Prevalence of knowledge, attitudes toward sexual education, and sexual abuse prevention skills among primary school children in Malaysia

Child sexual abuse is a global public health issue with lasting physical, psychological, and social impacts. Despite awareness, gaps in sexual education leave many children without essential prevention skills, such as recognizing unsafe situations, setting boundaries, and seeking help from trusted adults. This study aimed to determine the prevalence of knowledge, attitudes toward sexual education, and skills related to sexual abuse prevention among primary school children in Malaysia. A cross-sectional study was conducted using stratified multistage cluster sampling. Schools were randomly selected from five regions, with one class per standard. A single-proportion formula determined a sample size of 1,758 children from both the lower and upper primary levels. Data were collected using validated SmartShield questionnaires and categorized according to Bloom’s cut-off (60–80%). Scores within this range indicated a moderate level of knowledge, a neutral attitude, and moderate skills. Descriptive statistics were analyzed using SPSS version 29. A total of 1,758 government primary school students across five regions in Malaysia participated, comprising 881 lower primary (97.9% response rate) and 877 upper primary students (97.4% response rate). High knowledge levels were found in 48.1% of lower primary and 59.9% of upper primary students. Positive attitudes were reported by 39.8% of lower primary and 41.4% of upper primary cohorts, while good prevention skills remained stable across both groups at 78.5% and 78.9%, respectively. A significant number of students had moderate to high sexual education knowledge, but fewer than half held positive views. Most reported good prevention skills. Future research should explore factors shaping knowledge, attitudes, and skills, including cultural norms, parental guidance, education access, and societal stigmas, along with qualitative insights into key influences.