Research On The Neglect Rate And Impact Factors Of School-aged Children In Rural Areas Of Western China

Objective:To investigate the current situation and impact factors of child neglect in rural areas of Chongqing and Shaanxi, to provide scientific evidence for targeted intervention measures.Methods:A cross-sectional survey using multi-stage stratified cluster random sampling was conducted in 26 rural schools of Shaanxi and Chongqing from September 2012 to April 2013. All the school-aged children were centralized to complete a questionnaire survey and the child neglect was measured by Scale on Child Neglect in Rural China（SCNRC）. The neglect rates between groups were compared with Chi-square test and Cochran-Armitage trend test. Factors perhaps associated with neglect were analyzed with binary logistic regression. All data were input in Epidata3.1 twice for error correction. All analyses were conducted in SPSS 21.0 and SAS9.2.Results:A total of 4356 children participated in the survey and 4131 eligible participants（2094 boys and 2037 girls） were recruited finally. The overall prevalence of child neglect was 55.50%. In this study, the most prevalent type of neglect detected was educational neglect（22.07%）, followed by physical neglect（20.71%）, emotional neglect（19.17%）, medical neglect（16.44%）, security neglect（16.23%） and social neglect（16.02%）.No significant differences were found between genders in the prevalence of neglect subtypes except for medical neglect（x²=8.829, p=0.003）. However, the neglect rate among children of Han nationality was higher than among children of Minorities except for educational neglect（x²=0.002, p=0.966）. Significant differences were found between children of different family structures in the prevalence of neglect subtypes except for social neglect（x²=6.192, p=0.185）. Neglect rate of all subtypes are significantly higher in left-behind students compared to non-left-behind students（p<0.05）, as well as in multi-child family compared to only-one-child family（p<0.05）. Significant differences were found between children of different birth order in the prevalence of neglect subtypes except for emotional neglect（x²=3.824, p=0.051） and social neglect（x²=6.268, p=0.012）. And the neglect rate of different subtypes differ in parents’ occupations（p<0.05） except educational neglect(x²_father=9.416, p=0.052; x²_mother=9.318, p=0.054) and social neglect(x²_father=3.228, p=0.520; x²_mother=6.351, p=0.174). The neglect rate of all subtypes increase with parents’ educational degree increasing; while decrease when parents leave home becoming longer, the trend between neglect rate and parents educational degree is significant, as well as between neglect rate and parents’ time of leaving home（p<0.05）.The binary logistic regression analysis result indicates that non-left-behind child, girl and higher father’s education were protective factors（OR: 0.79, 0.83, 0.66）. In the meanwhile, factors such as being minority, nuclear family, step family, one parent family, non-only child and mother seldom going home placed children at an increased risk of neglect（OR: 1.69, 1.26, 3.37, 1.88, 1.38, 1.11）.Conclusions:The neglect rate of school-aged children in rural areas of Chongqing and Shaanxi is at a high level. Children belong to the Minorities, one-parent families, step families and multi-child families, whose parents have low education level and seldom go home, are at a higher risk of being neglected and deserving more attention from government and researchers.