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Knowledge, Attitude and Practice of Public Primary School Teachers on Primary Prevention of Child Sexual Abuse in Southwestern Nigeria

Sekinat Olajumoke Owoyemi, Obioma Chukwudi Uchendu*, Olayide Olubunmi Olabumuyi

Department of Community Medicine, College of Medicine, University of Ibadan, P.M.B. 3017, G.P.O. Ibadan, Oyo State, Nigeria

Abstract: BACKGROUND: The professional role of primary school teachers in school-based programs makes them important stakeholders in child sexual abuse prevention. OBJECTIVES: To assess the knowledge, attitude and practices of primary school teachers on primary prevention of child sexual abuse in Agege Local Government Area of Lagos State. METHODS: Cross-sectional design that utilized a two-stage cluster sampling technique was used to select 463 public primary school teachers in Agege Local Government of Lagos State. A self-administered questionnaire was used to obtain information on respondents’ socio-demographic profile, knowledge, attitude and practices on primary prevention of child sexual abuse. Data were analysed using SPSS version 23. Descriptive statistics, Chi-square test and multivariate regression analysis were done. Statistical significance was set at 5%. RESULTS: The mean age of the teachers was 46.4±6.5 years and the majority (70.8%) were females. Adequate knowledge of primary prevention of child sexual abuse was found among 14.3% of respondents. 12.7% had a positive attitude towards primary prevention of child sexual abuse and good practice on primary prevention of child sexual abuse was found among 82.5% of the teachers. The male teachers were found to be about 2 times more likely to have adequate knowledge compared to female teachers (OR 1.9; 95% CI= 1.05-3.73) and were about 4 times more likely to have a good practice on primary prevention of child sexual abuse (OR 3.5; 95% CI= 1.71 - 6.97). CONCLUSION: The knowledge and attitude of primary teachers on the primary prevention of child sexual abuse in Lagos State was low.

Keywords: knowledge, attitude, practices, teachers, primary prevention, child sexual abuse

Received July 04, 2020; Revised August 05, 2020; Accepted August 14, 2020

Citation: Sekinat Olajumoke Owoyemi, Obioma Chukwudi Uchendu, Olayide Olubunmi Olabumuyi, Knowledge, Attitude and Practice of Public Primary School Teachers on Primary Prevention of Child Sexual Abuse in Southwestern Nigeria. American Journal of Educational Research, 8 (8). 536-542. January 2020. doi:10.12691/education-8-8-4

1. Introduction

“Child sexual abuse is an act of involving a child in sexual activities that the person in question; does not completely understand, is not developmentally prepared for and cannot give consent for. It is also an act that violates the laws or social taboos of the society” [1]

Child sexual abuse is a hidden public health problem. Therefore, the low prevalence reported underlies the actual magnitude of occurrence documented [2]. Despite that, the global prevalence of child sexual abuse has been estimated to be about 19.7% for females and 7.9% for males [3]. The African region having a prevalence of as high as 34.4% [4]. In Nigeria, one in four girls and one in ten boys had experienced sexual abuse before the age of 18 years [5]. The perpetrators of child sexual abuse are usually resident within the victims’ environment and are often known to, or are members of the family of the victims [6]. The effects of child sexual abuse can be severe and devastating on an individual’s psychological, emotional and physical well-being [7]. These emotional and behavioural difficulties can lead to significant disruption in children’s normal development and often have a lasting impact, leading to dysfunction and distress into adulthood [8].

In a survey of national dailies, 100 cases of child sexual abuse were identified whose ages ranged between 2 and 16 years. In Ilorin, 50% of commercial sex workers surveyed experienced child sexual abuse before 18 years [9]

Victims of child sexual abuse are often physically traumatized and are at increased risk of long-lasting psychological trauma, acquiring sexually transmitted infections (STIs) including HIV/AIDS, and other negative outcomes [2]. Child sexual abuse regularly happens in situations where children also suffer other adverse childhood experiences, such as child physical abuse, neglect, substance abuse among family members, community violence and mentally ill caregiver [6]. Many of these children, when abused sexually, will never tell anyone often as a result of threats or manipulation by the perpetrator [10].

