CHAPTER ONE

INTRODUCTION

 Background of the Study

Ika South is a Local Government Area of Delta State, Nigeria. Its headquarters are in the town of Agbor. It has an area of 436km2 and a population of 62,594 (Onyeche, 2012).

Child abuse and neglect is a social and public health problem in Nigeria, as well as a children’s rights issue. Abuse and neglect can lead to a wide range of adverse consequences for children and young people. There is generally not a single factor that results in the abuse or neglect of a child; it is usually a combination of various factors. In addition, the duration (such as the duration of an illness) or intensity (such as the level of drug or alcohol abuse) can make it more or less likely that a child will be at risk for abuse (Aber and Cicchetti, 2014).

Child abuse is a term used for maltreatment and neglect of children. Child maltreatment may be formally described as: …all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power (Woodhouse, 2011).

Child neglecton the other hand is generally seen as a different phenomenon from maltreatment. Child neglect may be defined as: “any recent act or failure to act on the part of a parent or caregiver, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm” (Culp, 2011). Neglect is in many ways the more insidious harm against a child, with long-term effects at least as damaging as physical abuse (if not more so) but often going unnoticed (Bloom, 2011).

The term ‘child abuse and neglect’ refers to the harm experienced by children or young people under the age of 18 yearsas a result of the actions, inactions or inability of people with a parental responsibility for them (Sylvestre and Mérette, 2010). Parental responsibility in relation to a child means all the duties, powers, responsibilities and authority which, by law, parents have in relation to children (Greenfield, 2010). The harm experienced by the child or young person may arise from a significant event or may arise from the cumulative effect of abuse and neglect. Most parents love their children, but when stress, tiredness, lack of skills, information and support combine it can be overwhelming (Drotar, 2012).

It is certain that no child is ever to blame for abuse inflicted on him or her by an adult. There may be no ‘child’ factors present at all when a child is abused. However the risk of abuse of a child may be increased if the child has attributes that make parenting more difficult or has high needs. Relevant factors might include being a premature baby, persistently crying, being one of a multiple birth, and/or having behavioural or mental health problems (Rosenbaum, 2011).

Some children may be vulnerable because of emotional difficulties they have that both reflect and exacerbate social isolation. The resulting cognitive and emotional deficits serve as signals of vulnerability and/or interfere with their self-protective skills outside the home (Vissing, 2012). Thus, some children are victimised again and again. Cognitive and emotional deficits resulting from sustained abuse (including family violence) or neglect at home may increase the risk of a vicious circle of victimisation outside the home as well. Thus, for example, experiences such as loss, conflict, deprivation or turmoil within the home may undermine a child’s ability to protect themselves, making them a potential target for bullies or sexual predators (Abram, 2010).

Low educational attainment of caregivers has been identified as a risk factor for child maltreatment and neglect (Berger, 2010) and is also associated with poverty. Hence poverty (especially when compounded with other risks such as sole parenthood), low educational attainment and maltreatment can set up a cycle whereby one perpetuates the other (Jacobson, 2010). As with other risk factors, the strength of the relationship between low educational attainment and neglect and maltreatment is unclear, as are the causal pathways. Low educational attainment can both reflect and contribute to disadvantage including precarious employment and low income. Lack of education may also mean a parent has less understanding of issues associated with parenting, or has limited ability to learn themselves (Twardosz and Lutzker, 2010).

A further widely recognised stressor is sole parenthood (Alessandri, 2011). Two factors appear to contribute to sole parenthood as a stressor and risk factor for children: the first is the strong link between sole parent households and poverty, especially reliance on benefit income (Chaffin, 2011) although, due to the loss of the absent parent’s wage-earning power, “the majority of single-parent, female-headed families [are driven] into poverty, regardless of whether the mother works.” [emphasis added] (Bloom, 2011); the other is that sole parenthood may be associated with lack of family or community-based support networks. And a sole parent is doing the work of two people. While support provided to mothers is significantly associated with them being able to provide support for their children, there is no evidence that lack of support and/or wider family dysfunction necessarily leads to maltreatment (Aber and Cicchetti, 2014).

Child abuse occurs in every country in the world, and despite considerable efforts and resources, rates of maltreatment and neglect in developed countries have not markedly diminished, nor are researchers much closer to being able to assess which children are at risk, and what programmes effectively change long-term behaviour so as to prevent maltreatment (Berger, 2010).

