Engaging a Disadvantaged Community in Identifying Determinants of Child Neglect using Health Promotion Approach: An Experience from a Sri Lankan Study

Abstract

Child neglect is a form of child maltreatment that causes adverse short and long term consequences. Neglect is a public health problem in Sri Lanka and throughout the world. The aim of this qualitative study was to identify the determinants of neglect with a disadvantaged community in Sri Lanka using health promotion approach. Mothers having at least one child in the age range 5–18 years, and the elder child of each mother within the age range 5–18 years were included in the sample. The sample size was 42 mothers and 42 children. The period of determinant identification took an average of three months. Participatory methods in accordance with the health promotion approach were used. Discussions between principal investigator and the participants were recorded, transcribed, translated to English, and analyzed using thematic and content analysis. Without the involvement of the principal investigator, children identified four determinants as poor economy, domestic violence, alcohol abuse of parents and un-education of mothers and mothers identified five determinants. Poor resources and poor economy were the first two determinants identified by mothers. After the facilitation by the principal investigator, children identified another seven determinants, and mothers identified another thirteen determinants. Mothers and children separated determinants in to levels as individual, family, and community level. Of the total identified determinants, mothers and children collectively prioritized poor practices of mothers, poor mother-child relationships, and poor social support to be addressed. Disadvantaged community mothers and children could identify and prioritize determinants of neglect successfully with minor guidance through a health promotion approach.