Exploring child protection reporting in English-speaking countries in Africa: A scoping review.

BACKGROUND

The evolution of child protection services varies globally, with Africa facing distinct challenges. By 2050, 42% of global childbirths will occur in Africa, amid persistent harmful traditional practices and poverty.

OBJECTIVE

This scoping review explores the nature, extent, barriers, and enablers of child protection reporting within African hospitals.

PARTICIPANTS AND

SETTING

Twelve peer-reviewed studies ranging between January 2011, and December 2021 were reviewed, capturing a collective sample of 973 under 18 years and 246 hospital healthcare professionals (HCPs) across English-speaking African countries.

METHODS

Guided by Arksey and O'Malley's and the PAGER framework, the review maps patterns and systemic gaps in child maltreatment reporting.

RESULTS

Included studies predominantly evaluated child sexual abuse (41.6%) and physical abuse (33.3%), with minors constituting 48% to 100% of victims within paediatric cohorts. Key barriers identified systemic fragmentation, social stigma, inadequate inter-agency collaboration, unclear professional roles, and insufficient forensic training resulting in low follow-up rates (0% to 72.3%). Conversely, documented police reporting rates varied widely (6.7% to 69%), while healthcare provider involvement and supportive legislation (e.g., Child Rights Act), highlighted critical pathways for targeted multidisciplinary intervention.

CONCLUSIONS

Strengthening child protection requires standardised, WHO-aligned hospital protocols, mandatory forensic/psychosocial HCP training, improved inter-agency coordination, and anti-stigma community initiatives. Future research should incorporate survivors' perspective, address male survivors, and utilise population-based designs.

IMPLICATIONS TO PRACTICE: This scoping review impacts clinical practice by highlighting requirements for standardised protocols, inter-agency collaboration, and mandatory HCP training. Overcoming systemic and sociocultural barriers requires integration of trauma-informed, multidisciplinary strategies for prompt child protection practices.