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2016 ; 13
(4
): e1002003
Nephropedia Template TP
gab.com Text
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English Wikipedia
Gender Differences in Homicide of Neonates, Infants, and Children under 5 y in
South Africa: Results from the Cross-Sectional 2009 National Child Homicide
Study
#MMPMID27115771
Abrahams N
; Mathews S
; Martin LJ
; Lombard C
; Nannan N
; Jewkes R
PLoS Med
2016[Apr]; 13
(4
): e1002003
PMID27115771
show ga
BACKGROUND: Homicide of children is a global problem. The under-5-y age group is
the second largest homicide age group after 15-19 y olds, but has received little
research attention. Understanding age and gender patterns is important for
assisting with developing prevention interventions. Here we present an age and
gender analysis of homicides among children under 5 y in South Africa from a
national study that included a focus on neonaticide and infanticide. METHODS AND
FINDINGS: A retrospective national cross-sectional study was conducted using a
random sample of 38 medico-legal laboratories operating in 2009 to identify
homicides of children under 5 y. Child data were abstracted from the mortuary
files and autopsy reports, and both child and perpetrator data data were
collected from police interviews. We erred towards applying a conservative
definition of homicide and excluded sudden infant death syndrome cases. We
estimated that 454 (95% CI 366, 541) children under the age of 5 y were killed in
South Africa in 2009. More than half (53.2%; 95% CI 46.7%, 59.5%) were neonates
(0-28 d), and 74.4% (95% CI 69.3%, 78.9%) were infants (under 1 y), giving a
neonaticide rate of 19.6 per 100,000 live births and an infanticide rate of 28.4
per 100,000 live births. The majority of the neonates died in the early neonatal
period (0-6 d), and abandonment accounted for 84.9% (95% CI 81.5%, 87.8%) of all
the neonates killed. Distinct age and gender patterns were found, with
significantly fewer boy children killed in rural settings compared to urban
settings (odds ratio 0.6; 95% CI 0.4, 0.9; p = 0.015). Abuse-related killings and
evidence of sexual assault were more common among older girls than in all other
age and gender groups. Mothers were identified as the perpetrators in all of the
neonaticides and were the most common perpetrators overall (71.0%; 95% CI 63.9%,
77.2%). Abandoned neonates were mainly term babies, with a mean gestational age
of 38 wk. We did not have information on abandonment motives for all newborns and
did not know if babies were abandoned with the intention that they would die or
with the hope that they would be found alive. We therefore considered all
abandoned babies as homicides. CONCLUSIONS: Homicide of children is an extreme
form or consequence of violence against children. This national study provides
one of the first analyses of neonaticide and infanticide by age and gender and
shows the failure of reproductive and mental health and social services to
identify and help vulnerable mothers. Multi-sectoral prevention strategies are
needed.