The school is a social institution where the majority of children spend a large part of their days. Teachers spend more time in daily contact with the children and beyond teaching them also act as the parent in loco for the period they are school. Teachers identify potential changes in a child’s appearance, or behaviour such as; isolation from social activities, an exhibition of adult-like sexual behaviours, knowledge and use of sexually explicit languages which suggest sexual abuse [11].

Teachers are the early educators of children after their parents. They occupy a vantage position towards the prevention of child sexual abuse because they have control over the kids to an extent [12]. The school is both a learning and social institution where children are under the consistent supervision of their teachers. The school environment provides a platform for both primary and secondary prevention of sexual abuse among children. Schools play a role in primary prevention of sexual abuse through school-based programs that can help increase the knowledge of children on child sexual abuse and teach them protective skills and behaviours [13]. Secondary prevention is achieved through early identification of children who are sexual abuse victims [14]. However, the extent to which the school environment can help in the prevention of child abuse is predicated on the teachers’ knowledge and attitudes towards child sexual abuse.

Prevention of child sexual abuse is of great importance because of the frequent long-term impacts [6]. Child sexual abuse is one of the main types of abuse still to be addressed within the field of education, yet the education system itself can serve as a primary tool for its prevention [15].

The prevalence of child sexual abuse in developing countries including Nigeria has made instituting interventions for effective control of this problem a priority. Lagos State is a metropolitan city where children are exposed to multiple factors that predisposes them to various forms of child abuse, including sexual abuse.

This study was therefore conducted to assess the knowledge, attitude and practices of public primary school teachers on primary prevention of child sexual abuse in Agege Local Government Area of Lagos State. The findings from this study will serve as an evaluation of the training received by teachers. It will also provide information on existing gaps if any on teachers’ knowledge and practices on primary prevention of child abuse. Lastly, it will provide the evidence required for designing appropriate school-based child abuse prevention programs in Lagos State.

2. Methods

2.1. Study Area

This study was conducted in Lagos state, a cosmopolitan city located in the South-western part of Nigeria with a population of 9,113,605 from the population census. It is the smallest state in and the economic capital of Nigeria. The indigenous inhabitants include the Aworis and Eguns who are settled in Ikeja and Badagry Divisions respectively [16]. The state has 20 Local Government Areas (LGAs) and 37 Local Council Development Areas (LCDAs). The state has 1,014 public primary schools with 10,851 teachers.

The economic activity in Lagos State attracts several migrants from other states and foreigners. These migrants come to find jobs or engage in economic activities. This influx of migrants has made the city overpopulated with a population density of 3,752/km² [17]. An outcome of the overpopulation is poor housing and proliferation of urban slums. Many residents of Lagos State are homeless or live in housing units described by the United Nations as a menace to health and human dignity [18]. Overcrowded slums in the metropolis have been found to contribute to high rate of; illiteracy, unemployment, poverty, divorce, juvenile delinquency, child abuse including sexual abuse, alcoholism, drug abuse, psychological disorders and mental deficiency [19].

This study was carried out in Agege local government area of Lagos state. Agege LGA is one of the three Local Government Areas in Lagos State which have been reported to have the highest rates of child sexual abuse. Other LGAs are Oshodi-Isolo and Kosofe [20]. As at 2006, the population of Agege was put at 461,743 with a population density of 37,406/km² [21].

Agege Local Government Area has 50 public primary schools with 500 teachers. There are also many private nursery/primary schools, secondary schools and vocational institutes [22].

2.2. Study Design

It was a school-based cross-sectional study.

