Occurrence and circumstances of child sexual assault in Maputo, Mozambique

Background: Child Sexual Abuse (CSA) is a significant public health issue, with its health and social consequences well documented. While CSA has been extensively studied in high-income countries, its incidence and circumstances of occurrence in low-income countries, especially in Africa, remains under-represented in the scholarly literature. Methods: This study aimed to investigate the occurrence and circumstances of CSA among victims assisted at the Forensic Service of the Hospital Central de Maputo in Mozambique. A cross-sectional, quantitative study was conducted using secondary data from 2015 to 2020, extracted from the medico-legal reports of all victims under 18 years old. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 28.0. Results: 2610 cases of CSA were reported for the period 2015 to 2020, of which 2588 were included for analysis. Of the cases analysed, the majority of victims were girls (93.7 %), predominantly aged 12-17 years (48.6 %). The reported types of penetration revealed that vaginal penetration was the most frequent (86 %), followed by anal (11 %) and oral (2 %). Most assaults occurred either at the victims' or perpetrators' homes (54.8 %), primarily during the week (71.1 %), and typically in the afternoon (36.5 %) or evening (41.9 %). The assaults were predominantly perpetrated by a single individual (88.7 %), who was most often identified as an acquaintance (72.9 %). Additionally, 54.1 % of the children experienced concomitant physical violence, and approximately 74.9 % of the perpetrators did not use condoms during the assault. Conclusions: The findings of this study underscore the urgent need to implement prevention measures specifically targeting adolescent girls and younger boys, aiming to promote early reporting and prevent mental, physical, and sexual and reproductive health complications. Raising awareness about all forms of child abuse, including sexual abuse, and enhancing reporting and diagnostic systems in Mozambique is crucial.