An Exploration of the Lived Experiences of Maltreated Children and Caregivers in Southwestern Uganda ()
1. Introduction
Globally, it is estimated that up to 1 billion children aged 2 - 17 years, have experienced physical, sexual, or emotional violence or neglect (Pearson et al., 2021) . Africa has been reported to have the highest rates of child neglect in the world where both boys and girls are being abused and neglected by their caregivers (Badoe, 2017; Hoefnagels et al., 2020; Sharley et al., 2019) . The vice of child maltreatment is a major threat to the achievement of sustainable development goals on the continent and has become increasingly topical with a dramatic increase in recognition and an appreciation of the long-term harmful effects on the affected population (Badoe, 2017) .
To prevent and respond to child maltreatment effectively, there needs to be a common understanding of those actions and omissions that constitute child maltreatment (Santoro et al., 2018) . Child maltreatment has been generally referred to as “any recent act or failure to act on the part of a parent or caretaker that results in death, serious physical or emotional harm, sexual abuse, or exploitation; or an act or failure to act that presents an imminent risk of serious harm” (Better Care Network, 2017; Blumenthal, 2015; DeBoer & Seaver, 2019; Galagali, 2020; Government of Uganda, 2020; UNICEF, 2019) .
There are quite a number of laws that are specifically aimed to protect children, both domestic and international. They include and not limited to; Some of these are; The UN Convention on the Rights of the Child, 1989; Two Optional Protocols to the UN Convention on the Rights of the Child; The ILO Convention 182 on the Worst Forms of Child Labour, 1999; The ILO Convention 138 on Minimum Age for Employment Admission, 1973; and The African Charter on the Rights and Welfare of the Child, 1999. At local level, Domestic legislations in Uganda include: The National Child Policy, 2020; The Children’s Act, 2006; The Constitution of Uganda, 1995; The Local Government Act, 1997; The National Council for Children Act, 1996; The Trafficking in Persons Act, 2008; The Employment Act, 1977; The Births and Registration Act, 1973; The Land Act, 1997; The Child Labour Policy, 2006; The Orphans and Vulnerable Children Policy, 2004.
Child maltreatment may include emotional, physical, and sexual violence as well as neglect. In a study on child maltreatment, cognitive functions and the mediating role of mental health problems among maltreated children and adolescents in Uganda, the researchers reported that children with experiences of child maltreatment performed poorly on tasks of working memory, attention, episodic memory and executive functions (Ainamani et al., 2021) . Similarly DeBoer and colleagues reported that child maltreatment resulted into traumatic stress, depression, fear, and low self-esteem among victims (DeBoer & Seaver, 2019; Galagali, 2020) . The major reasons that make child maltreatment pronounced in the study area include economically stranded families where the basic needs of children are not met, making children’s vulnerability to abuse more pronounced. Also there is failure by authorities like police to apprehend child abusers and irresponsible parents who neglect their children, leaving children in the hands of their abusers (Sserwanja et al., 2021) . It is against such a background that the current study sought to explore the lived experiences of maltreated children and caregivers in Southwestern Uganda.
2. Methods
2.1. Study Design
This was a purely qualitative, descriptive research study using a descriptive phenomenological approach. Data was collected by conducting focus group discussions (FGDs) and key informant interviews (KIIs) to e explore the lived experiences of maltreated children and caregivers’ views on child maltreatment in Southwestern Uganda. The actual data collection activities were done between the months of September 2022 and January 2023. Two interview guides were used, with one designated for Key Informants (KIs) and the other for the Focus Group Discussions (FGDs). The interview guides had items that sought for participants’ opinions and experiences relating to child maltreatment in Southwestern Uganda. Both the FGD and the KI interview guides were translated into Runyankore-Rukiga, the local language of the region. This was because some of the participants didn’t understand nor speak English the official language of Uganda.
2.2. Study Settings
The study was conducted in Shema district and Mbarara city in Southwestern Uganda. Shema district is located along Mbarara-Kasese Highway, about 34 kilometers from Mbarara City. It is a new district, which assumed the district status in July 2010, curved out of Bushenyi District, and is part of Ankole Subregion (https://en.wikipedia.org/wiki/Sheema_District). The district has fifteen Sub counties, but only two sub counties of Kabwohe Division (representing semi urban setting) and Masheruka Subcounty (representing rural setting) which registered many reports of child maltreatment as per the OVC Situation Report for Sheema District (2019), were selected for this study. The district has also on a number of occasions reported serious child abuse cases. Quite a number of government and civil society agencies (such as Compassion International, COVOID, Kihunda CDC, Rweibaare CDC, Advancing Ministries for the Gospel) have come into play to extend children protection needs. On the other hand, Mbarara city is located 269 kilometers from Kampala, the old traditionally known city in the country. The city was chosen because many children have come to the city due to several factors ranging from the search for work, neglect and abandonment by their parents and caregivers (Monitor newspaper, January 22, 2021).
