Violence
against
children
has
long
been
recognized
as a
social
problem
throughout
the
world,
and
Yemen
is no
exception.
Every
year
millions
of children
around
the
world
are
victims
and
witnesses
of abuse.
(1)
Published
studies
have
indicated
that
violence
against
children
is a
major
concern
for
public
health
around
the
world.
(2,3,4)
Various
international
studies
have
found
that
25-50%
of all
children
have
suffered
severe
and
frequent
violence,
although
rates
may
vary
by country.
(5,1)
Every
year,
40 million
children
aged
15 and
below
worldwide
are
neglected
or abused.
(6)
The
World
Health
Organization
estimated
that
about
1,300
children
die
annually
throughout
Europe
and
Central
Asia
after
being
abused
by their
caregivers.
(7)
Globally,
about
20%
of women
and
5-10%
of men
report
being
sexually
abused
in childhood,
while
23%
of the
people
reported
being
physically
abused
as children.
(8)
According
to the
World
Health
Organization
(WHO)
definition
“Child
maltreatment
is defined
as 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 the
relationship
of responsibility,
trust
or power”.
(6)
Child
abuse
is a
complex
process
that
results
from
the
interaction
of certain
risk
and
protection
factors
at four
main
levels:
individual,
family,
societal
and
community
level.
(9)
These
risk
factors
are
not
present
in all
social
and
cultural
contexts
but
provide
an overview
when
attempting
to understand
the
causes
of child
abuse,
such
as age
and
gender
(10,11)
Other
risk
factors
for
child
abuse
by parents
or caregivers
have
also
been
mentioned
in many
studies
such
as low
education,
age
of young
parents,
unemployment,
family
environment,
and
mental
disorders
of parents
such
as depression,
anxiety
and
drug
abuse.
(12,13)
The
impact
of social
and
demographic
risk
factors
on abuse
varies
according
to the
type
of abuse.
This
lack
of uniformity
in the
effects
of social
and
demographic
risk
factors
indicates
that
each
type
of abuse
has
somewhat
distinct
causes.
(14)
However,
Kellogg
et al.
Mentioned
that
child
abuse
is the
result
of a
set
of interrelated
familial,
social,
psychological
and
economic
variables.
(15)
Child
abuse
involves
serious
physical
and
psychological
consequences
that
negatively
affect
a
child’s
health
and
well-being
in
general.
(16)
The
child
is
definitely
affected
by
abuse
regardless
of
form
or
severity.
It
weakens
the
child’s
physical
and
mental
health
and
affects
his
or
her
risk
behavior,
resulting
in
different
negative
consequences.
The
life-long
consequences
of
child
abuse
were
found
to
impair
the
health
of
the
present
and
future
of
children
and
their
well-being
in
each
country
and
the
cultural
context
in
which
it
was
investigated.
(17)
There
is
a
paucity
of
studies
on
child
abuse
in
the
Arab
world,
which
have
very
different
family
structures
from
Western
countries
that
prevail
in
literature.
(18)
Arab
countries
are
generally
theocratic
states,
with
families
that
are
polygamous,
sexually
segregated,
and
extended.
Children
in
the
Arabian
Peninsula
are
exposed
to
all
forms
of
child
abuse
and
neglect.
However,
the
problem
is
ignored
or
even
tolerated
and
accepted.
Therefore,
abused
children
continue
to
suffer
and
most
aggressors
go
free,
without
punishment
and
without
treatment.
(19)
In
Yemen,
the
living
conditions
for
children
are
dreadful;
between
violence,
poverty,
and
health
problems,
dangers
of
death
are
their
everyday
life.
Children
can
be
a
victim
of
child
abuse
in
their
families
or
their
school
or
in
the
general
environment.
These
types
of
abuse
can
have
serious
consequences
for
their
mental
and
physical
health.
(20)
Child
abuse
is
a
violation
of
the
fundamental
human
rights
of
the
child
and
is
the
result
of
a
combination
of
family,
social,
psychological
and
economic
factors.
