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Franchino-Olsen H, Orkin M, Meinck F. Toward a Contextually Sensitive Understanding of Polyvictimization: A Latent Class Analysis of Violence, Risks, and Protections Among South African Adolescents From Highly Deprived Settings. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:3591-3618. [PMID: 38407004 PMCID: PMC11283737 DOI: 10.1177/08862605241233273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
South African adolescents experience a high prevalence of violence victimization alongside the health and economic burdens of HIV/AIDS and poverty. Polyvictimization is a useful theory and framework that allows for a nuanced understanding of lived adolescent experience patterns. Polyvictimization examinations are further enriched by person-centered analytical approaches. This study used latent class analysis to differentiate a sample of South African adolescents from highly deprived communities by their polyvictimization profiles and contextual violence risk and protective factors. Adolescents were sampled twice (2010/2011; 2011/2012), and data reflected their lifetime (sexual abuse) or recent (all other forms of assessed abuse/violence) violence victimizations, as well as individual, household, and community characteristics. Model fit indices supported a seven-class model with adolescents in high, moderate, and low polyvictimization classes. Adolescents in the high polyvictimization classes experienced a heavy burden of poverty and multiple forms of violence across contexts and were distinguished by HIV/AIDS and disability. Adolescents in the low polyvictimization class experienced relatively little violence, despite living in violent communities, and low household and individual burdens of HIV/AIDS and disability. Findings emphasize the importance of considering adolescent violence through a contextually sensitive polyvictimization lens to understand the complex web of violence that adolescents experience. This work supports previous research in low-resource South African settings highlighting the interconnected nature of violence, poverty, disability, and HIV/AIDS. Future research should explore these complex violence patterns and their effects, while program and policy actions must target and prevent adolescent violence especially for those impacted by poverty, disability, and HIV/AIDS.
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Affiliation(s)
| | - Mark Orkin
- University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Franziska Meinck
- University of Edinburgh, UK
- University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- North-West University, Vanderbijlpark, South Africa
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Carretier E, Jourdan M, Duchesne S, Flouriot J, Lachal J, Moro MR. Disclosure of sexual abuse by adolescents treated in a psychiatry department. L'ENCEPHALE 2024:S0013-7006(24)00043-5. [PMID: 38523028 DOI: 10.1016/j.encep.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 03/26/2024]
Abstract
OBJECTIVES The aim of the study is to describe the population of adolescents who have disclosed sexual abuse to a health professional during their care in a psychiatric department. We also want to discuss the circumstances that enable adolescents to make this disclosure. METHODS This single-center retrospective observational study is based on the mandatory reports (n=139) sent by a Paris adolescent psychiatry department between 2005 and 2021 after patients disclosed previous sexual abuse. R® (3.6.1) and RStudio® (1.2.5001) software were used for statistical analysis. RESULTS Girls accounted for almost all the adolescents who disclosed (95.7%). First abuse occurred around the age of 12 years and was first disclosed to a health professional a mean of 3.5 years later; 66 (47.5%) patients were admitted for inpatient care during their follow-up. The most common diagnoses were depression, eating disorders, posttraumatic stress disorders, and other anxiety disorders. Before disclosing to a health professional, most of these adolescents had already talked about it, mainly to a family member (69.8%) or peers (24.7%). CONCLUSION This is the first study in France on the reporting of sexual abuse after its disclosure by adolescents being treated in a psychiatry unit. Our results show that child sexual abuse is rarely reported and that health care professionals are far from being the first recipients of these disclosures. We recommend routine screening for sexual abuse in adolescent psychiatry units, improved training for staff receiving these disclosures, and consideration of how best to coordinate medical, social, and legal services for these adolescents.
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Affiliation(s)
- Emilie Carretier
- Laboratoire de psychologie clinique psychopathologie psychanalyse, Paris Cité University, PCPP, 92100 Boulogne-Billancourt, France; Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France.
