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Unmet Need for Healthcare Due to Physical Violence Against Children: A National Population-Based Survey in a Low-Income Country
Katherine T. Flynn-O'Brien, MD, MPH. University of Washington, Harborview Injury Prevention and Research Center, University of Washington, Harborview Injury Prevention and Research Center, Division of Violence Prevention, Centers for Disease Control and Prevention, Louis H. Marcelin, PhD, Department of Anthropology and Department of Health Sciences, University of Miami; Chancellor, Interuniversity Institute for Research and Development (INURED), Centers for Disease Control and Prevention, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention

Background: Quantify reported and actual unmet need for healthcare services due to physical violence against children in Haiti.

Methods: A three-stage clustered-sample population-based survey was administered to 13-24 year old Haitians. Reported unmet need was defined as a desire for medical services not received. Actual unmet need for basic and advanced healthcare was defined as children who sustained lacerations, sprains, or dislocations and deep wounds, fractures, permanent injury or disfigurement, respectively, but did not receive care. Poisson regression estimated weighted prevalence ratios (PR) were calculated.

Results: When weighted to the population, 63.7% were victims of physical violence prior to 18, representing over 1.5 million injuries (Table), however only 7.3% of victims received care for their injuries. Among victims, 6.7% reported unmet need, however, 61.0% had actual unmet need for basic healthcare and 14.4% had actual unmet need for advanced healthcare. While girls and boys had similar met need (PR 1.06 95% CI .60-1.60), girls were 50% less likely to report unmet need (PR .50, 95% CI .30-.84) yet more than twice as likely to have actual unmet need for advanced healthcare (PR 2.59, 95% CI 1.77-3.79).

Conclusions: The unmet need for healthcare services due to physical violence against children in Haiti is high, including need for advanced care and surgical services. Violence against children is an important component of the global burden of surgical disease.


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