ASSESSING THE CHALLENGES FACED BY SOCIAL WORKERS IN

WORKING WITH SEXUALLY EXPLOITED CHILDREN: CASE STUDY

OF BLANTYRE QUEEN ELIZABETH CENTRAL HOSPITAL ONE-STOP
CENTRE

BACHELOR OF SOCIAL SCIENCE DISSERTATION IN SOCIAL WORK

TAPIWA JERE

FACULTY OF SOCIAL SCIENCE

THE CATHOLIC UNIVERSITY OF MALAWI

APRIL 2024
 THE CATHOLIC UNIVERSITY OF MALAWI

DEPARTMENT OF SOCIAL WORK

ASSESSING THE CHALLENGES FACED BY SOCIAL WORKERS IN

WORKING WITH SEXUALLY EXPLOITED CHILDREN: A CASE STUDY
OF BLANTYRE QUEEN ELIZABETH CENTRAL HOSPITAL ONE-STOP
CENTRE

BY

TAPIWA JERE

(BSocSW/NE/2020/0937)

A DISSERTATION SUBMITTED TO THE DEPARTMENT OF SOCIAL

WORK IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
AWARD OF THE DEGREE OF BACHELOR OF SOCIAL SCIENCE IN
SOCIAL WORK

APRIL 2024
Declaration
I, Tapiwa Jere, hereby declare that the work entitled: The Challenges Faced by Social
Workers in Working with sexually exploited children at Queen Elizabeth Central Hospital,
One-stop Centre Malawi is my original work. I have not plagiarized from another student’s
work, or from any other source, except where due reference is made clearly in the text, and
this dissertation was not previously submitted to any other University for the same purpose.

___________________

Tapiwa Jere

___________________

Signature

___________________

Date
Certificate of approval
I certify that this research represents the student’s own work and effort, and is
submitted with my approval.

Supervisor: Ms. Gweneth Sakala

Signature: _________________________

Date: _________________________

Head of department: Mr Happy Chawawa

Signature: ____________________

Date: _________________________

Dean of Social Science: Mr Anthony Mtuta

Signature: ____________________

Date: _________________________

I
Dedication
I dedicated this to my late Grandfather who loved helping people and died knowing I wanted
to pursue a law degree and not social work, doing social work was God’s plan to continue
with his legacy and to impact more lives than he did thank you for the inspiration to help
people without your help I would not have been where I am today. May your soul continue to
rest in peace.

II
Acknowledgments
Firstly, I thank God for carrying me through my 4 year’s journey of pursuing this degree it
was not an easy journey but God was faithful. I thank my Parents for the support they gave
me both physically and spiritually they have been there for me since day one, providing me
with financial care and their unconditional love, every semester when results came out they
made sure they celebrated with me which brought me this far may God bless you dearly and
may you live to eat the fruits of your hands. A special thank you should go to my Uncle
Dumisani and Aunt Yaliwe who provided me with moral support when I needed it, receive
your flowers dear ones.

To my cousins, sisters, and brothers thank you for hyping me up each time I succeed, it’s
what kept on pushing me you are my motivation.

To my late grandmother Margret Khonje (may her soul continue to rest in peace) thank you
for positively impacting my life, and for being part of my journey up to the first year of my
university. To my late Grandfather who loved helping people thank you for giving me an
understanding of the importance of unity and helping people.

To my Aunt and Uncle who rendered help by providing me accommodation during my

attachments, I say thank you for giving me a safe space. May God bless you.

Thank you to my supervisor Ms G Sakala who corrected me and guided me when writing this
paper, and to Mrs Joy Chione thank you for supporting me throughout the process. To Mr
Chawawa and Miss Ludaka who taught me research, I’m grateful because I was able to apply
that in this paper.

Yes, there is a saying that you cannot do a degree alone a special thank you should go to my
friends. Amandlha Khongono, Jade Jalakasi, Grace Tapel Ernest Bandawe, and the social
work class of 2020. To my Friends, Nhokota, Monalisa, Emillia, Melinda, Taonga, and
Chawezi thank you very much.

III
Abstract
Child sexual exploitation is a worldwide problem with a range of health, emotional, mental,
physical, and social consequences for children. The social workers are often the first point of
contact with sexually exploited children. They use their knowledge and skills to identify and
assess the child's needs and risks, including physical, emotional, and social factors. They also
work with other professionals, such as law enforcement and healthcare providers, to ensure
the child's safety and well-being, in this case helping in identification and assessment.

This study therefore aimed at assessing the challenges faced by the social workers in working
with the sexually exploited children at Queen Elizabeth Central Hospital One-stop Centre.
The study was conducted using a qualitative research approach and phenomenological
design. It aimed at understanding and attaching meaning to the challenges faced by social
workers. Participants were sampled using purposive sampling. Data was collected using
semi-structured interviews using an interview guide. The findings were analyzed using
thematic analysis which revealed how social workers support sexually exploited children, the
roles they play, the challenges they face when working, as well as the factors that affect the
social workers when working with sexually exploited children.

IV
 TABLE OF CONTENTS

DECLARATION.......................................................................................................................................... I

CERTIFICATE OF APPROVAL................................................................................................................ I

DEDICATION............................................................................................................................................ II

ACKNOWLEDGEMENTS........................................................................................................................ III

ABSTRACT............................................................................................................................................... IV

LIST OF TABLES....................................................................................................................................... I

LIST OF APPENDICES.............................................................................................................................. I

LIST OF ACRONYMS AND ABBREVIATIONS.......................................................................................I

CHAPTER ONE.......................................................................................................................................... 1

INTRODUCTION....................................................................................................................................... 1

1.1BACKGROUND..................................................................................................................................... 2

1.1.2 BACKGROUND ON CHILD SEXUAL EXPLOITATION IN SUB-SAHARAN AFRICA................2

1.1.3 BACKGROUND ON CHILD SEXUAL EXPLOITATION IN MALAWI.........................................2

1.2 PROBLEM STATEMENT.................................................................................................................... 3

1.3 OBJECTIVE OF STUDY...................................................................................................................... 4

1.3.1 MAIN OBJECTIVE............................................................................................................................ 4

1.3.2 SPECIFIC OBJECTIVES................................................................................................................... 4

1.4 RESEARCH QUESTIONS.................................................................................................................... 5

1.5 SIGNIFICANCE OF THE STUDY....................................................................................................... 5

CHAPTER TWO......................................................................................................................................... 5

2.1 LITERATURE REVIEW AND THEORETICAL FRAMEWORK......................................................5

2.1.1 THE GLOBAL CONTEXT OF SEXUAL EXPLOITATION IN CHILDREN...................................6

2.1.2SEX AS A MEANS FOR SURVIVAL................................................................................................. 7

2.1.3 CHILD SEXUAL EXPLOITATION IN MALAWIAN CONTEXT...................................................8

2.1.4 ONE-STOP CENTRES AS AN APPROPRIATE MODEL TO DELIVER SERVICES TO

SEXUALLY EXPLOITED CHILDREN..................................................................................................... 9

2.1.5THE EXPERIENCES OF SOCIAL WORKERS WHEN WORKING WITH SEXUALLY

EXPLOITED CHILDREN........................................................................................................................ 12
2.2 THEORETICAL FRAMEWORK....................................................................................................... 13

2.2.1 CRITICAL THEORY....................................................................................................................... 13

CHAPTER THREE................................................................................................................................... 14

3.1STUDY DESIGN.................................................................................................................................. 14

3.2 STUDY AREA..................................................................................................................................... 14

3.3 STUDY POPULATION....................................................................................................................... 15

3.4 SAMPLING TECHNIQUE.................................................................................................................. 15

3.4.1 PURPOSIVE SAMPLING................................................................................................................ 15

3.4.2 SAMPLE SIZE.................................................................................................................................. 15

3.5 DATA COLLECTION TOOLS........................................................................................................... 16

3.5.1 INTERVIEW GUIDE....................................................................................................................... 16

3.5.2 DATA COLLECTION PROCESS.................................................................................................... 16

3.6 DATA ANALYSIS............................................................................................................................... 17

3.7 ETHICAL CONSIDERATIONS......................................................................................................... 17

3.7.1 CONFIDENTIALITY AND ANONYMITY.....................................................................................17

3.8.2 INFORMED CONSENT................................................................................................................... 17

CHAPTER FOUR..................................................................................................................................... 19

PRESENTATIONS, FINDINGS AND DISCUSSIONS.............................................................................19

4.1 DEMOGRAPHICS OF STUDY PARTICIPANTS..............................................................................19

4.1.1 AGE, RANGE, AND SEX OF RESPONDENTS...............................................................................20

4.1.2 SUMMARY OF PARTICIPANTS.................................................................................................... 22

4.2 THE CORE SERVICES PROVIDED AT QECH CHIKWANEKWANE ONE-STOP CENTER.......22

4.2.1 ASSESSMENT.................................................................................................................................. 23

4.2.2 COUNSELLING............................................................................................................................... 24

4.2.3 EDUCATION.................................................................................................................................... 26

4.3 THE ROLES PLAYED BY SOCIAL WORKERS WORKING WITH SEXUALLY EXPLOITED
CHILDREN............................................................................................................................................... 27

4.3.1 COUNSELORS................................................................................................................................. 27

4.3.2 EDUCATORS................................................................................................................................... 27
4.3.3 ADVOCATOR.................................................................................................................................. 28

4.4 THE CHALLENGES FACED BY THE SEXUALLY EXPLOITED CHILDREN.............................28

4.4.1 FEAR OF REPORTING................................................................................................................... 29

4.4.2 PHYSICAL CONSEQUENCES........................................................................................................ 30

4.4.3 FINANCES FOR TRANSPORTATION...........................................................................................31

4.5 FACTORS AFFECTING THE SOCIAL WORKERS WHEN WORKING WITH SEXUALLY
EXPLOITED CHILDREN........................................................................................................................ 31

4.5.1 CULTURAL DYNAMICS................................................................................................................ 31

4.5.2 GENDER AND AGE......................................................................................................................... 32