2.3. Study Participants
A total of 114 participants (46 children, 46 community members, and 22 officials from government and civil society institutions) participated in this study. Children were included in the study because they had experienced the maltreatment themselves. Caregivers also gave their views on what maltreated children were going through in the community. Children who took part in this study were aged between 10 and 17 years mixed both girls and boys. The inclusion criteria for maltreated children were done by using CDC project directors. The project directors helped to mobilize and identify maltreated children who were project beneficiaries. Children who met the inclusion criteria but at the time of the interviews were under the influence of drugs, sick or undergoing very hard emotions of maltreatment were excluded from the study. The community members included parents and local area leaders in Mbarara city and Shema district. The other participants were officials working with government departments such as Police and Community Based Services. The other category of respondents was civil society staff such as those working with Child Development Centers, Community Volunteer Initiative for Development (COVOID) and Transcultural Psychosocial Organization (TPO) (Table 1).
![]()
Table 1. Summary of different categories and number of study participants (N = 114).
2.4. Data Collection Procedures
The study employed both Focus Group Discussions and Key Informant Interviews. Data from FGDs were collected until saturation point was reached. We conducted 12 FGDs (6 with children, and another 6 with community members). Also, 13 Key Informant Interviews were conducted with officials in the government service and in the civil society sector. Purposive sampling technique was used to select the key informants based on their expertise knowledge in the detection, prevention and management of child maltreatment cases. Permission to collect data was sought from the BSU-REC, the Uganda National Council for Science and Technology and all local authorities from the area of study. Therefore, upon presentation of the authorization letters from relevant offices, and explanation of the purpose of the study, participants were requested to participate in the study voluntarily. Those who accepted, either written informed consent or assent were obtained from them. The interviews were conducted in designated places that were considered safe for both the participants and the researcher team.
The FGD and KII guides composed of open-ended questions which sought to collect data on the lived experiences of maltreated children in Sheema District and Mbarara City in South Western Uganda. The Key Informants’ Interviews lasted for about 30 to 45 minutes while FGDs lasted for 45 to 60 minutes. All participants were offered a small token of appreciation of five thousand Uganda shillings (1.5 USD) as compensation for their time to participate in the study. Participants were also given contacts of the Principal Investigator in case they had any emerging questions to ask. Moreover, all participants were assured that the study was for academic purposes only, voluntary and that there were no any risks involved in the study. Participants were also assured of their right to withdraw from the study at any time without penalty or anything to lose if they declined participating.
2.5. Data Management and Analysis
The Runyankore-Rukiga language was used to conduct Focus group discussions since it is a common language used and understood by the residents in the study area. However, some key informants’ interviews were conducted in English which is an official recognized language of Uganda. All Focus Group Discussions and interviews, upon being granted permission from participants, were audio recorded in order to allow for later transcription such that verbal information was translated into text records in English. Data were transcribed verbatim by research assistants and compared with the audio recordings to verify the fidelity of the transcription. The transcripts in Runyankole-Rukiga were then translated into English by an independent translator. Any discrepancies in the translation were discussed and amended accordingly. All the authors (AM, RB, AA and HEA) independently read through the transcripts. The initial coding was done by the PI (AM), and then the codes were discussed with the other co-authors for consensus based on the themes that emerged from the data. We adopted a thematic analysis for this study because it allows the researchers to fully reveal the meanings emerging from the data while conceptualizing narrative reports as per significant units (Morgan, L, 2011). Four themes (child neglect, emotional abuse, physical abuse and sexual abuse) emerged from the data from the FGDs and KIIs. We selected quotations from both FGDs and KIIs in support of our results.
3. Results
Four broad themes were generated from the data namely child neglect, emotional abuse, physical abuse and sexual abuse of children as expounded hereunder.
