Violence against children in Afghanistan: Concerns and opportunities for positive change

The sexual abuse of adolescent boys in humanitarian emergencies: A qualitative study of how international humanitarian organisations are responding

BACKGROUND

Over the last decade, public health research has increasingly shown that humanitarian emergencies can negatively impact the wellbeing of adolescents. However, recent studies have largely not addressed the differentiated impact on adolescent boys or how humanitarians are responding.

OBJECTIVE

We sought to understand how humanitarian organisations respond to child sexual abuse against adolescent boys in humanitarian emergencies.

PARTICIPANTS AND SETTING

Sixteen humanitarian staff based in Geneva, Switzerland, and 35 humanitarian staff and 52 child protection caseworkers from the Rohingya refugee crisis response in Cox's Bazar, Bangladesh.

METHODS

We employed a critical ethnographic research design. Between September 2018 and October 2019, we conducted interviews with humanitarians in Geneva, as well as interviews, focus group discussions, and observation of the humanitarian response to the Rohingya refugee crisis in Bangladesh.

RESULTS

Sexual abuse of adolescent boys is present in numerous humanitarian emergencies and boys appear to be at risk in certain contexts, including workplaces, streets, and shelters. Humanitarian actors are responding through individualised casework but referrals to services are often limited by the operating environment. The most promising approaches to support survivors are specifically accessible to adolescent boys and provided by services that boys trust. Of note, humanitarian responsibility for adolescent boy survivors appears to be a context-specific negotiation between humanitarian sectors and this may be causing difficulties in the delivery of effective interventions.

CONCLUSION

Humanitarian actors should employ a more systematic approach to supporting adolescent boys that experience child sexual abuse, as an important matter for adolescent rights and health equity.

Understanding the influence of socioeconomic status on children physical disciplinary practices in Bangladeshi households

Background Despite progress in reducing violence against children, physical disciplinary practices remain prevalent in many parts of the world, including Bangladesh. Understanding the sociodemographic factors contributing to these practices is crucial for developing effective interventions to protect children from violence. This study aims to estimate the prevalence and impact of household economic status on the physical disciplinary practices experienced by children under five years old in various sociodemographic contexts. Methods Data from the Bangladesh Multiple Indicator Cluster Survey (MICS) 2019 was used to explore physical disciplinary practices against children under five, focusing on factors such as household wealth, region, type of residence, child's gender, and mother's education level. Logistic regression analysis was employed to examine the adjusted association between sociodemographic factors and physical disciplinary practices. Findings The study found that 64.88% of children under five experienced physical disciplinary practices at home. The odds of being subjected to PDP were higher for children from lower wealth index categories (poorest, poorer, middle, richer) compared to those in the richest category, with AORs ranging from 1.21 to 1.35 and all p-values <0.01. Urban residence was associated with increased odds of being physically punished (AOR: 1.09, 95% CI: 1.01-1.20). Boys had higher odds of being physically punished compared to girls (AOR: 1.15, 95% CI: 1.07-1.23). The odds of being physically punished were greater for children of less-educated mothers. Furthermore, mothers who believed that physical punishment was necessary for child-rearing had higher odds of using such practices (AOR: 2.10, 95% CI: 1.94-2.27). Conclusion Socioeconomic factors, especially household wealth, significantly influence the risk of experiencing physical disciplinary practices among children. The findings emphasize the need for targeted interventions to protect vulnerable children, particularly in urban and impoverished settings.

Child maltreatment and psycho-social impairments among child laborers in rural Bangladesh

PURPOSE

The current study focused on exploring the impact of maltreatment of child laborers on their psychosocial health condition from the views of their parents.

METHODS

A total of 100 parents of child laborers were recruited using snowball sampling. The structured questionnaire comprised two validated scales including ISPCAN Child Abuse Screening Tool (ICAST-P), and Paediatric Symptom Checklist (PSC) were used for the survey. Factor analysis and multivariable linear regression analysis were performed to examine the data using SPSS version 26, and Stata version 16.1.