4.6 THE CHALLENGES FACED BY SOCIAL WORKERS WORKING WITH SEXUALLY

EXPLOITED............................................................................................................................................. 33

4.6.1 OPENING UP................................................................................................................................... 33

4.6.2 FOLLOW UP.................................................................................................................................... 34

4.6.3 DELAYS........................................................................................................................................... 34

4.6.4 LACK OF PSYCHOSOCIAL SUPPORT......................................................................................... 35

4.6.5 BIG CASELOADS............................................................................................................................ 35

4.7 HOW BEST DO YOU THINK YOU CAN DEAL WITH THESE CHALLENGES............................36

4.8 CHAPTER SUMMARY...................................................................................................................... 36

CHAPTER FIVE....................................................................................................................................... 37

5.1 RECOMMENDATIONS..................................................................................................................... 37

5.2 AREAS FOR FURTHER RESEARCH............................................................................................... 38

5.3 STRENGTHS AND LIMITATIONS OF THE STUDY.......................................................................39

5.3.1 STRENGTHS.................................................................................................................................... 39

5.3.2 LIMITATIONS................................................................................................................................. 39

5.4. CONCLUSION................................................................................................................................... 39

REFERENCES.......................................................................................................................................... 41

APPENDIX 1: INTERVIEW GUIDE FOR SOCIAL WORKERS, CHILDREN AND GUARDIANS.....44

VERBAL CONSENT................................................................................................................................ 44

APPENDIX 2: DATA COLLECTION LETTER......................................................................................47

LIST OF TABLES
Chapter 4; Table 1: Age range and Sex of respondents

Chapter 4; Table 2: Total number of respondents

LIST OF APPENDICES
Appendix 1: Interview Guide for Social workers, children, and guardians

Appendix 2: Data collection letter

LIST OF ACRONYMS AND ABBREVIATIONS

CSEC Commercial sexual exploitation of Children

CSE Child sexual exploitation

DFID Department of International Development

QECH Queen Elizabeth Central Hospital

SE Sexual exploitation

UNICEF United Nations Children’s funds

VSU Victim Support Unit

WHO World Health Organization

V
 CHAPTER ONE
This chapter sets out the background of the research. It also describes the study problem
statement and the main and specific objectives. The other section in this chapter

includes the justification of the study.

Introduction
Throughout history, social workers from various backgrounds have not only advocated
against child sexual exploitation but also provided therapeutic services to victims of such an
inhuman crime. In this case, the United Nations High Commissioner for Refugees 2020, has
defined Sexual exploitation as an actual or attempted abuse of someone’s position or
vulnerability (such as a person depending on you for survival, food rations, school, transport,
or other services), differential power or trust to obtain sexual favors in return of money.
Sexual exploitation of children has become a global multi-billion-dollar industry over the past
several decades.
According to the United Nations Children’s Fund (UNICEF), a child is anybody below the
age of eighteen, hence sexual exploitation in children involves forcing children or
manipulating them into sexual activity for something in return such as money, gifts, drugs,
and alcohol among others. Any child may be at risk of sexual exploitation, regardless of their
family background or social status. Sexual exploitation results in children suffering harm and
it causes significant damage to their physical and mental health. The Social workers who
provide services are trained professionals who work with all types of vulnerable people,
groups, and communities striving to improve their lives (Coursera, 2023). Sexual exploitation
in children, they are supposed to help in both prevention and response to the child at risk of
being sexually exploited, including street children, orphans, children with disabilities, and
those who have already been sexually exploited.
In Malawi, the social workers working with sexually exploited children are found in public
hospitals and various non-governmental organizations. In public hospitals, these social
workers work at a one-stop centre. According to (Pasula, 2021) it is an initiative that was
established to bring together all stakeholders involved in assisting sexually exploited victims
as well as victims of gender-based violence.

1
1.1Background
The Vulnerable group of children can be identified as more at risk of child sexual
exploitation than children in the general community. This study acknowledges that child
sexual exploitation (CSE) is not a recent global social problem and due to the evolution of its
conceptualization, it has attracted attention from child welfare professionals across nations
(McDonald, 2019). Additionally (Frederick, 2010) posits that sexual exploitation (SE)
adversely affects the lives of countless children, from preschool boys and girls to adolescents
and no country is free from its existence.

1.1.2 Background on child sexual exploitation in Sub-Saharan Africa

The World Health Organization (2016) stated that the global issue of Commercial and Sexual
Exploitation (CSE) has reached 151 countries, with 33 percent of the CSE population being
children. This issue has become more prevalent in our society. Globally, 72 percent of sex
traffickers are males as opposed to 28 percent of females (United Nations Office on Drugs
and Crime, 2014).
Additionally, South Africa ranked 16 out of the 60 countries scored by the Out of the
Shadows Index on the country’s response to child sexual exploitation and abuse, with a score
of 58.1. Within Sub-Saharan Africa, South Africa was the top performer among the 16
countries surveyed, ranking just ahead of Uganda (57.3) and Tanzania (56.5).
According to (Franken, 2019), designated social workers in South Africa have an average
caseload of 150 cases per annum, and these cases are usually complex requiring work
experience and expertise. The social workers in South Africa face different challenges which
include a lack of human and other resources, as well as the lack of support systems to follow
up on these investigations. The above-listed challenges cause frustration to the designated
social workers as they have to deal with 150 cases per annum. Additionally, the lack of
psychosocial support provided to the social workers working with child sexual exploitation
cases impacts social workers more negatively as it creates the most intense experiences.
These investigations are emotionally, and intellectually challenging for the designated social
worker. Research has shown that designated social workers also have lower levels of work
satisfaction due to the high levels of work-related stress they experience when working
(Franken, 2019).

2
1.1.3 Background on child sexual exploitation in Malawi
According to (Pediatrics, 2018), in Malawi, 23.8% of children said they had been forced to
have sex against their will, 14% reported having been touched on their genitals or breasts
against their will, and 3.9% of children over 13 years reported having been forced to engage
in some form of oral sex. The Violence Against Children and Young Women Survey in
Malawi in 2013 found that 21.8% of girls and 14.8% of boys aged 18 to 24 had experienced
sexual abuse before age 18 and 37.7% of girls and 9.8% of boys aged 18 to 24 said that their
first sexual experience before age 18 was unwanted. Services for these children are lacking.
Two-thirds of sexual assault survivors reported the incident to an authority figure, but only
10% received professional assistance.
Some of the challenges before 2010 in Malawi were that the medical, legal, and social
welfare agencies did not work together to assist survivors of child sexual abuse. Parents
would bring their children to police who had not been trained in forensic interviewing or the
need for appropriate medical examination. In addition, some of the families were then
referred hospital for an examination, where only 24% of the doctors could correctly interpret
genital findings. In most hospitals, they had to wait in separate lines for treatment, HIV
testing, and emergency contraception. Then they were told to go back to the police with their
completed form. The other challenge was the poor linkages between departments led to poor
case management and children being lost to follow-up. Hence several countries have
developed One-Stop Centres where medical, legal, social welfare, and counseling services
take place under one roof (Pediatrics, 2018). In Blantyre, Malawi, the Queen Elizabeth
Central Hospital is home to the first One-Stop Centre.

1.2 Problem statement

Child sexual exploitation is a worldwide problem with a range of health, emotional, mental,
physical, and social consequences for children, 262 patients were evaluated at the Queen
Elizabeth Central Hospital One-Stop Centre between August 1, 2012, and June 30, 2013. Ten
cases of physical assault were removed from the analysis. An additional 24 cases were
removed as the allegation of abuse was not substantiated, and the presentation was unrelated
to child sexual abuse of the remaining 228 child abuse survivors and their guardians, 59 were
lost to follow up and 62 did not give consent, leaving 107 participants who completed the
questionnaire.
Semi-structured interviews (SSI) were held with 25 guardians in their homes and with 10
service providers representing all the agencies involved in the child protection service. Three

3
of the questionnaires were conducted either at the centre or another site other than home
because the perpetrator or relatives of the perpetrator were at home and guardians felt the
environment was unsafe. Ninety-nine percent of the children were girls, average age of 9
years. (Mulambia, Miller, & Kennedy, 2018) Most research has been focused on the
challenges faced by sexually exploited children and less is known about the challenges faced
by social workers, it only suggested that the social workers faced challenges as it dwelled
much on the children who were sexually exploited without having to hear why the children
fail to get much access to resources.
The social workers are often the first point of contact with sexually exploited children. They
use their knowledge and skills to identify and assess the child's needs and risks, including
physical, emotional, and social factors. They also work with other professionals, such as law
enforcement and healthcare providers, to ensure the child's safety and well-being, in this case
helping in identification and assessment.
However, Malawi remains in a struggle to advance as there are few social workers as well as
time constraints that have led to ineffective prevention and response to cases. In addition, the
lack of public awareness results in underreporting). Under-reporting is compounded by gaps
in resources and capacity that impede efforts to screen, identify, and refer the survivors and
affected children back to their homes. Despite the profession’s immense contribution to the
well-being of disadvantaged and vulnerable populations, governments on the continent have
tended not to give due recognition to social work in general.
This research has delved into and has documented the social worker’s unique roles and
challenges, it has highlighted what areas need to be greatly improved. The knowledge that
this study has revealed is of great importance and if used correctly can go as far as
influencing change geared at improving the experiences of these social workers.

1.3 Objective of the study

1.3.1 Main objective

The general objective of the study is to assess the challenges faced by Social workers in
working with sexually exploited children in Blantyre Queen Elizabeth Central Hospital
(QECH) One-Stop Centre.

1.3.2 Specific objectives

1. To evaluate the core services provided at Blantyre QECH One-Stop Centre.

4
 2. To explore the roles played by social workers in working with sexually exploited
children.
3. To investigate the challenges faced by the sexually exploited children.
4. To analyze the factors affecting social workers when working with sexually
exploited children.

1.4 Research questions

1. What are the core services provided at the One-Stop Centre?
2. what are the roles played by social workers in working with sexually exploited
children?
3. What are the challenges faced by the sexually exploited children?
4. What are the factors affecting social workers when working with sexually
exploited children?

