Dignity: the cornerstone of psychological health among victims of child labor, a qualitative study

Abstract

Background

Respecting the dignity of child labor is one of their most urgent needs. In many cases, the dignity of child labor is not maintained in countries with unfavorable economic conditions. The aim of the present study was understand adolescents’ perceptions of their dignity in child labor.

Methods

This study is a qualitative research with conventional content analysis approach. Twenty teenagers who having work experience as child labor were selected from one welfare center and three charity centers in using purposeful sampling method in 2022–2023. Data was generated through individual, deep, and semi-structured interviews. In order to analyze the data was used Granheim and Lundman’s method.

Results

Three main themes were presented in this study including, “preservation of privacy and security”, “honoring individual identity to develop dignity” and “comprehensive support”, and 9 categories.

Conclusion

understand adolescents’ perceptions as child labor of their dignity, privacy and security of child labor victims and respect for their identity and all-round support are defined. And in this supportive environment, the dignity of working children is preserved and appropriate behavioral consequences are created. Therefore, it is suggested that a cultural and institutional background be provided in which all components of the child labor’s dignity are emphasized.

Introduction

Children who are victims of child labor are among the most vulnerable members of society, facing threats to their dignity and well-being [1, 2]. Child labor involves children performing work that is inappropriate for their age and abilities, leaving them susceptible to physical, mental, and sexual violence. This violence can cause severe physical and psychological harm, stripping these children of their human dignity [3, 4]. Child labor are a group of children who do work that is not according to their age and ability and often defined as work that deprives their potential and their dignity, and that is harmful to physical and mental development [3]. The prevalence of violence against teenagers varies from country to country. Still, in many places, especially where child labor is prevalent, children are at a higher risk of experiencing violence [3, 5, 6].

According to WHO, violence against teenagers and child abuse include all forms of physical abuse, sexual abuse, deception, and financial exploitation of teenagers which lead to actual or potential harm to the health, survival, development, or dignity of teenagers [4]. Statistics released by WHO showed that 1 billion teenagers across the globe were exposed to various forms of child abuse. UNICEF reported that 3500 teenagers lost their lives as a result of physical violence and negligence [4, 7].

Child abuse is universally condemned and is recognized as a criminal offense with legal repercussions in many countries [8, 9]. Evidently, the victims of child labor are in a more critical situation and are more likely to suffer violence, which destroys their dignity and inclines them to demonstrate anti-social behaviors [10]. In a study by Jalili Moayad et al. (2020), it was found that a significant number of children and teenagers involved in child labor have experienced some form of abuse, with 77.6% reporting at least one type of abuse. The most common form of abuse reported was emotional abuse, affecting 70.4% of the victims. Neglect was the second most prevalent form of abuse at 52%, followed by physical abuse at 5.8% and sexual abuse at 3.6% among victims of child labor [11].

Exposure to various forms of violence erodes the dignity of children and leads them to exhibit anti-social behaviors [10], resulting in society developing a negative perception of them. This ultimately undermines the human dignity of child labor victims [12].

Having their dignity preserved is one of the basic rights of the members of every society [13]. Dignity is a multifaceted and nuanced concept that defies a single comprehensive definition [14]. Nevertheless, key attributes commonly linked to dignity encompass worth, esteem, humanity, recognition, regard, and standing [15]. Maintaining and promoting human dignity is one of the key responsibilities of healthcare providers [5, 6, 16].

In recent years, many studies have addressed dignity in a wide variety of patients in terms of illness [17]. A physical or mental disorder of any type can pose a threat to an individual’s dignity [18, 19]. On the other hand, showing respect for an individual’s dignity increases his/her satisfaction, improves inter-personal communication, and boosts motivation for activity [20].

However, the dignity of the victims of child labor has not been investigated in any studies up to now. Since it is not possible to preserve the dignity of this population without explaining and defining the concept of dignity from the point of view of these children, it is not possible, the present study aims to understand adolescents’ perceptions of their dignity in child labor.

