Determinants of Violence Against Children in Indonesia: A Literature Review

Violence against children is a public health issue that has implications on a child's health and well-being throughout their lifetime. To prevent violence, it is important to understand the factors associated with violence against children. This literature review aims to determine these factors in Indonesia. A total of 1,025 articles published between 2018-2022 were screened from Garuda, Google Scholar, and DOAJ databases. After applying specific criteria and objectives, 16 articles were selected for this review. This review highlights that there are individual, interpersonal, community, and institutional factors that contribute to violence against children. The individual factors that contribute to violence against children include children's knowledge and attitudes, while interpersonal factors such as parental characteristics and the quality of parent-child relationships. Parental characteristics including education, occupation, socio-economic status, and knowledge, as well as the parent-child relationship in terms of parenting and family environment. Community factor is described through the influence of social media. Institutional factors in schools include the traditional bullying practices, the lack of standard operating procedures, and the social environment. It is essential to consider these factors when developing strategies to prevent violence against children in Indonesia.


INTRODUCTION
Violence against children includes all forms of violence against individuals under the age of 18, regardless of the perpetrator being a parent or caregiver, peer, partner, or a stranger (WHO, 2020). Child abuse is a public health concern that has a correlation with social issues and violations of human rights, resulting in severe negative outcomes (Hillis et al., 2016;WHO, 2014). The negative impact of violence experienced during childhood can have long-lasting consequences on a child's well-being and health throughout their life (WHO, 2022).
In the past year, an estimated 1 billion children aged 2-17 have experienced some form of violence, with the highest prevalence in Africa, Asia, and North America, and at least 50% of children experiencing violence in the past year (Hillis et al., 2016). One in three school-aged children aged 11-15 become victims of bullying by peers in the past month, and 120 million girls under the age of 20 are estimated to have experienced forced sexual contact (UNESCO, 2019;UNICEF, 2014).
Violence against children in Indonesia is reported through the Online Information System for Women and Children Protection (SIMFONI PPA), a recording and reporting system developed by the Ministry of Women's Empowerment and Child Protection of Indonesia. As of January 10, 2023, a total of 13,636 incidents of child violence have been recorded by SIMFONI PPA in 2022, making up 59.3% of all reported cases of violence. Child violence cases were reported in the age group of 0-5 years with 1,517 cases (11.1%), the 6-12 years age group with 4,305 cases (31.6%), and the 13-17 years age group with 7,814 cases (57.3%). (Kementerian Pemberdayaan Perempuan dan Perlindungan Anak RI, 2022a) Based on the results of Indonesia's Violence Against Children and Youth Survey (VACS) or Survei Nasional Pengalaman Hidup Anak dan Remaja (SNPHAR) in 2021, 26.58% of girls and 20.51% of boys aged 13-17 reported experiencing violence in the past 12 months. The data also revealed that 3 out of 10 girls and 2 out of 10 boys had experienced violence in any form. Additionally, throughout their lifetime, 4 out of 10 girls and 3 out of 10 boys had experienced violence in any form. (Kementerian Pemberdayaan Perempuan dan Perlindungan Anak RI, 2022b) Violence can lead to death, injury, and disability. Throughout their lives, children exposed to violence are at higher risk of mental illness and anxiety disorders, high-risk behaviors such as drug abuse, alcohol, smoking, and unsafe sex, chronic diseases such as cancer, diabetes, and heart disease, infectious diseases such as HIV, and social problems including low education, further involvement in violence, and crime. (WHO, 2022) Various studies conducted worldwide have reported that prevention can be done to avoid cases of child violence. Efforts to prevent and address violence against children require a systematic approach to dealing with risk and protective factors at all four interrelated risk levels: individual, relational, community, and societal. (WHO, 2022) A systematic review conducted by Cerna-Turoff et al. (2021) in low-and middle-income countries found that low family socioeconomic status, female gender, and maternal and adult education levels in the family or household are associated with emotional violence, and girls are at risk of experiencing sexual violence. According to other studies, ongoing intergenerational child maltreatment is associated with parental individual characteristics like mental health and age, childhood adversity such as various difficulties faced, relational factors such as partner adjustment processes, attachment/personal relationships, and social support, as well as contextual factors such as adversity and violence in the community (Langevin et al., 2021).
This literature review aims to identify the factors that contribute to violence against children in Indonesia, based on the results of previous studies.