3.1. Children Experiences of Child Neglect and Their Caregivers’ Views
From the discussions that were conducted with children, results pointed to child neglect as one of those emerging issues that children were experiencing. It was established that indeed children were facing it rough with their lives, especially in families whose socio-economic standards were poor. It was also found that cases of child maltreatment existed in those families where children were not living with their biological parents, or where children were living with at least one of their parents (single parent) due to a number of reasons such as death of one of the parents. In trying to understand more from the children’s point of view, in one of the discussions, an eleven-year-old girl explained thus;
I, for instance, was neglected by my/our own father… I am now staying with my mother and with my other two young brothers and a sister. Our father was always coming home drunk until my mother could no longer bear with him and she decided that we shift and rent in the nearby trading centre… I think you have seen that trading centre when you were coming here? Life is not good at home. We are going through serious problems. I think our father married another woman. We don’t know where he is now. It is hard for us to get what to eat, even paying house rent is very difficult. I feel sad about what we are going through. However, I thank the church for supporting me by paying my school fees (FGD, CDC child participant 1).
The above narration points to child neglect, a common form of child maltreatment as was reported by the children themselves. The majority of the children in almost all the discussions explained how they are being neglected by their own parents, or reported those they have seen being neglected in their communities, with men (fathers) being the majority perpetrators. From the verbatim presented above, it is observed that children are aware that they are missing a lot because of being neglected. They noted that they are missing parental care and love, are unable to access the basic necessities of life, and that this does not only affect the attitude they develop towards their neglectful parents but also it affects their emotional wellbeing as noted in the above case where the child reported that she felt very sad that she was living such kind of life.
More still, a further analysis of the responses from community members about the experiences of maltreated children also suggested that all was not well. These, reported that they were aware some children were not being treated well. In one of the FGDs with community members it was shared, although hesitantly, to show that none of them mistreats the children;
It is true some of our children are being neglected by their parents and caregivers. Some children are in their homes doing nothing. They keep moving around the whole village. But I think it is because of the poverty that is in this community. There are no jobs and we don’t have jobs so that we can earn something to provide for our families. We are actually asking the government to help us so that we get jobs and provide for our families in terms of taking care of our children and other needs like paying school fees… child neglect is of course not a good thing because it can make children to hate themselves and even their parents… And I can assure you that no parent on earth would want to abandon their children but sometimes conditions become very difficult and some parents especially men decide to run away. (FGD, Community member participant 1)
This response suggests that community members expressed awareness that child neglect is taking place in their communities. The study participants, however, distanced themselves from taking part in such acts of child neglect. They also reported, just like children, that child neglect indeed manifests in various ways and impacts children’s lifestyle and general emotional growth like negative attitudes towards their parents, and self-hate and that it can later reflect through reduced self-esteem and create anger.
The Key Informant Interviews that were conducted with key informants reported similar views about the issue of child neglect at family level. Almost all of these participants expressed concern and worry that parental responsibility of taking care of children is no longer taken seriously. In one of the interviews with a key informant, it was observed and emphasised that child neglect is rampant and needs to be given attention as reported;
As a government department that handles family and children’s issues in the district, we are challenged with the overwhelming numbers of children who are neglected and others even abandoned everywhere. Parents are no longer taking charge of their children. Some children are not in school even when there is universal primary education! But I also think that some organs of government are not doing their work very well, especially police. Police for instance will always ask for money first in order to handle such cases which involve child maltreatment, yet as a department we also do not have adequate facilitation to handle such cases so that children can get justice. But overall, I think two things should be emphasised; one, as we call on government to fund departments that handle such issues of child abuse, but secondary also, the parents should know that charity begins at home… meaning that irrespective of whatever economic situation, parents have not only a responsibility of fully taking care of their children but should also see it as their obligation to provide for their children and not perpetrators of abuse on their children (KII, participant 1).
It is therefore observed that there was a general agreement from the different categories of study participants that indeed, child neglect is a more pronounced form of child maltreatment. Such kind of life was found to be reflected among children who have missed on parental love and care, failure to go to school, poor or limited access to medical care and other basic needs of life. As already noted, child neglect as reported by participants consequently affects children emotional being for the rest of their life. The emotional aspect is therefore another kind of life that was established.
3.2. Experience of Children Emotional Abuse and Views of Their Care Givers
From the study key participants and other respondents like children and community members, maltreated children were reported to have been psychologically abused. Such a view was reported by one of the study participants who worked in one of the civil society organizations in Mbarara city:
“There is nothing that has a lifelong impact on the lives of children as any act that either directly or indirectly inflicts on their psychological faculty” (KII, participant 2 aged 56).
Hence, childhood maltreatment indeed poses long lasting consequences on the future life of children. The mental and emotional consequences like depression, anxiety and memory issues are more likely to develop.
Emotional abuse was reported to be inflicted on children by their parents, caregivers and other relatives through name calling/labelling. For instance, it was reported that some mothers who had had challenges with their husbands especially where men had failed or refused to provide for their families, decided to divert their anger to children. Mothers resorted to abuse their children with such words like “iwe mwaana we ori omusiru noshusha sho” literally meaning that “you child, you are as stupid as your father”. Such kind of maltreatment was reported to be practiced against children who stayed with their step-mothers.