The researchers hope that the findings of the study will help policymakers and administrator provide a supportive environment in which these children’s rights and dignity are respected. Therefore, the purpose of this study was understand adolescents’ perceptions of their dignity in child labor.

Materials and methods

This study was a qualitative research with conventional content analysis approach. Conventional content analysis was also used when little information was available on the concept. The reporting of the study was based on the consolidated criteria for reporting qualitative research (COREQ) checklist [21].

Twenty child labors were selected from one welfare center and three charity centers in using purposeful sampling method in 2022–2023. Notably, purposeful sampling is a method used in qualitative research to identify and select the individuals or groups of individuals who are especially knowledgeable about or experienced in a phenomenon [22]. Inclusion criteria were teenagers10-19 years who having at least two years of work experience as child labor, speaking and understanding Persian language and unwillingness to continue the interview was the criterion for exclusion from the study. There was an attempt to select the participants of this study with maximum variation. Base on, teenagers were selected from a wide range of age, sex, financial status, educational levels, number of family members, guardian’s disease status, and living status. Data generation was done through individual and semi-structural interviews. These interviews were conducted face-to-face in a quiet environment in corresponding author’s office who is experienced and expert in qualitative research. The corresponding author began individual interviews using such as: “what does dignity mean child labor?”, “In which situations is the dignity of child labor at risk?” Based on the answers to these questions, follow-up questions such as “Can you explain more?” “What do you mean?” “Why did you feel so?” were asked. The interviews were audio-recorded were taken with the permission and awareness of the participants. Each interview lasted between 60 and 70 min. In this study, the interviews were continued until all the authors agreed that saturation had been established and that no new codes, categories, or themes would be created and saturation has occurred. Because, Saturation occurs when there is no new categories emerging and the categories are saturated based on their characteristics and dimensions [23].

For data analysis was used conventional content analysis using Granheim and Lundman’s method; after each interview, the first author listened to them and transcribed them, and later to achieve data immersion and acquire insight and deep understanding of the phenomenon under study, the transcriptions were studied several times. Then, meaning units were identified based on the objectives and research questions. Next, the key points were extracted as open codes, considering the obvious and hidden contents of the meaning units. These codes were categorized based on their similarities and differences and the abstraction process continued until the theme was extracted [23].

In order to ensure the trustworthiness were used Guba and Lincoln criteria [23]. For this purpose and in order to increase the acceptability and accuracy of data, data collection was done with several techniques (semi-structured interviews), prolonged engagement and drowning in data and 3 member checks and 5 peers.

Ethics approval and consent to participate

The institutional review board of the medical universities located in the West of Iran IR.UMSHA.REC.1400.959. Also at the beginning of each interview, the researcher introduced herself and explained the goals of the study and assured that all information would remain confidential and that they could withdraw from the study at any time. Then, written informed consent from the legally authorized representative of the child labor.

Results

In this study, 20 interviews were carried out with child labor. The participants consisted of 12 boys and 8 girls. The average age of the participants was 12.24 ± 3.15 years. The majority of them had a primary school’s degree and most of them were homeless. The three main themes were extracted from the interviews privacy, respecting individual identity, and comprehensive support while 9 categories (Table 1).

Table 1 Explaining the concept of dignity in child laborers

Preservation of privacy and security

The victims of child labor interviewed in the present study stated that they had experienced physical violence, sexual abuse, and emotional neglect many times and that their dignity had been violated as a result. Accordingly, to preserve their dignity, the society should avoid exposing this population to physical-sexual violence and emotional neglect. The theme of preservation of privacy and security consists of the categories of avoiding physical violence, Sexual violence destroys physical and mental security, and avoiding emotional neglect.

Destruction of privacy with indescribable physical violence

The participants stated that their guardians and family members and even passersby punched them and kicked them: being shoved was the mildest form of physical violence they experienced on a daily basis. Exposure to physical violence had destroyed their dignity and filled them with bitterness.

