الفهرس 
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Abstract
Child sexual harassment is a prevalent and pervasive societal issue that affects children across various socioeconomic backgrounds in both developed and developing countries. It is a form of violence that involves a significant power imbalance, violating children’s rights and impeding their overall development. The consequences of child sexual harassment are far-reaching, impacting not only the child but also their families, communities, and society as a whole. According to the CDC, it is estimated that nearly one in eight girls and one in four boys are affected by child sexual abuse before the age of 10 in 2021.
This destructive phenomenon carries serious implications, encompassing mental and physical health effects, as well as behavioral, academic, economic, and social consequences for the child, their family, and the broader community. As part of the sustainable development goals (SDGs), governments worldwide have prioritized creating a safe and equitable environment for all children, free from all forms of violence, including sexual harassment and abuse, by 2030. While Egypt has taken steps to combat and prevent child sexual abuse and harassment, this harmful phenomenon continues to persist within Egyptian society.
Thus, it is imperative to conduct research that investigates into a deeper understanding of child sexual harassment, particularly from the perspective of the primary caregivers who play a crucial role, specifically mothers. This understanding is pivotal in identifying the underlying factors contributing to child sexual harassment to effectively combat this pervasive issue. The present study aims to analyze mothers’ awareness regarding child sexual harassment protection as a fundamental step towards formulating effective recommendations and strategies for prevention and intervention. By examining mothers’ knowledge, attitudes, and practices, this study seeks to shed light on specific areas that require targeted interventions and support, ultimately fostering a safer environment for children and empowering mothers to protect their children from the risks of sexual harassment.
The study was conducted using a cross-sectional descriptive research design. Through the implementation of a multistage random technique using the equal allocation method, two family health facilities were randomly chosen from each health zone affiliated to the MOHP in Alexandria. Using the equal allocation method, a sample of 25 mothers was conveniently selected from each setting, resulting in a total of 400 mothers.
Tools for data collection:
Four tools were developed and used to collect the study’s data: a semi-structured interview to assess mothers’ general characteristics (demographic and socio-economic characteristics) and mothers’ experience with sexual harassment; and three scales to assessmothers’ knowledge, attitude, and subjective practice. Before data collection, the study tools were tested forcontent validity by a jury consisting of five experts in the fields of community health nursing, pediatric nursing, and psychiatric nursing.
The main findings revealed from the study:
Part I: Mothers’ general characteristics.
A. Demographic and socio-economic characteristics of the participant mothers and their preschool children.
- The mothers included in the study had an age range of 21 to 50 years, with an average age of 30.04 years. Over half of the mothers (54.25%) were between the ages of 20 and 30, while around two-fifths (39.75%) were between the ages of 30 and 40. The majority of the mothers (77.75%) resided in urban areas, while the remaining 22.25% lived in rural areas. The vast majority of mothers (92.25%) were married.
- Approximately 62.25% of the mothers had only one child in this age group. Around one-third (33.25%) had two children, and a small percentage (4.50%) had three or more children, with an average of 1.423 children.
- Approximately 41.75% of the mothers had boys, while slightly over one-third (35.75%) had girls. Additionally, about one-fifth (22.50%) of the mothers had both boys and girls.
- Three-quarters of families (78.25%) consist of fewer than five members, and around one-fifth (21.75%) have more than five members, with an average family size of 3.998.
- Slightly less than two-thirds of mothers (60.75%) live in private houses, while more than one-fifth (26.25%) live in shared houses and approximately one-tenth (13%) reside in rented houses.
- Slightly more than three-quarters (76.50%) of households had a medium socio-economic status, 14% had a high socio-economic status, and only 9.50% had a low socio-economic status, with a mean of (27.740).
B. Mothers and their preschool children’s previous experience with sexual harassment.
- Slightly more than two-fifths of the participant mothers (43%) reported experiencing sexual harassment, particularly during their childhood. With over two-fifths of mothers (44.19%) experiencing harassment between the ages of 5 and less than 10, with an average age of 10.912. The majority of harassers were strangers (65%), followed by relatives (21.51%) and acquaintances or friends (14%).
