Why does the medical staff remain silent? Preventing child abuse begins with reporting: A cross-sectional study

Background Despite mandatory reporting laws, discrepancies between the estimated prevalence of child maltreatment and official reports may reflect both under-identification and failure to report recognized concerns. Healthcare professionals face emotional, cognitive, and institutional barriers that may influence reporting willingness. Methods This cross-sectional study examined sociodemographic, professional, cognitive, emotional, perceptual, and institutional factors associated with healthcare professionals' self-reported willingness to report suspected child maltreatment. The sample included 272 healthcare professionals caring for children (44% physicians, 43% nurses). Data were collected using a validated anonymous questionnaire. Results Years of experience were positively associated with identification ability ( r = 0.24, p < .001). Women reported higher willingness to report than men (M = 20.97 vs. 18.77, p < .001). Hospital-based staff demonstrated higher self-reported willingness to report than community-based staff (M = 20.74 vs. 18.95, p < .001), and managerial staff demonstrated higher self-reported willingness to report than non-managerial staff (M = 20.96 vs. 20.18, p = .03). Anger toward the child's family was the most common emotional response (44%). More positive perceptions and attitudes, together with greater emotional readiness, were associated with greater self-reported willingness to report suspected child maltreatment. Conclusions Female healthcare professionals, professionals with greater clinical experience, hospital-based healthcare professionals, and those in managerial roles reported greater willingness to report suspected child maltreatment. Targeted training incorporating clinical exposure, emotional processing, and ethical decision-making is recommended, particularly for community-based and male professionals. Stronger leadership and organizational support may enhance reporting willingness.