Research Article - (2017) Volume 11, Issue 3
Israel Bekele1*, Wondosen Zewde2 and Abiru Neme1
1Faculty of Health Sciences, Institute of Health, Jimma University, Ethiopia
2Medical Center, Jimma University, Ethiopia
*Corresponding Author:
Israel Bekele
Faculty of Health Science
Institute of Health, Jimma University
Jimma, Oromia, Ethiopia
Tel: +251915419518
E-mail: israel.bekele90@gmail.com
Received Date: 27 April 2017; Accepted Date: 31 May 2017; Published Date: 08 June 2017
Citation: Bekele I, Zewde W, Neme A. Assessment of Prevalence, Types and Factors Associated with Adolescent Sexual Abuse in High School in Limmu Gnet High School. Health Sci J 2017, 11: 3.
Copyright: © 2017 Bekele I, et al. This is an open-access article distributed under the terms of the creative Commons attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Introduction: Adolescent sexual abuse is one of the major problems of adolescent that affect their health and security. Specifically, as various (regional, national and global) studies indicate the prevalence of the problem in primary and secondary school environment as caused by different individual and contextual factors. But due to different reasons in Limmu Genet high school the problem of adolescent sexual abuse specifically its prevalence, type and determinant factors are not yet well stated and studied. Objective: The main objective of this study is to explore the prevalence, type and identify major determinant factors associated with adolescent sexual abuse of students in Limmu Genet high school. Methodology: The study was conducted and a quantitative research method was used to collect data about the prevalence, type and major factors associated with adolescent sexual abuse from 354 randomly selected high school students in Limmu Genet high school by sampling procedure in the school compound. The data collection was done by self-administered questionnaire that was analyzed with descriptive and explanatory statistics. Results: The result of this study revealed that sexual abuse is prevalent in the study area in the form of exposing adolescent to verbal sexual advances (32.4%) kissing adolescent in a socially unacceptable manner (29.1%), the combination of touching and fondling adolescent sexually (25.9%), making adolescent to look at somebody's genitals (22.7%), forcing to expose their genitals (18.3%) and other forms like discussing about sexual practices (16.5%). Conclusion: In conclusion, the result of this study revealed that the problem is prevalent (34.9%) in Limmu Genet high school. Also Marital status and monthly family income, factors associated with sexual abuse like alcohol drinking and chewing chat have statistically significance with sexual abuse (P<0.05). Recommendation: As a result of the abuse students may become emotionally disturbed, absence/shortage of education, etc. Therefore, measures should be taken against the abusers, by counseling services, gender club, student maladaptive behavior and others by school teachers.
Keywords
Sexual; Violence; Factor; Student
Introduction
Background: Today’s adolescent who are socialized in a safe and healthy environment are the adults of tomorrow and the bases for the future development of a country. In this regard, schools are among the institutions entrusted with the responsibility of providing adolescent with healthy environment and basic information. Adolescent abuse is a state of emotional, physical, economic and sexual maltreatment meted out to a person below the age of eighteen and is a globally prevalent phenomenon. It is both within and outside of a formal relationship is common in many adolescent’s lives, it is noted that data on the literature is limited, partly because of unwillingness by the victims to discuss or report the problem. However, in Ethiopia, as in many other countries, there has been no understanding of the extent, magnitude and trends of the problem. The growing complexities of life and the dramatic changes brought about by socio-economic transitions in Ethiopia have played a major role in increasing the vulnerability of adolescent to various and newer forms of abuse [1].
The development of positive interpersonal relationships and interactions is directly related to the capacity of the new generation to develop those social codes required for a healthy social interaction. However, in a situation where children, whose psychological integrity is not yet reliably intact, are exposed to abusive, neglectful and exploitative instances it would be futile to expect adolescent to develop these social qualities [2,3].
