Impact of child-protection law on child maltreatment reporting: A comparison of pre- and postlaw data from a hospital registry.

BACKGROUND

Child maltreatment (CM) is a global public health problem that affects countries at variable rates. Many factors can reduce this problem, but the existence of national law is an essential factor. The objective of the study was to compare reporting patterns of CM after the implementation of the Saudi Child Protection Law to the prelaw period.

MATERIALS AND

METHODS

This cross-sectional study retrospectively reviewed the cases of CM cases reported in the registry of King Abdullah Specialized Children Hospital, a governmental tertiary care hospital in Riyadh, Saudi Arabia. The registry data from 2014 to 2022 were compared with CM cases evaluated at the same institution from 2000 to 2008, prior to the implementation of the child protection law.

RESULTS

From 2014 to 2022, 1370 patients were referred to the child protection team; of these, 878 (64.1%) patients were confirmed as CM and entered into the CM registry. For 878 confirmed cases of CM, the issue was that of neglect (58.3%), followed by physical abuse (27.8%), emotional abuse (8.4%), and sexual abuse (5.5%). Most prevalent finding in physical abuse cases was bruises (26.2%) followed by fractures (16.0%). Parents were identified as the perpetrators in 77.9% cases of CM. Comparing the current data to the prelaw data, the reported CM cases increased from 6 cases per year in 2000 to over 200 cases in 2022, with a 7-fold increase in the reporting rate between the two periods. The reports of neglect increased by 89.2%, physical abuse increased by 38.9%, and sexual abuse decreased by 14.3%. Case fatality rate decreased from 8.3% to 3.2%.

CONCLUSION

The implementation of the child protection law led to an increase in CM reporting. Data from the registry will enable decision makers to analyze types, trends, and magnitude of CM, and provide a foundation for the development of effective prevention programs.