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 issue, 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 interventions to prevent child sexual abuse/exploitation to inform decision-making. A systematic search was conducted on eight databases for studies published until April 2023. Gray literature was searched using Google. The inclusion criteria were economic evaluation of interventions targeted at children, perpetrators/offenders, or professionals addressing child sexual abuse/exploitation. There was no limitation by country, but an English language abstract was required for non-English articles. Studies without a specific focus on child sexual abuse/exploitation, such as physical, emotional, and domestic violence-related abuse, were excluded. All costs were adjusted to US$ 2023. Reporting quality assessment was conducted using the Consolidated Health Economic Evaluation Reporting Standards 2022 checklist. Of 5,180 screened articles, 17 were included in the final synthesis, with most from the United States and focused on tertiary prevention delivered to offenders. While the intervention components varied across studies, all demonstrated promising and cost-effective results. The findings highlight a small but growing body of economic evidence for child sexual abuse/exploitation interventions. The existing economic evaluation evidence is dominated by tertiary prevention, which focuses on offenders and child victims and highlights the need for more research and action on primary and secondary preventative interventions for general and at-risk populations.