| | - Marine Jourdan
- Département de médecine légale, université Paris Sorbonne Cité, Paris, France; Service de médecine légale et pénitentiaire, centre hospitalo-universitaire Pontchaillou, Rennes, France
| | - Sophie Duchesne
- Service de gynecologie-obstétrique - maison des femmes, hôpital Pitié-Salpêtrière, AP-HP, Sorbonne université, Paris, France
| | - Julien Flouriot
- Département de psychiatrie et de médecine addictologique, site Lariboisière Fernand-Widal, AP-HP GHU Nord, 75010 Paris, France
| | - Jonathan Lachal
- Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France; Service de psychiatrie de l'enfant et de l'adolescent, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; Université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - Marie-Rose Moro
- Laboratoire de psychologie clinique psychopathologie psychanalyse, Paris Cité University, PCPP, 92100 Boulogne-Billancourt, France; Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France; Maison des adolescents - maison de Solenn, hôpital Cochin, AP-HP, 75014 Paris, France
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Williams AW, Williams AH, PettyJohn ME, Cash SJ, Schwab-Reese LM. Understanding how peers respond to online child maltreatment disclosures: A qualitative content analysis of family violence discussions on social media. CHILD ABUSE & NEGLECT 2023; 146:106401. [PMID: 37769360 DOI: 10.1016/j.chiabu.2023.106401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/11/2023] [Accepted: 08/10/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Positive, supportive responses to child maltreatment disclosure are critical for victims to receive appropriate resources and support for healing. Young people often prefer to disclose to their peers, frequently on social media platforms. OBJECTIVE We assessed young people's use of TalkLife, an online peer-to-peer support platform, to respond to the disclosure of child maltreatment. METHODS We conducted a qualitative content analysis of 1090 comments on childhood maltreatment-related posts on TalkLife between 2013 and 2020. We used an iterative, team-based qualitative content analysis approach to understand how peers responded to maltreatment disclosure. FINDINGS Peer responses tended to be supportive, including asking questions about the abuse and offering advice, emotional support, and other positive responses. Most commonly, peers advised the victim to report, focus on their strengths instead of the abuse, reach out to adults for more support, or confront the perpetrator. On occasion, however, peers began an irrelevant discussion, joked about the situation, or even directly attacked the discloser. CONCLUSIONS Learning about child maltreatment disclosures on social media builds the foundation for research to assist in identifying and applying interventions on online platforms. Further, these findings can inform programs that teach how to provide healthy responses to child maltreatment disclosures.
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Affiliation(s)
- Amelia W Williams
- Department of Public Health, Purdue University, United States of America
| | | | - Morgan E PettyJohn
- Center for Violence Prevention, University of Texas Medical Branch, United States of America
| | - Scottye J Cash
- School of Social Work, Ohio State University, United States of America
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Moolman B, Tolla T, Essop R, Isaacs N, Makoae M. "I felt like I was going to cause conflict. So, I kept quiet …" (Female child rape victim, 15 years). CHILD ABUSE & NEGLECT 2023; 144:106355. [PMID: 37541094 DOI: 10.1016/j.chiabu.2023.106355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND There is limited research in South Africa that has analysed the experiences of child and youth victims of crime and sexual victimisation who accessed formal response services through the victim empowerment programme. OBJECTIVE The primary aim of this article is to explore children and youth's experiences of accessing the Victim Empowerment Programmatic services, through the criminal justice system in South Africa. The focus of the article is on childrens' disclosure, reporting and social support. PARTICIPANTS AND SETTING The participants in the study are male and female victim/survivor of crime between the ages of 12-17 years who has been through a Victim Empowerment Programme (VEP) for at least 12 months. The Victim Empowerment Programme is a governmental programme located within the National Department of Social Development in South Africa. METHOD The full study is a mixed method study but the children's(youth) participation in the study is limited to qualitative methods. The data analysis utilised a thematic approach and ATLAS.ti software. RESULTS The findings revealed four themes, namely, (1) children's (as youth) perceptions of the presence and frequency of rape in communities, (2) disclosure and reporting rape; (3) interlinkage of disclosure and reporting of child rape and child sexual victimisation; and (4) seeking social and professional support to deal with the trauma of child (youth) rape and child sexual victimisation. The findings showed that children (youth) perceive their community environments as unsafe spaces where they are exposed to crimes such as rape and burglary; that there are delays in disclosure of sexual victimisation and victims/survivors are still dealing with the trauma of rape as they report the crime and navigate the pathways of the criminal justice system. CONCLUSION In conclusion, this study confirms the delay in disclosure of childhood (youth) sexual victimisation and identifies the complex tension for children (youth) who disclose, that they are often pressured to report the crime, and journey through an adversarial criminal justice system, and so 'breaking the silence' is often unpredictable and emotionally and psychologically costly for children and youth.