2.3. Study Population and Sampling

The study was conducted among consenting public primary school teachers in selected primary schools in Agege Local Government Area, who have been teaching in the same school for the last three years and above. Teachers who are not paid by the local government (PTA teachers and National Youth Corp Service teachers) and those absent on the date of data collection were excluded from the study. A minimum sample size of 358 primary school teachers was estimated after a 10% adjustment for non-response using the formula for estimation of single proportion [23]. A margin of error of 5%, a 95% confidence interval, and a prevalence of knowledge of child sexual abuse prevention among primary school teachers in Fuxin, China of 30% was used [24].

2.4. Sampling Procedure

A two-stage cluster sampling technique was used to select eligible public primary school teachers. The first stage was the selection of Agege Local Government from three Local Governments (Oshodi-Isolo, Agege and Kosofe) having the highest rate of child sexual abuse in Lagos state (22) by balloting. In the second stage, forty-five (45) public primary schools were selected from 50 schools by balloting. The estimate prior to the study was that there would be at least 10 teachers in each school and the minimum sample of teachers would be recruited from 45 schools. However, all 465 eligible and consenting public primary school teachers in Agege LGA were recruited for this study.

2.5. Data Collection

A structured, self-administered questionnaire was used to elicit information on socio-demographic characteristics, knowledge, attitude and practices of primary prevention of child sexual abuse. The instrument was adapted from findings of the literature review of studies on primary prevention of child sexual abuse. Content validity was done by researchers in reproductive health, school health and child abuse research who critiqued and revised the instrument. Pre-testing of the instrument was conducted among 38 primary school teachers in a different local government with similar characteristics to Agege Local Government Area. Necessary adjustments and corrections were made to produce the final version of the instrument that was used for this study. Written informed consent was obtained from all respondents prior to data collection. Ethical approval and permission were obtained from the Ministry of Education and the Education District 1 Office respectively. Confidentiality was maintained throughout the period of the research and after.

2.6. Data Management

The primary outcome for this study was the practice of primary prevention of child sexual abuse by public primary school teachers. The secondary outcomes were the knowledge of primary prevention of child sexual abuse and attitude on primary prevention of child sexual abuse by public primary school teachers.

2.6.1. Practice of Primary Prevention of Child Sexual Abuse

The practice of the teachers was assessed using 7 “Yes” or “No” questions. The correct response to each of the first five practice questions was scored 3 points because the first five questions were extracted from the school curriculum while a correct response to each of the last two questions was scored 1 point. An incorrect response to any of the practice questions was scored 0. The maximum obtainable score was 17 while the minimum obtainable score was 0. Teachers with practice scores of 12 and above were categorized as having “good practice of primary prevention of child sexual abuse” while those with scores below 12 were categorized as having “poor practice of primary prevention of child sexual abuse”.

2.6.2. Overall Knowledge of Primary Prevention Of Child Sexual Abuse

The knowledge of public primary school teachers on primary prevention of child sexual abuse was assessed using questions on ‘general knowledge on child abuse’, ‘knowledge on signs of child sexual abuse’, ‘knowledge on child abuse prevention’ and ‘knowledge on the perpetrators of child abuse’ with a “Yes”, “No” or “I don’t know” options. Correct responses to each knowledge question were scored 1 while incorrect or “I don’t know” responses were scored 0. The scores were summed up to obtain maximum and minimum obtainable score of 36 and 0 respectively. Teachers with scores of 27 and above were categorized as having “good knowledge of primary prevention of child sexual abuse” while those with scores below 27 were categorized as having “poor knowledge of primary prevention of child sexual abuse”

2.6.3. Attitude towards Primary Prevention of Child Sexual Abuse

The attitude of public primary school teachers to primary prevention of child sexual abuse was assessed using 7 questions on a five point Likert scale from “strongly agree” to “strongly disagree” which were positively worded with scores of 0 to 4. The scores assigned to the response categories were: “Strongly agree” = 4, “Agree” = 3, Undecided” = 2, “Disagree” = 1, “Strongly disagree” = 0. The scores were summed up to obtain maximum and minimum obtainable scores of 28 and 0 respectively. Teachers with scores of 22 and above were categorized as having “positive attitude towards primary prevention of child sexual abuse” while those with scores below 22 were categorized as having “negative attitude towards primary prevention of child sexual abuse”

2.7. Independent Variables

2.7.1. Socio-demographic Factors

Age

Respondents’ age was recoded into the following three categories: “less than 40 years”, “40-49 years” and “≥ 50 years”.