METHODS
The research method used in this study is a literature review through searching the Garuda, Google Scholar, and DOAJ databases. The keywords used in the search were "faktor kekerasan anak". Articles were screened based on inclusion and exclusion criteria. The inclusion criteria consisted of research articles published between 2018-2022, written in Indonesian and English, available in full text, published in national and international journals, and quantitative research conducted in Indonesia. The exclusion criteria consisted of articles included in theses, dissertations, and proceedings, as well as qualitative studies and review articles. After conducting the database search, 1,025 abstracts on the topic of violence against children were identified. Screening was then conducted on these articles according to the inclusion and exclusion criteria, resulting in 16 selected articles for analysis. The article screening process is presented in a PRISMA flowchart in Figure 1.

RESULTS AND DISCUSSION
Sixteen articles were obtained from the search that met the criteria for analysis. All of these articles used a quantitative approach and were published between 2018-2022. Table 1 provides a summary of the articles on the factors influencing violence against children. Out of all the articles, one focused on verbal violence, one addressed sexual violence, while eight discussed bullying, and six addressed violence against children in all its forms.
In this literature review, a conceptual framework adopting the socio-ecological model developed by Bronfenbrenner (1979Bronfenbrenner ( , 2005 as adapted by Maternowska et al. (2016) was used. This socio-ecological approach provides an explanation for the complex and dynamic nature of the influence of physical, emotional, and sexual violence against children. Violence against children is influenced by various interactions at the micro, meso, and macro levels, as well as in specific contexts. This approach identifies individual (child), interpersonal, community, institutional, and structural factors that influence the occurrence of violence against children (Maternowska et al., 2018). Table 1 shows that factors influencing violence against children include several factors categorized based on different levels within the socio-ecological framework. The individual factors include the child's knowledge and attitudes, while the interpersonal factors include the child's relationships with parents and peers. Parental characteristics, including education, occupation, economic status, and knowledge, also play a role in influencing the occurrence of violence against children, as well as the child's relationship with parents in relation to parenting and the family environment. Community factors are also identified as influencing factors, described through the influence of social media. Institutional factors also play a significant role, with schools, for instance, consisting of the tradition of bullying, the lack of standard operating procedures, and the social environment. All these factors interact and affect each other in causing violence against children. Bullying occurs due to the lack of empathy from the perpetrators and the failure of schools to prevent it. Amri & Zulharmaswita, 2018 Factors Related to Bullying Incidents among Fourth, Fifth, and Sixth Grade Elementary School Children in SD X Padang City The variable that most significantly influences the incidence of bullying is the environmental factor with a pvalue of 0.073 (OR = 4.092). Nurdiana et al., 2020 Factors Related to Bullying Experiences in SMK Negeri 2 Bogor, West Java Province, in 2018 The victim's attitude factor (p-value = 0.003, RR = 0.090 (0.012-0.703)), perpetrator attitude factor (p-value = 0.000, RR = 0.789 (0.690-0.903)), and tradition factor of both parties (p-value = 0.036, RR = 2.471 (0.979-6.237)) are related to the occurrence of bullying. Bulu et al., 2019 Factors Influencing Bullying Behavior in Early Adolescents The peer factor, social media, and social environment are statistically significant with p-values of 0.003, 0.006, and 0.004, respectively (p value ≤ 0.05). The peer factor has an OR value of 5.0, social media has an OR value of 3.857, and social environment has an OR value of 4.5. Emilda, 2018 Factors There is a significant relationship between the level of parental education and the form of violence against children, as indicated by an F value of 0.348 and a significance level of 0.00. Muarifah et al., 2020 Identification of Forms and Impacts of Violence against Early Childhood in Yogyakarta Parents often use pinching and staring as a form of violence to regulate their children's behavior. Muliawati, 2021 Parenting education as an effort to prevent violence against elementary school children during the COVID-19 pandemic There is a significant relationship between the two variables. The correlation value between the variable of knowledge level about violence against children and the variable of incidence of violence against children is -0.391. Maghfiroh & Wijayanti, 2021 Parenting Stress and Verbal Violence against School-Age Children during the COVID-19 Pandemic Parenting stress has a significant relationship with verbal violence against school-aged children during the COVID-19 pandemic (p value 0.001). Rahmah, 2018 The influence of peer group on the intensity of bullying behavior at childhood age There is an influence of peer group on the occurrence of bullying behavior in children with an F sig of 0,022, which is smaller than the significance level of 5% (0.022 < 0.05). Amalia et al., 2018 The Effect of Sex Education on the Incidence of Sexual Violence against Children in SD Negeri 04 Balai Rupih Simalanggang Payakumbuh in 2018 The average incidence of sexual violence before the intervention was 13.00 and decreased to 12.06 after the intervention. Sexual education has a significant relationship with the incidence of sexual violence against children (p = 0.000).