RESULTS

A three-factor model consisting of internalizing, externalizing, and attention associated psycho-social impairments of child laborers were derived from the 35-item scale of PSC tool and represented a good fit to the data. A mean estimate of maltreatment indicates that a majority of child laborers are maltreated psychologically, followed by physical maltreatment and neglect. The factor analysis resulted that maltreated child laborers are highly prone to exhibit internalized psycho-social difficulties, followed by externalized and attention-associated emotional and behavioral difficulties among child laborers. The regression model further depicts that child laborers, who had been physically and psychologically maltreated, are significantly more likely to be affected by internalized and attention-related psycho-social impairments.

CONCLUSIONS

The study concluded that victimized child laborers exhibited significant internalized, as well as attention-related problems. These findings may be useful for future studies that examine emotional and behavioral problems among maltreated child laborers and, therefore, for developing prevention strategies.

Supporting caregivers of children living with disability in a humanitarian context: realist-informed evaluation of the 'Mighty Children' programme in Afghanistan

INTRODUCTION

To ensure that humanitarian action is disability-inclusive, evidence is needed to understand how different strategies to support children living with disabilities and their families can work in these settings. Evidence from other contexts suggests support groups can improve caregiver quality of life (QOL). This study reports an evaluation of the 'Mighty Children' programme a participatory educational support group programme for caregivers of children living with disability in Kabul province, Afghanistan.

METHODS

We conducted a mixed-methods realist-informed before-and-after study to measure change in caregiver-reported QOL and explore how and for whom the programme worked, and in what contexts. Female caregivers of children with any disability were recruited through clinics in urban Kabul (n=3) and rural Paghman district (n=3). We collected quantitative data on QOL pre/post programme using the Paediatric Quality of Life Inventory Family Impact Module (PedsQL-FIM). Qualitative data were collected through facilitator and participant focus groups postprogramme.

RESULTS

118 caregivers participated in two cohorts (November 2020, February 2021). Caregivers expressed a significant increase in QOL from baseline to programme completion (t(125)=-10.7, p≤0.0001). Participation in cohort 2 was associated with the greatest PedsQL-FIM change.Qualitative data revealed positive changes postprogramme in five key areas: caregiver mindset, parenting practices, disability-inclusive behaviours, psychological well-being and child functioning. These changes were seen as both outcomes and mechanisms influencing the primary outcome of QOL. Mechanisms that mediated these changes included increased knowledge of disability and the core acceptance and commitment therapy components of mindfulness and acceptance.

CONCLUSION

The Mighty Children caregiver support programme for children living with disability in Afghanistan was associated with improved caregiver QOL. Further studies are warranted to explore pathways to scale, sustainability and potential application in other settings.

The impact of humanitarian emergencies on adolescent boys: Findings from the Rohingya refugee crisis

Adolescent boys (age 9-19) are impacted differently by humanitarian emergencies. However, academic research on adolescent health and child protection has tended to focus on the direct impacts of an emergency rather than indirect impacts that may arise after a crisis. We sought to identify child protection concerns affecting adolescent boys in emergency settings and boys who are more vulnerable to harm through a case study of the humanitarian response to the 2017 Rohingya refugee crisis. We collected data in the Rohingya refugee crisis in Cox's Bazar, Bangladesh between 2018-2019. This included six months of participant observation, 23 semi-structured interviews and 12 informal ethnographic interviews with humanitarian staff working in the crisis, and 10 focus group discussions with a total of 52 child protection caseworkers from four child protection organisations. Our results showed that adolescent Rohingya boys were exposed to numerous protection concerns, including child labour, drug trafficking, substance abuse, family violence, and neglect. We classified these into three main typologies: community-related violence, income-related violence, and life-stage vulnerabilities. We found that adolescent boys who were unaccompanied or separated from their caregivers, adolescent boys who were members of vulnerable households, and adolescent boys with a disability were at more risk of harm. Our findings indicate that adolescent boys are exposed to an array of impactful child protection concerns in humanitarian emergencies and that this has implications for the delivery of public health and child protection interventions. We believe that humanitarian actors should improve recognition of the complexity of adolescent boys' lives and their exposure to gender and age-based harm as a critical matter for addressing adolescent health equity.