There were other practices that were reported by the different categories of study participants which have implications on the cognitive functioning and emotional state of children. They included screaming at children, shaming them before their colleagues in public, threatening them with words like “I will kill you”, “you will never make it in life”, rejection and withholding love.
In an in-depth interview with one Project Director of one child development centre (CDC) institution, such kind of emotional abuse was mentioned to be problematic as children victims of emotional abuse come to terms experiencing such a life. This was recorded in one of the narrations that:
You know many of the children that we support here in our work are victims of maltreatment. I am sure you are also aware that irrespective of any form of abuse imposed on children, it is bound to affect their thinking about life and their abusers in one way or another. In fact, it’s one of our bigger challenges that we face as we relate, teach, counsel and build these children. Sometimes when we are talking to them, we realise their minds are very far and are instead not attentive, depending on the kind of abuse they faced and its severity. But we don’t blame or judge them. We understand what they would have gone through and we do our work as required. Our programs and activities like Centre Days, morning devotion, guidance and counselling, co-curricular activities, gardening, sports among others have contributed so much in terms of giving hope to the children who are victims of abuse. (KII, Participant 3)
It is true children were also aware of abusive cases and were able to mention them in their communities. However, many of them were shy to mention that they were the victims. Some of the abuses seen in their communities included locking children in houses, subjecting them to hard labor such as fetching jerrycans of water by underage children, denial of food and refusal to pay school fees.
One child victim of emotional maltreatment shared her story about how she felt, the fact that she knew the community members are aware of what she was going through:
I feel shy to easily interact with my fellow age mates in the public. I hate it to find out that people know me as somebody who doesn’t have parents and is at risk of any likely abuse, simply because I have no stable family where to stay. The mistreatment I have gone through is hard to bare! I feel bad about myself. (FGD, Child Victim of Child Neglect)
This shyness, the “feel bad” attitude about oneself and the self-hate are some of the emotional lifestyles that maltreated children are not happy about. But all these are facts on the ground and cannot be underrated in terms of the poor state of mind that children are experiencing.
The above emotional lived experiences were supported by other voices as recorded from the officials of civil society organizations in the following narrative:
Because of the several abuse exposed to children in the communities, those maltreated children live in Inferiority complex, and lose confidence to express themselves. This is not good for our children especially as they grow into adults when they are expected to become responsible parents themselves and future leaders. (KII, Participant 4)
One police officer under the child and family protection unit quoted:
Threats have been inflicted on children. Many parents and guardians threaten children with scaring words and actions, like telling them heir traumatizing past or intentions to beat them all the time. It is high time that more sensitization campaigns be done to educate our community members about how to speak to children in a more comforting manner (Child and Family Protection Unit official, KII Participant 5).
These testimonies by children are supporting the above reports by the key informant, who elaborated that indeed, any form of abuse to a child affects his or her psychological growth and development. Hence, the generalinfluence of child neglect on children’s future development is that child neglect inhibits the entire physical development of the child like brain retardation which has negatively led to psychological challenges like low self-esteem and behavioural problems that can manifest through alcohol and drug use.
3.3. Children Experiences of Physical Abuse and Caregivers’ Views
The other lived experience of maltreated children in the study area was found to be physical harm. Findings revealed that children were being physically harmed. It was reported that many children were being beaten in their homes especially by their step-mothers. Other children were also reported to be beaten by their parents and other caregivers. Respondents reported that children were being beaten by whipping, slapping and use of objects like sticks, pangas. It should be noted that beating children was abolished even in schools by the government of Uganda, and it is considered a form of corporal punishment and punishable.
Whereas some parents thought that they had all the rights to discipline their children by beating them, the other participants especially government and civil society officials were not in support. There were divided viewpoints about disciplining children. In an interview with the community members’ FGD, a participant expressed that;
As parents we have a big challenge with our children indiscipline cases. As parents we cannot do much in trying to bring our children to order, especially when they adopt indiscipline cases or if they misbehave. Children of these days have been given too much freedom by government because if you discipline a child as a parent, be careful the police can come for you if the child reports you to authorities like LC chairpersons or police. Even in schools, teachers cannot do much because the act of “disciplining” (beating) children was stopped (FGD, Community member Participant 2).
