Economic evaluation of prevention interventions for child sexual exploitation or child sexual abuse: a systematic review

Child sexual abuse, including sexual exploitation, is a global problem, affecting 8% to 31% of girls and 3% to 17% of boys worldwide. This systematic review aims to synthesize economic evidence on the cost-effectiveness of community-based interventions to prevent child sexual abuse/exploitation to inform decision-making. A systematic search was conducted in eight databases for studies published up to April 2023. A Google search was conducted for gray literature. The inclusion criteria were the economic evaluation of interventions aimed at children, perpetrators/perpetrators or professionals addressing child sexual abuse/exploitation. There was no country restriction, but an English summary was required for non-English articles. Studies without specific focus on child sexual abuse/exploitation, such as physical, emotional and domestic violence, were excluded. All costs have been adjusted to US$ 2023. Reporting quality assessment was conducted using the Consolidated Health Economic Evaluation Reporting Standards 2022 checklist. Of the 5,180 articles screened, 17 were included in the final synthesis, most of which were from the United States and focused on tertiary prevention delivered to offenders. Although the intervention components varied across studies, they all showed promising and cost-effective results. The findings highlight a small but growing body of economic evidence for child sexual abuse/exploitation interventions. The existing evidence from economic evaluation is dominated by tertiary prevention, which focuses on perpetrators and child victims and highlights the need for more research and action on primary and secondary preventive interventions for general and at-risk populations.