1.5 Significance of the study

The study has helped in dealing with the effects of child sexual exploitation on the child as
well as the help given to those at risk of being sexually exploited and those who have already
been exploited. This has helped in increasing the level of knowledge among social workers
and developing strategies that address physical, emotional, psychological, and legal aspects,
providing a holistic approach to support. Additionally, the study’s literature serves to enrich
the academic world through its expansion of the knowledge gathered on the challenges faced
by social workers in working with sexually exploited children. Finally, the findings have
helped elicit insights and provide recommendations on how best the social workers can be
assisted. This will enhance the enactment of the government and other stakeholders to deal
with the challenges to increase the proper provision of services.

5
 CHAPTER TWO

2.1 Literature review and theoretical framework

This chapter consists of exploring past research that is most relevant to the current topic of
the challenges faced by social workers in working with sexually exploited children. The
subsections will include the context of sexual exploitation in children and research on how
One Stop Centres are an appropriate model for providing services to sexually exploited
children. As well as the research behind the social worker’s reluctance to work with children
who are sexually exploited. The final subsection will examine the experiences impacting
therapeutic outcomes and issues of client transference towards the social workers in the
therapeutic relationship, as both are relevant to this topic.

2.1.1 The global context of sexual exploitation in children

According to (Parkinson P, 2017), a substantial proportion of children across all regions of
the world have experienced physical and sexual violence in childhood. Child sexual
exploitation is a gendered crime, with the vast majority of perpetrators (around 90%) being
male and (10%) Being female. Females are at a significant risk factor for sexual abuse and
exploitation in most parts of the world and this sexual abuse and exploitation is linked to the
gender-based power inequalities that persist globally, although it is important to recognize
that boys can also be sexually abused, exploited, stigmatized and deliberately targeted
because of their gender (WHO, 2012). Providing an exact figure for the scale of the problem
is difficult. Research in Hospital Incident Command System (HICS) and Low-or middle-
income countries(LMICs), shows the rates of sexual victimization found in self-report
surveys are consistently higher than the administrative records of services such as the police
and child protection. Research shows a lot of sexual abuse never comes to the attention of
authorities. For example, surveys in Finland (Lahtinen, Laitila, Korkman, & Ellonen, 2018)
show that although well over three-quarters of victims of childhood sexual abuse have told
somebody about the abuse, most often a friend, at best only 14% of the disclosures were
passed on to authorities. 76% in Germany, and 80% in Finland. Additionally, a Review of the
Evidence Research on violence against children in seven LMICS, Cambodia, Haiti, Kenya,
Malawi, Eswatini, Tanzania, and Zimbabwe, similarly found the proportion of victims who
received service was not less than 10% in most countries surveyed (Sumner et al, 2015). A
review of survey data from 30 countries collected for UNICEF found that only 1% of

6
adolescent girls who had experienced forced sex reached out for help from services
(UNICEF, A Familiar Face: Violence in the lives of children and adolescents, United Nations
Children’s Fund,. , 2017a).
The difficult situations at home can also be a risk for youth becoming sexually exploited.
Oftentimes youth who run away from home because of difficult situations have a high risk of
being sexually exploited; they are often targeted by adults who take advantage of their
circumstances (Smeaton, 2013). Most recruitment research on sex work focuses on the risk of
working on the streets and diminutive research discusses the recruitment process for street
prostitution, which often happens among sexually exploited youth (Kennedy, Klein, Bristow,
Cooper & Yuille, 2007). Additionally, many of the recruitment techniques include the
pretense of love, threats of being in debt to the pimp, drug addiction, manipulation, and
violence (Kennedy, 2007). These techniques often leave the sexually exploited feeling like
they have few alternatives to working

7
on the street.
The 2007 study done by Kennedy, described 16% of their forty-four respondents being
emotionally attached to their pimps. The respondents described being turned out by their
pimp who pretended to love them, which was especially true for the minor victims the pimps
were able to play on the girl’s vulnerabilities and insecurities, skewing their sense of right
and wrong (Kennedy, 2007). Buying gifts and paying attention to girls are other ways pimps
use seduction to lure girls; such as making sure the girls know money spent on them by their
boyfriends and the money spend on them ultimately became a debt that has to be repaid by
working for the pimp (Genevieve Cameron, Ellie Mendez Sayer, 2016).
The study showed that the recruitment process usually takes from three to six months
however, the respondents of this study reported that in some cases it took as little as 24 hours,
describing the pimps as being charming, intelligent, and good judges of human nature. Girls
who find themselves in this situation often feel too embarrassed or ashamed to call home for
help and there are times threatened or experience violence (Dame, 2022).

2.1.2Sex as a Means for Survival

When homeless girls are on the streets, there are few legitimate ways of supporting
themselves. Many children especially girls end up engaging in survival sex or are forced into
sex work by pimps to survive on the streets (Sowell, 2016). This author (Sowell, 2016) also
notes that being on the street is associated with being offered money, drugs, shelter, or food
in return for sexual Favors. The estimates of the prevalence of survival sex among the
homeless population vary widely and are based on several factors; however, it is known that
the behavior of survival behaviors before becoming homeless.
A study done by (Cobbina & Oselin, 2011) adolescent versus adult entry into
prostitution. In comparing the different pathways into the entry, they found that many young
girls who have experienced childhood abuse find that the only way to escape the violence in
their homes is to run away. In turn, these girls were found to rely on survival strategies such
as street sex work to survive. Some women who were interviewed stated their entry into life
as an adolescent was a way for them to normalize their sexuality and regain control of their
lives. A commonality among the women that entered as adolescents eighteen years or
younger was childhood victimization, including sexual molestation, rape, incest, and physical
assault, which resulted in running away to flee these situations (Cobbina & Oselin, 2011).
The other theme found was that women who entered before the age of eighteen thought
prostitution was normal. Some of the respondents stated that prostitution was normal and

8
even glamorized in the neighbourhoods that they grew up in and as a result, they viewed
prostitution as a viable option for income (Cobbina & Oselin, 2011)One respondent said that
her father was a pimp, so she was always around prostitutes as well as another way for her to
be around her father. Another respondent described prostitution as a way of achieving status,
a way to get nice clothes, and making money (Cobbina & Oselin, 2011) For older women, the
survival strategy presents itself differently; entering into the life of prostitution is often
connected to economic necessity (Cobbina & Oselin, 2011).
The authors continue to state that women that have lower socioeconomic status (SES) often
have fewer educational opportunities as well as employment opportunities making it
challenging to avoid poverty (Cobbina & Oselin, 2011) In the study, some women that
described their entrance into sex work said that it was to sustain a drug habit. In addition,
over 65% of the women who entered over the age of eighteen said that they had been
addicted to drugs or alcohol and that they came from a family or environment where drug use
was prevalent (Cobbina & Oselin, 2011). Another 35% of the women described that sex was
a necessary survival strategy to earn money and maintain housing. While the entry pathways
differed among the two groups, it is evident that structural factors make prostitution a
practical option for lower-class women; some women described their work as glamorous, and
others described their involvement primarily for income (Cobbina & Oselin, 2011). The
findings of this research are important to consider as they speak to the different pathways that
lead younger girls and women into prostitution.

2.1.3 Child sexual exploitation in the Malawian context

The Malawi Network against Trafficking says it managed to rescue 40 children who were
being sexually exploited in brothels and bars in two districts of Mulanje and Phalombe in
December 2020. According to Caleb Thole, executive director for the network most of the
girls aged between 13 to 18 are those being lured into the business initially as house workers.
Thole told MIJ Online that they are engaging police and other stakeholders to deal with the
situation. Most Malawian trafficking victims are exploited within the country, generally
transported from the southern part of the country to the central and northern regions for
forced labor in agriculture (predominantly the tobacco industry), goat and cattle herding, and
brickmaking. Many cases of child labor external to the family involve fraudulent recruitment
and physical or sexual abuse, indicative of forced labor.
Traffickers, primarily facilitators or brothel owners typically lure children from their families
in rural areas under pretenses of employment opportunities, clothing, or lodging for which

9
they are sometimes charged exorbitant fees, resulting in sex trafficking coerced through
debts. Malawi Authorities Take Steps to Protect Children from Sexual Exploitation, a report
from a 2018 article by Victor Mhango an executive director for the Centre for Human Rights
Education, Advice and Assistance. lauded the campaign but says the problem is that the real
culprits are left unpunished. These children are being employed by people, the adults. Maybe
they are used as pimps. So, they collect the money from the clients then they receive the
money themselves and give something to the children, so to us, that is a crime, he notes
(Masina, 2021).
Human Rights lawyer Ruth Kaima points out that prostitution is legal in Malawi. “For these
minors for them engaging in sex work on their own, they are not committing an offense, but
It’s illegal because you are not supposed to harbor minors and engage them in sex work
because (by doing so) you are exploiting them and you are abusing them,”. However, rights
campaigners say the sexual exploitation of children in Malawi will only end if underlying
factors like poverty are addressed (Masina, 2021).
According to (Voice, 2022) PSGR is taking the initiative by negotiating with different
institutions like the Malawi Institute of Tourism to enrol those willing to be trained at the
institution with financial support coming from the People Saving Girls at Risk (PSGR).
Targeting three districts in the southern region, Blantyre because it is a hub for socio-
economic activities, Mangochi being a tourist attraction place, and together with Balaka
where cases of child trafficking and early marriages are rampant.