The above view was also shared by many government’s civil servants who were not happy with the way many children were conducting themselves. Some of the Key informants indeed opted for an allowance of beating as a form of disciplining children. This they argued, that if a child becomes a problematic one, it’s the parent who will lose out. The view of one government civil servant can also be shared here, who authoritatively emphasized that;
I think we need to be more serious about telling our people the difference between harassing children and disciplining them. I like the traditional way of disciplining children. I can tell you if my parents were not harsh on me, I would not have made it to a position where I am now. They were serious disciplinarians; they were no jokes. Unfortunately for today, almost nobody is there to discipline children when they go wrong. Even then, our children are raised in soft life! This is not very good! Children used to be for the community, everyone had a responsibility of disciplining any child whether it was yours or not. Children grew into responsible citizens. The story is different now. I am not supporting physical abuse of children, but am calling upon parents to understand that disciplining your children responsibly is necessary (KII, Participant 4).
This excerpt is trying to bring out the idea that some community members did not understand properly what constituted an abuse and disciplining of children. In fact, the government official in the above excerpt observed that some parents beat their children to hurt and harm, which is very wrong. This is because inflicting harm on children in form of injury is for example more harmful since it leaves them in bad shape and can also have lasting psychological effect on them. Physical harm was proved through asking the children whether some of them were victims or if they saw or knew such cases in the communities where they came from. Some children mentioned that they see and know of cases of children who are beaten, hit, kicked, burnt and subjected to hard labour. In Mbarara City South Division, for example, there is a common place called Omukikoona in Ruti Nyamitanga where many under age children who come from the neighboring districts of Kabale, Isingiro, Ntungamo, Rukungiri, Mitooma among others, do gather as they engage in activities like selling bananas, work in saloons, and hotels. This kind of hard labour is not good for under-age children as it affects their physical growth, denies them an opportunity to live in family environment and loss of family bondage.
One child in a focus group discussion reported about her fate of physical maltreatment as thus:
…I feel my stepmother is making me do a lot of work. It’s me to do almost everything at home including washing cups and plates, fetching water from the well, and cooking. I have to do work both in the morning before I (come) go to school in the morning and evening after school (FGD, Child survivor Participant 1 aged 14).
The aforementioned was a case a child victim of maltreatment and she was free to share the kind of physical abuse that she was going through child labour inflicted on her by a stepmother.
To emphasise the point about the existence of physical abuse cases in the community, children reported having seen and being aware of their fellow children who were being maltreated. One other child participant reported;
We also know many young girls and boys who are working as house girls and house boys and for sure they are doing too much work and their bosses do not even give them some time to rest. (FGD, Child Participant 5 aged 15)
The above narration is testimony by child victims of abuse and witnesses. The fact that children have lived in an environment of maltreatment and also observed heir fellows going through abuse are makes us conclude that indeed child maltreatment is real and neither is child maltreatment pleasant.
3.4. Children Experiences of Sexual Abuse and Their Care Givers’ Views
The final lived experience of maltreated children was that of sexual abuse. Although it was found not as prominent, responses from the study participants who were the children themselves, community members, local leaders and government officials and those from the civil society established that some of those cases exist. The major questions asked on this issue were; how are children abused sexually, who abuses them, which children are more vulnerable to such form of abuse and how often? It was noted that everyone can be a perpetrator of child abuse as long as children are left alone, uncared for, un attended to or un accompanied.
The two major child sexual abuse forms were rape and defilement. It was heartbreaking that among the suspects and actual perpetrators were fathers of girl children. The others were idlers who were suspected to be drug and substance abusers as well as male relatives of girl children.
As a probation office, we handled and followed a case of sexual abuse in 2020 during the Covid-19 lockdown. We had a case where the father defiled his own daughter in a village called Bugongi… And this is not the only case, there was another one in Kashanjure village…. The mother had gone to take care of her sick father (father in-law of her husband). The man took advantage of the absence of his wife and defiled his own daughter. We receive child abuse cases on a daily basis! It has come to our knowledge that there are mothers who abandon their children because of reasons like being absent for work or domestic violence, leaving girl children with their fathers. Consequently, fathers resort to sexually abusing their daughters. As a mother, I feel hurt that our children especially girls are going through such. But we are trying to do whatever possible we can to promote the welfare of our children. I however want to encourage our mothers to do all they can to protect their children. Women should know that the lives of children are in their hands and have no reason whatsoever to abscond from that responsibility especially in todays’ era of women empowerment (KII, Participant).
Three issues can be pointed from the conversation in the KII. The first one is that sexual abuse of children is practiced by their own relatives and neighbors. The other one is that abandoning children for longer periods especially girls makes them more vulnerable to the same vice. But also, mothers should ensure they take charge of protecting their children because even in the environment where most men have resorted to alcoholism, it is possible that fathers unfortunately have become perpetrators of sexual abuse on their own young daughters.
