Tag Archives: Child abuse

Abuse of children in a family, institutional, or other setting. (APA, Thesaurus of Psychological Index Terms, 1994)

Female genital mutilation in children presenting to a London safeguarding clinic: a case series

Arch Dis Child. 2015 Jul 27. pii: archdischild-2015-308243. doi: 10.1136/archdischild-2015-308243. [Epub ahead of print]

Female genital mutilation in children presenting to a London safeguarding clinic: a case series.

Hodes D, Armitage A, Robinson K, Creighton SM


OBJECTIVE: To describe the presentation and management of children referred with suspected female genital mutilation (FGM) to a UK safeguarding clinic.

DESIGN AND SETTING: Case series of all children under 18 years of age referred with suspected FGM between June 2006 and May 2014.

MAIN OUTCOME MEASURES: These include indication for referral, demographic data, circumstances of FGM, medical symptoms, type of FGM, investigations and short-term outcome.

RESULTS: Of the 47 girls referred, 27 (57%) had confirmed FGM. According to the WHO classification of genital findings, FGM type 1 was found in 2 girls, type 2 in 8 girls and type 4 in 11 girls. No type 3 FGM was seen. The circumstances of FGM were known in 17 cases, of which 12 (71%) were performed by a health professional or in a medical setting (medicalisation). Ten cases were potentially illegal, yet despite police involvement there have been no prosecutions.

CONCLUSIONS: This study is an important snapshot of FGM within the UK paediatric population. The most frequent genital finding was type 4 FGM with no tissue damage or minimal scarring. FGM was performed at a young age, with 15% reported under the age of 1 year. The study also demonstrated significant medicalisation of FGM, which matches recent trends in international data. Type 4 FGM performed in infancy is easily missed on examination and so vigilance in assessing children with suspected FGM is essential.

This article can be accessed in this LINK

Awareness and predictors of female genital mutilation/cutting among young health advocates

FREEInt J Womens Health. 2015 Feb 20;7:259-69. doi: 10.2147/IJWH.S78664. eCollection 2015.

Awareness and predictors of female genital mutilation/cutting among young health advocates

Abolfotouh SM, Ebrahim AZ, Abolfotouh MA


The act of female genital mutilation/cutting (FGM/C) is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students’ Associations (IFMSA)-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25%) than in non-rural areas (10.8%, P=0.001), and in those residing in Upper (southern) Egypt (20.6%) than in Lower (northern) Egypt (8.7%, P=0.003). The students’ mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8%) were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (P<0.001 in all cases) associated with male sex, residency in Upper Egypt, rural origin, previous circumcision, and the preclinical medical phase of education. The low level of knowledge among even future health professions in our study suggests that communication, rather than passive learning, is needed to convey the potentially negative consequences of FGM/C and to drive a change in attitude toward discontinuation of this harmful practice.

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Gender-Based Domestic Violence against Children: Experiences of Girl-Children in Nigeria

Journal of Psychology in Africa, 2009, 19(1), 107-111

Gender-Based Domestic Violence against Children: Experiences of Girl-Children in Nigeria

Esere MO, Idowu AI, Omotosho JA


This study investigated the dynamics of gender-based domestic violence against children in Nigeria. This qualitative study explored the experiences of 20 purposively selected girl-children (age range = 12 to 15 years) from two SOS Children’s Village who have been victims of Domestic Violence (DV). Qualitative data on DV experiences and associated factors were collected through 6 Focus Group Discussions (FGDs). Physical violence was reported by 90% of the participants; psychological abuse by 80% and violent sexual abuse (rape) by 10%. Major factors associated with last episode of DV experiences included: inability to finish selling wares that were being hawked, late preparation of food, getting home late from the market, burning of the employer’s cloth while ironing, refusal to be genitally cut and refusal to be raped by the man of the house. Self-reported consequences of DV by victims included amongst others: constant headaches (30%) physical injury (25%), sleep disturbances (20%), excessive fear and anxiety (10%), hatred for men (10%) and suicidal ideation (5%). These findings suggest that DV may be playing significant but salient role in the poor state of health of Nigerian children and effective intervention processes at all levels are needed to address it.

