Sexual abuse of children in shelter homes and observation homes in south asia
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Child sexual abuse in India: A systematic review
Vikas Choudhry, Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Validation, Writing – original draft, Writing – review & editing,1,2,* Radhika Dayal, Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Supervision, Writing – review & editing,1 Divya Pillai, Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Writing – review & editing,1 Ameeta S. Kalokhe, Conceptualization, Data curation, Formal analysis, Methodology, Writing – review & editing,3,4 Klaus Beier, Funding acquisition, Methodology, Writing – review & editing,5 and Vikram Patel, Conceptualization, Funding acquisition, Methodology, Resources, Supervision, Visualization, Writing – review & editing1,6
Alexander C. Tsai, Editor
Child Sexual Abuse (CSA) is a pressing human right issue and public health concern. We conducted a systematic review of quantitative and qualitative studies published in the past decade on CSA in India to examine the distribution of the prevalence estimates for both genders, to improve understanding of the determinants and consequences of CSA and identify gaps in the current state of research.
Introduction
The World Health Organization (WHO) defines Child Sexual Abuse (CSA) as “the involvement of a child 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…”[1]. CSA includes an array of sexual activities like fondling, inviting a child to touch or be touched sexually, intercourse, exhibitionism, involving a child in prostitution or pornography, or online child luring by cyber-predators [2, 3].
CSA is a serious problem of considerable magnitude throughout the world. A recent systematic review of 55 studies from 24 countries found much heterogeneity in studies in terms of definition and measurement of CSA and concluded that rates of CSA ranged from 8 to 31% for females and from 3 to 17% for males [4]. Despite similar methodological challenges, other systematic reviews which included studies conducted worldwide across hundreds of different age-cohort samples have observed alarming rates of CSA, with averages of 18–20% for females and of 8–10% for males, with the lowest rates for both girls (11.3%) and boys (4.1%) found in Asia, and highest rates found for girls in Australia (21.5%) and for boys in Africa (19.3%) [5, 6].
Children, under the age of 18, contribute to 37% of India's population [14] with large proportions experiencing great deprivations such as lack of access to basic education, nutrition or health care [15]. In addition, they are susceptible to different forms of adverse childhood experiences (ACEs) including various forms of abuse, neglect, and maltreatment with child protection remaining largely unaddressed [16–18]. A large-scale national study conducted in 2007 by Ministry of Women and Child Development (MoWCD), to assess the extent and nature of child abuse in India, uncovered some alarming statistics; that among the 12,447 children interviewed, more than half (53 percent) reported experience of sexual abuse, defined as “sexual assault, making the child fondle private parts, making the child exhibit private body parts and being photographed in the nude” and over 20 percent reported severe sexual abuse [19]. While these statistics need to be interpreted with caution as it was conducted in a convenience rather than nationally representative sample, the numbers speak to the significance of the problem and highlight particularly high-risk groups. Smaller studies from India have also reported very high prevalence of CSA [17, 20, 21].
Increased attention in the public discourse and activism around child protection led to the Government of India passing the, ‘The Protection of Children from Sexual Offences (POCSO)’ law in 2012. This act criminalizes a range of acts including rape, harassment, and exploitation for pornography involving a child below 18 years of age and mandates the setting up of Special Courts to expedite trials of these offences. However, the issue of CSA remains a taboo in India. As around the world, the research findings in India support significant underreporting of CSA to authorities versus reporting in protected research settings [17, 22]. Only 3% of CSA offences uncovered by national level study in 2007 were reported to the authorities. Renuka Chowdhury, the then minister of women and child development, in her introduction to this national survey report of MoWCD referred CSA as “…shrouded in secrecy with a conspiracy of silence around the entire subject” [19].