There was another proof of sexual harassment of young girls by community members. One 15-year-old girl shared her story…
Step mothers (families) either force or chase young girls to go and get married in order to get dowry, but some children are mistreated through chasing them from home. There are also cases where step fathers rape and defile girl children that they are taking care of. Some men do sexually harass us. They can pretend to show that they want to take care of you by buying small gifts after realising that you come from a poor family. Later, they start demanding for sex and when you refuse to succumb to their demands, you become a target of rape or defilement (FGD, Child Participant)
In summary, child maltreatment was very pronounced in the study area, manifesting itself through child neglect, emotional abuse, physical abuse and sexual abuse. The impact was found to be demeaning to the lives of children especially emotionally, and denying children to live a happy life. Such state of affairs will continue to put the life of children at stake if not controlled since the impact of abuse is a lifetime process.
4. Discussion
The objective of this study was to explore the lived experiences of maltreated children and caregivers in Southwestern Uganda. Four broad themes were generated from the data namely child neglect, emotional abuse, physical abuse and sexual abuse of children as expounded hereunder;
There were rather bad life experiences for children who had been maltreated by their abusers, as revealed by the different study participants. Whereas the two forms of child maltreatment of child neglect were reported, the major four major forms of child maltreatment of: physical, sexual, neglect and psychological abuse have been prominently reported and documented (UNICEF, 2019; UNICEF & Overseas Development Institute, 2009) . In many of child maltreatment cases and child protection work that have been done globally, child neglect has been described as the most common form of child maltreatment, generally characterized by omissions in care resulting in significant harm or risk of significant harm (Manapsal, 2016; Parkinson et al., 2017; Services, 2018; U.S. Department of Health and Human Services, 2004) . Also, neglect is frequently presented by the same source in terms of a failure to provide for the child’s basic needs, deprivation of adequate food, clothing, shelter, supervision, or medical care; a view that results of this study concur with.
The other experienced life of maltreatment that children were going through was that of emotional abuse. Also known as psychological abuse, this form of abuse occurred when parents, relatives or caregivers of children often screamed at them, called them degrading names, and threatened to kill them (MoGLSD, 2018a; Molnar et al., 2021; Santoro et al., 2018) . Other arguments have been that psychological abuse does not stand on its own but can be caused by other forms of abuse such as physical, and affects both boys and girls (Clarke et al., 2016; Santoro et al., 2018) . As was reported, our results highlighted that some children were told that they would never make it in life, reminded about their dead parents and others are even told to go and find their dead parents in the graves. We can observe, as many studies have established, that different factors may give rise to the different forms of child abuse for both boys and girls (Wandera et al., 2017) . The findings of this study are in line with the findings of the study that was conducted in Zimbabwe which established that physical and emotional abuse impact on children’s’ change in behavior and conduct like not talking in class anymore, not having friends in their neighborhood, and loss of weight (Wandera et al., 2017) .
The other reported maltreatment experience among children was physical abuse. Our results revealed that children were experiencing physical abuse involving intentional acts of physical force by a parent or caregiver. In the study area, step-mothers were being reported as the most abusers of children in families. Uganda Violence Against Children Survey (MoGLSD, 2018a) , identified these indicators to include; punching, kicking, whipping, beating with an object, strangling, suffocating, attempted drowning, burning intentionally, using or threatening with a knife, gun, or other weapon. In this study, respondents were specifically asked about physical acts of violence perpetrated by four types of potential perpetrators, including: intimate friends, peers parents, adult caregivers, or other adult relatives, and other adults in the neighborhood (Child Abuse and Neglect by Parents and Other Caregivers, n.d.; Clarke et al., 2016; UNICEF, 2005; Wandera et al., 2017) . As is the case of this study’s findings, there is agreement in the same findings. Of Ugandans aged 18 - 24 years, six in ten females (59%) and seven in ten males (68%) reported experiencing physical violence during their childhoods. Meanwhile, four in ten girls (44%) and six in ten boys (59%) ages 13 - 17 experienced physical violence in the last year (MoGLSD, 2018b) . Although this current study only aimed to explore the lived experiences of maltreated children, the same physical acts of abuse were revealed. The difference could be explained in the numbers of boys and girls who reported experience of abuse in their childhood.
