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Child Abuse in Latin America and the Caribbean

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Title: Child Abuse in Latin America and the Caribbean


1
Child Abuse in Latin America and the Caribbean
  • Angela D. Garner
  • MPH Candidate GWU
  • PAHO Research Assistant
  • Alberto Concha-Eastman
  • PAHO Washington, DC

2
Presentation Format
  • Definitions
  • Risk Factors
  • Studies/Situation
  • PAHOs Role
  • Summary

3
General Definition of Child Abuse
  • Child Abuse or maltreatment constitutes all forms
    of physical and/or emotional ill-treatment,
    sexual abuse, neglect or negligent treatment or
    commercial or other exploitation, resulting in
    actual or potential harm to the childs health ,
    survival, development or dignity in the context
    of a relationship of responsibility, trust or
    power. (WHO, 1999)

4
Components of the Definition
  • Physical Abuse
  • Results in actual or potential physical harm from
    an interaction or lack of an interaction by the
    parent or caregiver.
  • May be a single or repeated incident

5
Components of the Definition (cont.)
  • Emotional Abuse
  • Belittling
  • Threatening
  • Ridiculing
  • Non-physical
  • These cause the child not to develop emotional
    stability focusing on mental, spiritual, moral
    and social development.

6
Components of the Definition (cont.)
  • Neglect and negligent treatment
  • Failure to provide basic necessities for the
    child which could result in harm to the child.
  • Failure to properly supervise and protect a child
    from harm as much as possible, which could lead
    to harm.

7
Sexual Abuse
  • Involvement of a child in sexual activity that he
    or she does not understand.
  • Unable to give informed consent.
  • Violation of the laws or social taboos.

8
Situation
  • WHO estimates 40 million children 0-14 years
    suffer from abuse.
  • Injuries, unintentional and intentional accounted
    for 16 of the global burden of disease in 1998.
  • US alone one million children were proven
    victims of child abuse or suspected child abuse.

9
Situation (cont.)
  • Sexual abuse common in the Caribbean.
  • Corporal punishment high in Latin America.
  • Neglect occurs in families with many children.

10
Health Consequences of Child Abuse
  • Physical
  • Sexual
  • Emotional
  • Long-term
  • Fatal

11
Health Consequences of Child Abuse
  • Physical
  • -Bruises, welts
  • -Ocular damage
  • -Fractures
  • - Injuries in central nervous
    system
  • -Poisoning

12
Health Consequences of Child Abuse
  • Sexual Abuse
  • -Unwanted pregnancy
  • -Sexually-transmitted Infections
  • -HIV/AIDS
  • -Adverse outcomes for reproductive health

13
Health Consequences of Child Abuse
  • Emotional and behavioral
  • Poor self-esteem
  • Self -inflicted injury
  • Sleeping disorders
  • Eating disorders
  • Depression and anxiety
  • Feelings of shame and guilt

14
Health Consequences of Child Abuse
  • Long-Term
  • Developmental effects
  • Disability
  • Alcohol/drug abuse
  • Reproductive health outcomes
  • At risk of being abusive
  • Violent behavior

15
Consequences of Child Abuse
  • Fatal
  • Homicide
  • Suicide
  • Infanticide
  • HIV/AIDS

16
Risk Factors for Abuse
  • History of child abuse
  • Substance abuse
  • Witnessing abuse
  • Education level
  • Low socio-economic Level
  • Lack of social support

17
(No Transcript)
18
Source PAHO, HPP Maras Study 2001
19
Sexual Abuse Studies
  • Barbados 30 of female participants were
    sexually abused.
  • Costa Rica 32 of female participants were and
    13 of male participants sexually abused,
  • Nicaragua 26 of female participants and 20 of
    male participants were sexually abused.

20
Sexual Abuse Studies
  • Leads to high-risk Behavior
  • Sexual activity starts an early age.
  • Increase in STIs.
  • Increase in unwanted pregnancies.
  • Repeated sexual encounters.
  • Mental health problems
  • Gang activity

21
Corporal Punishment
  • Survey in Mexico found
  • Corporal punishment is viewed as a necessary,
  • positive practice to produce good citizens.
  • Fathers education had no direct effect.
  • Mothers education level effected parenting.
  • Mothers occupation did not effect parenting.
  • Abuse higher in families of suspected abuse
  • Internal consistency high (Frías-Armenta et al.)

22
Corporal Punishment
  • Survey in Chile among parents whose children
    attend public and private schools (Vargas et
    al.).

23
Candies in Hell
  • Cross-sectional study in Leon, Nicaragua.
  • Nearly half the women reported their children
    witnessed their abuse.
  • Children of abused women more than
  • twice as likely to suffer from learning,
    emotional and behavioral problems.
  • seven times as likely to be abused (Ellsberg, E.)

24
Nicaragua Study
  • Children of women who witness physical or sexual
    abuse are six times more likely to die by the age
    of five.
  • (Asling-Monemi et al., Jejeebhoy et al.)

25
Results
  • 938 surveys validated 80 boys (homeboys)
    20 girls (hainas).
  • Age Mean 20.2 y- Range 7- 25y
  • Age for becoming a gang member
  • 7-10 ----- 2
  • 11-15 ---- 52
  • 16-25 ---- 46
  • (Santacruz-Giralt et al.)

26
Reasons for Involvement in Gangs
50
40
30
20
10
Hanging around
Family Problems
Peer Presssure
Weak Parental Relationship
Protection
27
ACTIVA Study
  • Describes the prevalence of aggressive behavior
    towards their children.
  • Describes the prevalence of corporal punishment.
  • Describes the association between parents
    victimization and aggressive behavior.

28
ACTIVA Study (cont.)
  • 29 of the parents reported spanking their
    children.
  • 11 hit them with an object during the 12 months
    prior to the survey.
  • Spanking
  • 20 in San José, Costa Rica.
  • 36 in Cali, Colombia.

29
ACTIVA Study (cont.)
  • Hitting with an object
  • 3 in Santiago, Chile.
  • 3 in Madrid, Spain.
  • 20 in Cali, Colombia.

30
ACTIVA Study (cont.)
  • Parents as children
  • 77 reported being spanked as a child at least
    occasionally.
  • 13 reported being spanked almost every day.

31
ACTIVA Study (cont.)
  • Parents spanked as children are more likely to
  • hit their children (OR 2.6).
  • hit their children with an object (OR3.5).
  • slap their partner (OR2.6).
  • hit their partner with an object (OR3.6).
  • hit a non-family member (OR2.8).

32
ACTIVA Study
33
Risk Factors
Unfavorable living conditions
Family characteristics
Perceived Reasons for Gang Involvement
Cost-benefit being in gangs
Hanging out leads to social recognition
Access to drugs
Involvement in Gangs
Socialization learned in the street
Increase in drug use
Fulfilling Violent obligations to remain in the
gang
Santacruz-Giralt et al.
34
PAHOs ROLE
  • Development of information systems.
  • Promotion of scientific research.

35
PAHOs Role (cont.)
  • Joint agreement with IMCI (Integrated Management
    of Childhood Illness).
  • Goal Create networks for the prevention of
    violence against children.
  • Modify the culture of corporal punishment as a
    method of disciplining children.

36
PAHOs Role (cont.)
  • Train health professionals and educators in the
    detection and care of children at risk or victims
    of violence
  • Promote schools of non-violence

37
Summary
  • Definitions
  • Risk factors
  • Studies/Situation
  • PAHOs Role
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