Child sexual abuse : psychosocial aspects of cases seen in the greater Durban metropolitan region.
The sexual abuse of children is recognised worldwide as a problem of significant proportions. It is generally acknowledged that South Africa has one of the highest rates of sexual crime in the world. Despite high prevalence figures for child rape in South Africa, there has been no systematic attempt to explore the nature and scope of the problem in this country. The identification of factors which increase a child's risk for sexual abuse is of considerable importance in the design and implementation of appropriate prevention interventions. With this in mind, this investigation set out to identify psychosocial aspects associated with child sexual abuse in an urban sample of South African children. The main question that guided this investigation was: What were the psychosocial factors that might have contributed to the sexual abuse in the study sample? An integrated conceptual framework with some of the most frequently occurring etiologic factors across existing theoretical perspectives was used as a lens for understanding the various factors that might have contributed to child sexual abuse in the study sample? The identification of psychosocial aspects involved a file review of 245 cases of child sexual abuse reported to the Crisis Centre Unit at the Mahatma Gandhi Memorial Hospital during the period of November 2002 - April 2003. The site for data collection for this study was the Durban Region which is located in KwaZulu Natal and which has the second highest incidence rate for child sexual abuse in South Africa. A recording sheet was completed by the researcher with which data from the sample of content was taken. A wide range of variables was tapped, including ethnic distribution, socioeconomic status of the family, age and sex distribution of the child, type of family constellation, relationship of perpetrator to the child and probable psychosocial factors or mechanisms that contributed towards the sexual abuse. Descriptive statistics and the chi-square test of significance were used to analyse the data. The results showed clearly that situational factors (absence of other adults at home, poor or no supervision, child alone or unprotected and abduction) appeared high on the list among the psychosocial aspects. Other factors included child factors (child mentally retarded), perpetrator factors (psychiatric illness, unemployment and drug and alcohol abuse) and parental factors (marital problems in parents). Though the results showed clearly that situational factors appeared high on the list among the reported probable factors, whatever information obtained through socioeconomic status, family constellation, ethnicity and relationship of perpetrator to the child has thrown some light on understanding the various factors related to child sexual abuse in a South African setting. Living in a housing condition that was not protective, living in a family with a low income and living in a broken family setup, all of which have been associated with higher risks of abuse, were factors that were prevalent in most cases in the study sample. The results of this study indicated that sexual abuse is a complex phenomenon caused by the interaction of a wide variety of equally complex variables which is congruent with the conceptual framework for this study (based on a content analysis of different theories) that views child sexual abuse as a complex multifactorial phenomenon and not a simplistic cause and effect event. The research, therefore, concludes with recommendations to policy makers on primary prevention of child sexual abuse. This would mean actively involving themselves in programmes that assist in the eradication of poverty and, provision of better housing, recreational and after-school care.