Social disorganization and history of child sexual abuse against girls in sub-Saharan Africa: a multilevel analysis.
BACKGROUND
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden. illyahaya@yahoo.com
Ismail
I
Yahaya
Olalekan A
OA
Uthman
Joaquim
J
Soares
Gloria
G
Macassa
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000850:Anomie; D002648:Child; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003710:Demography / Q000639:trends*; D005260:Female; D006801:Humans; D008875:Middle Aged; D055361:Multilevel Analysis; D016017:Odds Ratio; D012111:Residence Characteristics; D055815:Young Adult