Although
the
problem
of
child
abuse
and
human
rights
violations
is
one
of
the
most
important
issues
on
the
international
human
rights
agenda,
in
Yemen,
until
recently,
the
government
did
not
intervene
and
child
rights
and
protection
are
now
being
given
importance.
(20)
Moreover,
there
are
certain
types
of
traditional
practices
that
are
accepted
throughout
the
country,
whether
knowingly
or
unknowingly
are
to
the
extent
of
child
abuse.
The
current
socio-economic
and
political
conditions
make
some
children
vulnerable
and
more
at
risk
of
abuse,
exploitation
and
neglect.
(20)
In
Yemen
documented
studies
on
child
abuse
are
very
rare.
According
to
our
knowledge,
relatively
few
studies
have
addressed
the
problem
of
child
abuse
in
Yemen,
but
none
of
these
studies
have
studied
all
forms
of
abuse,
particularly
sexual
abuse
and
related
factors
and
their
consequences,
which
so
far
might
lead
to
underestimation
of
the
size
of
the
problem
(21-24).
This
study
is
the
first
attempt
to
determine
the
prevalence
of
various
forms
of
child
abuse
physical,
emotional
and
sexual
abuse,
as
well
as
identifying
it
is
risk
factors
and
outcomes
among
Hadhramout
University
students
in
Al-
Mukalla
city
Hadhramout
Governorate,
Yemen.
This
was
a
cross-sectional
study
conducted
at
Hadhramout
University
in
Al-Mukalla
city,
the
capital
of
the
Hadhramout
Governorate,
Yemen.
The
target
population
consisted
of
all
Hadhramout
University
students
who
were
available
during
the
academic
year
2015-2016
of
males
and
females,
aged
between
18-24
years
old
and
Yemeni
nationality
who
were
invited
to
participate
in
the
study.
A
sample
size
of
384
students
was
determined
by
using
recommended
statistical
methods.
(25)
It
was
increased
to
400
students
for
an
expected
non-response
and
to
avoid
any
missing
among
participants
during
the
data
collection.
A
multi-stage
random
sampling
was
performed.
In
the
first
stage,
five
colleges
were
randomly
selected
which
were
College
of
Medicine
and
Health
Sciences,
Sciences,
Engineering
and
Petroleum,
Arts
and
Girls.
In
the
second
stage,
two
departments
from
each
college
also
were
randomly
selected.
In
the
third
stage,
the
sample
size
(400)
was
proportionally
distributed
according
to the
proportion
of students
in the
selected
departments
for
each
college.
Simple
random
sampling
was
applied
to select
students
from
each
department
in selected
colleges.
The
data
were
collected
by
self-reported
questionnaire,
which
consist¬ed
of
two
parts.
The
first
part
was
a
sociodemographic
questionnaire
developed
by
the
researcher
includ¬ing
information
about
students’
personal
data
(gender,
age),
education
and
employment
status
of
parents,
family
income
and
questions
about
family
structure
(living
with
parents,
or
with
others),
number
of
people
living
in
the
same
room
(Crowding
Index).
The
family
living
environment,
alcohol
abuse
or
drug
addiction
among
parents
was
also
included.
Parents
at
home
who
argue
with
each
other,
hit
or
hurt
each
other,
the
presence
of
psychiatric
problems
among
one
or
both
parents
were
also
inquired
about.
In
the
second
part
a
stan¬dard
Child
Abuse
Screening
Tool
(ICAST)
self-reported
Arabic
version
questionnaire
was
used
(32).
The
questionnaire
is
a
multi-country
collaborative
questionnaire
developed
by
the
International
Society
for
the
Prevention
of
Child
Abuse
and
Neglect
(ISPCAN)
with
the
assistance
of
UNICEF
and
the
Oak
Foundation.
It
has
been
reviewed
by
more
than
100
professionals
from
different
countries,
translated
into
many
languages
including
Arabic,
and
tested
for
validation
and
reliability.
It
is
structured
to
report
all
forms
of
violence
against
children,
more
accurately
and
more
representative
of
the
true
scope
of
the
problem.
This
form
retrospectively
inquires
of
the
the
young
adult
about
exposure
to
any
type
of
child
abuse
before
the
age
of
18
years.
