Physical and Emotional Child Abuse in Haiti: Prevalence, Help-Seeking Behavior, and Mental Health Outcomes

Background and purpose: Child maltreatment is a major global health problem that has both short and long-term deleterious outcomes for those who experience it. Therefore, understanding the prevalence and its influences is important for risk identification and interventions. Haiti is a poor country with history of major natural disasters and political unrest, yet we know little about child abuse in this Caribbean country. The present study seeks to identify the national prevalence of child emotional and physical abuse, and examine the mental health consequences of abuse experiences.

Methods: A nationally representative, cross-sectional household sample of Haitian youth (n= 2916) from the Violence Against Children Survey (VACs) was used to estimate prevalence of emotional and physical abuse of children aged 13 to 17; and to investigate the mental health outcomes, self-harm and help-seeking behaviors of those exposed to child abuse compared to those who did not. Data were analyzed using survey-specific commands to accommodate sample weights and clustering. Linearized variance estimation was used for standard error estimates to provide confidence intervals for proportions. Descriptive statistics were first completed to estimate abuse prevalence and children’s help-seeking behaviors. Weighted binary logistic regressions were then conducted to examine the association between physical and emotional child abuse and mental health outcomes while controlling for age and gender. Adjusted odds ratios (ORs) were calculated with 95 percent confidence intervals to indicate the odds of children experiencing abuse reporting poor mental health outcomes and self-harm behaviors compared to those without such experiences while controlling for other factors.

Results: Results indicated that the lifetime prevalence of child physical and emotional abuse was 67% (95% CI 0.63 – 0.69) and 39% (95% CI 0.36 – 0.41) respectively, and the prevalence in the last 12 months was 26% (0.21 – 0.28) and 22% (0.19 – 0.23) respectively. Girls experienced higher rate of emotional abuse perpetrated by both parents, and boys experienced higher rate of physical abuse perpetrated by fathers. Most victims (90%; 95% CI 0.88 – 0.92) did not seek official help. Not needing services or not knowing where to go were the most common reasons given for not seeking help. For those experiencing physical child abuse, the odds of severe mental distress were 1.49 (95% CI 1.07 – 2.07) relative to those who did not; while for those experiencing emotional abuse, the odds were 2.29 (95% CI 1.68 – 3.11), both of which were statistically significant. Among those who experienced physical and emotional abuse, the odds of experiencing suicidal ideation were 1.69 (95% CI 1.17 – 2.44) and 3.42 (95% CI 2.67 – 4.40) respectively, compared to those without abuse, which were both statistically significant.

Conclusion and implication: The results suggest that the prevalence of child physical and emotional abuse in Haiti is high and both abuse types are associated with poor mental health and suicidal ideation. This highlights the importance of identifying protective family and community factors immediately and implementing intervention programs to prevent child abuse and self-harm behaviors with the help of social workers and health professionals.