“Beating is what I get from life every day. I’m getting beaten from the moment I get up till the time I go to sleep. My guardian hits me so hard. He punches me and kicks me. It’s like getting beaten with a hammer. It’s worse when I come home empty handed or with only a little money. When we run after people and beg them for money, they don’t understand. They get nervous and push us or hit us. I’ve experienced anything but respect and dignity …” (The child began to weep) (13-year-old boy).

Sexual violence destroys physical and mental security

The participants’ experiences showed that many of them, especially the girls, had experienced various forms of sexual abuse, from being touched and kissed to being raped, at a young age. Many victims of child labor are abused by the people around them and, when they get older, they are forced into sexual relationships or arranged marriages.

“When I was younger, I didn’t understand …. When he patted me and kissed me, I thought it was because he cared about me. People like me are always hungry for some affection. When I grew up a little, he made me do things I didn’t like to do and he asked for more and more. My life is too dark to have any room for dignity in it” (14-year-old girl).

Avoiding emotional neglect

The victims of child labor in the present study stated that their emotional needs were not regarded at all and that they were experiencing considerable emotional neglect. The liked to go to school like other children, receive genuine love, and have their fears and concerns properly attended to. However, their psycho-emotional needs were always neglected by the society.

“I’m always getting beaten, and I don’t even have someone to talk to so I can feel less afraid and upset …. I wish I could go to school and study, but I have to be at the intersection and sell chewing gums every day. No one cares about me; no one cares if I’m happy or not, if I’m afraid or not, if I’m laughing or crying …” (10-year-old boy).

Honoring individual identity to develop dignity

The victims of child labor stated that the society rarely showed respect for their age identity, sexual identity, beliefs and attitudes. Many of the interviewed teenagers mentioned that disrespect combined with pity was one of the major threats to their dignity. This theme consisted of the categories of esteem to beliefs and attitudes, respect for their age-sexual identity, and avoiding humiliation and pity.

Esteem to beliefs and attitudes

The participants stated that, even though they roamed the streets and panhandled or peddled things to make money, the society should respect their beliefs, attitudes, and culture so that their dignity would not be compromised.

“I sell things on the streets to pay for my education and help my dad. It doesn’t feel good, but I believe I should pay for my education myself. Sometimes, my classmates and teachers buy things from me without judging me. They respect my belief that I want to make money to pay for school and that helps me not feel embarrassed or lose my self-esteem” (12-year-old boy).

Respect for their age-sexual identity

One of the primary ethical principles in maintaining individuals’ human dignity is showing respect for their age and sexual identity, regardless of their beliefs and living conditions.

“When I’m selling things on the street, some buyers speak to me rudely; they just don’t care that I’m a young boy who has pride and dignity. I’ve experienced insults so much I’ve lost all my dignity” (14-year-old boy).

“I peddle stuff with my mom on the sidewalk. Sometimes, the people who are passing by say offensive things and make offers that are an insult to my identity and virtue” (13-year-old girl).

Avoiding humiliation and pity

The victims of child labor mentioned that unwanted sympathy and pitying looks and behaviors hurt their feelings and undermined their self-esteem.

“I work on the streets. My clothes aren’t new, but they aren’t shabby or untidy either. Some passersby who want to help me, their look and attitude is just full of pity. I sometimes get angry and walk away. I can hear them telling each other I’m ungrateful… I’m not ungrateful; my soul is wounded by pity” (13-year-old boy).

Comprehensive support

The victims of child labor who were interviewed in the present study stated that comprehensive support could a major contributing factor in maintaining their dignity. Accordingly, it is essential that their families and relatives, schools, organizations and charities provide the teenagers who are forced into labor with comprehensive support. This theme consists of the categories of extended family support, support of schools, and support of organizations and charities.