- Approximately three-quarters of mothers (71.51%) reported experiencing sexual comments, 65.1% reported unwanted touching, and 52.33% reported instances of nudity or masturbation in front of them.
- 61.62% reported it occurring on the street, followed by public transportation (35.46%), and inside either the harasser’s or victim’s home (34.30%).
- Only 5% were reported to have experienced some form of sexual harassment according to their mothers, while more than one-tenth of the mothers (12.75%) were unsure if their children had been exposed to harassment.
- Around 40% of the children were under 5 years old, and half of them were between 5 and less than 10 years old at the time of harassment.
- Relatives were reported as the harassers in 40% of cases, while slightly less than one-third (30%) involved acquaintances, friends, orstrangers (30%).
- The types of harassment reported by mothers included physical touch (40%), viewing sexual images (15%), prosecution or tracking for sexual contact (15%), and displaying private body parts or masturbating in front of the child (15%). Additionally, 10% of the children experienced complete sexual harassment, and 5% faced threats and intimidation.
- The majority of incidents (60%) occurred in either the child’s or the harasser’s home.
- More than half (55%) of reported confronted the harasser, while the same percentage (15%) took legal action, punished the child, remained calm, or didn’t disclose the incident to anyone.
Part II: Mothers’ views, opinion, and their informational needs regarding child sexual harassment protection.
- 78% of mothers believe sexual harassment is prevalent, with 99.36% attributing it to a lack of religion. 84.29% pornographic websites and child molestation, substance abuse (70.19%), absence of legal deterrent (66.67%), family disintegration (54.49%), delayed marriage age (48.08%), mental illness (40.06%), childhood abuse (36.86%), and poverty/unemployment (32.05%).
- Among mothers who don’t believe harassment is prevalent, 63% think women use complaints as threats or for popularity, and 37% believe the media promotes false cases.
- Effective ways to protect children: increasing penalties for harassers (62.5%), parent education programs (44%), teaching about body boundaries (40%).
- Mother’s reactions if child is harassed: reporting and legal action (39.25%), confronting the harasser (38.25%), punishing the child (6.75%), staying calm and not telling anyone (6.25%).
- Institutions mothers would turn to specialized institutions (38.25%), emergency services (35.50%), social media (8%), harasser’s family (5.75%), unsure (12.5%).
- 52.50% of mothers received information on child sexual harassment protection, primarily from social media (91.90%), followed by television (80%), friends and neighbors (40.48%), surrounding cases (35.24%), and family (23.81%).
- 77.50% of mothers expressed a desire for more information on child sexual harassment protection.
- 66.25% of mothers preferred the internet, while 40.25% preferred educational workshops by professionals. 29.50% preferred stories and printed media for mothers and children. Television, relatives, friends, or neighbors were reported by 26.75% and 16.5% of the mothers, respectively.
Part III: Mothers’ knowledge, attitude, and subjective practice regarding child sexual harassment protection.
- Mothers’ knowledge regarding child sexual harassment protection.
• 51.50% had average knowledge about child sexual harassment protection, 41.75% had poor knowledge, and only 6.75% had good knowledge.
• The mean percent score for mothers’ knowledge about child sexual harassment protection was 52.092%, indicating average knowledge.
- Mothers’ attitude regarding child sexual harassment protection.
• 69.75% of mothers had a positive attitude towards child sexual harassment protection education. 22% had a neutral attitude, while only 8.25% had a negative attitude. with a mean percent score of 75.746%.
- Mothers’ practice regarding child sexual harassment protection.
• 67.75% of the participant mothers had poor practice levels, while 32.25% had average practice levels. none of them had good levels of practice, with a mean percent score of 53.027%.
Part IV: Mothers’ self-perception regarding their knowledge and practices towards child sexual harassment.
