Factors associated with knowledge on risk factors of sexual abuse among house girls and house boys in Singida municipality, central zone-Tanzania: A cross-sectional study

Background : Sexual abuse is a situation whereby any people or individual entered in any sexual malpractice or sexual contact without his/her will. Sexual abuse among house girls and house boys is among of general medical issue in our nation particularly in the urban areas and towns. The aim of the study was to examine predicators associated with knowledge on risk factors of sexual abuse among house girls and house boys in Singida Municipality. Methods : The cross section study involved a total of 252 participants from the selected house hold in Singida Municipality. A multistage sampling technique was used to obtain sample and data was collected by using self-administered structured questionnaire. Chi-square and logistic regression were used to determine the association between knowledge on risk factors and sexual abuse among house girls and house boys. Results: The large numbers of respondents with mean age of 22years old were single. Only 53.1% of house girls were knowledgeable on risk factors associated with sexual abuse compared to house boys. After control of the confounders the predictors of knowledge about risk factors on sexual abuse were educational level (AOR = 0.332, p = 0.002, 95%CI:0.167; 0.659), how did you find a job(AOR=2.412, p=0.001, 95%CI:1.433; 2.523), and type of family he/she living(AOR=4.672, p=0.002, 95%CI:0.0709; 0.719, nuclear family (AOR=4.023, p=0.023, 95%CI:0.101;0902). Conclusion: The findings depicted that the study participants have inadequate knowledge on risk factors associated with sexual abuse and it discovered that the influencing factors were education level, means of getting a job and type of family.


Background
Wisconsin Child welfare pds Reporter Training defined Sexual abuse as when any people or individual entered in any sexual malpractice or sexual contact without his/her will (1). Forms of brutality (abuse) that including pertaining in sexual intercourse with kids, girls or boy (by questioning or providing something or by any means), intend to expose (of the private parts, house girl's sexual exploitation) or using these house keepers to increase sexuality such as watching sexual movies.
Assault and other types of sexual conducts direct against house workers happen in variety of settings, in their homes, the home environment and around the city. 1 of every 3 girls and 1 out of 4 boys experience sexual contact in whole life (2). Lastly not list 1 out of 5 girls and 1 in every 38 boys has in contact with fully or doing sexual acts and 1 in every 14 boys were made to penetrate somebody the whole of his/her life duration. In age of 11-17 years, 1 of every 3 girls had raped and 1 out of 8 reported this incidence. Mostly 1 out of 5 girls (18.3%) and 1 in every 71 boys (1.4%) in the USA has been raped some occasion in their lifetime (3).
Furthermore, WHO revealed sexual assaults and the precipitating factors that increases sexual abuse in the families were male-female inequalities views, multiple partners/infidelity, acceptance of violence, low level of education, gang membership and harmful or use of alcohols or drug (4). Various plans and approaches have been made by world association to varnish sexual abuse in the society, education institutions, families and characters of the people. These techniques and plans such as motivation in social conducts and norms that shield against brutality, teaching ability to end sexual brutality by providing chance to empower and uplift these women, young ladies, men and young boys by creating protective environments and defense house workers/survivors to decrease endangerment to them (2).
Few studies were done and reported on sexual brutality on these house workers. Moreover, in African countries has revealed that there are increase in sexual assaults problem that still exist such as in Namibia it accounts 3.6% and South Africa 14.3%(4). In Uganda is estimated to be 23%, Zambia 23%, Ghana 30%, Malawi 38% in the same way they tried to report sexual abuses in children, women, boys and men in the societies (5). According to WHO report on sexual violence and sexual assaults among children, it was observed that most young women experience sexual assaults while are in educational organizations as revealed by the research done in Meru Kenya (4).
African countries are still facing the same problem because findings from different countries about sexual abuse on children and women especially in primary schools show that different sexual acts were performed including touching their genital parts, and even raping the students in primary schools (4). As reported by pan African medical journal that 311 children experienced rape or assault due to different influential factors such as being teenager, disable people, low economic status, family structure, poor parenting, conflict within the family, being female, communication system and government organizations to be weak (6). They explained the effects of sexual abuse on the children and women and ways to minimize the situations in the societies and families through counseling, supporting them, and psychological rehabilitation (6).
The United Nations for children's fund in 2016 tried to show different facilitating factors that increase the occurrence of sexual assaults in African countries such as being female gender, poor relationship within the family, meandering children, poor economic status of the family and performing of children's activities which are illegal such as house workers (5). Despite the studies which were done on sexual assaults in Africans countries on men, young children but were little research done sexual assaults among house workers (house girls and house boys).
Different research which were done in the Republic of Tanzania have portrayed the different circumstances of sexual assaults on women, adult women and men, children in different regions but no study which was done in Singida municipality on sexual abuse among house workers.
Only one research was done on sexual assaults on students at school who at risks to be conducted sexual abuse due to the distance from school (4).
Moreover, the report from DIT findings show that 27.7% of young girls ranged 13-24years old experience more sexual assaults than young boys of the same age which is 15% (6). No research were done on portraying sexual abuse among house girls and house boys in Singida region and the relationship of knowledge on risk factors and sexual assaults among house workers in Singida municipal and region in general. Therefore, the aim of this study was to examine predicators associated with knowledge on risk factors of sexual abuse among house girls and house boys in Singida Municipality.

Study design and setting
A descriptive cross-sectional study was conducted in Singida municipality since June 16, 2019 up to January 31, 2020, whereby the expected numbers of house girls and house boys were selected from almost six wards of Singida municipal found central highlands of Tanzania. The district had a total population of 150379 (73484 males, 76895 females) according to the census of August 26, 2012, population area 721km 2 and density of 208.7km 2 . The mean age of house girls and house boys at Singida municipal was 22years old from the age ranged from 10 up to 34years old.