Marital status

Respondents’ marital status was dichotomized into those that were “currently married” (married) and those “not currently married” (single, co-habiting, divorced, separated and widowed).

Highest level of education

Respondents’ level of education was categorized into those that had “less than university education” (Grade II, NCE and polytechnics certificate), and those with “university education” (graduate and postgraduate certificate).

Years of teaching experience

Respondents’ years of teaching experience was categorized into “less than 10 years”, “10-19 years” and “≥ 20 years”.

Grade level

The grade level of teachers was collected as discrete variable and categorized into three groups of “lower grade level (6-9)”, “mid-grade level (10-12)” and “higher grade level (13-15)”.

Other independent variables were; gender, participation in training on prevention of child sexual abuse.

Data collated was cleaned daily, coded and entered into the computer using Statistical Package for Social Sciences software (SPSS), version 22 [25]. Age was summarized using mean and standard deviation, while frequencies, percentages were used to summarize all categorical variables. Chi-square test was used to determine the independent variables associated with the outcome while logistic regression was used to determine the predictors of the outcome variable. A 5% statistical significance level was used.

3. Results

Data from 463 students were analysed from the 465 questionnaires distributed among the consenting public primary school teachers in the selected schools giving a response rate of 99.6%.

3.1. Socio-demographic Characteristics

The mean age of the teachers was 46.4±6.5 years, 218 (47.0%) were ≥ 50 years and a higher proportion of the teachers were females, 328 (70.8%). About half of the teachers, 251 (54.2%), had more than 10 years of teaching experience while 249 (53.7%) were on grade level 10-12 (Table 1).

Table 1. Sociodemographic Characteristics of Respondents

3.2. Respondents’ Knowledge, Attitude and Practice on Primary Prevention of Child Sexual Abuse

General knowledge on child sexual abuse was good among 133 (28.7%) of the public primary school teachers. Less than a fifth of them 89 (19.2%) and 83 (17.9%) had good knowledge on; the signs of child sexual abuse and preventive measures for child sexual abuse respectively. Furthermore, 310 (67.0 %) of the teachers had good knowledge of the perpetrators of child sexual abuse (Table 2). However, the overall knowledge of primary prevention of child sexual abuse was good in 66 (14.3%) teachers. Regarding their attitude towards primary prevention of child sexual abuse, 59 (12.7%) of the teachers had a positive attitude. Furthermore, 382 (82.5%) of the teachers had a good practice on the primary prevention of child sexual abuse (Table 2).

Table 2. Knowledge, Attitude and Practice of Primary Prevention of Child Sexual Abuse (CSA) among Respondents

3.3. Factors Associated with and Predictors of Knowledge on Primary Prevention of Child Sexual Abuse among Respondents

A significantly higher proportion of the male teachers (23.0%) and teachers <40 years of age (42.4%) respectively had good overall knowledge on primary prevention of child sexual abuse compared to female teachers and older teachers. Teachers with University degrees had significantly good knowledge on primary prevention of child sexual abuse compared to those without a university education. Teachers between ages 40-49 years had 8 times to the odds of having good knowledge on primary prevention of child sexual abuse compared to those ≥ 50 years (OR 7.99; 95% CI 3.09-20.65). The odds of having good knowledge on primary prevention of child sexual abuse was about twice higher among male teachers than female teachers (OR 1.98; 95% CI 1.05-3.73) (Table 3).

