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

Abstract

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.

Keywords: Child abuse; Child welfare; Forensic medicine; Health personnel; Reporting; Social; Stigma.