Sexual abuse was yet another reported children’s lived experience in the study area. This form of abuse was found to manifest itself in an experience that involves contact and non-contact sexual acts, inflicted by any adult or child in a position of power over the victim, to seek or obtain physical or mental sexual gratification. All these happen when the child does not have capacity to provide consent, or has capacity but does not provide consent (MoGLSD, 2018a; Uganda Police, 2020) . From the study, results pointed to children (especially young girls) being forced to have sex with old men who were their fathers, relatives or neighbors. It can however be substantiated that the focus of the VACS survey was on high-prevalence HIV and AIDS, specific to the clusters of Bukomansimbi, Ssembabule, Rakai, Mubende, Mityana, Gomba, Mukono, Gulu, Oyam and Lira. The findings can however be generalized to south western Uganda to include the selected study area since the region has also been reported to have recorded increasing cases of HIV/AIDS infections. Children could be the targets by infected men who may want to infect innocent young girls with the HIV virus.
5. Limitations
The study adopted a cross-sectional design that is subject to biases that were prevalent in the population at the time of data collection (Leung, 2015), our study was limited to only one city, one town council and a subcounty and this limits its generalizability.
6. Conclusion
Maltreated children go through a lot of emotional torture, physical harm, sexual abuse and neglect. We recommend interventions geared towards mitigating child maltreatment and its effects be propagated for wholistic and complete healthy child development. For instance, local governments need to integrate child protection programming in the development. Communities should change their attitudes towards cultural beliefs and practices like child marriage, child labour, and child punishment for wrong-doing which all harm children’s well-being (Richard & Rhoda, 2015) .
Acknowledgements
We acknowledge the financial support of Bishop Stuart University towards data collection activities. In the same spirit, we also thank the Bishop Stuart University Research Ethics Committee for reviewing the study protocol and providing the ethical clearances required to conduct the study. We also appreciate all the participants for agreeing to take part in the study. We appreciate the contribution of the Research Assistants in the data collection process.
Ethical Approval and Consent
Ethical approval for the study was given by the Bishop Stuart University Research Ethics Committee (BSU-REC 31/08-22). The study was also registered with the Uganda National Council of Science and Technology to conduct the study in Uganda (UNCST SS1483ES), a body that oversees the conduct of research in Uganda. Permission from the Mbarara city and Shema district authorities was obtained to allow us conduct the study from their areas of jurisdiction. The study procedures were explained to all the participants and they all provided written informed consent. For participants under 18 years, assent was obtained.
Authors Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; had agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.
Competing Interests
All authors declare that they have no any conflict of competing interests of any form.
References
- 1. Ainamani, H. E., Rukundo, G. Z., Nduhukire, T., Ndyareba, E., & Hecker, T. (2021). Child Maltreatment, Cognitive Functions and the Mediating Role of Mental Health Problems among Maltreated Children and Adolescents in Uganda. Child and Adolescent Psychiatry and Mental Health, 15, Article No. 22. https://doi.org/10.1186/s13034-021-00373-7 [Paper reference 1]
- 2. Badoe, E. (2017). A Critical Review of Child Abuse and Its Management in Africa. African Journal of Emergency Medicine, 7, S32-S35. https://doi.org/10.1016/j.afjem.2017.09.002 [Paper reference 2]
- 3. Better Care Network (2017). Violence against Children and Care in Africa (p. 76). A Discussion Paper. [Paper reference 1]
- 4. Blumenthal, A. (2015, January). Child Neglect I: Scope, Consequences, and Risk and Protective Factors (pp. 1-9). Canadian Child Welfare Research Portal. https://cwrp.ca/sites/default/files/publications/141E.pdf [Paper reference 1]
- 5. Child Abuse and Neglect by Parents and Other Caregivers (n.d.). [Paper reference 1]
- 6. Clarke, K., Patalay, P., Allen, E., Knight, L., Naker, D., & Devries, K. (2016). Patterns and Predictors of Violence against Children in Uganda: A Latent Class Analysis. BMJ Open, 6, e010443. https://doi.org/10.1136/bmjopen-2015-010443 [Paper reference 2]