Studies have revealed that child abuse, neglect and exploitation are widely spread in Ethiopian schools. Research findings have indicated that students are inflicted with corporal punishment without due inquiry. Furthermore, they are said to be exposed to humiliating situations in the form of sarcasm, ridicule, name-calling, rejection, and forced labor. However, since studies in the area of sexual abuse in school environment are lacking in the country, it was not possible to clearly state the nature, magnitude, etc., of the problem [4].
Research works conducted in the area are very limited both in number and scope. Though not substantiated with objective research findings there are also some indications that adolescent sexual abuse is widely spread in most rural high schools. Female students are said to be threatened with their grades if they fail to comply with the will of their teachers and engage in sexual relationships. One of the immediate effects of violence and abuse on school girls concerns poor class attendance of girls. Currently, sexual violence is one of the priority health issues because of its impact on women's health. Sexual violence is more severe because it is linked to some of the most intractable reproductive health issues of our times including teenage pregnancy, high risk sexual behaviors, sexually transmitted diseases and HIV/AIDS, unsafe abortions and maternal mortality. Also the effects of violence against adolescent will cause various psychological and physical effects which may have a lifelong impact on the mental and physical development of the adolescent. More hazardously, violence increases a women's risk for HIV infection through forced or coercive sexual intercourse and by limiting their ability to negotiate HIV preventive behaviors [5].
Abuse can impact the adolescent’s language development, as well as their physical, and cognitive development. Consequently, the abused adolescent is at greater risk of academic problems and school failure. They are more likely to have substance abuse problems, experience domestic violence, and engage in criminal behaviors which complicate and compound their problems. This unfortunate repetition impacts future generations, our communities, and our society as a whole [6].
In Ethiopia, children irrespective of their ages like high school students are at risk or sexual abuse in the past many years and in the future because it is least recognized, unnoticed and undocumented partly due to its taboo nature. So this research is intended to identify the hider but the most important health problem of adolescent; this Research is needed on violence against students to change harmful cultural and traditional practice that will darken the life of students by affecting their health, which eventually leads to poverty; which have negative impact on the development of the country. Research is needed to show the scope and magnitude of the problem and the misunderstanding regarding violence against students which leads to denial of its existence in Ethiopia. Hence, this study had tried to fill the gap and addresses the issue of adolescent sexual abuse in Limmu Genet high school students and makes a significant contribution, it offers practical preventive, remedial and rehabilitative recommendations leading towards the minimizing of adolescent sexual abuse. This study can also help as a reference for future studies in the area which appears to be grossly deficient and enable the local decision make [7-10]. The aim of this study is to assess the prevalence, types and factors associated with adolescent sexual abuse in Limmu Genet high school students, Jimma zone Oromia region, south west Ethiopia, 2015.
Materials and Methods
The study was conducted on Limmu Genet high school students of grade 9th and 10th students. Limmu kossa woreda is one of eighteen woredas in the Jimma zone of the Oromia Regional State and is located 75 km distance in the west of Jimma town and 427 km from the capital city of the country Addis Ababa, Ethiopia. The woreda is structured forty (40) rural and 11 urban kebeles. And Limmu Genet high school is found in the town of the woreda which is known as Limmu Genet kebele 01. According to 2005 E.C census, the total population of the Limmu Genet was 12,037 of whom 6,063 mere males and 5,974 were females [11,12]. The school has 19 sections of grade 9th and 9 sections of grade 10th with total of 1984 students and 975 male and 1009 female. The study was conducted from May 25-June 25, 2015.
School based, cross sectional descriptive study was employed. Sample size was determined using single population estimation formula by considering the absence of previous data on a specific study population to obtain the maximum sample size 50% of prevalence was used in the calculation with assumption of 95% confidence interval, 5% and considering [13]. Considering non-response rate of 10%, final total sample sizes was 354 and Proportionate stratified sampling technique was used by taking grade as strata. Then after stratification of grades, simple random sampling was used to select the number of students included in the study. All sections of grade 9th and 10th students as source population and Sample drawn from students of 9th and 10th grade used as the study population [14,15].
