title: Magnitude and factors associated with child abuse in a mega city of developing country pakistan.
abstract: OBJECTIVE
  Child abuse is one of the major challenges for health care providers. This study was conducted to determine the burden of child abuse (physical & emotional) and the factors associated with it in an urban city of Pakistan.
  
  
  METHODS
  This cross-sectional study was conducted in primary care clinics affiliated with a tertiary care hospital in Karachi, Pakistan between March to December 2010. Mothers with children aged between 6 and 12 years were included in the study. Those mothers' suffering from any acute illness like high grade fever, were excluded. A total of 412 mothers were recruited through consecutive sampling and written informed consent was taken. A pre-tested questionnaire was used to seek information about child abuse. Data was analyzed using SPSS version 19 and multivariable logistic regression was used to identify the factors (age, gender of child, family structure, educational status of parents, and mother's perception of her home environment) associated with child abuse.
  
  
  RESULTS
  Of the total 412 mothers, final analysis was conducted on 379 mothers. In all, 32.5% of children had been abused, 25.5% physically and 17.9% emotionally. Abuse was reported more among children whose mothers had minimal or no schooling (P=0.02), who were abused by their husbands (P<0.001), not satisfied with their marital life (P<0.001), and stressful home environment (P=0.02). In the multivariate analysis, the factors found to be independently associated with child abuse were mothers abused by their husbands (AOR=4.2; 95%CI: 2.2-7.9) and child being a girl (AOR=8.7; 95%CI: 4.5-16.8).
  
  
  CONCLUSIONS
  The prevention of child abuse can be achieved through comprehensive, multifaceted and integrated approaches requiring joint efforts by the government, policy makers, stake holders, social workers, educationists, and public health practitioners.
authors.affiliation: Department of Family Medicine.
authors.forename: Niloufer Sultan
authors.initials: NS
authors.lastname: Ali
authors.affiliation: Community Health Sciences, Aga Khan University , Karachi, Pakistan.
authors.forename: Farzana Nawaz
authors.initials: FN
authors.lastname: Ali
authors.affiliation: Department of Family Medicine and Community Health University Hospitals, Case Medical Center , Ohio, USA.
authors.forename: Ali Khan
authors.initials: AK
authors.lastname: Khuwaja
authors.affiliation: Department of Family Medicine.
authors.forename: Kashmira
authors.initials: K
authors.lastname: Nanji
keywords: Child Abuse; Emotional Abuse; Maternal Abuse; Pakistan; Physical Abuse