Qualitative study uncovers pervasive child sexual abuse and polyvictimisation across low- and middle-income regions, highlighting the need for trauma-informed co-design in child protection.
Purpose This article aims to share insights gained from consultations with children and youth, including those with lived experience of child abuse and exploitation, during the design phase of programme development. This programme co-creation process was undertaken by a non-governmental, child protection organisation across a wide range of operational contexts in Sub-Saharan Africa, South and South East Asia and Eastern Europe. Design/methodology/approach Qualitative data from consultations with 138 children and young people (aged 11–22 years old) were collected as part of the programme design process. Young participants were sampled from ongoing programmes implemented in 11 low- and middle-income countries. Secondary data from one trauma-informed, arts-based activity undertaken during the workshops were included in the analysis for this article. The outputs of the activity were stories (n = 33) about imaginary characters living in the same environment as the children who created them. Drawings of the characters (avatars) were accompanied by detailed backstories and fictional narratives of their experiences of child abuse and exploitation. Using Atlas.it software the stories were analysed, using thematic analysis, to centre children’s perspectives. Findings Meaningful child participation resulted in rich and nuanced data which facilitated a deep understanding of children’s experiences and support needs. Child sexual abuse (CSA) and polyvictimisation emerged as leading themes. Research limitations/implications This paper is based on secondary data from a programme co-creation process rather than a research study. Practical implications This article demonstrates a trauma-informed approach to consultative child participation at scale, which is feasible and effective as part of a programme co-design process. Findings indicate that the design of child protection, prevention and response programmes needs to account for the complex and often overlapping nature of victimisation. Social implications Children are mostly relegated to being passive recipients of programming despite the United Nations Convention on the Rights of the Child, which advocates for centering their voices. This article demonstrates how fruitful it is when children and youth have space to voice their experiences, perspectives and needs and meaningfully influence decisions which affect their lives. Originality/value This paper fulfils an identified need to illustrate the value of child participation in shaping child protection programming. In addition, children and youth from low and middle-income countries described new and emerging forms of CSA, including various examples of technology-facilitated gender-based violence which are poorly described in these contexts.
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Elphick et al. (2026) studied this question.
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