Abstract

Introduction
In Malawi, sexual violence towards women and girls is common and normalised but there aren’t any comprehensive published national studies on the topic. The few studies that have been undertaken have focused on girls’ experiences and prevention strategies outside their homes (Decker et al., 2018; Dzimadzi & Klopper, 2007; Pelser et al., 2005). The increased cases of defilement during the Covid-19 pandemic, signify the vulnerability of girls within their own homes (Chikhungu, 2023; Malawi-Police-Service, 2021). It is also known that victims of defilement are likely to report to the police when the perpetrator denies responsibility for a pregnancy (Chikhungu 2023). This entails that although a large number of cases of sexual abuse go unreported, we should expect a close association between the level of sexual abuse and the number of pregnancies. Such an expectation provides an opportunity for exploiting the District Health Information System 2 (DHIS2) data for monitoring sexual abuse towards women and girls in Malawi. This study uses administrative data to provide a narrative of district and regional patterns and a national-level outlook of girl child sexual abuse in Malawi.

Data
The study uses Malawi Police data on reported cases of defilement and the number of girls aged 14 years or less who accessed maternal health services in Malawi public health facilities. We analyse data on maternal health (antenatal, childbirth, post-natal and post-abortion care services) from the DHIS2 website: https://dhis2.health.gov.mw/dhis-web-commons/security/login.action. The study also uses data from the Malawi population census and the 2015 Malawi Demographic and Health Survey to corroborate the reliability of the use of administrative data in monitoring girl child sexual abuse in Malawi
Analysis
Population-adjusted prevalence rates are produced per 100,000 women aged 12 years or older in each district based on the 2018 Malawi Population Census estimates. Graphical analysis is employed to study the patterns and trends in the number of reported cases of defilements and girls that attended antenatal, childbirth, post-natal and post-abortion care services in the 28 districts and four administrative regions to provide a national-level outlook of girl child sexual abuse in Malawi. To confirm if the difference in child sexual abuse variables across population groups and regions is statistically significant the Mann-Whitney U statistical test is performed.
Findings and Conclusion
The findings of this study show that routine administrative data from the Malawi Police and Public health facilities provides a good depiction of the extent of girl-child sexual abuse in Malawi, it aligns well with survey or census data and therefore can be relied on for the monitoring of programmatic interventions to tackle child sexual abuse in Malawi. We also learn that districts from the North are more likely to report cases of defilement compared to districts in the Southern and Eastern regions. The Central region has the lowest level of girl child sexual abuse cases. These findings suggest that while data on defilement may adequately depict girl child sexual abuse in the Northern region, maternal health data will be more useful in the Eastern and Southern regions.