The
questionnaire
inquired
about
exposure
of
students
to
physical,
emotional
and
sexual
abuse.
(32)
Emotional
abuse
was
investigated
by
asking
each
student
about
any
history
of
being
insulted
or
criticized,
hearing
that
he/
she
was
not
loved
by
anyone,
or
was
refused
(one
wished
that
he
was
not
born
or
was
dead),
or
were
threatened.
In
terms
of
physical
abuse,
each
student
was
asked
about
any
history
of
being
beaten,
punched,
or
beaten
with
something
that
left
marks
such
as
a
stick,
whip,
belt
etc.,
kicked,
severely
shaken,
burned,
slapped
and
stabbed.
In
addition,
students
were
asked
about
exposure
to
anyone
placing
chili
in
any
part
of
their
body
to
cause
pain.
With
regard
to
sexual
abuse,
students
were
asked
about
the
occurrence
of
inappropriate
sexual
behavior
by
the
abuser
during
childhood,
such
as
being
spoken
to
in
a
sexual
way
by
an
abuser,
fondled
(their
private
parts)
by
an
offender,
forced
to
watch
/or
fondle
an
offender’s
private
parts,
forced
to
show
themself
naked,
forced
to
look
at
pornography
or
forced
into
Contact
Sexual
Assault.
The
type
of
questions
was
yes
/
no.
Students
who
answered
with
“Yes”
to
any
of
the
above
questions
(about
physical,
emotional,
and
sexual
abuse)
were
asked
to
report
the
types
of
abuse
they
had
experienced
and
the
relationship
of
the
offender
to
the
students
(to
detail
who
did
it).
In
addition,
the
abused
students
were
asked
about
the
impact
(outcome)
of
abuse
on
their
life
as
to
whether
they
have
had
poor
educational
performance,
anxiety
and
nightmares,
depressive
symptoms,
pain
of
unknown
origin,
fear
of
other
sex,
violent
behavior
acquired,
thinking
or
attempted
suicide
or
wishing
revenge.
A
pilot
study
was
conducted
among
20
students
from
two
colleges
not
included
in
the
main
study,
to
ensure
that
the
questionnaire
items
were
clear,
understandable
and
culturally
acceptable.
Data
collected
were
checked
for
accuracy
and
completeness
and
were
coded
and
entered
into
the
Statistical
Package
for
Social
Sciences
(SPSS)
software
version
20.
Firstly
descriptive
statistics
was
used
to
present
the
frequencies
and
percentages
for
categorical
variables,
followed
by
bivariate
and
multivariate
analysis
in
order
to
determine
statistical
association
between
the
outcome
and
explanatory
variables.
Variables
which
showed
significant
association
in
the
bivariate
analysis
were
entered
into
multivariate
logistic
regression.
Logistic
regression
analysis
was
done
by
calculating
the
adjusted
Odds
Ratios
[aORs],
and
95%
confidence
intervals
and
P-value
level
<0.05
was
considered
significant
throughout
the
study.
Project
approval
was
obtained
from
Hadhramout
University,
College
of
Medicine
(HUCOM)
and
Community
Medicine
Department.
A
letter
from
the
College
of
Medicine
to
the
Dean
of
each
of
the
five
selected
colleges
was
obtained
to
facilitate
the
process
of
data
collection.
The
team
followed
ethical
standards
of
confidentiality
in
participation.
The
objectives
of
the
study
were
explained
to
the
participants
taking
into
account
the
moral
and
social
difficulties,
and
each
student
was
voluntarily
invited
to
participate
in
the
study.
If
the
student
agreed
to
participate,
informed
verbal
consent
was
obtained
from
him/
her
after
confirming
that
the
information
to
be
collected
would
be
used
for
scientific
and
research
purposes
only
and
the
participants
were
asked
not
to
write
their
personal
identity
information.
In
addition,
each
student
received
an
envelope
with
the
questionnaire
to
facilitate
the
return
of
completed
questionnaire
to
a
special
ballot
box
that
had
been
prepared
in
advance
in
each
college
library
selected
in
the
study
to
better
ensure
keeping
of
privacy
and
confidentiality
in
the
study.