- 7. DeBoer, S., & Seaver, M. (2019). Child Maltreatment. Journal of Emergency Nursing, 45, e23-e25. https://doi.org/10.1016/j.jen.2019.06.002 [Paper reference 2]
- 8. Galagali, P. M. (2020). Theme: Child Abuse and Neglect. Indian Pediatrics, 57, 782-782. https://doi.org/10.1007/s13312-020-1950-3 [Paper reference 2]
- 9. Government of Uganda (2020). National Child Policy (pp. 1-76). [Paper reference 1]
- 10. Hoefnagels, C., Evers, S., Snoeren, F., Meesters, C., & Lamers-Winkelman, F. (2020). Self-Reported Quality of Life of Maltreated Children Who Have Been Reported to Advice and Reporting Centers on Child Abuse and Neglect. Journal of Child and Family Studies, 29, 471-481. https://doi.org/10.1007/s10826-019-01604-4 [Paper reference 1]
- 11. Manapsal, J. P. (2016). Ouch! It Hurts: The Lived Experiences of Physically and Emotionally Abused Children. International Journal of Psychology and Counseling, 6, 1-14. [Paper reference 1]
- 12. MoGLSD (2018a, August). Uganda Violence against Children Survey (p. 184). SAPS Annual Report. [Paper reference 3]
- 13. MoGLSD (2018b, August). Uganda Violence against Children Survey. SAPS Annual Report. [Paper reference 1]
- 14. Molnar, B. E., Scoglio, A. A. J., & Beardslee, W. R. (2021). Community-Level Prevention of Childhood Maltreatment: Next Steps in a World with COVID-19. International Journal on Child Maltreatment: Research, Policy and Practice, 3, 467-481. https://doi.org/10.1007/s42448-020-00064-4 [Paper reference 1]
- 15. Parkinson, S., Bromfield, L., Mcdougall, S., & Salveron, M. (2017). Child Neglect: Key Concepts and Risk Factors: A Report to the NSW Department of Family and Community Services Office of the Senior Practitioner (pp. 1-47). Australian Centre for Child Protection. http://www.unisa.edu.au/Global/EASS/Research/ACCP/ChildNeglect,Keyconceptandriskfactorsreport.pdf [Paper reference 1]
- 16. Pearson, I., Butler, N., Yelgezekova, Z., Nihlén, A., Yordi Aguirre, I., Quigg, Z., & Stockl, H. (2021). Emerging Responses Implemented to Prevent and Respond to Violence against Women and Children in WHO European Member States during the COVID-19 Pandemic: A Scoping Review of Online Media Reports. BMJ Open, 11, e045872. https://doi.org/10.1136/bmjopen-2020-045872 [Paper reference 1]
- 17. Richard, W. W., & Rhoda, K. (2015). Strengthening Community Formal and Non-Formal Systems to Prevent Violence against Children in East Africa: What Is Working? International NGO Journal, 10, 12-26. https://doi.org/10.5897/INGOJ2015.0294 [Paper reference 1]
- 18. Santoro, A. F., Shear, S. M., & Haber, A. (2018). Childhood Adversity, Health and Quality of Life in Adults with Intellectual and Developmental Disabilities. Journal of Intellectual Disability Research, 62, 854-863. https://doi.org/10.1111/jir.12540 [Paper reference 3]
- 19. Services, D. of H. and H. (July 2018). Child Abuse and Neglect Fatalities: Statistics and Interventions. Child Maltreatment, 1-7. [Paper reference 1]
- 20. Sharley, V., Ananias, J., Rees, A., & Leonard, E. (2019). Child Neglect in Namibia: Emerging Themes and Future Directions. The British Journal of Social Work, 49, 983-1002. https://doi.org/10.1093/bjsw/bcz043 [Paper reference 1]
- 21. Sserwanja, Q., Kawuki, J., & Kim, J. H. (2021). Increased Child Abuse in Uganda amidst COVID-19 Pandemic. Journal of Paediatrics and Child Health, 57, 188-191. https://doi.org/10.1111/jpc.15289 [Paper reference 1]
- 22. U.S. Department of Health and Human Services (2004, February). Emerging Practices Project, Emerging Practices in the Prevention of Child Abuse and Neglect. Child Welfare Information Gateway. https://www.childwelfare.gov/preventing/programs/whatworks/riskprotectivefactors.cfm [Paper reference 1]
- 23. Uganda Police (2020). Uganda Violence against Children Survey. SAPS Annual Report (Issue August). [Paper reference 1]
- 24. UNICEF (2005). The Convention on the Rights of the Child. Protection Rights: Keeping Safe from Harm (pp. 4, 32-33). https://www.britishcouncil.ug/sites/default/files/un_convention_on_the_rights_of_the_child-summary.pdf [Paper reference 1]
- 25. UNICEF (2019). UNICEF Uganda 2019 Report (pp. 1-48). [Paper reference 2]
- 26. UNICEF, & Overseas Development Institute (2009). Strengthening Social Protection for Children (p. 56). [Paper reference 1]
- 27. Wandera, S. O., Clarke, K., Knight, L., Allen, E., Walakira, E., Namy, S., Naker, D., & Devries, K. (2017). Violence against Children Perpetrated by Peers: A Cross-Sectional School-Based Survey in Uganda. Child Abuse and Neglect, 68, 65-73. https://doi.org/10.1016/j.chiabu.2017.04.006 [Paper reference 3]