Psychological Problems in the Context of Political Violence in Afghan Children

PURPOSE OF REVIEW

This review provides an overview of recent literature examining psychological problems in the context of political violence among Afghan children.

RECENT FINDINGS

Using recent literature (2018-2023) we identified: 1) heightened levels of psychological problems experienced by children in Afghanistan; 2) the factors associated with these psychological problems, including loss of family and community members, poverty, continuous risk of injury and death, gender, substance use, war, daily stressors, and poor access to education; 3) psychological problems have potentially worsened since the 2021 political changes; 4) conflict and poverty have resulted in violence against children being a serious issue; 5) emerging psychological interventions have been adapted to Afghan contexts; and 6) there is a desperate need for psychological assistance and further research in the region. All children in Afghanistan have experienced conflict and political violence. While children are not responsible for this conflict, it has impacted their mental health. Further research is needed to examine the development and evaluation of interventions.

The Epidemiology of Young People's Work and Experiences of Violence in Nine Countries: Evidence from the Violence against Children Surveys

Globally, 497 million young people (15-24 years) are in the labour force. The current research on work and violence indicates reciprocal links across the life course. This study draws on data from 35,723 young people aged 13-24 years in the Violence Against Children Surveys (VACS) in nine countries to describe the epidemiology of work in order to explore associations between (1) current work and violence and (2) childhood violence and work in a hazardous site in young adulthood. The prevalence of past-year work among 13-24-year-olds was highest in Malawi: 82.4% among young men and 79.7% among young women. In most countries, young women were more likely to be working in family or domestic dwellings (range: 23.5-60.6%) compared to men (range: 8.0-39.0%), while men were more likely to be working on a farm. Work in a hazardous site was higher among young men compared to women in every country. Among children aged 13-17 years, we found significant positive associations between past-year work and violence among girls in three countries (aORs between 2.14 and 3.07) and boys in five countries (aORs 1.52 to 3.06). Among young people aged 18-24 years, we found significant positive associations among young women in five countries (aORs 1.46 to 2.61) and among young men in one country (aOR 2.62). Associations between childhood violence and past-year work in a hazardous site among 18-24-year-olds were significant in one country among girls and in three countries among boys. Continued efforts are needed to prevent hazardous work, improve work environments, and integrate violence prevention efforts into workplaces.

Confronting situations of violence against children and adolescents from the perspective of Guardianship Counselors

OBJECTIVE

To describe the potentialities and limits in confronting situations of violence against children and adolescents seen from the perspective of Guardianship Counselors.

METHOD

Qualitative research, developed with 18 Guardianship Counselors from two municipalities in the central region of the State of Rio Grande do Sul, Brazil. Data were generated between June and July 2021, using the focus group technique, and were subjected to thematic content analysis.

RESULTS

The following were identified as potentialities for combating violence against children and adolescents: denunciations; networking; and media coverage. As limits, we have: naturalization of violence; pandemic of the Covid-19; de-structuring of the intersectoral network; lack of training; and difficulty in developing preventive actions.

CONCLUSION

The Guardianship Councilors require training to act in cases of violence against children and adolescents, as well as support from other sectors, such as health, education, public safety, and social assistance, in order to fully attend to these cases.

Unraveling the Jeopardy: Child health in Afghanistan

A humanitarian crisis started in Afghanistan after the United States and international Allies withdrew in August 2021, causing numerous challenges and have especially impacted children. Children in Afghanistan have been affected by a long history of suffering from violence, war, and poverty. The US withdraw and COVID-19 pandemic have caused an economic crisis causing high rates of child malnutrition and prevented them from receiving healthcare and education. In the long run, the impacts of the current situation will significantly affect the child growth, education, and psychological health. There is a need for international organizations to intervene now to ensure children do not further suffer and have the option for a bright future. In turn, ensuring a brighter future for Afghanistan.