This article can be accessed in this LINK

Genital lesions complicating female genital cutting in infancy: a hospital-based study in south-east Nigeria.

Ann Trop Paediatr. 2007 Dec;27(4):285-90.

Genital lesions complicating female genital cutting in infancy: a hospital-based study in south-east Nigeria.

Ekenze SO, Ezegwui HU, Adiri CO.

Paediatric Surgical Unit, Department of Surgery, Federal Medical Centre, Owerri, Nigeria. soekenze@yahoo.com


BACKGROUND: Despite the global outcry against female genital cutting (FGC), the practice continues in many African communities. The morbidity of this practice on the girl child deserves more attention.

OBJECTIVE: To determine the genital lesions complicating childhood FGC and the underlying factors that sustain this practice among the Igbos in south-east Nigeria.

METHODS: Prospective evaluation of girls with genital complications of FGC between January 2003 and June 2005 at the Federal Medical Centre, Owerri, south-east Nigeria. The girls’ mothers were interviewed at presentation and subsequent visits to determine their perception and attitudes towards FGC.

RESULTS: The average age at presentation was 3.5 years (range 1-5) and the genital cutting procedures were performed 8-90 days after birth. The procedure was undertaken by traditional practitioners in 14 (66.7%) girls and by nurses in 7 (33.3%) girls. Twelve girls (57.1%) had type I genital cutting and nine (42.9%) type II. Inclusion clitoral dermoid cyst and labial fusion were the complications in 13 (61.9%) and eight (38.1%), respectively. Treatment involved complete excision of the cysts and operative division of the labial fusion. Post-operative complications were wound infection (5) and labial adhesion (2). With duration of admission ranging from 3 to 5 days, the average cost of managing each child was $120. Of the girls’ mothers, 15 (71.4%) had been educated to secondary level and 17 (80.1%) were aware of the campaign against FGC. Regrettably, all the mothers had genital cutting themselves during childhood and 13 (61.9%) stated that they would like to perpetuate the practice for socio-cultural reasons. Despite this, they all volunteered that FGC is enforced by the child’s paternal relations.

CONCLUSION: Childhood FGC contributes to appreciable morbidity among girls, a large proportion of whom are not managed in a hospital setting. The cost of managing these complications can be enormous, especially in low-resource settings. Girl child education to tertiary level and the involvement of traditional rulers and local decision-makers in the campaign against FGC might help to eradicate the practice.

This article can be accessed in this LINK.

Cultural issues in child maltreatment

J Paediatr Child Health. Jan 2012 48(1): 30–37

Cultural issues in child maltreatment

Raman S, Hodes D


Aims:  Waves of immigration from the latter half of the 20th century have changed the cultural and ethnic mix of major regions of the world. Dynamic multicultural societies now are a reality across the Western world. The relationship and influence of these diverse cultures to the understanding and identification of child abuse and neglect is challenging and complex. Health professionals working with children from culturally and linguistically diverse groups often find themselves with the challenge of exploring and resolving the tension between definitions of harm in child protection practice and various cultural and child-rearing practices. In this paper, we set out ways of thinking about the influence of culture when approaching and dealing with the suspicion of child maltreatment.

Methods:  We will explore how culture shapes the experiences of childhood, child-rearing practices, and identify common barriers in working with children and families from culturally diverse backgrounds when presenting with child maltreatment. We will use case examples from Europe and Australia to illustrate the real life challenges of working in the area of child maltreatment across cultures. We will review the scientific literature exploring the nexus between culture and child maltreatment, identifying the gaps in the literature and highlight areas for future research.

Results:  We suggest a model for dealing with cultural issues in child maltreatment that is culturally competent and respectful.

Conclusions:  The model for cultural competency in child health and child protective services incorporates four domains for advocacy and action – individual, professional, organisational and systemic.

This article can be purchased in this LINK

Social context of HIV infection in Uganda.

Health Transit Rev. 1995;5 Suppl:1-26.LME

Social context of HIV infection in Uganda.

Adeokun LA, Twa-Twa J, Ssekiboobo A, Nalwadda R.