Table 3. Predictors of Knowledge, Attitude and Practice of Primary Prevention of Child Sexual Abuse among Respondents

3.3. Factors Associated with and Predictors of Attitude towards Primary Prevention of Child Sexual Abuse among Respondents

A significantly higher proportion of teachers with less than 10 years of teaching experience (25.6%) had a positive attitude towards primary prevention of child sexual abuse compared to those with higher years of experience. Similarly, a higher proportion of those on grade levels 6-9 (33.3%) had a positive attitude towards primary prevention of child sexual abuse compared to their counterparts with higher grade levels. The odds of having a positive attitude to primary prevention of child sexual abuse was lower by about 6 times (OR 0.17 95% CI 0.08-0.34) and 3 times (OR 0.30; 95% CI 0.15-0.61 in teachers on grade levels 10-12 and 13-15 respectively compared to those on lower grade levels (Table 3).

3.4. Factors Associated with Practice and Predictors of Primary Prevention of Child Sexual Abuse among Respondents

A higher proportion of male (88.9%) and currently married (84.6%) teachers respectively had a good practice of primary prevention of child sexual abuse compared to the female teachers and those that were not currently married. Male and married teachers had about 4 times (OR 3.45; 95% CI 1.71-6.97) and 3 times (OR 2.64; 95% CI 1.37-5.07) respectively the odds of having good practice on primary prevention of child sexual abuse compared to the female and unmarried teachers. Other predictors of good practice were years of teaching experience and grade level (Table 3).

4. Discussion

This study conducted among primary school teachers in a metropolitan city in South West Nigeria showed that few (14.3%) of them had good knowledge on primary prevention of child sexual abuse. This was similar to that of a study conducted among primary school teachers in an urban region of Fuxin, China where less than one-third of the teachers (30%) had good knowledge on prevention of child sexual abuse [24]. Another study conducted in Zhejiang province of China by Zhang et al., to determine preschool teachers’ knowledge, attitudes and training education on early prevention of child sexual abuse also reported that teachers had limited knowledge on prevention of child sexual abuse [26]. The poor knowledge could be as a result of lack of interest due to the stigma that comes with sexual abuse. Another reason could be the lack of proper training/awareness in terms of contents about sexual abuse.

Age was found to be a predictor of good overall knowledge on prevention of child sexual abuse from this study with younger ones having good knowledge on primary prevention of child sexual abuse compared to their older counterparts. This perhaps is because teachers in this age group (≤49 years) have more access to information, education and communication (IEC) materials through various modern platforms compared to the older teachers who may find some of the platforms unwieldy and difficult to use. Also, older teachers may assume they already have good knowledge on child sexual abuse prevention because of their years of teaching experience. The findings from this study, however, differ from that conducted by Mlekwa et al. among parents living in rural community of Shinyanga district, Tanzania to determine their knowledge, attitudes and practices of child sexual abuse and its prevention. Mlekwa and colleagues reported that age had no significant influence on the level of knowledge on child sexual abuse and its prevention among parents [27]. Their finding was due to the frequent public education programmes for parents as reported in the study.

Respondents’ sex was also identified as a predictor of good knowledge on primary prevention of child sexual abuse as male teachers with higher likelihood of having good knowledge on primary prevention of child sexual abuse compared to their female counterpart. In contrast to this study, Martin and Silverstone (2016) studied caregivers and professionals who interact with children in Western Canada to determine their level of knowledge, attitude and behaviour on preventing child sexual abuse. They reported that gender had no significant influence on the level of knowledge of preventing child sexual abuse among them [27]. This difference could be due to the different study population. The respondents from the Canada study were professionals who are being trained regularly, hence the level of knowledge of both male and females were found to be similar. This study, however, looked at the population of teachers who are not being formally trained. The finding from this study could also be due to the fact that in this clime, male teachers are considered to be more tolerant, more approachable and have the capacity to take action more than the female teachers [27].

The study found that about a tenth of the respondents (12.7%) had a positive attitude towards primary prevention of child sexual abuse. A higher proportion (98.1%) of the teachers were of the opinion that teachers cannot play a big role in preventing child sexual abuse, while 68.1% agreed there was no need to conduct child sexual abuse prevention education, as children will acquire it as they grow. The low level of positive attitude towards prevention of child sexual abuse in this study is however in tandem with the low level of good knowledge fond among the same respondents.

