Prevalence and long term mental health outcomes of child maltreatment in Ethiopia: A systematic review and meta-analysis

BACKGROUND: Child maltreatment (CM) is a pervasive issue with serious mental health (MH) symptoms. Data on prevalence and associations with MH from countries like Ethiopia remain limited. This gap highlights the need for evidence synthesis to inform public health planning and targeted interventions. OBJECTIVES: This review aimed to synthesize available evidence on the prevalence of CM, MH symptoms and to examine the CM-MH links. SETTING AND PARTICIPANTS: This review included total of 85,570 participants from 58 CM prevalence studies and 26,514 from 28 studies examining MH outcomes following CM in Ethiopia. METHODS: A systematic search of PubMed, Scopus, PsycINFO, Web of Science, Google Scholar, and local sources identified 64 eligible studies reporting CM prevalence or its association with MH symptoms. Study quality was assessed using the NIH tool for observational studies. Meta-analyses were conducted in R using multilevel random-effects models. RESULTS: The pooled prevalence of CM was 38% (95% CI: 32%-44%), with higher rates in children and adolescents (41%) and studies using national samples (45%), and validated-comprehensive tools (49%). Neglect showed 28% prevalence, while child labor was highest (52%). Emotional (47%), physical (36%), sexual (29%) abuse, and witnessing intimate partner violence (42%) were other forms. MH symptoms following CM affected 22% of participants, doubling the odds of poor MH (2.27, 95% CI 1.92-2.68). Social support (β = 0.178, p = .024) moderated these associations. CONCLUSION: CM and related impacts are widespread in Ethiopia. CM is linked to higher MH risk, especially among those with low social support. These findings stress the need for targeted prevention and support, though conclusions remain cautious due to methodological limits and contextual differences across studies.