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Kurtz M, Kawka H, Horstick O, Brenner S, Deckert A, Louis VR, Winkler V, Lowery Wilson M, Bärnighausen T, Dambach P. The prevalence of emotional abuse in children living in Sub-Saharan Africa - A systematic review. CHILD ABUSE & NEGLECT 2023; 140:106155. [PMID: 37004459 DOI: 10.1016/j.chiabu.2023.106155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES This study is meant to put a focus on the prevalence of emotional abuse in low-income states like the Sub-Saharan region. METHODOLOGY Searching PubMed, Google scholar, and web of science during February and April 2021 a total of 2264 articles were identified, 27 met the inclusion criteria. We added the results of 13 VAC (Violence Against Children and Youth) studies, conducted by UNICEF capturing information about experienced sexual, physical, or emotional violence in 13-24-year-olds, as well as 56 MIC (Multiple Indicator Cluster) studies, conducted by the CDC to research the disciplinary methods used with children aged 1-14 years in the past month by older household members. Finally, in a meta-analytic approach, we aimed to calculate a pooled estimate of the prevalence. RESULTS The included studies depicted a wide range in prevalence rates across countries. For example, while the VAC study in Lesotho in 2018 showed low incidence rates of emotional violence (6.9 % Females, 3.8 % Males), the average prevalence recorded by the MIC study was as high as 57.8 % for females and 59.2 % for males. On average, the MIC studies displayed a higher incidence and the discrepancy of prevalence of emotional abuse between females and males was small. Calculating a pooled estimate of the prevalence was not possible, due to the heterogeneity of the data. CONCLUSIONS In general countries displayed a high prevalence. A standardized use of a uniform definition of emotional abuse might help to display a more homogenous data set in the future, giving the opportunity for pooled estimates of prevalence.
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Affiliation(s)
- M Kurtz
- University Heidelberg, Germany.
| | - H Kawka
- University Heidelberg, Germany
| | - O Horstick
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Germany
| | - S Brenner
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Germany
| | - A Deckert
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Germany
| | - V R Louis
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Germany
| | - V Winkler
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Germany
| | - M Lowery Wilson
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Germany
| | - T Bärnighausen
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Germany
| | - P Dambach
- Heidelberg Institute of Global Health, University Hospital Heidelberg, Germany
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Devries K, Cerna-Turoff I, Fabbri C, Turner E, Nyakuwa R, Nherera CM, Nhenga-Chakarisa T, Nengomasha BC, Moyo R. Exploring children's formal help-seeking behaviour for violence in Zimbabwe: analysis of national survey and routine service provider data. BMJ Open 2023; 13:e067818. [PMID: 37137561 PMCID: PMC10163484 DOI: 10.1136/bmjopen-2022-067818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
OBJECTIVES To explore knowledge of formal services and help-seeking behaviour for violence among Zimbabwean children aged 18 years and under. DESIGN We use cross-sectional data from the 2017 Zimbabwe Violence Against Children Survey (VACS), which is nationally representative and had a 72% response rate for female participants and 66% for males; and anonymised routine data from one of the largest child protection service providers' (Childline Zimbabwe) call database. SETTING Zimbabwe. PARTICIPANTS We analysed data from 13 to 18 year old participants in the 2017 VACS and pertaining to respondents aged 18 years and under from Childline Zimbabwe's call database. MEASURES/ANALYSIS We describe characteristics of children, and fit unadjusted and logistic regression models to estimate associations between selected characteristics and help-seeking knowledge and behaviours. RESULTS 1339 of 4622 children aged 13-18 years surveyed for the 2017 VACS in Zimbabwe (29.8%) reported experience of lifetime physical and/or sexual violence. Of these, 829 (57.3%) children did not know where to seek formal help, 364 (33.1%) children knew where to seek help but did not, and 139 (9.6%) children knew where to seek help and did seek help. Boys were more likely to know where to seek help, but girls were more likely to actually seek help. During the 6-month period when VACS survey data were being collected, Childline received 2177 calls where the main reason for the call was recorded as violence against someone aged 18 years or under. These 2177 calls contained more reports from girls and children in school, versus the national profile of children who had experienced violence. Few children who did not seek help reported not wanting services. Most children who did not seek help reported that they felt at fault or that their safety would be put at risk by disclosure. CONCLUSION Both awareness of services and help-seeking are gendered, suggesting that different strategies may be needed to support boys and girls to access the help they want. Childline in particular may be well placed to expand its outreach to boys and to receive more reports of school-related violence, and should consider efforts to reach out-of-school children.
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Affiliation(s)
- Karen Devries
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Ilan Cerna-Turoff
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Camilla Fabbri
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Ellen Turner
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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De Schacht C, Paulo P, Van Rompaey S, Graves E, Prigmore HL, Bravo M, Melo F, Malinha JE, Correia D, Cossa R, Chele E, Audet C. Health care services for survivors of gender-based violence: a community and clinic-based intervention in Zambézia province, Mozambique. AIDS Care 2023; 35:16-24. [PMID: 35578397 PMCID: PMC11288795 DOI: 10.1080/09540121.2022.2067313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
Mozambique introduced guidelines for integrated gender-based violence (GBV) services in 2012. In 2017, we trained providers on empathetic and supportive services to GBV survivors and introduced home-based services for survivors who are loss-to-follow up. Rate ratios of clinic visits were compared before and after intervention initiation, using exact significance tests. Data of 1,806 GBV survivors were reviewed, with a total of 2005 events. The median age was 23 years (IQR 17-30) and 89% were women. Among those reporting violence, 69% reported physical violence, 18% reported sexual violence (SV), and 12% reported psychological violence. Rates of care-seeking behavior were higher in the intervention period (rate ratio 1.31 [95%CI: 1.18-1.46]); p < 0.01. Among those eligible for post-exposure prophylaxis (PEP), 94% initiated PEP. Uptake of HIV retesting improved in percentage points by 34% (14% to 48%), 34% (8% to 42%) and 26% (5% to 31%) at 1-, 3- and 6-months, respectively. The intervention led to an increase in the rate of GBV survivors seeking health care services, and improved rates of follow-up care among SV survivors initiating PEP. Strengthening of PEP adherence counseling remains crucial for improving GBV services.