Study population
The study population was 252 house girls and house boys who were living in Singida municipality.

Data collection tools
A pre-tested and structured self-administered questionnaire was used for data collection. It was adopted and modified and suited to address the objectives of this study. It was written in English version and then translated to Swahili version and retranslated to English to checkout for its consistency by the linguistics. The questionnaire was pretested to 50 house girls and house boys among 252 households. They were put into separate rooms to provide confidentiality and secrecy during the filling action of questionnaires by a researcher. Findings from the pre-test were applied to cross check the tool in terms of rectifying the queries in order to avoid some errors.
This questionnaire was composed to get facts on the demographic data and associated elements on risk factors of sexual abuse among house girls and house boys. The factors with p-value of < 0.05 were considered to be predicators of being risk factors on sexual abuse.
Hence 10% of the non-involving people were added so as to have my desired sample size which was equal to 113+13= 126. As a result of 126 girls and 126 boys, therefore the total target of the participants was 252.
Singida region was purposively selected to be the area understudy in Tanzania. One district (Singida urban) was selected by simple random sampling from the seven districts of Singida Region. Three staged multi-stage cluster sampling technique was used to obtain study participants. In first stage random sampling, all wards (16 wards) in Singida urban (municipality) were listed and by the use of purposive random sampling five wards (Ipembe, Mandewa, Uhamaka, Misuna and Mtipa) were picked. 20 streets were conveniently selected whereby 252 participants were obtained. The house workers with age ranged from 10 up to 34years were conveniently selected to be included into the sample.

Data processing and analysis
Data were collected from the respondents; both manual and software screening were done by using SPSS Version 20 to ensure the completeness and correctness of the data coded by SPSS.
Descriptive statistics were done to obtain frequencies and cross tabulation were used to describe relationship between risk factors. Both binary and multivariate logistic regression was used to show the association among the risk factors and sexual abuse.

Social-demographic characteristics
The total 249 house workers (boys and girls) in Singida municipal involved in answering the questionnaire during data collection. The huge number (67.1%, n=167) of the informants were girls and (32.9%, n=82) were boys which contained a total of 100% of the respondents. Those respondents who were in the age group of 10 to 18 years old, with the mean age of 14years old were (160, n = 64.3%). However, the huge numbers of informants abused were single which was equal to 89.2% of the participants quite different to other marital status of the informants. In terms of education levels, about half (52.6%, n=131) of the respondents had completed primary education, 25.3% (n=63) had never gone to school and 22.1% (n=55) had completed secondary education and above. Other information is shown in table1.

Factors influencing knowledge on risk factors about sexual abuse among house girls and house boys in Singida municipal, Tanzania
Knowledge on risk factors were dichotomized to create two groups namely, those with adequate knowledge on risk factors and those with inadequate knowledge on risk factors. Out of 249 participants 50.2% of them had adequate knowledge about risk factors on sexual abuse among house girls and house boys. Knowledge on risk factors were significant associated with education level (X 2 = 11.877, p = 0.003), type of family where he/she living (X 2 = 9.9179, p = 0.007), how did you find a job (X 2 = 10.949, p = 0.001), and other factors influenced (X 2 = 13.165, p = 0.001).
Among 249 respondents whose age ranged between the age of 10 to 34years old, single 4(50%)

Discussion
The aim of the study was to assess the risk factors associated with sexual abuse against house girls and house boys in Singida municipality, central zone-Tanzania.
One of the vital aspects of protecting house girls and house boys from sexual abuse, suspected cases must be reported immediately. Because most of house girls and house boys do not disclosure the information, the reporting of suspected cases by external people is very fatal. Only when a case is reported can be prosecuted and imprisoned by doing such kind of ashamed things (8).
Based on the results, it found that house girls and house boys who have high level of education were very knowledgeable about risk factors on sexual abuse, therefore the government and other NGOs they have a great job to educate both house girls and house boys in the societies so as to reduce the incidence of abuse. Not only that, the study showed that the type of family where house girls or house boys live they contribute much in causing these people to be abused especially extended and single parent family.
Moreover, those people who used find the means of job to house girls or house boys should be prohibited restricted to do so, because it show that 43.2% of the house girls or house boys are engaged on this kind of work is due to this people. Lastly, low economic status of most family at Singida municipal cause the adolescents to move into such kind of work, were the statistics showed that 48.6% of the respondents responded that low economic status of the family causes most adolescents to engage in house girls and house boys (9). But most of study done by different researchers were about sexual abuse on children, women and men and no research done on factors association between knowledge on risk factors and sexual abuse on house girls and house boys.

Limitations of the study
The mother house or father house were very angry when interviewing the one among of his/her worker because of fearing that he/she could provide the information about his/her boss. Not only that but also the time which was used to collect data was a rainy season this was also a hindrance for me and not forgetting the distance from one house to another was a problem. Therefore, in order to have good response privacy and confidentiality was maintained and the information was not disclosed to the third part.

Conclusion
The overall result is that many house girls had inadequate knowledge 34(53.1%) compared to house boys 50(48.9%) among 252 participants in Singida municipality on risk factors associated with sexual abuse and it discovered that the influencing factors were education level, means of getting a job and the type of family. Therefore, this high number of house girls with inadequate knowledge is caused by inadequate education provided by NGOs and government about sexual abuse among house girls and house boys in Singida municipality.

List of abbreviation
CDC-Center and disease Control. The ethical clearance approval was obtained from the University of Dodoma with high contribution from the Research review committee. Then the overall consent to participate to the community was provided by the Singida municipal. Also both written and oral informed consent to the house girls and house boys were given before starting data collection so as to ensure confidentiality and autonomy of the respondents, no names of the respondents were involved in the questionnaires.