Extended family support

The victims of child labor mentioned that they needed the full support of their families and close relatives to meet their need for food and clothes, pay their school expenses, and, especially, satisfy their emotional needs. If their basic needs are met and they can appear in public in decent clothes, even when they are peddling things, the teenagers who are exposed to child labor won’t be too desperate for money and attention to put their dignity at risk.

“I’ve seen a lot of hardship … when I see a child who is wearing good clothes and can eat good food pass me by holding her mom and dad’s hands, I feel jealous and angry …. If my dad or relatives supported me and paid my expenses, I could feel happy too, feel proud and have self-esteem” (11-year-old girl).

Support of schools

The participants also stated that they needed the general support of schools to get back their lost dignity.

“Schools have our files. They know everything about our family and financial conditions. If they give me financial and emotional support without taking pity, I will feel much better …. I can’t pay for extracurricular classes. If they help me so I can go to these classes, the other students won’t know that that I’m not there because I’m poor and I can keep my self-esteem” (12-year-old girl).

Support of organizations and charities

The sanctions imposed and the economic conditions caused by COVID-19 in recent years have made life harder than before for the victims of child labor. To make a living, they sometimes have to resort to anti-social behaviors which undermine their dignity. Therefore, to preserve their dignity, these teenagers need the general support of organizations and charities.

“Living conditions have become hard for everyone, let alone us …. Some days, I can’t sell anything. I can’t afford to buy any bread or eggs; so I have to steal from stores …. I’m ashamed of myself; I don’t have any dignity left. If charities helped us, gave us food and clothes, I wouldn’t have to steal bread and lose my dignity (16-year-old boy).

Discussion

Victims of child labor live in difficult conditions and have their dignity threatened by a variety of factors [24]. The findings of the present study stress the significance of preserving the dignity of victims of child labor. The dignity of this population was found to consist of three themes: personal space, respect for personal identity, and comprehensive support.

Dignity in victims of child labor had not been investigated before; therefore, because of lack of relevant studies, the findings of the present study were compared to the findings of other studies which have explored dignity in children.

Showing respect for individuals’ preservation of privacy and security is essential to preserving their human dignity. It is, therefore, necessary that every individual’s personal space, regardless of his/her beliefs or social status, be respected. In the society, teenagers and adolescents, especially those who are exposed to child labor, are among the main groups whose dignity is likely to be ignored. The findings of the present study showed that, in order for their dignity to be preserved, the Preservation of privacy and security of the victims of child labor must be respected.

Respect for Preservation of privacy and security comprised of avoiding physical violence, Sexual violence destroys physical and mental security, and avoiding emotional neglect. Several studies report that respecting the physical privacy of adolescents is essential to maintaining their dignity; however, their studies focused on the dignity of hospitalized adolescents or adolescents with behavioral disorders and stressed the significance of keeping their body parts, especially genitalia, covered [24,25,26]. Because of their difficult living conditions, the teenagers and adolescents who are forced to work are exposed to various forms of physical violence from their guardians, families, and even people on the street. It is evident that repeated physical violence against these teenagers who are not supported by anyone and are maltreated even by their own guardians and families destroys their dignity.

Another category under the theme of preservation of privacy and security in the present study was sexual abuse of the victims of child labor, especially the girls. Many studies emphasize that in order for the human dignity of individuals, especially those who cannot protect themselves, e.g. patients, teenagers with behavioral disorders, and hospitalized adolescents, to be maintained, their sexual privacy should be respected and they should not be sexually abused [24,25,26].

Sexual abuse is a major threat to an individual’s mental health, self-esteem, and dignity. In the Islamic culture, sexual matters are a very sensitive area and exposure to sexual abuse, especially rape, can seriously threaten an individual’s dignity and have a negative impact on the attitude of the other members of the society toward the victim. Accordingly, the victims of child labor, especially girls, try to avoid situations where their sexual privacy is threatened in order to maintain their dignity in the society.