Inclusion and exclusion criteria
Regular (day time) secondary school students Grade-9 and Grade-10, and who were present in the school on the day of the administration of the questionnaire was included and students who are not able to complete the questionnaire without assistance due to visual impairment and students unwilling to participate in the study were excluded from the study [16].
Data collection instrument
Data collection instruments were developed after review of relevant literatures. The instrument were grouped and arranged according to the particular objectives that they can address [17]. It is composed of socio-demographic questions, and association factors questions related to enabling factors. The questioner was being prepared in English and translated to local language and then back translated to English questioner version.
Data collection methods
For the sampled students the purpose of the study and importance of participation was being informed and verbal consent was ensured. Data was collected from the students through self-administered using structured questionnaire [18,19].
Data quality control measures
Training was given for facilitators on the objectives of the study, the contents of the questionnaire, issues related to the confidentiality of the responses and the rights of respondents.
The questionnaire was being pre-tested in Ambuye town high school which is 15 km from Limmu Genet town on 10% (35 students) to assess the reliability of data collection instruments. Findings were being discussed among data facilitators and supervisor so that, the tool was being modified before actual data collection and the final data collection was being conducted at convenient time by using of the modified questionnaire [20].
The collected data was being checked by principal investigator and data facilitators every day at the end of each data collection day and if necessary, corrective measures were being made for the area where difficulty identified.
Data processing, analysis and presentation
The collected data was being coded, sorted and processed using manual compilation and Descriptive and analytic statistical method was used to illustrate variables and chisquare test was employed to determine relationship of different factors with dependent variables and P-value of 0.05 is taken as a significant. The processed data were being interpreted and presented using simple frequency tables, text and graphs. Associations were also done [21-23].
Ethical considerations
The proposal document was revised and approved by the research advisor before the study was undertaken. Formal written permission letter for all possible supports was written from Jimma University to Limmu Kossa woreda educational office. After Permission obtained each respondent was asked for verbal consent, cultural and religious norms and values were respected throughout the course of the study. Privacy during data collection and confidentiality of the collected data was ensured by omitting the name of the respondents [24].
Results
A hundred person of respond rate was gained. Of the 354 participants, 14 (12.4%) students were male, 99 (87.6%) female, 18 (5%) were aged less than 16 years, the age between 17-21; 67 (18.9%) and 22-25 years were 21 (6%).
This study set out specifically to explore the prevalence, types and factors of sexual abuse in Limmu Genet high school environment. A total of 354 high school students were involved in the study. Generally, the perceived level of violence is (<40%), which indicates that the school environment and the way to and from the school is too unsafe for school adolescent.
Of the total students participated in the study 113 (31.9%) were sexually assaulted. Majority of the victims were between 17-21 (25%) age groups and unmarried 108 (24%). Data from selected samples of victim adolescent was examined to see the demographic variables of victim adolescent, their relationship with perpetrators. Hence, data collected from victims were examined and of the total 354 students participated in the study students living with both parents are 219 (62%) and followed by those who live with “others” 135 (38%) (Table 1).
Table 1 Socio-demographic characteristics of Limmu Genet High school students, August, 2015 GC.
