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National Health And Morbidity Survey 2016 : Maternal And Child Health (MCH) Volume II : Findings

CHILD PROTECTION

7.1. Inadequate Care

Contributors : Rajini Sooryanarayana, Rosliza Abdul Manaf, Shubash Shander Ganapathy, Nik Mazlina Mohammad,
Norazizah Ibrahim Wong, Tahir Aris

7.1.1. Introduction
One of the aspects that reflects quality of care in young children is adequate parental supervision.
Children should not be left unattended at home or be left under the care of another child, to ensure
their safety. Lack of supervision has been linked to a number of negative outcomes such as
1
unintentional injuries in young children. A child who is left unattended or left in the care of another
child under 10 years of age is more susceptible to accidents and injuries. 2

7.1.2. Findings

Table 7.1.2.1 shows the distribution of children under five being left alone or left in the care of another
child younger than 10 years of age for more than one hour at least once during the past week. About
2.7% of children aged 0-59 months were left in the care of other children, while 0.2% was left alone
during the week preceding the interview. Combining the two, it was calculated that a total of 2.9% of
children were left with inadequate care during the past week, either by being left alone or in the care
of another child. More girls (2.6%) were found to have inadequate care compared to boys (3.1%).
Inadequate care was more prevalent among children of Malay ethnicity (3.4%), as opposed to
Chinese (2.1%), and Indians (0.9%). Children aged 24-59 months (3.0%) and 12-23 months (3.6%)
were left with inadequate care more often than those aged 0-11 months (1.6%). Mothers who were
married had a lower occurrence of leaving their child with inadequate care (2.9%) as compared to
mothers who were never married, separated, divorced or widowed (3.8%). Parents working in the
public sector and of higher socioeconomic background in terms of education and income appeared
to leave their children with inadequate care more often than other parents. 51.9% of parents from rural
areas appear to leave their child alone compared to 34.5% of parents in urban areas. However, fewer
parents in rural areas left their child under the care of another child in the past one week (1.8%
compared to 3.2%) and this difference was statistically significant. Combining the two, overall
inadequate care of children was observed to occur at 1.9% (95% CI 1.5-2.5) in rural areas as
compared to 3.3% (95% CI 2.80-4.00) in urban areas, a finding that was statistically significant (Table
7.1.2.1).

7.1.3. Conclusion
While children below five should not be left unattended at all, the findings revealed that 2.9% of
parents admitted to leaving their child alone or under the care of another child in the past week. It was
alarming to note that a higher proportion of parents from better socioeconomic backgrounds left their
children with inadequate care compared to parents with lower education and lesser income.

7.1.4. Recommendations

i Parents need to be educated to positively engage and discipline a child in a manner that does not
affect their well-being or retard their physical and psychological growth.

ii Parents must be educated on the possible negative impact of violent punishments to the health
and development of their children.

iii This change in attitude should be reinforced through advocacy by health professionals, health
promotions, education to parents and a supportive environment for parents to raise their children.

1 Dubowitz, H. (2013). Neglect in children. Pediatric annals, 42(4), e72-e76.
2 Schnitzer, P. G., Dowd, M. D., Kruse, R. L., & Morrongiello, B. A. (2015). Supervision and risk of unintentional injury in young children. Injury prevention,
21(e1), e63-e70