2.1.4 One-stop centres as an appropriate model to deliver services to sexually exploited

children
In Blantyre, Malawi, the Queen Elizabeth Central Hospital (QECH) is home to the country’s
first One-Stop Centre, referred to as a Chikwanekwane (everything under one roof) building
on the work of a multidisciplinary team which has been operating in Blantyre since 2010, the
centre was established by funding from Department of International Development (DFID)
with the support of the Ministries of Health, Social Welfare and UNICEF (Mulambia, Miller,
& Kennedy, 2018). The team comprises pediatricians, nurses, social workers, police victim
support officers, and volunteer counselors working together to provide the best care possible
for child survivors. Currently, police Victim Support Units (VSU) are the main referral
agents, though self-referral is promoted and also welcomed. The police officers are trained in
the provision of counseling and support to victims. At QECH, experienced doctors examine

10
the child and document findings in a medico-legal report. An HIV test and post-exposure
prophylaxis are offered, along with follow-up tests at 3 and 6 months after the incident.
Sexually transmitted infection management and emergency contraceptives are given when
indicated. Additionally, Social workers and counselors located within QECH offer safety and
psychological support respectively (Mulambia, Miller, & Kennedy, 2018).
The social workers and counselors have longer contact with the victim than any other
provider of the service and arrange to see families weekly as required. Police and social
welfare workers then continue their investigation and visit the victim at home to assess the
safety of the child. The anecdotal experience of staff involved in this centre was that it
improved client satisfaction and outcomes. As a result, the government of Malawi has rolled
out the ‘Chikwanewane’ model to establish 4 other large and 23 smaller centres throughout
the country. However, no formal evaluation of the challenges faced by social workers has
ever been published in Malawi (Mulambia, Miller, & Kennedy, 2018).
According to (Mulambia, Miller, & Kennedy, 2018) a study was conducted to examine the
accessibility of services for the children who were sexually abused. The participants were
families who had received treatment at the Blantyre One-Stop Centre at Queen Elizabeth
Central Hospital. The largest government hospital in Blantyre offers free care to children
from the city and Southern Malawi. All children evaluated for sexual abuse during the study
period from August 1, 2012, to June 30, 2013, were eligible. The children’s guardian was the
person enrolled in the study and interviewed about their experiences. The study was
introduced to guardians on the day of presentation to the hospital. Guardians were given a
brief introductory leaflet explaining the research and contacted 3 months later to determine if
they were still willing to be involved in the study.
The written consent was obtained. The scope of the questions was designed to assess
whether the families had received the medical, legal, and social welfare services as required
in the Malawi National Guidelines for Provision of Services for Physical and Sexual
Violence (Mulambia, Miller, & Kennedy, 2018). All interviews took place in the family
home 3 months after their evaluation at the One-Stop Centre. All the families received a
questionnaire administered in person during this visit. The questionnaire was administered
verbally in Chichewa to all the participants; from this cohort, semi-structured interviews were
then conducted with 25 guardians who were representative of the study population in terms of
the age victim, and gender. With the permission of the respondent, a voice recorder was used
to collect the information. The interviews were transcribed. After familiarization with the
data in the preliminary analysis, a thematic framework was developed, and themes were

11
coded. The researchers were blinded to the child protection services outcomes at the time of
the visit. The child’s guardian was interviewed to prevent secondary victimization of the
survivor. Inclusion criteria included Participation in this study was offered to the guardians of
all children aged 0–14 years who, in the opinion of the medical staff, had been sexually
abused and who gave consent to be in the study. From this cohort of participants, a
representative subset of 25 guardians were chosen to also participate in the semi-structured
interview. Exclusion criteria cases in which the guardian did not give consent, or in which the
final diagnosis was not sexual abuse (Mulambia, Miller, & Kennedy, 2018).
In total, 262 patients were evaluated at the Queen Elizabeth Central Hospital One-Stop
Centre between August 1, 2012, and June 30, 2013. Ten cases of physical assault were
removed from the analysis. An additional 24 cases were removed as the allegation of abuse
was not substantiated, and the presentation was unrelated to child sexual abuse. Of the
remaining 228 child abuse survivors and their guardians, 59 were lost to follow up and 62 did
not give consent, leaving 107 participants who completed the questionnaire. Semi-structured
interviews (SSI) were held with 25 guardians in their homes and with 10 service providers
representing all the agencies involved in the child protection service. Three of the
questionnaires were conducted either at the centre or another site other than home because the
perpetrator or relatives of the perpetrator were at home and guardians felt the environment
was unsafe. Ninety-nine percent of the children were girls, average age of 9 years.
(Mulambia, Miller, & Kennedy, 2018)
All 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV
test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29%
had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12%
returned for further treatment; 95.3% had an initial police report and 27.1% ended in a
criminal conviction for child sexual abuse. Most of the families were satisfied with the
service they received, but a quarter of the families were not satisfied with the law
enforcement response, and 2% were not happy with the medical assessment. In conclusion,
although a perception of corruption or negligence by police may discourage the use of
service, we believe that the One-Stop model is an appropriate means to deliver high-quality
care to survivors of exploitation a form of sexual abuse in Malawi.

2.1.5The experiences of social workers when working with sexually exploited children
According to (Ahem, Sadler, Lamb, & Gariglietti, 2017) Semi-structured interviews were
conducted in the United Kingdom with frontline social workers and law enforcement

12
practitioners about their experiences interacting with youth during child sexual exploitation
investigations. The findings provided some tentative insights into the processes by which
practitioners sought to establish rapport with young people who have been exploited and
establish themselves as trustworthy abuse disclosure recipients. Practitioners reported that
rapport building in child sexual exploitation cases not only occurred over lengthy periods
(e.g., months or years) but also required repeated contact between the practitioners and young
people, during which practitioners minimized their roles as authorities and maximized their
authenticity as caring people. Practitioners mentioned the importance of dependability, light-
heartedness, and having a casual demeanour. Findings have implications for managing
reluctance and understanding rapport building when working with possible victims.
Studies suggest that social workers working with sexually exploited children in Malawi face
significant challenges, including limited resources, inadequate training, and cultural attitudes
that stigmatize victims. However, there is also a growing recognition of the need for more
support and resources for social workers, as well as for more effective policies and
interventions to address the problem of child sexual exploitation in Malawi (Pediatrics, 2018)
This literature review did not look at the challenges faced by social workers working with
sexually exploited children at QECH, it only suggested that the social workers faced
challenges and it dwelled much on the children who were sexually exploited without having
to hear why the children fail to get much access to resources. Therefore, this research through
the theoretical framework will focus on finding that gap in the concerns of social workers in
offering prevention and intervention to those who are exploited by sexual abuse. The
experiences have helped conclude why they face some of the challenges they have
mentioned.

13
2.2 Theoretical framework

2.2.1 Critical theory

Critical theory intends to raise society’s awareness regarding issues of oppression and to help
them understand these issues, as it aims to dig beneath the surface of social life and uncover
the assumptions that keep humans from a full and true understanding of how the world
works. In practice, social workers who align with this theory examine how society’s patterns
and preferences undermine the delivery of social services and welfare in general. Critical
theorists take a critical stance and challenge social forms such as slavery and indentured
servitude that hinder human development, they investigate the values and meanings
sustaining quality in social institutions (Crossman, 2019).
The researcher has used this theory in analyzing how power imbalances impact the ability of
social workers to effectively address the needs of exploited children. According to this
theory, the social worker should be able to recognize these challenges and continue to work
with them. One of the reasons that critical theory fits with this study is because of the
emphasis it places on social justice. Due to the hidden nature of child sexual exploitation
(CSE), getting victim’s perspectives and experiences are often difficult and ethically
challenging. It is social workers who are therefore situated to address these challenges and
give voice to victims (Hodge, 2014). In this context, the researcher has examined the societal
attitudes towards sexual exploitation, gender and age, fear of reporting, and stigmatization.
By interrogating these norms, the researcher has highlighted how they influence their actions
and the treatment of sexually exploited children not forgetting the challenges social workers
encounter in their work. Structural factors are also a reason this theory fits this study. The
theory states that problems are inherent aspects of societies that are structured in unjust ways
and are not caused primarily by the characteristics of the individual (Forte, 2007). The
barriers that sexually exploited children may encounter are directly related to the services that
are available to them.
The Social workers themselves with this theory have the interest of those who are oppressed
at heart. The society as a whole will need to recognize and respond to this issue. Racial and
economic disparities among children who have been sexually exploited are other reasons that
critical theory was chosen for this paper. Oppressions such as class as well as poverty and
homelessness are factors that increase the likelihood of being exploited (Kramer & Berg,
2003). The researcher has actively sought the perspectives of survivors, including their

14
experiences with social workers and other support services. By amplifying these voices, the
researcher has provided insights into the strengths and limitations of current approaches and
identified areas for improvement and these areas of improvement have been added to the
recommendations. Critical theory provides a framework to pull these together when
examining the barriers, that social workers face in providing services to sexually exploited
children. The researcher has investigated how these inequalities intersect with issues of
sexual exploitation, impacting both the prevalence of exploitation and the responses of social
workers. Understanding how structural factors contribute to vulnerability and hinder
intervention efforts is crucial for developing effective strategies.
This theory has helped in knowing of the social injustices and human experiences as a means
of promoting change and helping them see some of the challenges they did not think were
challenges.

CHAPTER THREE

This chapter shows the outline of how the research was done, the research design, and also
the methods that were used in the research. This is to show exactly how the data was obtained
and how it is being analyzed.

3.1Study design
This research employed a qualitative form of research. Given the nature of the topic and the
data that was gathered, the qualitative method was best suited for this study. Through the use
of qualitative interviews, this study has given an insight into social workers, perceptions of
the challenges they face in working with sexually exploited children, more especially those
they encounter when trying to provide supportive services such as accommodation and
mental and physical health services. It also made them realize their unique challenges such as
lack of psychosocial support as their always dealing with traumatic issues.

3.2 Study area

The research was administered in Blantyre district, at Queen Elizabeth Central Hospital
(QECH). Which is along Mandala Road T/A Kapeni. This is because QECH was the first
hospital in Malawi to have a One-Stop Centre working with sexually exploited children and
because it also has qualified social workers who work with Sexually Exploited Children
fitting the research study.

15
3.3 Study population
The study comprises 5 social workers, 4 parents of sexually exploited children 1 nurse, and 4
of the sexually exploited children found at the One-Stop Centre in Blantyre QECH. The
study was reached based on the availability of the social workers and the saturation point was
reached when no new information and themes emerged from the data collected from the
sexually exploited children. The social workers provided relevant information to the
researcher as she was looking for the challenges faced by social workers in working with
sexually exploited children. The parents and sexually exploited children also provided the
researcher with information on the challenges faced by the sexually exploited children and
their parents.

