A Mixed-Methods Systematic Review of Barriers and Facilitators to Mandatory Reporting of Child Abuse and Neglect in Low- and Middle-Income Countries

Mandatory reporting (MR) of child abuse and neglect is a crucial policy in child protection systems globally, including in low- and middle-income countries (LMICs). This systematic review explores facilitators and barriers to MR in LMICs, addressing a gap in existing literature that largely focuses on high-income settings. A comprehensive search of 7 databases yielded 50 studies (30 quantitative, 18 qualitative, and 2 mixed-methods) from 21 LMICs, representing 13,079 participants from various professional backgrounds. Adopting a convergent thematic synthesis methodology and the mixed-methods appraisal tool to assess the study quality, the review mapped 35 barriers and 19 facilitators under 6 themes: case characteristics, reporters’ individual characteristics, interpersonal, institutional, structural/community-level factors, and cultural factors. While reporters’ characteristics were predominantly evaluated, such as their varied priorities over competing and sometimes conflicted interests as a prominent barrier, systemic barriers were also salient across LMICs, such as insufficient mechanisms, poor inter-agency collaboration, tension between formal reporting and traditional informal settlements, and cultural beliefs about parental rights and physical discipline. Nonetheless, this review also suggested critical directions for action—via type- and context-specific policy adaptations, evidence-based training, developing reporting protocols, and enhancing multi-stakeholder collaboration for community and cultural change. The findings overall reflect an ecological model, particularly the decision-making ecology framework, emphasizing the interplay between case, individual, organizational, and external factors, with barriers outweighing facilitators. The review highlights potential areas for strategic investment and future research to improve the efficacy of MR policies in LMICs.