Abstract
Child Sexual Abuse (CSA) is both a global and national social issue, as well as an epidemic in various societies. Non-disclosure of CSA only worsens and extends survivors’ suffering, and CSA’s long-term effects can be devastating. Several studies have been done in the field of CSA and its health implications but rarely have previous studies addressed child sexual abuse disclosure (CSAD). The current study aimed at examining child factors of CSAD at Thika Level 5 Hospital (TL5H) in Kiambu County, Kenya. The study is a case study using a phenomenology approach where the primary data was collected from the sexual abuse survivors and caregivers using a mixed-method analysis. Interviews were conducted with 30 CSA survivors, 25 girls, and 5 boys: 5-17 years. The study utilised the convergent QUAL (investigative open-ended questions and storytelling) design with a Quan component (structured survey) to identify CSA survivors’ experiences while receiving medical treatment and therapeutic intervention at TL5H. Descriptive and thematic approaches were applied to analyse qualitative data that revealed survivors’ lived experiences with CSA. Informed by Bronfenbrenner’s Socio-Ecological Model (SEM), saliency analysis was applied to code the recurring and important themes from the data in order to identify which child factors. Survivors gave detailed accounts of types of threats and manipulation applied by perpetrators to stop them from disclosing abuse. Survivors said disclosing or not disclosing helped them cope with abuse trauma. Quantitative results revealed that 58% of the survivors who completed the disclosure process aged between 9-13 years, 83.3% were female, and 70% had achieved a lower level of education.
Highlights
Child Sexual Abuse (CSA) is categorised as a form of child abuse and is one of the most confusing and perplexing problems facing many societies in the world, including Kenya
Survivors between the age of 9 to 13 years were more likely to disclose sexual abuse when compared with the other age groups in the study
The current study established through interviewing the medical and social providers that compared to the younger survivors, the older children were more embarrassed about sexual abuse making it more difficult to disclose or sick treatment at Thika Level 5 Hospital (TL5H), which is consistent with the literature (Easton, 2013)
Summary
Child Sexual Abuse (CSA) is categorised as a form of child abuse and is one of the most confusing and perplexing problems facing many societies in the world, including Kenya. CSA is defined as the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society (World Health Organization, 2003). The impact of CSA on children is documented, both globally and nationally. Research shows a high percentage of children and youth (60-80%) delayed disclosure until adulthood. The survivors endure un-intervened pain and suffering when disclosure is delayed (Vizard, 2013)
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