3.4 Sampling technique

3.4.1 Purposive sampling

This researcher used this sampling technique to generate rich data specifically from the
social workers. The purposive sampling selected the five social workers who only work with
sexually exploited children at QECH One-Stop Centre, well experienced, and not any other
random group of social workers working within QECH. In addition, it selected four guardians
and four children who were victims of such an indecent crime, and one nurse was also
selected. This sampling method differs from random sampling or probability sampling in that
the inherent features of the population are defined, and there is an equal opportunity for all
members to be selected for the sample. Applying a purposive sampling approach to this
study, meant that the researcher's task was to identify social workers (SWs) who are
knowledgeable and have experience working with sexually exploited children, the social
workers identified helped in identifying the guardians and the children.
The chosen SWs should have worked within the children’s services for a minimum period of
six months and knew child protection issues as well as being part of a team that works with
sexually exploited children. The assumption is that those who had worked for a minimum
period of 3 months would have had at least some experience of the phenomenon being
investigated.
3.4.2 Sample size
As Matthews and Ross (2010) propose, the ideal sample size is determined by the saturation
point. It was reached at 14. With 5 being social workers, 1 nurse, 4 guardians, and 4 sexually
exploited children. 14 were chosen because Malawi, specifically QECH has relatively a small

16
number of social workers working at the one-stop centre. Additionally, most children give the
same reasons as to why they were afraid of reporting to their guardians hence only 4.

3.5 Data collection tools

Due to the qualitative and phenomenological nature of this research, this research used a data
collection method that served the purpose of bringing out real-life experiences. Primary data
was collected through semi-structured interviews using semi-structured questions.

3.5.1 Interview Guide

In this study the researcher asked more open-ended questions, allowing for a discussion with
the interviewee rather than a straightforward question-and-answer format. This created
opportunities for both the researcher and respondents to discuss some topics in more detail to
produce nuanced and detailed answers. For example, the interviews were opened with the
question “Can you please tell me briefly about the One-Stop Centre?” Followed by “Can you
tell me about your roles here when working with sexually exploited children?” realizing that
during interviews it is difficult to follow the order in which a researcher has designed their
questions on the interview guide. 10-15 minutes were provided to each respondent; this gave
each respondent time to give detailed information needed by the researcher.

3.5.2 Data collection process

To have effective results, the researcher made sure that the understanding of the research
topic was explained to each respondent. The data was collected by using qualitative
interviews using a recording and writing, where an interview guide was used with a set of
open-ended questions. The researcher interviewed 5 social workers who have been providing
counseling and assessment to sexually exploited children, additionally, the researcher
interviewed the children who were defiled and their guardians who brought them to the
hospital. The interviews were conducted in a way that made the respondents comfortable and
allowed them to share their experiences freely which made it easier for the researcher to also
ask follow-up questions and seek clarity where needed. The interviews were only done when
the social workers were available and when the clients were available too, so if the clients
were available the researcher would conduct the assessment and counseling sessions as she
had recent experience of working there at the beginning of the year.

17
3.6 Data analysis
3.6.1 Thematic analysis

Thematic analysis was done by closely identifying, analyzing, and reporting topics, ideas, and
patterns within the data set that came up repeatedly from the respondents. As an analysis tool,
the researcher ensured that the data was coded, which is important because it helped group
the said data into categories that were later merged into themes (Clarke, 2006). The themes
were drawn from answers that were frequently pointed out by the social workers and
children.

3.7 Ethical considerations

3.7.1 Confidentiality and anonymity

The researcher assured the social workers that whatever was being discussed between the
researcher and the social workers was going to stay confidential and every recording was not
going to be used anywhere unless otherwise but only with approved consent from them. In
addition, the researcher ensured privacy and confidentiality of the guardians and children
who were exploited, no recording was done for the clients as it was a very sensitive issue.
The researcher used numbers to ensure anonymity as the data was being presented.

3.8.2 Informed consent

For ethical purposes about credibility, the study informed all participants about the purpose of
the study and other necessary details of the research. Each social worker a consent form and
verbal consent before the interview to make sure that they were indeed comfortable with
sharing such information. This is in line with what Sara Manti defined as “informed consent”
It is a procedure through which the subjects after having received and understood all the
research-related information can voluntarily provide how or their willingness to participate in
the research. (Sari Manti, 2016)

18
The researcher was also given a consent letter by the Catholic University of Malawi to carry
out the research, this consent letter was presented to the Doctor at the department stop centre
and the doctor explained to the social workers and nurses the researcher’s motive to
successfully do the data collection process. It was easier because the researcher once did an
internship there so she built a good relationship, otherwise the researcher was supposed to go
through the QECH research department.

19
 CHAPTER FOUR

Presentations, findings, and discussions

This chapter aims to present the findings of the study as well as a discussion of the same. The
data was collected through qualitative interviews with 14 respondents, 5 social workers, 1
nurse, 4 guardians, and 4 sexually exploited children. The findings are presented in alignment
with the three specific objectives that this study was set to achieve.

 To evaluate the core services provided at Blantyre QECH One-Stop Centre.

 To explore the roles played by social workers in working with sexually exploited
children.
 To investigate the challenges faced by the sexually exploited children.
 To analyze the factors affecting social workers when working with sexually exploited
children.

Additionally, the findings are discussed critically, in terms of the existing body of literature
as well as the theoretical framework; Critical theory, to allow for a richer appreciation of the
status of the social workers that examine how society’s patterns and preferences undermine
the delivery of social services and welfare in general. Especially those working with sexually
exploited children. The analysis therefore opens room to discover the challenges faced by
social workers in working with sexually exploited children and why exactly they face them.

4.1 Demographics of study participants

The study had five social workers, one nurse, and eight service users, four being guardians
and the other four children. The presence of five social workers gave the researcher hope that
she was going to get heavy information. As per usual there are usually three social workers
present. Meeting clients who were open to the questions being asked was very crucial for the
researcher and allowing rendering assessment and counseling to the clients showed
availability of trust.

20
4.1.1 Age, range, and sex of respondents
AGE RANGE FEMALE MALE

11-16 4

20-34 6 1

35-52 3

Table 1: Indicates the age range and sex of the respondents

pie chart of respondents by age range

35-52
23%
11-16
31%

20-34
46%

Chart 1: indicates the age range of respondents by percentage

21
4.1.2 Summary of Participants

22
QUALIFICATION CODE AGE

Social worker 1 23

Nurse 2 52

Social worker 3 28

Child 4 11

Guardian 5 50

Child 6 14

Guardian 7 30

Child 8 13

Guardian 9 26

Social worker 10 26

Social worker 11 30

Child 12 16

Guardian 13 34

Social worker 14 35

4.2 The core services provided at QECH Chikwanekwane one-stop centre

To answer this specific objective, the researcher had to explore the core services that are
rendered to children who are victims of sexual exploitation. Being a sensitive issue, the
researcher wanted to know the mode of delivery of services as well as the core services
provided. The researcher categorized and established themes according to the responses of
the respondents.

23
4.2.1 Assessment
From all respondents, assessment was the first step of interaction between the client and the
social worker. An initial assessment is done. Which involves, an evaluation or examination
conducted to gather information about an individual's abilities and knowledge in a specific
context, such as education or employment. This assessment is typically carried out at the
beginning of the intervention to establish a baseline and inform the development of tailored
plans or strategies (Reece, 2006). The initial assessment was to get necessary information
concerning the patient and the guardian.

Respondent 2 (Nurse) highlighted

“Usually when a client comes they come with the guardian and they come by the
reception, ndipo timawafusa za buku laku chipatala ndikulemba pansi zofunikila
tikatelo timawatumiza kwa a za social wan di buku lo kuti acheze nawo (we ask them
for their health passport and we write down the important details as registration then
we send them to the social worker to have a chat with them).”

Respondent 1 (Social worker) on the other hand explained how they do their assessment as it
differed with respondent 2.

“We have a form which includes, the name of the client, school, age, location, home
village, village head, name of the perpetrator, his age, which police did you report to,
name of guardian, age, occupation as well as religion. So, we collect that information
while waiting for the doctor to examine the penetration process.”

Respondent 10 (Social worker) highlighted

“When the doctor is not busy with other clients the social workers meet the client at
the end after the results have been given. Nde choyambilila ndimawawuza dzina
langa kuti ndine mlangizi wa pano ndipo musachite mantha zomwe titakambilane
zithela momuno kenako timawafusano mafuso monga dzina, zaka za mwana yo,
munakanena ku police yakuti, nyumba yanu inayandikana ndichani akatchula delalo.
This is done for the sake of follow up timawafusa mafuso apa chi form ichi.”

Respondent 13 (Guardian) explained

“Titafika tinakhala pa mipando paja malingana ndikuti tinapezapo anthu ena, kenako
anamwino anatiyitana kuti tiwapase buku lakuchipatala ndipo anatifusa ngati

24
 tinapita ku polisi nde poti tinali titapita anati tiwapase polisi report li, atatelo
anatitumiza ku office la za social.(when we arrived we sat down on those chairs “she
pointed” This is because we found other clients so the nurse called me saying I
should give her the health passport, she asked if we had reported to the police and I
said yes then she asked for the police report she wrote down the details and sent us to
the social worker's office.)”

The study findings agree with (Reid, J. A., Baglivio, M. T., Piquero, A. R., Greenwald, M.
A., & Epps, N, 2017) workers are often the first point of contact with sexually
exploited children. They use their knowledge and skills to identify and assess the child's
needs and risks, including physical, emotional, and social factors. They also work with other
professionals, such as law enforcement and healthcare providers, to ensure the child's safety
and well-being, in this case helping in identification and assessment.

4.2.2 Counselling
Counseling meant a talking therapy session that was provided to the sexually exploited child
and the guardian present, it was done after a thorough initial assessment. The social worker
gives an introduction about, herself and explains how whatever they are discussing is
confidential, and it will end here. In short, it involves building a rapport, it involves the
presence of two or more people, exploring in depth the problem, and coming up with
alternative solutions.