| Socio-demographic Variables | SexuallyAssualted | |||||
|---|---|---|---|---|---|---|
| Yes | No | Total | P-value | |||
| # % | # % | # % | ||||
| 14(12.4) | 197(87.6) | 211(100) | 0.001 | |||
| Sex | Male | |||||
| Female | 99(87.6) | 44(12.4) | 113(100) | |||
| Total | 113(31.9) | 241(68.1) | 354(100) | |||
| Age | <16 | 18(5) | 64(18.1) | 82(23.1) | 0.001 | |
| 17-21 | 67(18.9) | 32(9) | 99(27.9) | |||
| 22-25 | 21(6) | 74(21) | 95(27) | |||
| >25 | 7(2) | 71(20) | 78(22) | |||
| Total | 113(31.9) | 241(68.1) | 354(100) | |||
| Marital status | Single | 81(23) | 166(47) | 247(70) | 0.946 | |
| Married | 17(4.9) | 39(11.1) | 56(16) | |||
| Divorced | 11(3) | 25(7) | 36(10) | |||
| Widowed | 4(1) | 11(3) | 15(4) | |||
| Total | 113(31.9) | 241(68.1) | 354(100) | |||
| Ethnicity | Oromo | 70(19.7) | 33(9.3) | 103(29) | 0.001 | |
| Amhara | 28(7.9) | 46(13) | 74(20.9) | |||
| Tigre | 5(1) | 68(19.2) | 73(20.2) | |||
| Gurage | 8(2.3) | 54(15.1) | 62(17.4) | |||
| Others | 2(1) | 40(11.3) | 42(12.3) | |||
| Total | 113(31.9) | 241(68.1) | 354(100) | |||
| Religion | Muslim | 39(11) | 74(21) | 113(32) | 0.003 | |
| Orthodox | 24(6.9) | 96(27) | 120(33.9) | |||
| Protestant | 32(9) | 53(15) | 85(24) | |||
| Catholic | 14(4) | 11(3.1) | 25(7.1) | |||
| Others | 4(1) | 7(2) | 11(3) | |||
| Total | 113(31.9) | 241(100) | 354(100) | |||
| Educational Status | Grade Nine | 43((12.1) | 171(48.3) | 214(60.4) | 0.001 | |
| Grade Ten | 70(19.8) | 70(19.8) | 140(39.6) | |||
| Total | 113(31.9) | 241(68.1) | 354(100) | |||
| Current Living status |
With family | 97(27.1) | 165(46.6) | 262(73.7) | 0.002 | |
| Alone | 10(2.8) | 50(14.1) | 60(16.9) | |||
| Other | 6(2) | 26(7.3) | 32(9.3) | |||
| Total | 113(31.9) | 241(68.1) | 354(100) | |||
| Monthly Family Income | Regular income | 71(20) | 174(49.2) | 245(69.2) | 0.204 | |
| Irregular income | 31(8.8) | 50(14.1) | 81(22.9) | |||
| Not defined | 11(3.1) | 17(4.8) | 28(7.9) | |||
| Total | 113(31.9) | 241(68.1) | 354(100) | |||
NB. The association between socio-demographic characteristics and sexually assaulted students of Limmu Genet High School August, 2015 G C
The data in Table 2 suggests that there is a high degree of agreement among the samples groups concerning the types of violence perceived to be most prevalent. The most common type of sexual abuse and violence as experienced by adolescent involves the use of exposing adolescent to verbal sexual advances (30.2%) by members of the school community aimed at undermining their self-esteem. The second most frequent type of violence experienced by adolescent involved is “making adolescent to look at somebody's genitals” (27.9%).
Table 2 Prevalence and types (forms) of sexual abuse of Limmu Genet high school students, May, 2015.
| No | Types of sexual abuse | Yes (Victimized) | No (Not victimized) | Total |
|---|---|---|---|---|
| # (%) | # (%) | # (%) | ||
| 1 | Exposing adolescent to verbal sexual advances | 107(30.2) | 6(1.7 ) | 113( 31.9) |
| 2 | Kissing in a socially unacceptable manner | 70(19.8) | 43(12.1) | 113( 31.9) |
| 3 | Touching and fondling adolescent sexually | 75(21.2) | 38(10.7) | 113 ( 31.9) |
| 4 | Making adolescent to look at somebody's genitals | 99(27.9) | 14(4) | 113 ( 31.9) |
| 5 | Forcing adolescent to expose their genitals | 50(14.1) | 63(17.8) | 113 ( 31.9) |
| 6 | Others | 48(13.6) | 65(18.3) | 113 ( 31.9) |
The third highest sexual abuse and violence is touching and fondling adolescent sexually and Kissing in a socially unacceptable manner adolescent sexually which account 21.2% and 19.8% respectively. However, several of the following types of sexual abuse and violence experienced by the adolescent can also be related directly to the school setting. These include:
“Sexual gestures were made to them by teachers or male students.” It is naturally disturbing to see that these types of abuse and violence occur within the school environment.