Child abuse and neglect have immediate and long-term consequences. In addition to negatively impacting on the child, child abuse and neglect impacts on the family, the school community, and even future generations. The ability to survive and thrive in the face of child abuse and neglect depends on a variety of factors, including the extent and type of abuse or neglect, whether it was continual or infrequent, the age of the child when abuse was initiated, the child’s relationship to the abuser, and how the abuse or neglect was responded to if discovered or disclosed. Outcomes are also dependent on the child’s personality traits, inner strength, and the support the child receives from those around them (Berger, 2015).

 Neglected children are also at considerable risk. These children are more likely than other children to suffer from a serious physical injury due to an accident such as falling, drowning, fire, or ingesting poison. They are also at a greater risk than other children of being physically and sexually abused from an unrelated caretaker, often times a significant other or friend of their parent(s) (Berger, 2010).

It is important to note that some children will not develop behavioral problems, so it cannot be assumed that a lack of behavioral problems is evidence against child abuse or neglect. When there are behavioral problems as a result of child abuse and neglect, they will most likely be related to difficulty following rules, being respectful, staying in their seats and keeping on-task, temper tantrums, and difficult peer relationships. As children become older they are more likely to engage in self (Woodhouse, 2011).

Statement of the Problem

Many child deaths, however, are not routinely investigated and postmortem examinations are not carried out, which makes it difficult to establish the precise number of fatalities from child abuse in Ika South Local Government Area of Delta State. There are problems in properly recognizing cases of infanticide and measuring their incidence. Significant levels of misclassification in the cause of death as reported on death certificates have been found, for example, in Ika South Local Government Area of Delta State. Deaths attributed to other causes – for instance, sudden infant death syndrome or accidents have often been shown on reinvestigation to be homicides.

Despite the apparent widespread misclassification, there is general agreement that fatalities from child abuse are far more frequent than official records suggest in Ika South Local Government Area of Delta State where studies of infant deaths have been undertaken.

Among the fatalities attributed to child abuse, the most common cause of death is injury to the head, followed by injury to the abdomen. Intentional suffocation has also been extensively reported as a cause of death. Injuries inflicted by a caregiver on a child can take many forms. Serious damage or death in abused children is most often the consequence of a head injury or injury to the internal organs. Head trauma as a result of abuse is the most common cause of death in young children, with children in the first 2 years of life being the most vulnerable. Because force applied to the body passes through the skin, patterns of injury to the skin can provide clear signs of abuse. The skeletal manifestations of abuse include multiple fractures at different stages of healing, fractures of bones that are very rarely broken under normal circumstances, and characteristic fractures of the ribs and long bones.

One of the syndromes of child abuse is the ‘‘battered child’’. This term is generally applied to children showing repeated and devastating injury to the skin, skeletal system or nervous system. It includes children with multiple fractures of different ages, head trauma and severe visceral trauma, with evidence of repeated infliction. Fortunately, though the cases are tragic, this pattern is rare.

Children may be brought to professional attention because of physical or behavioural concerns that, on further investigation, turn out to result from sexual abuse. It is not uncommon for children who have been sexually abused to exhibit symptoms of infection, genital injury, abdominal pain, constipation, chronic or recurrent urinary tract infections or behavioural problems. To be able to detect child sexual abuse requires a high index of suspicion and familiarity with the verbal, behavioural and physical indicators of abuse. Many children will disclose abuse to caregivers or others spontaneously, though there may also be indirect physical or behavioural signs.

There exist many manifestations of child neglect, including non-compliance with health care recommendations, failure to seek appropriate health care, deprivation of food resulting in hunger, and the failure of a child physically to thrive. Other causes for concern include the exposure of children to drugs and inadequate protection from environmental dangers. In addition, abandonment, inadequate supervision, poor hygiene and being deprived of an education have all been considered as evidence of neglect.

Data on non-fatal child abuse and neglect come from a variety of sources, including official statistics, case reports and population-based surveys. These sources, however, differ as regards their usefulness in describing the full extent of the problem. Official statistics often reveal little about the patterns of child abuse. This is partly because, in Ika South Local Government Area of Delta State there are no legal or social systems with specific responsibility for recording, let alone responding to, reports of child abuse and neglect. In addition, there are differing legal and cultural definitions of abuse and neglect between societies. There is also evidence that only a small proportion of cases of child maltreatment are reported to authorities, even where mandatory reporting exists.

Case series have been published in many countries. They are important for guiding local action on child abuse, and raising awareness and concern among the public and professionals (Corso and Mercy, 2011). Case series can reveal similarities between the experiences in different countries and suggest new hypotheses. However, they are not particularly helpful in assessing the relative importance of possible risk or protective factors in different cultural contexts, this study is therefore set to investigate the factors that are responsible for child abuse and neglect among parents in Ika South Local Government Area of Delta State.

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