• 49.25% of mothers perceived themselves to have good knowledge about child sexual harassment, with 25.25% rating themselves as very good and 9.25% as excellent. While 16.25% of mothers reported weak or very weak knowledge in this area.
• 34.25% felt they had a good ability to discuss body safety and privacy with their children, 23.75% rated themselves as very good, and 19.50% considered it excellent.
• Conversely, 22.50% of mothers reported a weak or very weak ability in this aspect.
• 38.50% described themselves as having good practices to protect their children from harassment, 27.50% as very good, and 17% as excellent. While 17% reported weak or very weak practices in this regard.
• 29.75% rated themselves as ’very good’ in handling child exposure to harassment incidents. 28.50% as ’good’ and 20.25% as ’excellent’.
• 52.75% of mothers had a high self-perception regarding child sexual harassment protection, 41% had a fair self-perception, and 6.25% had a low self-perception, with an average mean percent score of 66.15%.
Part V: Association between different study variables
- Mothers’ knowledge towards child sexual harassment protection and their socio-demographic characteristics.
• No significant association was found between mothers’ knowledge levels and their age (P=0.743).
• There was a statistically significant association between mothers’ knowledge levels and their residence (P=0.021), with 53.9% of rural mothers having poor knowledge compared to 38.3% of urban mothers.
• There was no significant association between knowledge levels and marital status (P=0.082).
• There was a statistically significant association between mothers’ knowledge levels and their education level (P=0.000) with less educated mothers, such as illiterate or those with literate certificates (76.2%), having poorer knowledge compared to those with higher education (33.7% with poor knowledge).
• No significant association was found between knowledge levels and work status (P=0.085)
• There was a significant association between knowledge levels and their per-Capita Income (P=0.025), with mothers with insufficient income having poorer knowledge (49.7% with poor knowledge) compared to those with enough and saving income (23.3% with poor knowledge).
• No significant association was found between knowledge levels and family size (P=0.844).
• There was a significant association between knowledge levels and their Socio-Economic Level (P=0.000), with mothers of low socio-economic status having the poorest knowledge (78.9% with poor knowledge).
- Mothers’ attitude towards child sexual harassment protection and their socio-demographic characteristics.
• There was a significant association between attitude levels and their age (P= 0.005). Younger mothers (20-30 years) showed a higher positive attitude (75.6%), while older mothers (40 years or more) had a negative attitude (25%).
• There was a significant association between attitude levels and their residence (P= 0.000). Urban mothers (76.2%) were more likely to have a positive attitude compared to rural mothers (47.2%).
• There was a significant association between attitude levels and their marital status (P= 0.005). Married mothers (71.5%) were more positive compared to separated, divorced, or widowed mothers (48.4%).
• There was a significant association between attitude levels and their Level of Education (P=0.000). Mothers with higher education (university degree or higher) had a more positive attitude (85.4%) compared to those with less education.
• There was no significant association between working and non-working mothers in their attitudes toward child sexual harassment protection (P=0.073).
• There was a significant association between attitude levels and their per-Capita Income (P=0.000). Mothers with enough saved income (90.7%) had the most positive attitude, followed by those with enough income (72.1%). None with enough saved income had a negative attitude.
• There was a significant association between attitude levels and their socio-Economic Level (P= 0.000). Mothers with high socio-economic status (78.6%) had the highest positive attitude, followed by those with medium status (72.9%).
- Mothers’ subjective practice towards child sexual harassment protection and their socio-demographic characteristics.
• There was no statistically significant association between mothers’ age and their practice levels (P=0.85).
• There was no statistically significant association between mothers’ place of residence and their practice levels (P=0.006).
• There was no statistically significant association was found between mothers’ marital status and their practice levels(P=0.690).
• There was no statistically significant association between mothers’ education levels and practice levels.
• The was no statistically significant association between mothers’ work status and practice levels(P=0.153).
• There was no statistically significant association between mothers’ per-capita income and practice levels.
