Child abuse in latin america and the caribbean
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Child Abuse in Latin America and the Caribbean. Angela D. Garner MPH Candidate GWU PAHO Research Assistant Alberto Concha-Eastman PAHO – Washington, DC. Presentation Format. Definitions Risk Factors Studies/Situation PAHO’s Role Summary. General Definition of Child Abuse.

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Child abuse in latin america and the caribbean l.jpg

Child Abuse in Latin America and the Caribbean

Angela D. Garner

MPH Candidate GWU

PAHO Research Assistant

Alberto Concha-Eastman

PAHO – Washington, DC


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Presentation Format

  • Definitions

  • Risk Factors

  • Studies/Situation

  • PAHO’s Role

  • Summary


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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 child’s health , survival, development or dignity in the context of a relationship of responsibility, trust or power.(WHO, 1999)


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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


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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.


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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.


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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.


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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.


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Situation (cont.)

  • Sexual abuse common in the Caribbean.

  • Corporal punishment high in Latin America.

  • Neglect occurs in families with many children.


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Health Consequences of Child Abuse

  • Physical

  • Sexual

  • Emotional

  • Long-term

  • Fatal


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Health Consequences of Child Abuse

  • Physical

    -Bruises, welts

    -Ocular damage

    -Fractures

    - Injuries in central nervous system

    -Poisoning


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Health Consequences of Child Abuse

  • Sexual Abuse

    -Unwanted pregnancy

    -Sexually-transmitted Infections

    -HIV/AIDS

    -Adverse outcomes for reproductive health


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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


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Health Consequences of Child Abuse

  • Long-Term

    • Developmental effects

    • Disability

    • Alcohol/drug abuse

    • Reproductive health outcomes

    • At risk of being abusive

    • Violent behavior


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Consequences of Child Abuse

  • Fatal

    • Homicide

    • Suicide

    • Infanticide

    • HIV/AIDS


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Risk Factors for Abuse

  • History of child abuse

  • Substance abuse

  • Witnessing abuse

  • Education level

  • Low socio-economic Level

  • Lack of social support



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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.


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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


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Corporal Punishment

  • Survey in Mexico found

    • Corporal punishment is viewed as a necessary,

      positive practice to produce good citizens.

    • Father’s education had no direct effect.

    • Mother’s education level effected parenting.

    • Mother’s occupation did not effect parenting.

    • Abuse higher in families of suspected abuse:

      Internal consistency high(Frías-Armenta et al.)


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Corporal Punishment

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


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“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.)


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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.)


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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.)


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Reasons for Involvement in Gangs

50%

40 %

30 %

20 %

10 %

Hanging around

Family Problems

Peer Presssure

Weak Parental Relationship

Protection


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ACTIVA Study

  • Describes the prevalence of aggressive behavior towards their children.

  • Describes the prevalence of corporal punishment.

  • Describes the association between parent’s victimization and aggressive behavior.


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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.


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ACTIVA Study (cont.)

  • Hitting with an object

    • 3% in Santiago, Chile.

    • 3% in Madrid, Spain.

    • 20% in Cali, Colombia.


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ACTIVA Study (cont.)

  • Parents as children

    • 77% reported being spanked as a child at least occasionally.

    • 13% reported being spanked almost every day.


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ACTIVA Study (cont.)

  • Parents spanked as children are more likely to

    • hit their children (OR =2.6).

    • hit their children with an object (OR=3.5).

    • slap their partner (OR=2.6).

    • hit their partner with an object (OR=3.6).

    • hit a non-family member (OR=2.8).



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PAHO’s ROLE

  • Development of information systems.

  • Promotion of scientific research.


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PAHO’s 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.


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PAHO’s 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


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Summary

  • Definitions

  • Risk factors

  • Studies/Situation

  • PAHO’s Role


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