Individual Factors
The provision of education regarding violence prevention information can increase children's knowledge (Muliawati, 2021). Research by Do et al. (2019) also supports this notion, as increasing awareness and knowledge about the risks of violence can help prevent violence against children. Children are a vulnerable group and have limited knowledge about danger and self-protection. By providing knowledge to children, they can recognize early warning signs and take steps to protect themselves from abuse (Madrid et al., 2020).
Based on the study conducted by Nurdiana et al. (2020), the attitude of bullying victims is related to their previous experiences of being bullied. Victims have the potential to participate in bullying conduct if they are provided with the chance. Bullying also occurs due to a lack of empathy or concern by the perpetrator (Rahayu & Permana, 2019). Developing empathy skills can help improve children's social competence and assist them in building healthy social relationships and adhering to rules (Rahayu & Permana, 2019). Dewi's (2020) research indicates that perpetrators of bullying frequently have aggressive and dominant characteristics, tend to view bullying or violence in a positive light, and demonstrate a deficiency in empathy.

Parents/Family
Parents often engage in violence, particularly verbal violence towards their children, regardless of their education level (Nurwijayanti & Iqomh, 2019). While one of the analyzed articles suggests that education is not a factor in parental verbal violence towards children (Nurwijayanti & Iqomh, 2019), two other studies have concluded that parental education, particularly the mother's, plays a significant role in child abuse. Mothers with low education are more likely to struggle to understand and lack knowledge about parenting (Emilda, 2018). The education level of parents can impact their parenting practices, level of attention, affection, and protection towards their children (Risma et al., 2018). Several studies have found a relationship between parental education and child abuse (Buffarini et al., 2021;Carlson et al., 2020;Pearson et al., 2022). Other studies suggest that low parental education is associated with physical neglect and a lack of supervision of children, which can lead to an increased risk of child abuse and sexual victimization by non-family adults (Turner et al., 2019). Conversely, high parental education can serve as a protective factor for children (Pearson et al., 2022). The incidence of child abuse decreases as mothers' knowledge increases through parenting education on violence prevention (Mufidah, 2018;Muliawati, 2021). The education that parents receive affects their understanding and skills, which can improve parenting practices in the family. Knowledge and perception of responsible parents are essential in preventing child abuse, and it is vital for parents to have an understanding of child abuse (AlRammah et al., 2018). Parents who have accurate knowledge, including knowledge about parenting, can play a significant role in preventing violence against children (Emilda, 2018).
