exposure to violence in 9 Balkan countries: the BECAN study

Abstract

BackgroundChildren’s exposure to violence is a major public health issue. The Balkan epidemiological study on Child Abuse and Neglect project aimed to collect internationally comparable data on violence exposures in childhood.MethodsA three stage stratified random sample of 42,194 school-attending children (response rate: 66.7%) in three grades (aged 11, 13 and 16 years) was drawn from schools in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Former Yugoslavian Republic of Macedonia (FYROM), Greece, Romania, Serbia and Turkey. Children completed the ICAST-C questionnaire, which measures children’s exposure to violence by any perpetrator.ResultsExposure rates for psychological violence were between 64.6% (FYROM) and 83.2% (Greece) for lifetime and 59.62% (Serbia) and 70.0% (Greece) for past-year prevalence. Physical violence exposure varied between 50.6% (FYROM) and 76.3% (Greece) for lifetime and 42.5% (FYROM) and 51.0% (Bosnia) for past-year prevalence. Sexual violence figures were highest for lifetime prevalence in Bosnia (18.6%) and lowest in FYROM (7.6%). Lifetime contact sexual violence was highest in Bosnia (9.8%) and lowest in Romania (3.6%). Past-year sexual violence and contact sexual violence prevalence was lowest in Romania (5.0 and 2.1%) and highest in Bosnia (13.6 and 7.7% respectively). Self-reported neglect was highest for both past-year and lifetime prevalence in Bosnia (48.0 and 20.3%) and lowest in Romania (22.6 and 16.7%). Experiences of positive parental practices were reported by most participating children in all countries.ConclusionsWhere significant differences in violence exposure by sex were observed, males reported higher exposure to past-year and lifetime sexual violence and females higher exposure to neglect. Children in Balkan countries experience a high burden of violence victimization and national-level programming and child protection policy making is urgently needed to address this.Electronic supplementary materialThe online version of this article (10.1186/s13034-017-0208-x) contains supplementary material, which is available to authorized users.

Improving measurement of child abuse and neglect: A systematic review and analysis of national prevalence studies

“…This review identified 23 articles reporting the results of national studies of the prevalence of all five or four of the recognized forms of child maltreatment. One of these articles reported the results of a study conducted simultaneously in nine countries in the Balkan Peninsula, and eight of these national studies met our eligibility criteria [46]. Accordingly, in total, our review identified 30 national studies, conducted in 22 countries.…”

“…There was one study in Denmark [60], the Netherlands [61], Switzerland [62], Japan [63], Suriname [64], Saudi Arabia [65], Israel [66], South Africa [67], and Hungary [68]. In the Balkans study [46], eight met eligibility criteria based on the number of types of maltreatment studied: Albania, Bosnia & Herzegovina, Bulgaria, Croatia, the Former Yugoslavian Republic of Macedonia, Greece, Romania, and Serbia; in general for our purposes, we treat these as one study. The Turkish study involved three forms of maltreatment, so was excluded from our analyses.…”

“…Fourteen studies measured all five maltreatment types [47][48][49][50][51]53,[56][57]61,[64][65][66][67][68]. Of nine studies measuring four maltreatment types, seven omitted EDV [46,52,[58][59][60][62][63], and two omitted sexual abuse [54][55]. Eleven studies measured prevalence throughout childhood and in the past year; nine measured prevalence through childhood only, and three measured past year incidence only.…”

“…Seven studies were conducted in schools: Taiwan [56][57], the Netherlands [61]. Switzerland [62], Suriname [64], and the Balkans study [46]. Eleven studies were conducted in households by interviews, in Hong Kong [54][55], Hungary [68], the UK [51][52][53], Germany [58][59], Japan [63], Saudi Arabia [65], and South Africa [67].…”

“…Regarding consent to participate, 18 of the studies involved child participants exclusively or with adult participants. Nine studies involved only child participants; in these, two required only the child's consent [56,62], one required the child's consent and parental passive consent [64], one required the child's consent and either passive or active parental consent [46], and five required parental active consent and the child's consent [54][55]57,61,[66][67].…”