The data in Table 3 shows that there is a high degree of agreement among the sample groups concerning those different forms of violence has common risk factors.
Table 3 Risk factors contributing to sexual abuse Limmu Genet high school students, May, 2015.
| No | Risk Factors (Risk Behaviors) |
Sexual Abuse | ||||
|---|---|---|---|---|---|---|
| Yes | No | Total | ||||
| # (%) | # (%) | # (%) | ||||
| 1 | Alcohol drinking | Yes | 14(12.4) | 113(31.9) | 241(68.1) | 354(100) |
| No | 99(87.6) | 113(31.9) | 241(68.1) | 354(100) | ||
| 2 | Chat chewing | Yes | 19(16.8) | 113(31.9) | 241(68.1) | 354(100) |
| No | 94(83.2) | 113(31.9) | 241(68.1) | 354(100) | ||
| 3 | Using pornography (Film) |
Yes | 48(42.5) | 113(31.9) | 241(68.1) | 354(100) |
| No | 65(57.5) | 113(31.9) | 241(68.1) | 354(100) | ||
| 4 | Using social medias | Yes | 53(46.9) | 113(31.9) | 241(68.1) | 354(100) |
| No | 60(53.1) | 113(31.9) | 241(68.1) | 354(100) | ||
Discussion
The finding of the study shall be analyzed in three parts, namely, the prevalence of sexual abuse, the types (forms) of and the major contributing factors for the abuse in Limmu Genet high school.
As reported by the study participants, among the reasons for not reporting incidents, the majority did not know what to do, feared perpetrators and possibilities of stigma. Hence, there might be a tendency of keeping it secret than telling it to somebody else. Ethiopia is one of the developing countries with traditional societal values expressed in terms of conservative views and practices related to children, families, gender and sexual relationships. The deep-rooted cultural and religious experiences and ties within families and communities might have a role either in protecting societal values or leading to withholding information that seem to be an unacceptable by peers, parents and other people around.
Among the total of 354 students, participated in the study 113 (31.9%) were sexually assaulted in the schools. The prevalence of sexual harassment in the school was higher than the findings of study conducted in Canada where the prevalence rate was 23% [25-27]. Study conducted in Kenya on schools revealed that prevalence of sexual harassment in school was 60% which is inconsistent with the corresponding values of this finding [28]. The sexual harassment prevalence of the study was not in line with the studies conducted in 2008 in Addis Ababa school, in 2003 in Dabat and in Jimma Zone high school students where the prevalence revealed that 74%, 44% and 73.4%, respectively [24,26,27]. One of the main possible reasons causing the different number of sexual harassment cases could be similar unwelcome sexual advance considered differently in different setting and in different researches.
As indicated in this chapter, the study found that various types of violence and abuse are committed against school children in different settings – in school, on the way to and from school and at home–throughout Ethiopia. Some of the different types of violence are interrelated thereby affecting school children in multiple ways. Similarly, sexual violence exposes school children to various types of psychological abuses which affect their confidence, self-esteem and future life. This implies that school student’s exposure to one type of violence may lead to another (more severe) type of violence.
In this study, the common types of sexual harassment in the schools were verbal sexual harassment 107 (30.2%) and which were comparable with 49.8% and 31.1% from the study conducted in Jimma zone on high school students [24,29-34].
According to the present results the different types of sexual abuses indicated in the literature are manifested in the study area also in Ethiopia.
There is no single known cause of adolescent maltreatment. Nor is there any single description that captures all families in which adolescent are victims of abuse. Adolescent maltreatment occurs across socio-economic, religious, cultural, racial, and ethnic groups. While no specific causes definitively have been identified that leads a parent or other caregiver to abuse adolescent. Research has recognized a number of risk factors or attributes commonly associated with maltreatment. The factors that may contribute to maltreatment in one family may not result in adolescent abuse in another family. For example, several researchers note the relation between poverty and maltreatment, yet it must be noted that most people living in poverty do not harm their children.
