Risk Behaviour of Street Children in Colombo

Papers 13. Goonewardene M, Seekkuge J, Liyanage C. Iron stores and 17. Montresor A, Ramsan M, Khalfan N, et al. Performance of its correlation to haemoglobin levels in pregnant women the haemoglobin colour scale in diagnosing severe and very attending an antenatal clinic. Ceylon Medical Journal 1995; severe anaemia. Tropical Medicine and International Health 40: 67-9. 2003; 8: 619-24. 14. Chalco JP, Huicho L, Alamo C, et al. Accuracy of clinical 18. Critchley J, Bates I. Haemoglobin colour scale for anaemia pallor in the diagnosis of anaemia in children: a meta-analysis. diagnosis where there is no laboratory: a systematic review. BMC Pediatrics 2005; 5: 46. International Journal of Epidemiology 2005; 34: 1425-34. 15. Stott GJ, Lewis SM. A simple and reliable method for 19. Anand H, Mir R, Saxena R. Haemoglobin color scale a estimating haemoglobin. Bulletin of World Health diagnostic dilemma. Indian Journal of Pathology and Organization 1995; 73: 369-73. Microbiology 2009; 52: 360-2. 16. Münster M, Lewis SM, Erasmus LK, Mendelow BV. Field 20. Prathapan S, Lindmark G, Fonseka P, et al. How good is the evaluation of a novel haemoglobin measuring device designed quality of antenatal care in the Colombo district of Sri Lanka for use in rural setting. South African Medical Journal 1997; in diagnosing and treating anaemia? Quality in Primary Care 87: 1522-6. 2011; 19: 245-50. Risk behaviour of street children in Colombo B C V Senaratna1, B V N Wijewardana2 (Index words: street children, health, risk behaviour, Sri Lanka) Abstract was conducted to validate data generated through FGDs and SSIs. Semi-structured questionnaires, a moderator Introduction Sri Lankan street children live in insecure guide, an interviewer-administered questionnaire, and and disadvantaged environments and have disrupted an observational checklist were used for SSIs, FGDs, and poorly functioning families resulting in their poor profiling, and observational study, respectively. socialisation. In this backdrop they are at high risk of adopting delinquent and antisocial behaviour and Results Majority of street children were boys and were becoming victims of abuse. Despite recognition of this aged 14 years or less. Nearly 18% lived alone without a as a social problem, an in-depth exploration of their guardian. Two thirds had never enrolled in a school. Many behaviour and its correlates has not been attempted. children were used for begging, neglecting their health vulnerabilities. Occupational risk behaviour included Objectives To describe risk behaviour among street heavy manual labour, transportation and sale of illicit children in Colombo city and the determinants of such alcohol and narcotics, robbing/pick-pocketing, behaviour. commercial sex work, and pimping. Recreational risk Methods A cross sectional qualitative study in Colombo behaviour included abuse of alcohol/narcotics, smoking, Fort, Pettah, Slave Island, and Maradana areas was sexual promiscuity, and patronising commercial sex conducted using focus group discussions (FGDs) with workers. street children and semi-structured interviews (SSIs) with Conclusions Increased awareness and strategies are street children and key informants in their environment. required to minimise threats to street children and society. Data generated were used to profile 283 children identified through referral sampling. An observation study Ceylon Medical Journal 2012; 57: 106-111 Departments of 1Community Medicine and 2Criminology University of Sri Jayewardenepura, Sri Lanka. Correspondence: BCVS, e-mail: <[email protected]>. Received 5 March and revised version accepted 19 May 2012. Competing interests: none declared. 106 Ceylon Medical Journal Papers Introduction children, and social workers/researchers who have working experience regarding street children). They were The global population of street children has been identified through prior knowledge. variously estimated to range from tens of millions to 100 million with numbers rising daily and a large proportion In Phase II, we recruited street children for research living in South Asia [1-3]. In 2006, the estimated number using referral sampling. Focus group discussions (FGDs) of street children in Sri Lanka was 15,000 [4]. Majority of were conducted with recruited children until no new them live in the Colombo city, which is the former capital information was forthcoming (ten FGDs, each with 8-10 and a busy commercial hub, and fulfils environmental children, aged 8-<18 years). We also conducted SSIs with requirements for their sustenance. 