Child Abuse in the West Bank: Lessons Learnt from a Qualitative Study

In preparation for a survey using two international child abuse screening tools (ICAST-P for parents and ICAST-R for young people), a qualitative study explored the use of discipline and the understanding of child abuse, including sexual abuse, in Palestinian West Bank society, and investigated the appropriateness, in relation to clarity, acceptability and relevance, of the instruments. Qualitative research teams conducted 30 in-depth interviews with mothers (10), young men (10) and young women (10). Our findings indicate that in a society where sexual abuse is not openly discussed and follow-up services may be inadequate or inaccessible, inclusion of sexual abuse questions in a survey may be inappropriate and even harmful. However, by asking respondents about sexual abuse questions, rather than asking specifically about an individual's experiences, this study initiated discussion, which acknowledged the occurrence of sexual abuse of both boys and girls in the West Bank population. The findings warrant serious attention by educational, psychological, social and legal services in Palestine. Additionally, the findings caution against administering internationally designed survey instruments in low- and middle-income countries (LMIC) before the potential implications related to cultural, social and political contexts have been carefully examined. Key Practitioner Messages Before administering an international child abuse screening tool, qualitative research must be conducted in order to understand the cultural context. Sexual abuse research must include questions on both male and female exposure to abuse. Conducting surveys on sensitive issues, such as sexual abuse, could have unforeseen negative consequences for both respondents and researchers. Qualitative research on sensitive topics may be sufficient in demonstrating the need for social interventions.