Respondent 3 (Social worker) highlighted

“timakhala pansi ndi mwana uja komaso kholo kuti timve nkhani yomwe abwelela ndi
mene zinakhalila kuti zichitike choncho, timawalimbikitsa kuti akhale omasuka kuti
athandizike. Kholo lija timaliwuza kuti lituluke kuti ticheze ndi mwanayo kuti
amasuke bwino bwino poti ana ena amakhala akuopa makolo. (we sit down with the
child together with the guardian to get a clear picture of the story when and where it
happened)”

“akakhala mwanayo kuti mwina wagwililidwa ndichibwenzi timatha kumufusa kuti

ndi zibwezi mwayambazo sukulu iyenda, some children are rude kugoona

25
 mayakhidwe. Nde timawapasa uphungu oyenela ndikuwawuza chilugamo kuti akungo
pusisidwa alimbikile maphunziro.

Respondent 5 (Guardian)

“A social anatiyitana mu office ine ndimwanayi awelenga polisi report kuti awone
nkhani yathu kenako anandiuza kuti ndifotokoze nkhani mene inayendela, kenako
ananditulusa kuti asale ndi mwanayu kuti amufuse mafuso, nde popeza mwanayu
zimuvuta kufotokoza mbali yake nde nditelo, koma anandiyitanaso kuti mukakhala
naye mwanaye zikumakhala bwanji chifukwa dzukulu wangayi ndiokonda kusewela
koma pano ayi”. (the social worker called us they read the police report to see how
the incident occurred, I explained my part then she told me she needed to chat with
the child though it was hard for her to explain, she called me again to ask that from
your observation how is she behaving, I answered that my granddaughter likes to
play but now she’s withdrawn.”

Respondent 2 said (Nurse)

“Ife mbali yathu ndizoyezayezazi zopeleka uphungu timawasiyila anzanthu aza

social, koma pena timatha kuonaso kuti mwana uyu olo kumulangiza abwelelaso,
kuno kunabwela mwana wina oti makolo ake anakamugoneka ku cell masiku awiri
kut awulule kuti chibwenzi chake chili kuti kumupitasa kwa aza social wa
amangoseka nde ana ena amakhala want”.(our part is to do testing’s we leave the
counselling part to the social workers but sometimes we can see that counselling this
child will go back, there came a child whose parents made her sleep in the cell for
two days for her to reveal about her boyfriend his whereabouts they brought her to
the social workers asking her questions she was just laughing).

Respondent 14 (Social worker)

“Usually we have a one-on-one with both the child who has been exploited and the
guardian, this is done in that way because other children fail to express how and who
exploited them because sometimes it’s their family members, so we sit down with
them alone to get to the story, we also assure them that we will not tell the guardian
what we discussed about this usually depends on the story at hand.

Respondent 13 (Guardian)

26
 “Uphungu omwe talandila kuno watithandizira kuziwa nkhaza iyi yapogonana
chifukwa ife timaonangati mwana yi atha kukwatira ali ndi zaka 16 nde poti
mwatiunikila ndikuti pasa uphugu woti atha kubwelela ku sukulu akabelaka mimbayi
izi zatithandiza telo. (we didn’t know that a child below the age of 18 cannot get
married and it’s a legal issue, the counselling session has helped now I know my
child can go to school despite the pregnancy.”)

Respondent 11 (Social worker)

“Counselling is the most effective intervention that is provided to our clients after
being exploited, we explain to them acceptance is a key factor to handling every
situation we assure them that it will never happen to them again, and we give them a
follow-up date to come counselling doesn’t happen once depending on the case, we
help them develop coping skills more especially if there struggling with acceptance”.

Social workers and counsellors located within QECH offer safety and psychological support
respectively (Mulambia, Miller, & Kennedy, 2018). Social workers provide counselling and
therapy to help sexually exploited children heal from trauma and develop coping skills. They
use evidence-based practices, such as cognitive-behavioural therapy and trauma-focused
therapy, to help children process their experiences and develop positive self-esteem and
relationships.

4.2.3 Education
Health education helps empower individuals to live healthier lives by improving their
physical, mental, emotional, and social health by increasing their attitudes about caring for
their well-being. Regardless of being a victim of sexual exploitation, they should not live a
reckless life but rather work for the betterment of themselves.

Respondent 14 (Social worker)

“We provide education to our clients explaining the type of abuse that has happened
to them because other clients also come with issues of physical abuse. Nde
timawalongosolela mwa mvemvemve kuti iyi ndi nkhaza yogonana, ndipo malamulo
amati chakuti chakuti inu si malamulo muku aziwa. (we clearly explain to them that
this is sexual exploitation, and the laws say this and this).”

Respondent 10 (Social Worker)

27
 “Usually, we explain to them that this is a legal issue we also explain to them the
legal processes, that it’s a crime to indulge in sexual activities with a child below 18
because that child cannot give consent”.

4.3 The roles played by social workers working with Sexually exploited children
To meet the second specific objective, the researcher conducted interviews to explore the
roles played by the social workers in connection with the core services provided at the one-
stop centre.

4.3.1 Counsellors
The Social Workers said to every client that comes to seek services, usually defilement and
rape cases need counselling. The social workers remain in close contact with the clients, and
they build an element of trust, the client explains to the social worker how everything
happened, and the social worker gives a talking therapy and assures the client of positivity.
The counsellors have been responsible for providing a safe, confidential environment, and
have been empathetic, understanding, and non-judgmental.

Respondent 3 shared

“Our topmost role as social workers is being a counsellor throughout every session
with our clients who are victims of sexual exploitation be it, children or adults, we
have to provide counselling; we hear their story out like talking therapy we assess
whether their results have shown HIV positive to provide more counselling services.
It is not only done once it depends on the extent of the client’s story and reactions.”

The study findings agree with (Mulambia, Miller, & Kennedy, 2018) Social workers who
play the role of counsellors located within QECH offer safety and psychological support
respectively. The social workers have longer contact with the victim than any other provider
of the service and arrange to see families weekly as required.

4.3.2 Educators
The social workers play the role of an educator educating them on the child’s rights, and all
legal processes.

Respondent 14 shared

28
 “We play the role of an educator; we teach them how to avoid such from occurring
again either advising them to keep close attention on their child. We educate them on
the legal processes that need to be done to ensure the perpetrator is behind bars.
There is also a lot of stigma and discrimination that comes with defilement cases, so
teach them so it becomes our job to make sure that people understand what it means
to be positive. And I honestly think it helps.”.

According to (Bishop, 2020), Social workers play a role in educating the victims about the
nature of sexual abuse, its impact on mental and physical health, and the available recovery
resources for example counselling. Additionally, the social worker provides psycho-
education on how to cope with trauma and educates them on the legal processes.

4.3.3 Advocator
Social workers play the role of an advocator, they ensure that the legal processes are being
made, they follow up through the police, and ensure justice is made.

Respondent 1 said

“We as social workers not only do provide counselling, we also play the role of an
advocatory we follow the client's story up to the court, and sometimes we also follow
up through the police if the perpetrator is under authority which also helps improve
the positivity of our clients as they feel their voice is being heard.”

Respondent 10

“As advocators, we also help the client get social justice, even though most cases are
left lying and not addressed but we do fight hard”.

Social workers advocate for the rights and needs of sexually exploited children. They work
with other professionals to ensure that the child's voice is heard and that their needs are met.
This may include advocating for appropriate medical or mental health care, education, or
legal support (Jansson, 2018). Ensuring that their required necessities are met by their
situation.

4.4 The challenges faced by the sexually exploited children

Children who have been defiled face several challenges both internal and external challenges
that also contribute to some of the challenges faced by the social workers. Others come as a
result of being abused, with physical consequences as well as mental consequences. To meet

29
this specific objective, the researcher had to play the role of a social worker attending to a
few clients on those particular days. The researcher having experience working at the One-
Stop centre could provide counseling services as well as assess the clients.

4.4.1 Fear of reporting

The researcher found that most children said they were afraid of reporting because they were
not aware that they were being sexually exploited.

Respondent 4 shared

“ndimaopa kunena kuti ndachitidwa zimenezi chifukwa ndimaopa amayi andikalipila

nkona sindinanene, komaso abambo wo anati ndikanena andipha nde nkona
ndimaopa. (I was afraid to report because I was afraid my mother would shout at me
that is why I did not report and also the man said he’d kill me if I reported to
anybody).”

Respondent 6 said

“sindimaziwa kuti ndikhaza yomwe ndimapangidwayo mesa ndichibwenzi changa

ngakhala amandikakamiza kupanga mchitidwe umenewu ine ndimalola chifukwa
amandipasa ndalama. (I didn’t know I was being exploited I thought his is my
boyfriend even though he was forcing me. I allowed because he was giving me
money).

Respondent 3 shared

“I feel like the fear of reporting comes in because some children become highly
dependent on the perpetrator.”

Respondent 4

“Ndimaopa kunena chifukwa anthu azindiseka kuti ogwililidwa uyu nkona

sindimafuna kunena, komaso anandiuza kuti ndisazaulule”. (I was afraid because
people would laugh at me and I was told not to report.)

The study findings agree with the literature found by (jegllc, 2019). sexual abuse is the most
under-reported crime, as the majority (63 percent) of individuals who experience sexual
violence do not report it to authorities. The Rape, Abuse, and Incest National Network

30
(RAINN) estimates that out of every 1000 sexual assaults only five of the perpetrators will be
incarcerated for the crime. Those who have experienced abuse report numerous barriers to
reporting including; Feelings of shame, guilt, and embarrassment, perceived negative
consequences of reporting, fear of retaliation by the perpetrator, financial dependence upon
the perpetrator and not wanting family members or friends to be prosecuted.

4.4.2 Physical consequences

Every child who has been defiled and has visited the One-Stop centre within the first 72
hours, has the visible presence of physical injuries usually bruises and a wide opening. Some
also can be infected with HIV and AIDS or other viruses.

