Global Pediatrics (Dec 2023)
Examining epidemiological patterns of the components of the severe physical punishment index used by UNICEF
Abstract
Background: UNICEF's severe physical punishment of children index is composed of the combination of two practices (being “beat” and “hit on head”) and may be considered as a proxy for child physical abuse. Objective: This study aimed to determine whether the prevalence patterns of these two punishments differ substantially and consequently might obscure understanding of individual punishments and generate an inadequate index. Methods: Nationally representative samples of households with children aged 5–14 years from low- and middle-income countries with populations of ≥10 million with datasets available from UNICEF's 6th Multiple Indicator Cluster Survey cycle were used. Weighted prevalences were determined for the two punishments and their combination and by child age and sex for all countries meeting inclusion criteria. Results: Across the 21 datasets from 18 countries, prevalence of being beat varied from 0.2% to 12.6%, and hit on head from 1.6% to 46.1%. The majority of the prevalence of the combined index was accounted for by being hit on head in all but one survey. In several, but not all, surveys, males and younger children were more likely to be exposed to each of the punishments.Across punishments, there were some surveys with differing age prevalence patterns, but minimal differences by sex. Conclusions: Obscuring the epidemiology of being beat, arguably the more severe of the two, is one consequence of combining these punishments into a single index. Being beat should be reported separately and a new composite index of severe and abusive physical punishment should be considered.