Violence against children can be influenced by parenting styles within families (Herawati & Deharnita, 2019;Muarifah et al., 2020;Yusuf & Haslinda, 2018). Authoritarian parenting styles make children obedient to the values set by their parents, with a tendency to restrict their desires and often impose physical punishment on them if they fail to meet the standards set by their parents (Lisnadiyanti & Bagus, 2019). Families in rural Western China, for instance, use severe physical punishment to discipline their children at home, posing a health risk to them (Huang et al., 2022). Conversely, permissive parenting styles may result in violence in schools since children become accustomed to acting freely without parental supervision or discipline, which may encourage bullying (Lisnadiyanti & Bagus, 2019). Parenting styles play a vital role in children's growth and development, and the interaction between parents and children can enhance children's problem-solving skills and strengthen their relationship (Nurwijayanti & Iqomh, 2019). According to the CDC (2022), parenting stress is one of the factors contributing to child violence. The incidence of violence against children increases in line with the higher level of stress experienced by mothers or caregivers, as it affects the behavior and attitudes of the caregiver, ranging from poor parenting, neglect, to even abusive behavior (Anggraini & Asi, 2022;Brown et al., 2020;Chung et al., 2022;Evin & Mello Laveena, 2021). Parenting stress is frequently linked to economic status, which often leads to financial difficulties that cause stress for parents (Lestari et al., 2018). This stress can lead to parents feeling overwhelmed and struggling to meet the expectations and demands of parenting (Andriani et al., 2019;Anggraini & Asi, 2022;Holly et al., 2019), which can result in disrupted parenting and increased risk of abuse and neglect towards children. Moreover, the COVID-19 pandemic has further exacerbated parenting stress, causing parents to resort to harsh parenting styles and putting children at higher risk of violence or abuse (Chung et al., 2022;Griffith, 2022).
Mother's occupation as one of the risk factors for child abuse is often related to the mother's dependence on her working husband. A non-working mother who relies on her husband's income to meet household needs is more likely to experience stress. This condition affects the child who may unknowingly become a target of emotional outbursts from the pressure faced by the mother (Emilda, 2018). Another study shows that losing a job due to the COVID-19 pandemic is associated with a significant risk of child abuse (Lawson et al., 2020). Parents who have lost their jobs and previously perpetrated psychological abuse against their children are more likely to commit psychological abuse during the pandemic (Lawson et al., 2020). In a systematic review, Conrad-Hiebner & Byram (2020) identified job loss as a major factor contributing to future psychological abuse and physical violence against children.. This is consistent with Bunting et al. (2018) who found that physical abuse is more consistently associated with income and occupation, and that there is an increase in reports of child neglect related to unemployment rates (Coulton et al., 2018). Other studies have found that socioeconomic status is related to child abuse and neglect (Anand et al., 2019;Bunting et al., 2018;Carlson et al., 2020;Turner et al., 2019).
Children who live in households where violence or disturbances frequently occur are exposed to the risk of becoming either the victims or the perpetrators of violence (Herawati & Deharnita, 2019;Muarifah et al., 2020). Family factors are also associated with the quality of the relationship between the mother and father/partner or the factors that determine family harmony (Buffarini et al., 2021;Mulyana et al., 2018). The poor quality of the relationship and disharmony within the family suggest disruptions in the family structure, which may lead to children becoming victims of violence (Buffarini et al., 2021;Kadir & Handayaningsih, 2020;Mulyana et al., 2018).