Respondent 8 said

“ndikumva kuwawa miyendo kumaso uku,anandipanga ndichintengo nde

ndikumamva kuwawa kwambiri.(I am feeling so much pain because he used a stick on
me)”

Respondent 13 (Guardian) shared

“mwana wanga anabadwa bwino bwino lelo uyu amupeza ndi matenda, zomwe zili
zolilisa zovuta kuvomeleza mayi omupanga chipongweyo anathawa. (my child was
born with no underlying health issues, today after being defiled she has been
diagnosed with HIV)”

Respondent 12

“anandimenya makofi nkundivula nkundioanga zawozo” (complained of being

slapped because she was refusing, so she was slapped and then forced to have sexual
intercourse.)

According to (UNICEF) Child sexual abuse and exploitation have a significant impact on the
health and well-being of children and adolescents worldwide. The impact will vary in relation
to the nature, severity, and duration of the abuse, developmentally about the child or
adolescent’s ability to understand the abuse, their coping strategies, and the responses from
family, friends, wider community, and services. The harm caused includes the impact on
physical health (such as high BMI, problems in childbirth), higher likelihood of contracting
HIV due to sexual risk-taking (such as having multiple sexual partners or inconsistent

31
condom use) drug or alcohol abuse, anxiety, depression, psychological trauma, and self-harm
offending behavior, missing school and lower educational attainment, A child who is sexually
abused or exploited is also at greater risk of experiencing other types of violence or abuse
from adults or peers in a range of settings. Children who experience multiple victimizations
tend to have the poorest outcomes. The consequences can be lifelong and include intimacy
issues, affecting relationships with family, partners, and children, and socio-economic
consequences such as homelessness and unemployment.

4.4.3 Finances for transportation

The social workers also mentioned that one of the issues that hinder the clients from
accessing services is the lack of money for transport to travel to the One-Stop Centre. Most of
them come from the outskirts of Blantyre.

Respondent 13 (Guardian)

“Ku bwela kuzanena mochedwa ndivuto la transport mu ma health center akwathu

anatitumiza kuno nde zinali zovuta kuti tipeze transport yochokela kwa bvumbwe kuti
tifike kuno nde komabe tafika koma vuto tinakumana nalo ndilimenelo. (the reason
why we came here late is because of lack of money for transport we were sent here by
a clinician from our health center in Bvumbwe)”.

(Maghsoodi, Bath, Cook, textor, & Barnert, 2017) , The study explained that the costs associated
with transportation can also be a barrier to seeking health care. The care coordinators
identified multiple financial constraints, ranging from not being able to afford a car (i.e., the
vehicle and/or insurance) to a lack of transit fare. Sometimes traveling to a health care
appointment can pose opportunity costs, in addition to any transportation-related costs. One
care coordinator remarked: “It’s not just paying for the gas, and that can be hard. But
sometimes it means a loss of wages for the day for the person who is going to bring the
patient.”

4.5 Factors affecting social workers when working with sexually exploited children
To meet this objective, the researcher conducted interviews to explore whether certain
aspects influenced the way the Social workers delivered their services to the sexually

32
exploited children. The researcher thoroughly coded, categorized, and established themes
based on the responses given to the questions under this objective. The themes are as follows;
cultural dynamics, gender, and age.

4.5.1 Cultural dynamics

The social workers highlighted that culture affects them when rendering help to sexually
exploited children. Culture is one aspect that plays a huge role in melding the way one thinks
and deals with situations depending on how one addresses certain issues according to their
beliefs. This is so because most children who are forced into early marriages enter those
marriages because of their cultural norms.

Respondent 3 shared

“The issue of diversity of culture hinders the proper counselling sessions to be

beneficial as most guardians of the children say mwanayi wakula akungoyenela
kukwatila ifeso tipeze ndalama without knowing what the legal instruments say
concerning a child below the age of 18 as well as forced marriages”.

The findings agree with (Malinga, 2014) . To develop effective intervention strategies and
programs, it is imperative to understand how cultural proverbs and myths create sexual norms
and shape the worldview of adolescents. The findings indicate that some cultural proverbs
and myths negatively influence adolescents hence exposing them to risky sexual behaviours.
The difficult situations at home can also be a risk for youth becoming sexually exploited.
Oftentimes youth who run away from home because of difficult situations have a high risk of
being sexually exploited; they are often targeted by adults who take advantage of their
circumstances (Smeaton, 2013)

4.5.2 Gender and age

Most cases of sexual exploitation are comprised highly of girls, for males it’s hard to even
receive a case due to fear of stigma but still more girls are sexually exploited. A highlight was
made concerning the age of girls who are often sexually exploited either by somebody they
know or they do not.

Respondent 11 said

“Most girls who are sexually exploited are from 13 to around 16, despite having
cases of toddlers being exploited. The teenagers are mostly exploited by their

33
 boyfriends who are even 18 and above. So, it is hard for them to accept that it is a
crime hence only a few reports, in addition we provide them with counselling, but
they go back to those relationships uziwa munthu akakhala muchikondi (you know
when one is in love)”.

Respondent 12 said

“Ine ndili ndi zaka 16 ndakula bola banja school singayende. (I am 16 years old I’m
a grown up I’d rather get married)”.

(Parkinson P, 2017) in his research said a substantial proportion of children across all
regions in the world have experienced physical and sexual violence in childhood. Child
sexual exploitation is a gendered crime, with the vast majority of perpetrators (around 90%)
being male and (10%) Being female. Females are at a significant risk factor for sexual abuse
and exploitation in most parts of the world. The age of children significantly influences the
work of social workers dealing with sexually exploited children. While child sexual
exploitation can happen to young people from all backgrounds, certain factors like gender
and age can make some children more vulnerable. Children who have experienced prior
abuse may be more susceptible to exploitation.

4.6 The challenges faced by social workers working with sexually exploited
According to the findings, every workplace and profession faces different challenges when
providing services to its clients, some of the challenges before 2010 in Malawi were that, the
medical, legal, and social welfare agencies did not work together to assist survivors of child
sexual abuse. Parents would bring their children to police who had not been trained in
forensic interviewing or the need for appropriate medical examination. In addition, some of
the families were then referred hospital for an examination, where only 24% of the doctors
could correctly interpret genital findings. In most hospitals, they had to wait in separate lines
for treatment, HIV testing, and emergency contraception. Then they were told to go back to
the police with their completed form. The other challenge was the poor linkages between
departments led to poor case management and children being lost to follow-up. After
conducting the research none of the above challenges were found but rather a list of new
challenges below are the results that were given out by the social workers.

4.6.1 Opening up
Respondent 10 said

34
 “One of the biggest challenges we face when working with these sexually exploited
children is the issue of opening up, it is difficult for a child who has been exploited to
open up even after the child has been brought to the hospital. We have to use different
techniques for example play therapy is for young children; some do open up and
some do not”.

Respondent 3 highlighted

“Being a male social worker it is more difficult to work with the sexually exploited
children often they portray us as perpetrators that’s just my thinking but it’s hard for
young girls to open up”

In a study written by (Caballero, 2018), most males were asked how gender impacts the
opening up of clients, and the response was historically female colleagues are better suited
for meeting the therapeutic needs of the CSEC populations. In other words, male therapists
would have had a trust issue in dealing with such clients.

4.6.2 Follow up
The SWs described follow-up as where a social worker reaches out to the client to make sure
they are following their goals, using their skills, and making sure the client is doing well.
According to the findings, all five social workers raised this point as a big issue that
sometimes the client might not have a phone to reach out as well or transport to come back to
the hospital in the end they end up in the same situation.

Respondent 10

“The other challenge is follow-up, we fail to follow up with our cases due to lack of
transportation to conduct home visits our department has not been provided with a
vehicle to help conduct follow-ups, so we lose contact even though we social workers
are supposed to remain in contact with them”.

A study written by (Franken, 2019) stated that the social workers in South Africa face
different challenges which include a lack of human and other resources, as well as the lack of
support systems to follow up on these investigations.

35
4.6.3 Delays
According to the study findings, most sexual exploitation cases are of vulnerable people who
do not have enough resources to get them their lawyer so they have to use Pro bono lawyers
who oftentimes are busy with high caseloads, as such sexual exploitation cases keep
increasing and the criminals have left aside, who knows whose child is being exploited next.

Respondent 3 said

“delays in prosecution, for the case to reach the court for hearing it, takes a long
time pena mpaka nkhani imachita kuyiwalidwa (we even forget the stories), so it’s a
challenge because we feel the client has not been helped, additionally the is also a
delay in closing the case nkhani imakhoza kufika ku court ya ana koma kuti gamulo
lipelekedwa pamakhala povuta (the story can go for hearing at the children's court
but it takes time for the final verdict to be given)”.

“the other challenge is we as social workers want to help but it happens that the
survivor and the perpetrator discuss and bribe the other party with money so it makes
us feel like we have not helped at all”.

Malawian NGO People Serving Girls at Risk PSGR ( Equality Now, 2022) reported that
victims of trafficking for sexual exploitation in Malawi are being failed by the country's
criminal justice system. Few cases make it to court and the ones that do are plagued by
multiple delays with perpetrators rarely punished.

4.6.4 Lack of psychosocial support

According to the study, the social workers meet different clients with different stories for
instance a case of a 2-year-old who has been defiled by her father, so every day they have to
deal with different situations. The study has shown that most of them are left with emotional
trauma that has not been dealt with, no time to rest their minds always thinking of a particular
client. We also need psychosocial support of any form.

Respondent 14 said

“In as much as we are social workers, we also need psychosocial support the stories
we hear regularly are overwhelming and very disturbing, so being provided with
psychosocial support may inform of soul-soothing activities can help us forget and
relax a bit”.

36
4.6.5 Big caseloads
The study showed that the respondents failed to give an overall report of how many cases
they have per month as the caseload changes depending on the season during holidays there a
high cases of child sexual exploitation, the researcher requested a report, the social workers
explained why they do not have proper reports as all reports are taken to the lighthouse which
is within QECH, and being a confidential issue they cannot obtain such information back.
Sometimes there is a big caseload like ten in a day with only one social worker without
counting the interns.

