Abstract
Children with disabilities (CWDs) are at a higher risk of being maltreated than are typical children. The evidence base on the abuse of children with disabilities living in low- and middle-income countries is extremely limited but the problem is particularly acute in East Africa. We don’t know the types of evidence that exist on this topic. This problem is compounded by the fact that key indicators of disability, such as reliable prevalence rates, are not available currently. This paper addresses this serious problem by mapping the existing evidence-base to document the coverage, patterns, and gaps in existing research on the abuse of children with disabilities in East Africa. An evidence map, following systematic review guidelines, was conducted and included a systematic search, transparent and structured data extraction, and critical appraisal. Health and social science databases (Medline, EMBASE, PsychInfo, Taylor&Francis, Web of Science, and SAGE) were systematically searched for relevant studies. A substantive grey literature search was also conducted. All empirical research on the abuse of CWDs in East Africa was eligible for inclusion: Data on abuse was systematically extracted and the research evidence, following critical appraisal, mapped according to the type of abuse and disability condition, highlighting gaps and patterns in the evidence-base. 6005 studies were identified and screened, of which 177 received a full-text assessment. Of these, 41 studies matched the inclusion criteria. By mapping the available data and reports and systematically assessing their trustworthiness and relevance, we highlight significant gaps in the available evidence base. Clear patterns emerge that show a major data gap and lack of research on sexual abuse of children with disabilities and an identifiable lack of methodological quality in many relevant studies. These make the development of a concerted and targeted research effort to tackle the abuse of children with disabilities in East Africa extremely difficult. This needs to be addressed urgently if the abuse of children with disabilities is to be prioritised by the global health community.
Highlights
Child maltreatment and abuse, which “includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity” [1], continues to be a global burden but not a global health priority
This may be because many children with disabilities (CWDs) in East Africa often receive limited education or no schooling at all and most surveys on child abuse are conducted at university or secondary school level [20,21]
Evidence mapping is a rigorous method of research synthesis, which transparently assesses and structures the type of research conducted in relation to a specific research question, to identify and visualize patterns and gaps in the existing evidence base [22,23,24]
Summary
Child maltreatment and abuse, which “includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity” [1], continues to be a global burden but not a global health priority. Data on the abuse of CWDs is almost non-existent for East Africa. A serious evidence gap exists on the nature of abuse of CWDs in East Africa. To address this pressing need, we need to begin by developing a detailed mapping of the gaps that are present within existing research. This will allow for the informed development of a comprehensive agenda for research and practice
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