Child Abuse Evaluations at the Centre Hospitalier Universitaire de Kigali (CHUK): Medical Education and Experience

Child maltreatment is a poorly recognized phenomenon worldwide, and many pediatric healthcare professionals do not receive adequate training in child abuse and neglect evaluations. In response to the paucity of child maltreatment literature on low- to middle-income countries, this study aims to determine the education and training needs of medical professionals at the Centre Hospitalier Universitaire de Kigali (CHUK) with respect to child abuse and neglect identification, investigation, evaluation, and case management. Data collection took place in July and August 2019 at CHUK in Kigali, Rwanda. A mixed-methods approach was employed, including semi-structured qualitative interviews with sixteen healthcare professionals (3 pediatricians, 7 pediatric residents, 2 nurses, and 4 social workers) at CHUK and a systematic chart review of child maltreatment cases evaluated at the hospital from July 2015 to July 2019. Interviews with professionals revealed perceived gaps in training regarding child maltreatment case evaluation, reporting, and management. Study participants noted the need for standardized, hospital-wide protocols for the handling of confirmed abuse and neglect cases as well as expanded curriculum on the topic throughout professional education. Chart reviews demonstrated inconsistent and sparse documentation of maltreatment cases in hospital records. In conjunction with our findings, we provide informant-based suggestions for the improvement of child abuse and neglect case management at CHUK, including consistent training modules, inter-departmental collaboration, and systematic documentation. Beyond the hospital, participants widely agreed that child maltreatment awareness and prevention measures should be implemented at the community level with professionals from CHUK getting involved in local efforts.