Background

The effect of different types of care environment on orphaned and separated children and adolescents’ (OSCA) experiences of abuse in sub-Saharan Africa is uncertain.

Objective

Our two primary objectives were 1) to compare recent child abuse (physical, emotional, and sexual) between OSCA living in institutional environments and those in family-based care; and 2) to understand how recent child abuse among street-connected children and youth compared to these other vulnerable youth populations.

Participants and setting

This project followed a cohort of OSCA in Uasin Gishu County, Kenya (2009–2019). This analysis includes 2393 participants aged 18 years and below, 1017 from institutional environments, 1227 from family-based care, and 95 street-connected participants.

Methods

The primary outcome of interest was recent abuse. Multiple logistic regression was used to estimate the odds of recent abuse at baseline, follow-up, and chronically for each abuse domain and adjusted odds ratios (AOR) between care environments, controlling for multiple factors.

Results

In total, 47 % of OSCA reported ever experiencing any kind of recent abuse at baseline and 54 % in follow-up. Compared to those in family-based care, street-connected participants had a much higher reported prevalence of all types of recent abuse at baseline (AOR: 5.01, 95 % CI: 2.89, 9.35), in follow-up (AOR: 5.22, 95 % CI: 2.41, 13.98), and over time (AOR: 3.44, 95 % CI: 1.93, 6.45). OSCA in institutional care were no more likely than those in family-based care of reporting any recent abuse at baseline (AOR: 0.85 95 % CI: 0.59–1.17) or incident abuse at follow-up (AOR: 0.91, 95 % CI: 0.61–1.47).

Conclusion

OSCA, irrespective of care environment, reported high levels of recent physical, emotional, and sexual abuse. Street-connected participants had the highest prevalence of all kinds of abuse. OSCA living in institutional care did not experience more child abuse than those living in family-based care.

中文翻译：

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肯尼亚西部孤儿、失散和流落街头的儿童和青少年中虐待儿童的普遍性、发生率和长期性：照料环境的影响是什么？

 背景

不同类型的照料环境对撒哈拉以南非洲孤儿和失散儿童和青少年 (OSCA) 虐待经历的影响尚不确定。

 客观的

我们的两个主要目标是 1) 比较生活在机构环境中的 OSCA 和生活在家庭护理环境中的 OSCA 最近的儿童虐待行为（身体、情感和性）； 2) 了解与其他弱势青少年群体相比，最近街头儿童和青少年遭受虐待的情况如何。

 参加者及设置

该项目跟踪了肯尼亚 Uasin Gishu 县的 OSCA 队列（2009-2019 年）。该分析包括 2393 名 18 岁及以下的参与者，其中 1017 名来自机构环境，1227 名来自家庭护理，以及 95 名街道参与者。

 方法

感兴趣的主要结果是最近的滥用行为。使用多重逻辑回归来估计每个滥用领域的近期虐待的基线、随访和长期发生率，并调整护理环境之间的比值比 (AOR)，控制多个因素。

 结果

总体而言，47% 的 OSCA 报告在基线时曾经历过任何类型的近期虐待，54% 的受访者在随访中经历过任何形式的虐待。与家庭护理中的参与者相比，与街道有联系的参与者在基线时报告的所有类型的近期虐待发生率要高得多（AOR：5.01，95％CI：2.89，9.35），在随访中（AOR：5.22， 95% CI: 2.41, 13.98)，以及随着时间的推移 (AOR: 3.44, 95% CI: 1.93, 6.45)。机构护理中的 OSCA 与家庭护理中的 OSCA 相比，在基线时报告近期虐待情况的可能性（AOR：0.85 95 % CI：0.59–1.17）或在随访时报告虐待事件的可能性（AOR：0.91，95 % CI： 0.61–1.47）。

 结论

OSCA 报告称，无论护理环境如何，近期身体、情感和性虐待的发生率都很高。街头参与者的各种虐待行为发生率最高。生活在机构照料​​中的 OSCA 并没有比生活在家庭照料中的儿童遭受更多的虐待。