• A statistically significant association was observed between family size and practice levels (P=0.019). Mothers with smaller families (less than five members) had better practices (35.1% had average practices) compared to those with larger families (78.2% had poor practices).
• A statistically significant association was found between socio-economic status and practice levels (P=0.035). Mothers with low socio-economic status had higher percentages of poor practices (84.2%), while those with high socio-economic status had more average practices (41.1%).
- Mothers’ knowledge, attitude and subjective practice levels and their self-experience regarding sexual harassment.
• 63% of mothers who had good knowledge level were subjected to sexual harassment compared 29.6% of mothers who weren’t subjected to sexual harassment.
• There was a statistically significant association between mothers’ knowledge and their past experience with sexual harassment (P = 0.009).
• There was no statistically significant association between mothers’ attitude and their past experience of sexual harassment (P= 0 .111).
• There was no statistically significant association between mothers’ practices and their past experience to sexual harassment (P= 0.727).
- Mothers’ knowledge, attitude and subjective practice levels and their children experience regarding sexual harassment.
• There was no statistically significant association between mothers’ knowledge and their children’s exposure to sexual harassment (P = 0.567).
• None of the mothers with a negative attitude had a child that was exposed to sexual harassment,
• There was a statistically significant association between mothers’ attitude and their children’s exposure to sexual harassment (P= 0.000).
• There was a statistically significant association between mothers’ practice and their children’s exposure to sexual harassment (P = 0.035).
- Mothers’ knowledge, subjective practice levels and their self-perception regarding child sexual harassment protection.
• There was a statistically significant association between mothers’ knowledge, subjective practice levels, and their self-perception regarding child sexual harassment protection.
• There was a difference in mean scores across all three self-perception levels for both mothers’ knowledge levels (F = 31.259, p = 0.000) and practice levels (F = 14.246, p = 0.000).
• It indicates that mothers with high self-perception scores had the highest mean scores for both knowledge (55.698) and practice levels (54.876),
• Mothers with low self-perception scores had the lowest mean scores for both knowledge (39.409) and practice levels (47.017).
Part VIII: Correlation between mothers’ knowledge levels, attitudes, and subjected practices regarding child sexual harassment protection.
• There was a moderately positive correlation between mothers’ knowledge and their attitudes (the correlation coefficient is 0.459).
• As mothers’ knowledge increases, so does their positive attitude towards it.
• There was a weak positive correlation between mothers’ knowledge and their subjective practice (the correlation coefficient is 0.179).
• A higher level of knowledge among mothers is associated with an increase in their reported practice of child sexual harassment protection.
• There was a weak positive correlation between mothers’ attitudes and their practice towards child sexual harassment (the correlation coefficient is 0.140)
• As mothers’ attitudes become more positive, their practices in addressing or preventing sexual harassment also tend to improve.
In light of the current study findings, the following recommendations could be suggested:
Ministry of Health and Population (MOHP):
Create detailed guidelines and procedures for healthcare providers for early screening and proper response to situations of child sexual harassment or abuse.
Incorporate child sexual harassment training sessions for healthcare professionals.
Create a specialist unit that can be linked with a mental health clinic inside healthcare facilities to provide full support services for child sexual harassment victims.
Collaborate and form partnerships with key parties, such as non-governmental organizations (NGOs) and child protection authorities to tackling child sexual harassment.
Awareness-raising programs and local workshops should be provided on a regular basis at family health centers.
Train healthcare professionals and community health workers, especially ”RaedatRefiat,” to increase parents’ knowledge about alarming signs of sexual abuse and refer them to appropriate local services.
Mothers should be provided with well-designed educational booklets regarding child abuse and its prevention methods.
Strenghth the role of family clubs in family health facilities in educating children about through activities such as coloring, storytelling, and craft making.
Public outreach campaigns with collaboration with other partners to raise awareness about child sexual abuse.
Develop and implement a nationwide study to assess the prevalence, causes, and consequences of child sexual abuse and harassment.