In my study I did not include a question that indicates who the perpetrator was. This may mask our understanding of where the perpetrators are located including close relatives and others though living with parents were found to be protective.
As reported by the study participants, among the reasons for not reporting incidents, the majority did not know what to do, feared perpetrators and possibilities of stigma. Hence, there might be a tendency of keeping it secret than telling it to somebody else. Ethiopia is one of the developing countries with traditional societal values expressed in terms of conservative views and practices related to children, families, gender and sexual relationships. The deep-rooted cultural and religious experiences and ties within families and communities might have a role either in protecting societal values or leading to withholding information that seem to be an unacceptable by peers, parents and other people around.
A few studies have been done on the risk factors for sexual violence perpetration in Africa including Ethiopia [23]. Sexual violence is caused by multiple factors [35,36] and therefore identifying the strongest risk factors is important for making interventions cost effective. However, few studies have focused on multiple risk factors for sexual perpetration [35,36] and to date; only one study has done so in Ethiopia.
In this study the percentage of ever use of alcohol (12.4%) was almost related to another study on ISY in Ethiopia that ranged from 17.9% in public high schools [22]. Our finding is less compared to 69% of adolescents in the US. Khat use was admitted by 16.8% in our study while it was reported by 69.1% of high school students on average [22]. We found Using pornography (Film) 42.5%, Using Face book Chartrooms and Other factors were 46.9.0% and 27.4% respectively.
In this study, drinking alcohol and chewing chat have statistically significance association with sexual violence.
Conclusion
This study identified that one-third of students were subjected to sexual abuse. Additionally many of them were exposed to different forms of sexual abuse, such as exposing adolescent to verbal sexual advances; kissing adolescent in a socially unacceptable manner (e.g. on the mouth); touching and fondling adolescent sexually; making adolescent to look at somebody's genitals; forcing adolescent to expose their genitals; touching, fondling or kissing adolescent's genitals; attempting coitus with adolescent through cajoling, persuading, threatening, forcing or any other way; Performing penile/vaginal coitus with adolescent through cajoling' persuading, threatening, forcing or other way; raping adolescent or performing penile/vaginal coitus with adolescent through physical force.
As necessary, a future study is suggested to be carried out using the longitudinal method to examine the multidimensional impact of adolescent sexual abuse and the development/progress they show in the process of psychosocial support they are provided. It has not been easy to effect positive change in most communities where cultural practices condone the sexual exploitation of children. Due to the fact that sex is taboo, many cases of sexual abuse of children go unreported for fear of stigmatization.
Recommendations
Depending on the result of the study, the following recommendations were forwarded
1. Adolescent exploited in ASA need proper care and protection against HIV/AIDs; there should need to expand outreach and mobile interventions targeting this population, and to systematically train staff at voluntary counseling and testing centers, management centers and clinics on how to provide child-friendly assistance, attract and retain contact with vulnerable adolescent by the woreda health office.
2. Access to education by girls must be steadily promoted through adequate policies and sensitization campaigns by MOE (Ministry of education). Concerning this Limmu Kossa wereda health office should aware the societies who are living in limmu kossa woreda.
3. A situational analysis research on how CSA manifest itself in Ethiopia is required to inform adequate counteraction by concerning authorities.
Possible Limitation of the Study
Since sexual abuse is sensitive issue, respondents may not provide their actual experience Because of its taboo nature, student’s willingness in giving genuine information might underestimate the magnitude of the problem and social desirability bias.
Acknowledgements
We would like to thank the followings for their contribution: Jimma University, College Health Sciences, for providing us ethical clearance; Jimma University specialized hospital, our data collectors, Study participants and others who participated directly or indirectly in this study.
Authors’ Contributions
Mr. Wondosen Zewde wrote the proposal, participated in data collection, analyzed the data and drafted the paper, Israel Bekele and Mr. Abiru Neme approved the proposal, participated in data analysis and revised subsequent draft of the paper. All authors read and approved the final manuscript.
Competing Interests
The authors declare that they have no competing interests.
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