Respondent 11

“Huge cases load usually during holidays, kumazaza kuno after Christmas olo nthawi
ya holiday ya ana (even during holiday’s), most cases of a child who was exploited
maybe by the neighbour or a relative came for holiday sometimes the child was sent
to the market on the way back. During the week Mondays are packed without the
interns who are here we struggle”.

According to (Franken, 2019), designated social workers in South Africa have an average
caseload of 150 cases per annum, and these cases are usually complex requiring work
experience and expertise. The social workers in South Africa face different challenges which
include a lack of human and other resources, as well as the lack of support systems to follow
up on these investigations. The above-listed challenges cause frustration to the designated
social workers as they have to deal with 150 cases per annum.

4.7 How best do you think you can deal with these challenges
According to the study findings some challenges also have solutions, and yet their other
challenges that the social workers can be able to work with just finding means of simplifying
them.

Respondent 14 said

“Awareness campaigns should be done every month in districts and areas which have
higher cases, and to the other areas as well this is to help minimize the caseloads”.

“Educating the community officials to teach their community members on child

protection can also help spread awareness”.

37
Respondent 10 said

“Psychosocial support for us can be as simple as us social workers praying together

and having time to share our experiences and teaching each other coping skills.’

“On the follow-up, the government has been told a lot of times to take initiative but
still”

4.8 Chapter Summary

This chapter presented the study findings, discussion, and analysis. It looked at the core
services provided in the study area, and further assessed the factors that lead to the challenges
faced by the social workers. In addition, the discussion also considered the children who were
exploited as some of the results contributed to the topic of study.

38
 CHAPTER FIVE
This chapter presents recommendations that have been made in line with the findings of the
study. The chapter also presents the study’s strengths and limitations before providing the
overall conclusion to the study, which aimed at assessing the challenges faced by social
workers in working with sexually exploited children.

5.1 Recommendations
It has been found within the findings of this study that child sexual exploitation has
challenges that are affecting both the child as well as those providing professional care. This
global issue is what has increased the need for awareness and solutions. Recommendations
here are made in light of the challenges faced by social workers as well as the challenges
faced by sexually exploited children: They are as follows;

 Awareness campaigns explaining child protection issues should be made in all areas
and districts explaining what the child protection issues are, what the legal
instruments say about it, and the punishments that come to one who has performed
such an indecent act to stop such behaviors.
 Children should be told to report if somebody is sexually assaulting them, for the
perpetrator to be brought to action.
 Social workers should also accept that there are also humans and seek support from
mental health professionals within the hospital.
 Social workers should also know their limits when working with the child they should
be patient when the child is failing to open up.
 They should find donors who can donate a car or motorcycle to be able to follow up
on cases.

39
  One-stop centers should be renovated in every district as people travel from other
districts to QECH One-stop centers.

5.2 Areas for further research

Previous studies on child sexual exploitation in Malawi have aimed at exploring the
challenges faced by sexually exploited children. This study aimed to provide an in-depth
understanding of the challenges faced by social workers working with sexually exploited
children as well as the factors affecting the social workers when rendering help. In the course
of this study, some relevant issues were discovered and were not addressed because that was
not the aim of the study. For instance, it is not fully known whether One counselling session
is an effective method to ensure that a child who has been exploited will recover. Follow-up
interviews with beneficiaries were supposed to be aimed at establishing how, if at all they
benefitted from the counselling session but since it is a challenge the aim has not been fully
achieved. If these efforts were made, they would further reduce the underreporting of cases
in Malawi.

5.3 Strengths and limitations of the study

5.3.1 Strengths
The study employed a qualitative phenomenological research approach and design
respectively. This was particularly advantageous because it helped collect detailed
information that helped to gain an understanding of complex issues that were under inquiry.
The respondents were fully willing and able to articulate their unique experiences, enabling
the researcher to assess the challenges faced by the social workers.

The researcher gave a consent form and verbal consent to collect data even though she had
been working as an intern there, just to ensure the researcher was not going against the
ethical considerations. ensuring that participants participated voluntarily and that the
information they shared has and will only be used for academic purposes.

5.3.2 Limitations
The study aimed to assess the challenges faced by the social workers working with sexually
exploited children, which also meant looking at the challenges faced by the children as some
contributed to the social worker’s challenges. One of the children failed to open up it took
the guardian to explain It took a long to collect the required data because of the nature of
their work, the targeted population works with individuals (patients) all the time which

40
meant I had to wait for other social workers to come so at first the researcher went in August
and she found two social workers then in November she found other three. Therefore,
working according to their free time was not the easiest thing because the researcher had to
make sure all data had been collected from all the social workers The researcher discovered
that this was the case because of how relatively small the number of SWs are available at
QECH.

5.4. Conclusion
The study aimed to assess the challenges faced by the social workers working with sexually
exploited children at QECH One Stop Center. To answer the main research question, four
specific objectives were laid out;

 To evaluate the core services provided at Blantyre QECH One-Stop Centre.

 To explore the roles played by social workers in working with sexually exploited
children.

 To investigate the challenges faced by sexually exploited children.

 To analyse the factors affecting social workers when working with sexually exploited
children

The study established that the QECH One Stop Centre is the department that deals with cases
to do with sexual exploitation providing services such as counselling, screening, education,
and advocacy, and with the topic at hand assessing the challenges faced by the social
workers working with sexually exploited children. Most of the respondents were familiar
with the nature of the topic, the guardians and sexually exploited children needed a detailed
briefing. It was interesting to learn that counseling was the order of the day and that the
social workers are the ones in most contact with the clients.

This study proves that social workers play a vital role in helping children who have been
sexually exploited, they not only provide counseling but also education, educating them on
coping skills as well as legal instruments that explain more about child protection issues and
the punishments that are given to the perpetrators. Being a parent or guardian who has a
child who has been sexually exploited is not easy. The study proves that guardians face

41
issues of fear of reporting from the child and sometimes they tend to question their parenting
skills. It is evident enough that not everyone knows what the law says about sexual
exploitation and sexual abuse this is due to a lack of knowledge and access to information.
Most clients fail to report to the police because they try to be considerate that this is the
child’s Uncle what will people say?

Dealing with individuals is never an easy task. Individuals are unique beings that process
everything differently as such they also interpret things differently depending on how they
look at situations. The factors affecting social workers when working with sexually exploited
children such as culture have proved as negative factors of some sort. Since QECH is visited
by different people with different social norms. Some parents suggested that their child
should just get married according to them it meant the child had grown up.

The study has also proven that a child who has been defiled faces physical consequences as
well as psychological consequences it was shown from my observation and assessment how
some child failed to open up and looked scared.

Lastly, the study has proved that not only do the sexually exploited children face challenges
but also the social workers who are in close contact with them, challenges such as resource
constraints that hinder them in following up on their clients, delays in prosecution of
perpetrator. Big caseloads during school holidays are caused by a lack of awareness and no
fear of the perpetrator. There is a need for transportation for follow-up of cases because I
believe one counseling session is not enough.

Lack of psychosocial support, of course, all social workers are trained on vicarious
traumatization but this study has proven that lack of psychosocial support is also a challenge
having to work and hearing such issues every day. The other challenge I observed was they
do not keep a copy of reports containing the cases they have per month or annually.

Overall, the services provided such as screening, and provision of pep have been effective,
children who have been found with HIV are given medication right away.

42
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Appendix 1: Interview guide for Social workers, children, and guardians

Verbal consent
I’m researching the challenges faced by social workers in working with sexually exploited
children. Are you comfortable with answering questions that can help me with the study, the
information you will provide me with will be confidential and I will observe anonymity as it
is only for an academic purpose.

Instructions

- I will ask questions and I will kindly ask that you give responses within the topic
bracket

- By participating in this study you will not be given any remunerations at the end of
this study as this is only for academic purposes.

- Feel free to seek clarity where a question has not been fully understood.

- If you feel uncomfortable at any point during the interview, you’re free to request for
termination of the interview

SECTION A

Demographic information

Age:….

Sex:……………………………….

Level of education:……………………….

46
Occupation and Profession:………………………..

SECTION B

Understanding the phenomena?

1) What do you understand by the term “CHILD SEXUAL EXPLOITATION”?

2) Do you deal with such cases here?

SECTION C: Interview guide for social workers working with the sexually exploited
children

1. What are the core services provided here at the one-stop centre?

2. As social workers working with sexually exploited children. What are the roles you
play?

3. What do you think can help the parents for better recovery of the children who have
been defiled?

4. What challenges do you face when working with these sexually exploited children?

5. What do you think can help in dealing with the above challenges?

6. How big is the caseload daily?

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 7. How does the coordination of different professions under one roof work considering
the slight difference in ethical considerations? E.g. social workers consider
congeniality while doctors and nurses might not make it their top priority

SECTION D: Interview guide for guardians and sexually exploited children

1. Background of her child’s story, assuring her in a most hopeful way that her child’s
story is confidential and that it will end in the room

2. What challenges did they face in getting the child to speak about the sexual
exploitation?

3. Is the victim of such an inhuman crime under the law?

SECTION E
1. Why were you afraid to report the case?

2. How is she progressing after the act?

Thank you for taking this interview!!

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Appendix 2: Data collection letter
THE CATHOLIC UNIVERSITY OF MALAWI

23rd August, 2023

Dear Sirs,

RE: DATA COLLECTION - FOR BACHELOR OF SOCIAL SCIENCES

Ms. Tapiwa Jere is a student at the Catholic University of Malawi enrolled in the Bachelor of
Social Sciences Degree in Social Work. She is in the process of collecting data that will help
complete her research study.

Any help that your organization may provide in the form of the need for data will be
appreciated. The data shall be handled with utmost confidentiality following all the
University’s research policies.

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Yours faithfully,

Mr. Anthony Mtuta

Dean, Faculty of Social Sciences

For: Vice Chancellor

Cc: The Director of Academic Affairs

• The Registrar - CUNIMA

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