Ministry of Social Solidarity, in collaboration with non-governmental organizations (NGOs):
Provide sexual harassment educational guidance for nursery teachers and workers to equip them with the necessary knowledge and skills to prevent incidents of sexual harassment.
Increase children’s awareness about sexual harassment prevention through music, art,and games to educate both normal and special needs children.
Strengthen and support the child hotline (16000) services in all governorates.
Provide families affected by incidents of child abuse with support to help them recover and seek the necessary assistance.
Foster collaboration with relevant ngos to combine efforts and resources to address child sexual abuse prevention.
Ministry of Religious Endowments and christian Clerics:
Create comprehensive, specialized training programs for religious leaders on child sexual harassment in collaboration with religious organizations.
Encourage educational initiatives and organize targeted awareness campaigns in collaboration with religious organizations about child sexual harassment prevention.
Child protection, including protecting children’s rights and keeping them secure, should be incorporated into religious messages through preaching, religious instruction, and family-oriented programs for kids, parents, and families.
Create support structures inside religious organizations to offer guidance, counseling, and assistance to survivors of child sexual harassment and their families.
Ministry of Communications and Information Technology (MCIT):
Implement restrictive guidelines and regulations for media content to stop the spread of pornographic or dangerous materials encouraging child sexual abuse.
Create responsible media rules for reporting about incidents of child sexual exploitation while guaranteeing the safety and privacy of victims.
Launch a thorough mass media campaign using a variety of media outlets, such as TV, radio, social media, etc.
Encourage media channels to create and broadcast educational campaigns and programs.
Encourage popular public figures to speak out against child rights issues.
Disseminate stories and positive role models that give victims and survivors of child sexual exploitation hope.
Political and legislative sectors:
Strengthen and implement existing child sexual harassment laws and regulations.
Create specialized task forces or sections (units) within law enforcement organizations to deal with cases of child sexual assault and arrest the abusers.
Work together with legal experts, child protection organizations, and other pertinent stakeholders to review and update legislation.
Create legislation obliging social workers, teachers, and health care professionals to report any suspected or confirmed child sex harassment.
The National Council for Childhood and Motherhood should increase the number of protection committees in all villages and cities to track down and report instances of child sexual assault.
Ministry of Education
Incorporate sexual education and sexual harassment protection into the curriculum in age-appropriate topics.
Educate teachers and school nurses on the warning signs of sexual harassment, how to react appropriately, and how to report incidences if they occur.
Create clear reporting protocols in schools to ensure that students are at ease to report sexual harassment.
Develop and implement awareness campaigns on preventing sexual harassment that target kindergarten students, their parents, and educators in collaboration with the appropriate stakeholders.
Ministry of Higher Education:
Add classes and modules on child protection and sexual exploitation to relevant academic curricula.
Promote collaborations with organizations and educational institutions to offer future professionals in child protection-related disciplines resources and training opportunities.
Raise university students’ knowledge about their responsibility in combating child sexual harassment.
Nursing students should have more opportunities in clinical settings and home visits to practice how to screen, assess, and care for victims of abuse.
Encouraging university students to incorporate child sexual assault awareness into their extracurricular activities.
Parents and family:
Parents and the family have a responsibility to be knowledgeable about the symptoms, causes, and preventions of child sexual harassment.
Develop a trusted relationship with their kids and encourage them to express any worries.
Instruct parents about guided supervision for both online and offline activities.
Children:
Teach children about their legal rights, including the right to bodily integrity and protection.
Giving children the basics of self-defense can enable them to defend themselves in an emergency.
Teach children how to say ”NO” to unwanted touching and encourage them to report any occurrences of harassment.
Recommendations forfurther research:
Qualitative research on maternal perspectives and barriers to addressing child sexual harassment and abuse.
Assessing the effectiveness of educational programs about child sexual abuse prevention across diverse settings.
Exploring child sexual harassment phenomena within vulnerable groups: homeless, disabled, and orphan children.