Peers
Adolescents frequently create groups with commonalities, such as age and interests, to serve as a platform for discovering their identity and developing communication abilities (Bulu et al., 2019). Peer groups play a significant role for children to learn new social roles and interact with their social environment (Herawati & Deharnita, 2019;Lisnadiyanti & Bagus, 2019). These groups also play a role in shaping behaviors, both positive and negative, such as bullying (Herawati & Deharnita, 2019;Rahmah, 2018). Children who are victims of bullying are at higher risk of becoming perpetrators of violence (Senanayake et al., 2019). Babarro et al. (2020) found that children who have strong relationships with peers and receive social support are less likely to engage in bullying. Meanwhile, Sabramani et al. (2021) discovered that peer-related factors, such as the number of peers and frequency of quarrels or fights with peers, are significantly associated with students' involvement in bullying.

Community Factor (Social Media)
Peers often use social media as a platform for engaging in bullying behavior towards one another (Bulu et al., 2019). Victimization from cyberbullying results in anxiety among elementary school children (Kaloeti et al., 2021). Sabramani et al. (2021) reported that the amount of time spent on social media during weekends is significantly associated with student involvement in bullying. Craig et al. (2020) also found that there is a correlation between social media use and bullying behavior. Due to the widespread accessibility and use of social media, there is an increased risk for users, particularly children, to engage in problematic behavior such as bullying, and therefore public health intervention is necessary (Craig et al. 2020). The use of social media can contribute to the disruption of children's mental health through practices such as seeking validation, fear of judgment, body comparisons, addiction, and bullying towards peers (Popat & Tarrant, 2022). However, positive effects of social media have also been found on adolescent mental health, particularly regarding connection, support, and discussion forums for those with the same mental health diagnosis (Popat & Tarrant, 2022).

Institutional Factors (School)
Schools that fail to prioritize measures to prevent violence demonstrate an apathetic attitude within the school environment that views bullying as a commonplace occurrence among students, including the absence of counseling teachers and standard operating procedures in schools (Rahayu & Permana, 2019). Persistent bullying behavior in schools is also a factor that contributes to bullying becoming a normative tradition within the school community. Forms of bullying behavior, such as seniority, are often perpetuated by senior students towards their juniors (Nurdiana et al., 2020). The absence of regulations for students involved in bullying does not effectively discourage this behavior and could potentially promote its recurrence (Rahayu & Permana, 2019). Additionally, bullying incidents are caused by insufficient supervision from schools and the neglect of problems that occur between students, including bullying behavior (Herawati & Deharnita, 2019). Demol et al. (2020) reported that active response from teachers to bullying incidents is the key to bullying intervention in schools, particularly responses that clearly indicate that bullying behavior is not acceptable. Amri & Zulharmaswita (2018) concluded that a child who is exposed to a bullying-prone environment once has the potential to engage in bullying up to four times. Another study found that the school environment significantly affects children's violent behavior, particularly bullying, with an OR value of 4.5 (Bulu et al., 2019). Social support is associated with lower levels of violent behavior in schoolchildren, with family support being the strongest predictor (Šmigelskas et al., 2018). Acceptance in school is a protective factor against victimization, and prevention interventions should focus on educational centers and involve all educational communities (Sánchez et al., 2019).

CONCLUSIONS AND SUGGESTIONS
This literature review has indicated that there are several factors that contribute to violence in children. These factors can be classified into individual, interpersonal, community, and institutional factors. The individual factors cover children's knowledge and attitudes, and interpersonal factors, which include parental characteristics and the child's relationship with parents and peers. Parental characteristics may include education, occupation, economic status, and parental knowledge, as well as the child's relationship with parents and their parenting style in relation to the family environment. The community factor is illustrated through the impact of social media. Institutional or school factors may include the existence of bullying traditions, the absence of standard operational procedures, and the social atmosphere in schools. The involvement of various stakeholders is essential in preventing violence against children. Moreover, due to the limited research on violence against children in Indonesia, it is critical to conduct evidence-based studies to identify the risk and protective factors associated with this issue. The determinants of violence against children are crucial to consider in developing strategies to prevent violence against children in Indonesia.
ETHICAL CONSIDERATIONS Funding Statement.
No funding was received to assist with the preparation of this manuscript.