Institute of Statistics and Applied Economics, Makerere University, Kampala, Uganda.


Some of the important policy and research implications of accumulating HIV/AIDS data are being ignored because of the attraction of social science research focused on the “multiple sexual mechanism’ of infection and transmission. Attention is drawn to the other policy and research issues relating to information on the timing of infection through a reanalysis of existing data on cumulative AIDS cases. The most urgent need is to supplement the mainstream research on risk groups with studies of the timing and circumstances of entry into sexual activity in the pre-teen years.


Some of the important policy and research implications of HIV/AIDS data are being ignored because of the focus of social science research upon the multiple sexual mechanism of infection and transmission. Attention is drawn to the other policy and research issues relating to information on the timing of infection through a re-analysis of existing data on cumulative AIDS cases. However, the most urgent need is to supplement the mainstream research on risk groups with studies of the timing and circumstances of entry into sexual activity during the pre-teen years. The authors comment upon the social science response to the epidemic. This paper was written to help broaden the scope of discussion of the socioeconomic context of the rapid reproduction of infections and to focus upon the role of pre-teen girl-child sexuality in the dynamics of the epidemic.

There is no link to view this article online.

Virginity testing in South Africa: re-traditioning the postcolony.

Cult Health Sex. 2006 Jan-Feb;8(1):17-30.

Virginity testing in South Africa: re-traditioning the postcolony.

Vincent L.

Department of Political and International Studies, Rhodes University, South Africa. L.Vincent@ru.ac.za


Umhlanga is a ceremony celebrating virginity. In South Africa, it is practiced, among others, by the Zulu ethnic group who live mainly in the province of KwaZulu Natal. After falling into relative disuse in the Zulu community, the practice of virginity testing made a comeback some 10 years ago at around the time of the country’s first democratic election and coinciding with the period when the HIV pandemic began to take hold. In July 2005 the South African Parliament passed a new Children’s Bill which will prohibit virginity testing of children. The Bill has been met with outrage and public protest on the part of Zulu citizens. Traditional circumcision rites are also addressed in the new bill but are not banned. Instead, male children are given the right to refuse to participate in traditional initiation ceremonies which include circumcision. This paper asks why the practice of virginity testing is regarded as so troubling to the new democratic order that the state has chosen to take the heavy-handed route of banning it. The paper further asks why the state’s approach to traditional male circumcision has been so different to its approach to virginity testing. Finally, the paper asks what these two challenging cases in the country’s new democracy tell us about the nature of liberal democratic citizenship in South Africa 10 years after apartheid’s formal demise.

This article can be purchased in this LINK

Genital trauma in prepubertal girls and adolescents.

Curr Opin Obstet Gynecol. 2011 Oct;23(5):307-14. doi: 10.1097/GCO.0b013e32834ab544.

Genital trauma in prepubertal girls and adolescents.

Merritt DF.

Department of Obstetrics and Gynecology, Pediatric and Adolescent Gynecology, Washington University School of Medicine, Barnes Jewish Hospital, St Louis Children’s Hospital and Missouri Baptist Medical Center, St Louis, Missouri 63110, USA. merrittd@wustl.edu

PURPOSE OF REVIEW: To look critically at recent research articles that pertain to children and adolescents who present with genital injuries. RECENT FINDINGS: Emerging evidence supports links to long-term psychological sequelae of child sexual abuse. Parents should be educated to instruct their children regarding types of child abuse and prevention. ‘Medicalization’ of female genital mutilation (FGM) by health providers, including ‘cutting or pricking’, is condemned by international organizations. SUMMARY: Genital injuries whether accidental or intentional need to be reported with standardized terminology to allow for comparisons between reported outcomes. Motor vehicle accidents associated with pelvic fractures may result in bladder or urethral trauma. Adverse long-term psychosocial behaviors may be sequelae of child sexual abuse. FGM is willful damage to healthy organs for nontherapeutic reasons, and a form of violence against girls and women. Healthcare providers should counsel women suffering from the consequences of FGM, advise them to seek care, counsel them to resist reinfibulation, and prevent this procedure from being performed on their daughters.

This article can be purchased in this LINK