Magnitude of child sexual abuse and its associated factors among high school female students in Dire Dawa, Eastern Ethiopia: a cross-sectional study

Abstract

Background Child sexual abuse (CSA) refers to the involvement of a child (< 18 years) in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society. It is a serious public health problem affecting millions of people each year worldwide but the most neglected and least documented form of violence in Ethiopia among school girls. Therefore, this study aimed to assess the magnitude of child sexual abuse and its associated factors among female high school students in the Dire Dawa administration, Eastern Ethiopia. Methods An institutional-based cross-sectional study was conducted among female high school students in Dire Dawa administration between March 1 and 23/2021. We employed stratified and multistage sampling techniques to include 794 participants from selected high schools. A pretested self-administered questionnaire was used, and the data were analyzed using the SPSS software version 24. Results The proportion of students who reported at least one form of sexual abuse was 384 (48.9%) and approximately 19% of the students reported rape from the total respondents. Students who live alone 4.3 times (AOR 4.30; 95% CI 1.81–10.24), those who live with their friends five times (AOR 5.02; 95% CI 2.24–8.04), and those who live with their single parent three times (AOR 3.31; 95% CI 1.23–8.89) more likely to experience sexual abuse than those living with both parents. The odds of experiencing sexual abuse among students of rural residence were 3.2 times higher than their urban counterparts (AOR 3.2; 95% CI 2.02–4.51). Students who didn’t drink alcohol were 70% more protective than those who drank alcohol (AOR 0.70; 95% CI 0.28–0.97). Among rape survivors (64, 37.9%) developed unwanted pregnancies, 26.0% of them underwent an abortion, and (39, 26.0%) developed STI as an outcome of sexual abuse. Conclusion This study demonstrated that the magnitude of child sexual abuse among female students in Dire Dawa was high. Lack of discussion about sexual issues with parents, living without both parents, drinking alcohol, and being a rural residence had a significant association with child sexual abuse. Unwanted pregnancy, abortion, and STIs have been reported as reproductive health outcomes of rape. Therefore, policymakers should introduce and strengthen comprehensive sexual and reproductive health education both in school and out of school, in addition to formal education to reduce the magnitude of the problem. Parents should discuss all sexual and reproductive health issues with their children to reduce the magnitude and consequences of child sexual abuse.

Child sexual abuse and its determinants among children in Addis Ababa Ethiopia: Systematic review and meta-analysis

“…The determinants of child sexual abuse not included in the meta-analysis due to inconsistent categorization or being reported only in one primary study were systematically reviewed. Hence, children over the age of 14, and rural residents were more likely to experience sexual abuse [ 35 , 36 , 38 ]. Additionally, children who had mental illness and physical disability were more likely to be sexually abused [ 36 ].…”

“…Additionally, children who had mental illness and physical disability were more likely to be sexually abused [ 36 ]. Furthermore, children who did not have an open discussion with their parents on sexual and reproductive health, and living with their single parent were also more likely to experience sexual abuse [ 35 , 36 ].…”

Prevalence and Factors Associated with Sexual Violence against Children in a Brazilian State

“…This prevalence was also found in Florianópolis [ 35 ], and in the north of the state of Minas Gerais [ 13 ]. These results can reflect the structural violence that is strongly present in urban areas and the difficulty of access to health services in the rural area, besides cultural issues that hinder the revelation of the violence [ 36 , 37 ].…”

Burden of Gender Based Violence in Ethiopia in case of High School Female Students: Systematic review and Meta-analysis

“…All of the studies included in this review and meta-analysis were conducted in Ethiopia's four administrative regions and used a cross-sectional design. There were seven studies in the Southern Nations, Nationalities, and Peoples' Region (SNNPR) [20][21][22][23][24][25][26], four in Amhara [27][28][29][30], three in Oromia [31][32][33], and one in Dire Dawa [34]. The sample size for the primary study ranged from 140 at Debre Markos town in Amhara [27] to 1,199 at eastern Ethiopia in Oromia [31].…”