Assessing the asymmetric war-growth nexus: A case of Afghanistan

This study explores the war-growth nexus in Afghanistan, a country where war-torn acts inform resource allocation. Employing the asymmetric ARDL, dynamic multipliers, and asymmetric causality techniques, the initial results confirm the existence of a long-run asymmetric nexus amid predictors. The asymmetric ARDL results indicate that a positive asymmetric shock from the per capita cost of war reduces per capita GDP—that is, economic growth—while a negative asymmetric shock from the per capita cost of war increases growth in the short and long run. Moreover, the findings reveal that per capita capital investment, per capita energy consumption, per capita household consumption, per capita remittance, per capita foreign direct investment, population growth, and inflation rate have significantly asymmetric effects on growth, highlighting non-monotonic impacts in scale and magnitude. The results of the asymmetric causality technique by bootstrap confirm that there is an asymmetric bidirectional causality between growth, per capita cost of war, per capita household consumption, per capita capital investment, and per capita foreign direct investment, while expanding only unidirectional causality with per capita remittance, population growth, and inflation rate. Based on the findings, the study concludes by offering relevant policy recommendations.

Comparison of adverse childhood experiences of working and nonworking adolescents

BACKGROUND

Although adverse childhood experiences (ACEs) in adolescents are partially presented at the national level, few studies of ACEs in working adolescents by comparing them with those who are not working that provide an opportunity for international comparison have been conducted.

OBJECTIVE

This study was aimed to compare the ACEs of working and nonworking adolescents.

METHODS

This study was conducted in Turkey with 213 working adolescents enrolled in the vocational training center and 457 nonworking adolescents enrolled in high schools between the ages of 15 and 18.

RESULTS

As a result of the study, the prevalence and incidence of psychological and physical ACEs and neglect in nonworking adolescents were found to be higher than the prevalence and incidence in working adolescents.

CONCLUSIONS

Research should be conducted to define the awareness of neglect and abuse among working and nonworking adolescents and to explain the reasons why nonworking adolescents experience more ACEs.

The Association Between Child Marriage and Domestic Violence in Afghanistan

Child marriage and intimate partner violence have been globally recognized as human rights violations. Both indicators can derail an individual's future and have various public health implications. Previous studies have shown an association between child marriage and domestic violence in low- and middle-income countries; however, data in Afghanistan are not known. This study aimed to assess the association between child marriage and domestic violence in Afghanistan. We used nationally representative data collected by the Demographic and Health Surveys to conduct logistic regression analyses. Child marriage was separated into three categories: very early marriage (<15 years), early marriage (15-17 years), and adult marriage (≥18 years). Domestic violence was the response variable and was assessed as any violence, physical violence, emotional violence, and sexual violence. Of the sample (N = 21,324), 15% of the respondents were married before the age of 15; 35% were married between the ages of 15 and 17; and 50% were married as adults. After adjusting for current age, place of residence, and socioeconomic status, the odds of sexual violence were 22% higher among women who married before age 15 compared with those married as adults (OR = 1.22, 95% CI = [1.05, 1.40], p = .005). However, the odds of reporting any violence, physical violence, and emotional violence among those who married as children did not differ compared with those who married as adults. This may be due to a shift in traditional norms or underreporting in Afghanistan. This study adds to the body of research on child marriage and intimate partner violence, and specifically provides novel information on this association in Afghanistan.

Children are in need of humanitarian aid in Afghanistan

Almost 60% of Afghans forced to flee their homes in 2021 because of the Taliban advance are children. They are starving. It is estimated that approximately one million will suffer from severe, life-threatening malnutrition by the end of 2021. Many have been separated from their families by the chaos that has ensued in Afghanistan after Taliban took power, and hundreds of them were driven out of the country unaccompanied. How must these children have been when they suddenly found themselves without their relatives during the chaotic crisis, or when they boarded an evacuation flight? It is vital to identify them quickly. Too many children witnessed scenes that no child should see. Children and teenagers are dealing with anxiety and fear and desperately need help and mental health care. This is the sad reality facing Afghan children, regardless of ongoing political developments and changes in government.