The findings of the study also showed that neglect of the psycho-emotional needs of the victims of child labor (emotional neglect) incline them to be drawn to criminal groups and demonstrate ant-social behaviors at the slightest gesture of kindness. According to studies, teenagers who are forced to work experience considerable emotional neglect and stigma, which seriously threatens their psycho-emotional health and self-esteem [27,28,29].

Mohammadi et al. (2019), report that teenagers with behavioral disorders have been exposed to certain degrees of emotional neglect [24]. In addition, Reiter states that stigmatization and psycho-emotional neglect and abuse of teenagers and adolescents with mental and developmental disorders are prevalent [30].

In the present study, honoring individual identity to develop dignity was associated with respect for beliefs and attitudes, respect for age-sexual identity, and avoiding humiliation and pity. Mohammadi et al. (2019), report that showing respect for the age and sexual identity and cultural and religious beliefs of adolescents is essential to preserving their personal identity and dignity [24]. Similarly, several studies point out that respect for the age-sexual and religious-cultural identity of hospitalized adolescents is an effective step in maintaining their identity and dignity [25, 26, 31, 32].

Another important category of respect for personal identity was avoiding humiliation and pity toward the victims of child labor. Acts of pity not only create feelings of hatred and anger in these children, but undermine their self-esteem and dignity. According to studies, expressions of sympathy and support for the victims of child labor can improve their living conditions and increase their resilience, but undue pity will have a negative influence on their mind and self-stem.

The final theme extracted from the findings in the present study was comprehensive support.

Comprehensive and systematic support of their families and relatives, schools, organizations and charities for the victims of child labor can help reduce the financial needs of these children, so that they will not have to resort to any means to satisfy their basic needs. Furthermore, the emotional support of schools and teachers can satisfy part of this population’s need for sympathy and consequently reduce the risk of sexual abuse among them. Many studies stress the significance of the extended family support for the teenagers who are forced to work.

These studies point out that receiving support from their families and relatives can help the victims of child labor better cope with the hardships of their lives, e.g. working and studying at the same time, and reduce the rate of anti-social behaviors among them. By providing financial support and meeting the basic needs of this population, charities can contribute to preserving the dignity of the victims of child labor. Moreover, schools can make a contribution by identifying and giving effective support, especially psycho-emotional support, to these children. On a similar note, several studies state that general social support provided by schools, charities, and NGOs can improve the living conditions of the victims of child labor and consequently help preserve their dignity [33,34,35,36].

Children have the right to an adequate standard of living, health care, education and services, and to play and recreation. They should benefit from extensive family and social support. Also, Children have the right to protection from abuse, neglect, exploitation and discrimination [13]. Therefore, to realize the 2030 Sustainable Development Goals and promote the dignity and mental health of working children, it is essential that health care providers and children protection organizations have monitor directly and accurately monitor the functioning of families, schools, and environments where children are employed. Also, by providing cultural platforming, comprehensive support for working children and efforts to claim their rights, in line with maintain and promote the dignity of child labor take effective actions.

One of the limitations of the study is that data were mainly collected through individual interviews, while other methods of data collection, including focus groups and observation, could have increased the richness of the results of this qualitative research. Accordingly, it is suggested that future research address the dignity of victims of child labor from the perspective of child labor and their guardians and, in addition to individual interviews, use other methods of collecting qualitative data, including observation and focus groups.

Conclusion

Teenagers’ perceptions as child labor of their dignity, the dignity, privacy and security of child labor victims and respect for their identity and all-round support are defined. And in this supportive environment, the dignity of working children is preserved and appropriate behavioral consequences are created. In order to achieve the 2030 Sustainable Development Goals and improve the mental health and dignity of working children, it is essential to create a cultural environment that values all aspects of their dignity. By implementing the findings of this study and establishing a supportive environment, authorities and policymakers can take positive steps to uphold the dignity of these children.