Few problems deserve attention more than stopping the abuse of vulnerable children, yet this area remains in great need of more reliable data. For example, UNICEF estimates that anywhere between 500 million and 1.5 billion children endure violence each year. Such uncertainty is a result of the hidden nature of much abuse, but it also suggests many countries have little idea what may be happening across their populations. Advocates for children and the media have helped advance understanding, even as experts struggle to formulate evidence-based policies. Recent attention has focused on changing international adoption policies and disputes, and the ongoing plight of AIDS orphans, but more knowledge is still required at a fundamental level.

For children living outside the care of biological parents, the situation is assumed to be the most dire, particularly in the developing world. Neglect, discrimination and malnutrition affect orphans more commonly than their non-orphaned peers: Research has shown such children are more likely to go to bed hungry and to be exploited (subjected to child labor) and less likely to be enrolled in school. Increasing urbanization in the developing world, growing poverty and the rising number of orphans requiring care — UNICEF estimates there are more than 150 million worldwide — exacerbate all these problems.

About one-third of all orphans worldwide live in sub-Saharan Africa, where poverty — despite some recent progress — persists at its most profound levels globally. Related research is often qualitative and anecdotal, focusing on limited surveys of affected communities. A 2013 study, “Child Abuse and Neglect among Orphaned Children and Youth Living in Extended Families in Sub-Saharan Africa: What Have We Learned from Qualitative Inquiry?” reviews some of the best available field studies. The researchers note that the “studies are remarkably consistent in finding orphaned children and youth vulnerable to multiple forms of maltreatment.” Overall findings include:

• There are “several perceived risk factors for orphan’s maltreatment: poverty, stigma, non-biological caregivers and alcohol abuse. Interventions to curtail child maltreatment will likely only be partially successful unless they are coupled with poverty-reduction and income-generating projects … and stigma-reduction campaigns.”
• “Tackling poverty and stigma should also help to curb maltreatment of orphans living with non-biological caregivers, as these two factors appear to underlie much of the increased vulnerability.”
• Throughout the studies reviewed, a wide variety of problems were reported for children, including: discrimination within their own household relative to biological children; material and educational neglect; labor exploitation; and sexual, physical and emotional abuse.

For the most serious forms of abuse and their prevalence, available research suggests that the reality may not always be simple. A 2013 study published in Child Abuse & Neglect, “Physical and Sexual Abuse in Orphaned Compared to Non-orphaned Children in Sub-Saharan Africa: A Systematic Review and Meta-Analysis,” analyzes the current scholarly literature, narrowly focusing on a small set of the most rigorous studies. The findings include:

• Researchers found non-orphan children in sub-Saharan Africa are victims of physical and sexual abuse just as often as orphaned children.
• According to existing quantitative data, orphans do not appear to be at higher risk of physical and sexual abuse compared with non-orphans in sub-Saharan Africa. In compiling the results, the authors included data from 10 studies in which 17,336 children (42% orphans) were involved.
• A major weakness in the existing data is a lack of a clear definition of abuse and the tools to adequately identify and classify it: “To design effective policy and practice responses, we need a much clearer understanding of abuse among children and youth within the region.” Additionally, most of the studies used took place in South Africa and Zimbabwe, which limits the ability to generalize the results.

Related research: Research continues on later-life outcomes for orphans in sub-Saharan Africa. Scholars have found that these children are more susceptible to problems such as alcoholism and HIV/AIDS, highlighting the urgency of interventions in these societies. As the HIV/AIDS epidemic continues to change patterns of society in southern Africa, new research is also focusing on how different family structures are accomodating these realities. For a more global look, UNICEF provides a data and policy primer on many aspects of child protection.

Keywords: orphans, sub-Saharan Africa, sexual abuse, physical abuse, abuse, systematic review