Children are in need of humanitarian aid in Afghanistan

Almost 60% of Afghans forced to flee their homes in 2021 because of the Taliban advance are children. They are starving. It is estimated that approximately one million will suffer from severe, life-threatening malnutrition by the end of 2021. Many have been separated from their families by the chaos that has ensued in Afghanistan after Taliban took power, and hundreds of them were driven out of the country unaccompanied. How must these children have been when they suddenly found themselves without their relatives during the chaotic crisis, or when they boarded an evacuation flight? It is vital to identify them quickly. Too many children witnessed scenes that no child should see. Children and teenagers are dealing with anxiety and fear and desperately need help and mental health care. This is the sad reality facing Afghan children, regardless of ongoing political developments and changes in government.

Enfrentamento das situações de violência contra crianças e adolescentes na perspectiva de Conselheiros Tutelares

RESUMO Objetivo: Descrever as potencialidades e limites no enfrentamento das situações de violência contra crianças e adolescentes na perspectiva de Conselheiros Tutelares. Método: Pesquisa qualitativa, desenvolvida com 18 Conselheiros Tutelares de dois municípios da região central do Estado do Rio Grande do Sul, Brasil. Os dados foram gerados entre junho e julho de 2021, por meio da técnica de grupo focal, sendo submetidos a análise de conteúdo temática. Resultados: Elencaram-se como potencialidades para o enfrentamento da violência contra crianças e adolescentes: denúncias; atuação em rede; e divulgação midiática. Como limites, tem-se: naturalização da violência; pandemia da Covid-19; desestruturação da rede intersetorial; ausência de capacitações; e dificuldade para desenvolver ações de prevenção. Conclusão Os Conselheiros Tutelares requerem instrumentalização para atuar nos casos de violência contra crianças e adolescentes, bem como o apoio dos demais setores, como saúde, educação, segurança pública e assistência social, de modo a atender integralmente esses casos.

Mental health of women and children experiencing family violence in conflict settings: a mixed methods systematic review

BACKGROUND

Armed conflict has significant impacts on individuals and families living in conflict-affected settings globally. Scholars working to prevent violence within families have hypothesised that experiencing armed conflict leads to an increase in family violence and mental health problems. In this review, we assessed the prevalence of family violence in conflict settings, its association with the mental health of survivors, moderating factors, and the importance of gender relations.

METHODS

Following PRISMA guidelines, we systematically reviewed quantitative and qualitative studies that assessed the prevalence of family violence and the association between family violence and mental health problems, within conflict settings (PROSPERO reference CRD42018114443).

RESULTS

We identified 2605 records, from which 174 full text articles were screened. Twenty-nine studies that reported family violence during or up to 10 years after conflict were eligible for inclusion. Twenty one studies were quantitative, measuring prevalence and association between family violence and mental health problems. The studies were generally of high quality and all reported high prevalence of violence. The prevalence of violence against women was mostly in the range of 30-40%, the highest reported prevalence of physical abuse being 78.9% in Bosnia and Herzegovina. For violence against children, over three-quarters had ever experienced violence, the highest prevalence being 95.6% in Sri Lanka. Associations were found with a number of mental health problems, particularly post-traumatic stress disorder. The risk varied in different locations. Eight qualitative studies showed how men's experience of conflict, including financial stresses, contributes to their perpetration of family violence.

CONCLUSIONS

Family violence was common in conflict settings and was associated with mental health outcomes, but the studies were too heterogenous to determine whether prevalence or risk was greater than in non-conflict settings. The review highlights an urgent need for more robust data on perpetrators, forms of family violence, and mental health outcomes in conflict-affected settings in order to help understand the magnitude of the problem and identify potential solutions to address it.

Determinants of severe physical disciplinary practices against children in Egypt

BACKGROUND

Although nearly 43 % of Egyptian children aged less than 14 years had ever experienced severe physical violent punishment at home, no previous studies identified the predictors of the practice in Egypt.

