Social disorganization and history of child sexual abuse against girls in sub-Saharan Africa: a multilevel analysis
1 Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden
2 London School of Hygiene and Tropical Medicine, London, UK
3 Birmingham Heart of England NHS Foundation Trust, Birmingham, UK
4 Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry CV4 7AL, United Kingdom
5 Liverpool School of Tropical Medicine, International Health Group, Liverpool, Merseyside, UK
6 Division of Social Medicine, Department of Public Health Foundation Sciences, Karolinska Institute, Stockholm, Sweden
7 Department of Occupational and Public Health Sciences, University of Gavle, Gavle, Sweden
BMC International Health and Human Rights 2013, 13:33 doi:10.1186/1472-698X-13-33Published: 7 August 2013
Child sexual abuse (CSA) is a considerable public health problem. Less focus has been paid to the role of community level factors associated with CSA. The aim of this study was to examine the association between neighbourhood-level measures of social disorganization and CSA.
We applied multiple multilevel logistic regression analysis on Demographic and Health Survey data for 6,351 adolescents from six countries in sub-Saharan Africa between 2006 and 2008.
The percentage of adolescents that had experienced CSA ranged from 1.04% to 5.84%. There was a significant variation in the odds of reporting CSA across the communities, suggesting 18% of the variation in CSA could be attributed to community level factors. Respondents currently employed were more likely to have reported CSA than those who were unemployed (odds ratio [OR] = 2.05, 95% confidence interval [CI] 1.48 to 2.83). Respondents from communities with a high family disruption rate were 57% more likely to have reported CSA (OR=1.57, 95% CI 1.14 to 2.16).
We found that exposure to CSA was associated with high community level of family disruption, thus suggesting that neighbourhoods may indeed have significant important effects on exposure to CSA. Further studies are needed to explore pathways that connect the individual and neighbourhood levels, that is, means through which deleterious neighbourhood effects are transmitted to individuals.