Original Research Child maltreatment in Nepal: prevalence and associated factors P. Kandel a , R. Kunwar b , S. Karki b , D. Kandel c , P. Lamichhane d,* a Research and Action in Public Health, Kathmandu, Nepal b School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia c Kathmandu School of Law, Bhaktapur, Nepal d Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia article info Article history: Received 5 December 2016 Received in revised form 22 May 2017 Accepted 24 June 2017 Keywords: Child maltreatment Physical punishment Nepal Child Violence abstract Objectives: Child maltreatment is a global public health problem. There is limited infor- mation about this problem in low-income countries. We aimed to document the preva- lence and factors associated with physical punishment of children less than 14 years of age in Nepal. Study design: Population-based cross-sectional study. Methods: We conducted an in-depth analysis using data from the Nepal Multiple Indicator Cluster Survey, a nationally representative multi-stage-stratified cluster sampling survey. Data were collected from 13,000 households in 520 sample enumeration areas. We assessed prevalence of physical punishment and different child violence related acts on 5081 children aged 3e14 years for whom complete information on all acts and attitude towards violence was available. Logistic regression was used to investigate the association between physical punishment of child and factors such as household and maternal demographics. Results: Our results suggested violence is common across Nepal, with data showing one in every second child is physically punished. One in every third (33%) of children were spanked, hit or slapped on the bottom, 25% were hit or slapped on the face and approx- imately 3% were beaten up hard. Odds of facing physical punishment were higher among children aged 3e5 years (odds ratio [OR] 2.9, 95% confidence interval [CI]: 2.0e4.3), aged 6 e8 years (OR 2.8, 95% CI: 2.2e3.7), engaged in child labour activities (OR 1.4, 95% CI: 1.1 e1.7), with mother that accepted wife beating by husband is justified (OR 1.2, 95% CI: 1.1 e1.4), whose father is currently abroad (OR 1.5, 95% CI: 1.2e1.9) and whose father is away from home but in the same country (OR 1.60, 95% CI: 1.1e2.3). The risk was also higher among children living in households that believe physical punishment of children is necessary (OR 3.5, 95% CI: 2.9e4.3) and from lower caste/indigenous (dalit/janajati) ethnicity (OR 1.3, 95% CI: 1.1e1.7). Those less likely to experience physical punishment included female children (OR 0.7, 95% CI: 0.6e0.9) and children with an older mother (34 e49 years; OR 0.5, 95% CI: 0.3e0.9). * Corresponding author. Department of Epidemiology and Preventive Medicine, Level 4, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia. E-mail addresses: kandelpragyaa@gmail.com (P. Kandel), ritu.kunwarkarki@gmail.com (R. Kunwar), surendra.karki@gmail.com (S. Karki), dikshakandel7@gmail.com (D. Kandel), prabhatone@gmail.com (P. Lamichhane). Available online at www.sciencedirect.com Public Health journal homepage: www.elsevier.com/puhe public health 151 (2017) 106 e113 http://dx.doi.org/10.1016/j.puhe.2017.06.020 0033-3506/© 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.