OBJECTIVE

This research aims at identifying the determinants of the use of any severe violent physical practice to discipline children.

PARTICIPANTS AND SETTING

The latest national Egyptian Demographic and Health Survey is the main source of data. The caregivers of 13024 children were interviewed.

METHODS

A binary logistic regression model is developed to identify the determinants of the use of severe physical disciplinary practices.

RESULTS

Results show that children whose parents believe that physical punishment is necessary to discipline children are more likely to experience severe violence (OR = 3.3). Children in the preprimary stage have a high odds ratio of experiencing a severe violent punishment compared to those in preparatory and secondary stages (OR = 3.5). Children whose mothers have experienced domestic physical violence are more likely to be subject to severe physical violence (OR = 1.6 for husband violence, and 1.4 for parents/siblings violence). Children living in Urban Lower Egypt are approximately twice likely as children living in urban governorates to be subject to severe physical violence. Children living in the poorest households are the most likely to experience severe physical violence.

CONCLUSION

Severe violent disciplinary practice inside the home is common in Egypt. The findings urge for activating Egyptian Child Law and implementing continuous training programs for parents on positive parenting.

Child abuse in the West Bank of the occupied Palestinian territory (WB/oPt): social and political determinants

BACKGROUND

Child maltreatment is a global epidemic. It affects morbidity, mortality, social behavior, wellbeing, and quality of life of children. This study aims to assess prevalence of child abuse in the West Bank (WB) of the occupied Palestinian territory (oPt) and to determine some of its social and political associated factors.

METHODS

We analyzed secondary data obtained from a cross sectional study conducted on a sample representing Palestinian children on the West Bank and using the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) tool. The ISPCAN Child Abuse Screening Tool for parents (ICAST-P) questionnaire was completed by 1107 Palestinian mothers to estimate physical and emotional child abusive practices at home for children aged 0-12 years. Univariate, bivariate, and multivariate binary logistic regression analyses were performed using the SPSS® version 20 to assess prevalence and predictors of child abuse.

RESULTS

Overall, around 34% of the West Bank-children were abused by their mothers. Results of the logistic regression analysis indicated that male children, children of younger mothers, children whose fathers were with low levels of education, children whose mothers reported low levels of parental warmth, and children whose parents were exposed to political violence were at greater risk of being abused.

CONCLUSIONS

Child abuse is highly prevalent among children of the Palestinian society in the West Bank. Policy makers need to pay more attention to this epidemic. The association between child abuse and political violence found in this study makes a just solution for Palestinians essential for improving the welfare of children and families.

Coming of Age in the Shadow of the Taliban: Adolescents' and Parents' Views Toward Interpersonal Violence and Harmful Traditional Practices in Afghanistan

OBJECTIVES

To understand Afghan adolescents' and parents' attitudes toward interpersonal violence.

METHODS

We used a 2-stage sampling method in 6 provinces during 2016; we included 916 adolescents aged 12 to 15 years and 454 parents.

RESULTS

In the abstract, a minority of adolescents or parents endorsed violence; however, specific situations justified most violence (e.g., husbands beating wives, parents hitting children). Both adolescents (48.0%) and parents (39.0%) thought a wife hitting her husband was least justifiable. Endorsement of violence justification did not appear to vary significantly on the basis of parental education or wealth. More fathers rejected all violence rationale than did mothers, and women were more likely to justify wife beating (75.0% vs 58.6%; P < .01), beating of daughters (78.5% vs 60.6%; P < .01), and teachers hitting students (62.9% vs 51.5%; P < .01). Of all respondents, 25% approved of threatening a child if he or she speaks out against harmful traditional practices.

CONCLUSIONS

Although it may be socially unacceptable to advocate physical aggression, most Afghans still find numerous conditions that justify it. Without deliberate violence reduction strategies, education alone is unlikely to reduce the high levels of interpersonal violence in Afghanistan.