25 children, selected to represent their variability in age, Street children are considered a social problem [4]. In sex, ethnic group and religious group. In Phase III, we addition to obtaining provision from parents or guardians, profiled all recruited children using variables generated they also earn their own income by legal as well as socially through SSIs and FGDs. unacceptable and/or illegal means [5]. In the backdrop of We used two pre-piloted, interviewer-administered, the insecure and disadvantaged environments they live semi-structured questionnaires to conduct SSIs with KIs in, these children are at high risk of adopting delinquent and street children. A pre-piloted, moderator's question behaviour and becoming victims of abuse [4-7]. guide was used to moderate FGDs. An interviewer- Experiencing deviant behaviour in their environment and administered questionnaire was used for profiling. All lack of normally functioning families results in their poor interviewers had prior experience in studies/programmes socialisation [4, 5]. involving street children, and therefore had a good rapport Street children worldwide adopt a wide range of risk with participants. SSIs and FGDs were tape recorded with behaviour, commonest of which include risky sexual consent of participants whenever possible, and notes were practices, alcohol and substance abuse, and violence [8- taken down. Tapes were transcribed and notes expanded 14]. Extreme poverty, lack of appropriate care by adults, immediately after each SSI and FGD. Data were analysed been victims of violence, and substance abuse have been using qualitative content analysis. We observed children’s repeatedly shown to be common determinants of behaviour using a pre-piloted behaviour checklist and delinquent and anti-social behaviour of street children [2, these data were used to validate information that emerged 4, 8]. Nevertheless, street children in different regions and from SSIs and FGDs. countries have unique behaviour patterns and Informed consent was obtained from all participants, determinants shaped by distinctive socio-cultural and including children. In addition, informed consent of economic environments in their respective societies [14- parents/guardians was also obtained for participation of 15]. However, in-depth explorations of risk behaviour of their children. Ethical approval was obtained from Ethical Sri Lankan street children and analysis of determinants of Review Committee of Faculty of Medical Sciences, such behaviour are scarce [4, 16]. University of Sri Jayewardenepura. Whenever children Recognising street children as a social problem, law- were in need of support services from health, social enforcement authorities of Sri Lanka continue to take services, or any other sector, we referred them to relevant punitive actions against delinquent behaviour of these sectors. children [4, 16]. Unfortunately, such litigations do not act as deterrents [2, 4, 16]. In order to protect street children Results as well as society from any harm originating from such delinquent and anti-social behaviour, an in-depth KIs included 6 parents/guardians, 6 street vendors, understanding of such behaviour and their determinants 5 persons working in boutiques, and 3 social workers/ are imperative. We conducted this study to describe risk researchers. Our sample included 283 children (of-street behaviour and determinants of such risk behaviour among n=102; 36% and on-street n=181; 64%) representing all street children in Colombo city. major ethnic and religious groups. Nearly 62% were aged 14 years or less. Majority were boys. Around 40% lived either with one or both parents, but nearly 18% lived alone. Methods Two thirds had never enrolled in a school (Table 1). We carried out this qualitative, cross-sectional study Despite diversity of social, demographic, cultural and (in three phases) in Colombo Fort, Pettah, Slave Island economic strata these children represent, they shared and Maradana areas of Colombo City. For purposes of common socio-economic disadvantages, and valued this research, we defined street children as children living delinquent behaviour over traditional social norms and on street most of time regardless of whether they still values. Social prestige is usually bestowed upon a street maintained some contact with their families or not [10]. child based on a set of mostly anti-social behaviour In Phase I, we conducted twenty semi-structured demonstrated by that child. On the other hand, their lifestyle, interviews (SSIs) with key informants (KIs – including and at times their very survival, is closely tied to such risk parents/guardians of street children, street vendors/ behaviour which are means of their sustenance. However, persons working in boutiques in areas frequented by street they also use some risk behaviour as recreations. Vol. 57, No. 3, September 2012 107 Papers Table 1. Basic socio-demographic data of the contacted street children Female Male Total

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