Kandel P, Kunwar R, Karki S, Kandel D, Lamichhane P
Research and Action in Public Health, Kathmandu, Nepal.
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
Public Health. 2017 Oct;151:106-113. doi: 10.1016/j.puhe.2017.06.020. Epub 2017 Jul 29.
Child maltreatment is a global public health problem. There is limited information about this problem in low-income countries. We aimed to document the prevalence and factors associated with physical punishment of children less than 14 years of age in Nepal.
Population-based cross-sectional study.
We conducted an in-depth analysis using data from the Nepal Multiple Indicator Cluster Survey, a nationally representative multi-stage-stratified cluster sampling survey. Data were collected from 13,000 households in 520 sample enumeration areas. We assessed prevalence of physical punishment and different child violence related acts on 5081 children aged 3-14 years for whom complete information on all acts and attitude towards violence was available. Logistic regression was used to investigate the association between physical punishment of child and factors such as household and maternal demographics.
Our results suggested violence is common across Nepal, with data showing one in every second child is physically punished. One in every third (33%) of children were spanked, hit or slapped on the bottom, 25% were hit or slapped on the face and approximately 3% were beaten up hard. Odds of facing physical punishment were higher among children aged 3-5 years (odds ratio [OR] 2.9, 95% confidence interval [CI]: 2.0-4.3), aged 6-8 years (OR 2.8, 95% CI: 2.2-3.7), engaged in child labour activities (OR 1.4, 95% CI: 1.1-1.7), with mother that accepted wife beating by husband is justified (OR 1.2, 95% CI: 1.1-1.4), whose father is currently abroad (OR 1.5, 95% CI: 1.2-1.9) and whose father is away from home but in the same country (OR 1.60, 95% CI: 1.1-2.3). The risk was also higher among children living in households that believe physical punishment of children is necessary (OR 3.5, 95% CI: 2.9-4.3) and from lower caste/indigenous (dalit/janajati) ethnicity (OR 1.3, 95% CI: 1.1-1.7). Those less likely to experience physical punishment included female children (OR 0.7, 95% CI: 0.6-0.9) and children with an older mother (34-49 years; OR 0.5, 95% CI: 0.3-0.9).
Our results suggest that physical punishment of children is common across Nepal with varying severity. Prevention efforts should focus on designing and promoting interventions that support parents to adapt alternative forms of parenting practices.
儿童虐待是一个全球性的公共卫生问题。低收入国家关于这一问题的信息有限。我们旨在记录尼泊尔14岁以下儿童遭受体罚的患病率及其相关因素。
基于人群的横断面研究。
我们利用尼泊尔多指标类集调查的数据进行了深入分析，该调查是一项具有全国代表性的多阶段分层整群抽样调查。数据收集自520个样本普查区域的13000户家庭。我们对5081名3 - 14岁儿童的体罚及不同的儿童暴力相关行为进行了评估，这些儿童具备关于所有行为及对暴力态度的完整信息。采用逻辑回归分析来研究儿童体罚与家庭及母亲人口统计学等因素之间的关联。
我们的结果表明，暴力行为在尼泊尔普遍存在，数据显示每两个儿童中就有一个遭受体罚。每三个儿童中有一个（33%）被打屁股、拍打或掌掴，25%被打脸，约3%被狠狠殴打。3 - 5岁儿童（优势比[OR] 2.9，95%置信区间[CI]：2.0 - 4.3）、6 - 8岁儿童（OR 2.8，95% CI：2.2 - 3.7）、从事童工活动的儿童（OR 1.4，95% CI：1.1 - 1.7）、母亲认为丈夫殴打妻子合理的儿童（OR 1.2，95% CI：1.1 - 1.4）、父亲目前在国外的儿童（OR 1.5，95% CI：1.2 - 1.9）以及父亲离家但在同一国家的儿童（OR 1.60，95% CI：1.1 - 2.3）遭受体罚的几率更高。生活在认为有必要对儿童进行体罚的家庭中的儿童（OR 3.5，95% CI：2.9 - 4.3）以及来自低种姓/原住民（达利特/贾纳贾蒂）族裔的儿童（OR 1.3，95% CI：1.1 - 1.7）遭受体罚的风险也更高。不太可能遭受体罚的儿童包括女童（OR 0.7，95% CI：0.6 - 0.9）以及母亲年龄较大（34 - 49岁）的儿童（OR 0.5，95% CI：0.3 - 0.9）。
我们的结果表明，尼泊尔儿童体罚现象普遍，程度各异。预防工作应侧重于设计和推广支持父母采用替代育儿方式的干预措施。