This study found teachers’ grade level as a predictor of positive attitude towards primary prevention of child sexual abuse among the respondents. Teachers on higher-grade level were found to be less likely to have a positive attitude compared to those on lower grade level. This is contrary to Adogu and Nwafulume’s study [28] conducted among secondary school teachers in Nnewi, South Eastern, Nigeria to determine their knowledge, attitude and willingness to teach sexuality education which found no significant association between grade level of teachers and their attitude towards teaching sexuality education. The difference in the findings may be attributed to the different population that was studied. Secondary school teachers irrespective of their grade level may be of the opinion that secondary school students are old enough to know how to prevent themselves from sexual abuse compared to primary school students [29]. Differences in socio-cultural beliefs may also contribute to the disparity in findings.

Despite the low levels of knowledge and positive attitude, this study has shown that high proportions (82.5%) of the primary school teachers had good practices on primary prevention of child sexual abuse. This could be due to the National Policy on Education curriculum that has mandated primary school teachers to teach the pupils about primary prevention of child sexual abuse in Lagos State.

In this study, male teachers are more likely to have good practices on primary prevention of child sexual abuse compared to their female counterparts. This can be attributed to the fact that male teachers were found to be more sensitive to the needs of their pupils than female teachers, hence an issue as sensitive as child sexual abuse and it’s prevention may be better practiced by them compared to the females [30].

Also, married teachers were more likely to have a good practice on primary prevention of child sexual abuse than the unmarried ones. This may be due to the fact that most married teachers are mothers and fathers with children therefore they may view addressing the needs of children on protective skills to prevent child sexual abuse as something that personally concern them. [31]

Teachers on higher grade level had a higher likelihood of good practices on prevention of child sexual abuse than those on lower levels. This is however not surprising since previous studies had shown teachers on higher grade levels to be better skilled and more effective compared to those on lower levels [32]. It has also been documented that lower grade level teachers were sometimes unable to work with speed, flexibility or mental models that permit effective handling of a large amount of information [33]. It could also be due to the fact that lower-level teachers easily get overwhelmed with and could not make out time to practice primary prevention of child sexual abuse.

Teachers with fewer years of teaching experience in this study had a higher probability of good practices on primary prevention of child sexual abuse than those with more years of experience. This is in tandem with the finding of Rice that found that teachers show the greatest productivity during their first few years on the job after which their performance level tends to level off [34]. Also, teachers with more years of experience are likely to be older and it has been found that as teachers age, they become sceptical and develop a psychological condition of exhaustion and inefficiency, this may, therefore, account for poor practice on primary prevention of child sexual abuse among them [35].

5. Conclusion

Overall, primary school teachers are part of children’s everyday life and can play important role in protecting school children from the problem of sexual abuse if they have the necessary skills needed. However, a higher proportion of primary school teachers in Agege Local Government Area of Lagos State were found to have poor knowledge and negative attitude towards primary prevention of child sexual abuse. Age and sex of the teachers were found to be predictors of good knowledge while grade level was found as a predictor of a positive attitude. Marital status, sex, years of teaching experience and grade level were the predictors of good practice on prevention of child sexual abuse among primary school teachers in Agege LGA. This study showed a gap in the knowledge and attitude of primary school teachers in Agege LGA. There is, therefore, a need for intervention on primary prevention of child sexual abuse appropriate for different strata of primary school teachers in Agege LGA, Lagos State.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Acknowledgements

We would like to appreciate:

Ÿ The staff of Lagos State Ministry of Education and Educational District I for their support through the course of the work.

Ÿ The teachers from the selected primary schools that volunteered to be part of the work.

Ÿ Mr Olawale Awosika for his contribution during the development of this manuscript

Statement of Competing Interests

The authors have no competing interests.

List of Abbreviations

None.

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