Child maltreatment among school children in the Kurdistan Province, Iran
Introduction
Despite increased attention to child maltreatment as a cause of childhood injury, little is understood about the factors associated with child maltreatment in developing country settings. Although child maltreatment is often described as an important public health problem (MacMillan, 1998), research into its causes and prevention in developing country settings has been lacking. The fact that little data are available on the extent of this serious problem is a matter of concern; such data are essential to the development of public health interventions and policy for developing countries. The burden of suffering associated with child maltreatment should precipitate a drive towards a greater understanding of its determinants as a public health priority for developing countries (MacMillan, 1998).
This study examines the prevalence of and factors associated with three different types of child maltreatment: mental maltreatment, physical maltreatment and neglect, among school children between 11 and 18 years old (individuals older than 14 are repeating academic years) in the Kurdistan Province of Iran. The aim of this study is to understand the differing factors associated with three types of child maltreatment in order to facilitate the development of more targeted interventions. The study will also improve knowledge about the severity of child maltreatment problems at both home and school and provide useful measures for classifying at risk populations.
Section snippets
Background: the determinants of child maltreatment
Previous studies of child maltreatment show that it is commonly associated with familial, demographic, socioeconomic, and familial factors. A number of familial characteristics have been found to be associated with child maltreatment (Cox, Kotch, & Everson 2003). These include both the quality and quantity of the family structure. Family structure refers to the presence of the father's or mother's partner and the family size (Coohey & Braun, 1997). The increases in physical and psychological
Methods
Data were collected from school students (11–18 years old) from both urban and rural areas of the Kurdistan Province of Iran. Middle school includes ages 11–14, so children 15–18 are those who are repeating school years. Children completed a semistructured questionnaire and were asked to report their experience of physical and mental maltreatment in both the home and at school. Data were collected in 2003 via a school-based questionnaire conducted in eight cities (Sanandaj, Saghez, Baneh,
Definition of child maltreatment
Previous studies have distinguished psychological maltreatment from emotional maltreatment based on the degree of damage the maltreatment is thought to inflict (O’Hagan, 1993, O’Hagan, 1995; Moran, Bifulco, Ball, Jacobs, & Benaim, 2002). However, it is clear from the literature that many use the term interchangeably. In the present article, the two labels are not distinguished, but the term mental maltreatment preferred; the term child maltreatment is used to refer to any of the three types of
Data analysis
Six logistic models are fitted: physical maltreatment in the home, physical maltreatment at school, mental maltreatment at home, mental maltreatment at school, neglect at home, and neglect at school. Each of the models uses a binary outcome coded one if the respondent reports ever experiencing this type of maltreatment. Among 1,370 respondents, 130 children had lost one or both of the parents. This high rate of parental loss is attributed to the combination of high maternal mortality and
Results
Table 1 shows the frequency distribution of the variables: the majority of the respondents were 11–14 years old (83.1%), Kurd (90%), male (62.6%), and living in urban areas (61.9%).
Associations with physical maltreatment
Among the sample, 38.5% (477) and 43.3% (537) of the students reported physical maltreatment at home and school, respectively. Table 2 shows the results of the modeling of physical child maltreatment in the home and school, controlling for all independent variables. Relative to urban residents, students of rural areas had significantly greater odds of reporting physical maltreatment, either at home or at school (home OR = 1.60; CI = 1.21, 2.12) and school (OR = 1.37; CI = 1.04, 1.81). Ethnicity was not
Associations with mental maltreatment
Of the respondents, 74.5% reported being mentally maltreated at home while the prevalence of reporting mental maltreatment at school was 59.9%. Table 3 shows the results of modeling of mental child maltreatment. The child's age displayed a significant positive relationship with the odds of reporting being mentally maltreated at school. Relative to children aged 11–14, the age group 15–18 had significantly greater odds of reporting being mentally maltreated (OR = 1.74; CI = 1.20, 2.51), but there
Associations with neglect
Of the respondents, 80.1% and 54.4% reported experiencing some kind of neglect at home and school, respectively. Table 4 shows the results of the modeling of neglect. Both the child's age (15–18 OR = 1.64; CI = .00, 2.67) and place of residence (rural OR = 1.77; CI = 1.20, 2.60) were significantly associated with a student's greater odds of reporting neglect at home. Girls were less likely to report being neglected in the home (OR = .47; CI = .35, .65). Children from families with more than four children
Discussion
The study found that levels of self-reported child maltreatment in the Kurdistan province of Iran are high, ranging from 19.6% for physical maltreatment to 80.2% for neglect at home. The factors determining each of the types of maltreatment examined showed considerable variation. Key risk factors for the reporting of child maltreatment were residence in a rural area, Kurdish ethnicity, being a male child, being 15–18, poor school performance, the use of addictive substances by family members,
Conclusion
The data show a high prevalence of each of the types of child maltreatment in the Kurdistan Province. The most prevalent type of maltreatment was neglect, which, although not physically apparent, has a significant effect on the child's personality development and mental health.
References (40)
- et al.
Toward an integrated framework for understanding child abuse
Child Abuse & Neglect
(1997) - et al.
Psychiatric co-morbidity in caregivers and children involved in maltreatment: A pilot research study with policy implications
Child Abuse & Neglect
(2001) - et al.
Growing up with parental alcohol abuse: Exposure to childhood abuse, neglect, and household dysfunction
Child Abuse & Neglect
(2001) The effect of neglect on academic achievement and disciplinary problems: A developmental perspective
Child Abuse & Neglect
(1996)- et al.
Risk of child abuse or neglect in a cohort of low income children
Child Abuse & Neglect
(1995) Emotional and psychological abuse of children: Problems of definition
Child Abuse & Neglect
(1995)The factors of child abuse in Korean immigrant families
Child Abuse & Neglect
(2001)Risk of physical abuse to children of spouse abusing parents
Child Abuse & Neglect
(1996)- et al.
Child maltreatment in the “children of Nineties:” deprivation, class, and social networks in a UK sample
Child Abuse & Neglect
(2002) - et al.
Identification of child maltreatment with the parent-child conflict tactics scales: Development and psychometric data for a national sample of American parents
Child Abuse & Neglect
(1998)