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Affiliation(s)
| | - Paula Paulo
- Friends in Global Health (FGH), Quelimane, Mozambique
| | | | - Erin Graves
- Vanderbilt University Medical Center (VUMC), Institute for Global Health, Nashville, TN, USA
| | - Heather L. Prigmore
- Department of Biostatistics, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA
| | | | | | | | - Della Correia
- Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
| | - Raquel Cossa
- National Directorate of Medical Assistance, Ministry of Health (MoH), Maputo, Mozambique
| | - Elsa Chele
- Provincial Health Directorate of Zambézia (DPS-Z), Quelimane, Mozambique
| | - Carolyn Audet
- Vanderbilt University Medical Center (VUMC), Institute for Global Health, Nashville, TN, USA
- Department of Health Policy, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA
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Wamoyi J, Ranganathan M, Mugunga S, Stöckl H. "It Gives You a Feeling of Pride when You Touch Her": The Role of Masculinity in Sexual Harassment of Adolescent Schoolgirls in Tanzania. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP108-NP127. [PMID: 35350928 DOI: 10.1177/08862605221080957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual harassment or the unwanted offensive behaviours that women and girls experience is a pervasive global challenge. Yet, there is limited evidence on the lived experiences of sexual harassment from school-based settings in sub-Saharan Africa. We explore students' perceived experiences, perpetration, and drivers of sexual harassment in schools in Mwanza, Tanzania. This study employed a qualitative research design involving 30 in-depth interviews and seven focus group discussions with 30 male and 40 female secondary school pupils aged 13-19 years. Data was analysed using a thematic approach. The findings show that experiences of sexual harassment among schoolgirls were widespread. Common forms of harassment were verbal and non-verbal gestures of a sexual nature. The desire to prove one's masculinity and peer pressure were key drivers of perpetration among schoolboys. Teachers took advantage of their positions of authority to sexually harass female pupils and employed corporal punishment to those who resisted their advances. Sexual harassment had multiple negative outcomes, including schoolgirls dropping out of school and mental health issues, such as anxiety, stress and poor academic performance. Girls rarely reported sexual harassment for fear of further victimisation and stigma from others. Sexual harassment of girls is common in secondary schools in Mwanza and is mainly driven by peer pressure and the desire to prove one's masculinity. Given its harmful effects, there is a need to implement clear policies to protect girls, support confidential disclosure and reporting and to address toxic masculinity norms among young men.
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Affiliation(s)
- Joyce Wamoyi
- Department of Sexual and Reproductive Health, 119151National Institute for Medical Research, Mwanza, Tanzania
| | - Meghna Ranganathan
- Department of Global Health and Development, 4906London School of Hygiene and Tropical Medicine, London, UK
| | - Samuel Mugunga
- Department of Sexual and Reproductive Health, 119151National Institute for Medical Research, Mwanza, Tanzania
| | - Heidi Stöckl
- Department of Global Health and Development, 4906London School of Hygiene and Tropical Medicine, London, UK
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Langwenya N, Toska E, Stöckl H, Cluver L. Which groups are most affected by sexual violence? A disaggregated analysis by sex, age, and HIV-status of adolescents living in South Africa. CHILD ABUSE & NEGLECT 2022:105981. [PMID: 36473807 DOI: 10.1016/j.chiabu.2022.105981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/08/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Estimates on sexual violence (SV) among adolescents are rarely disaggregated by key indicators. OBJECTIVE We examine the independent effects of sex, age, HIV status and mode of HIV acquisition on the exposure to SV using generalised estimating equations models and proportional hazard model. PARTICIPANT AND SETTING Data from a 4-year prospective cohort study of 1447 adolescents (ages 10-19, 57% girls, 76% living with HIV) in South Africa. METHODS We describe the lifetime prevalence of three forms of SV: non-contact (unwanted showing of private parts), contact (coerced sexual debut, attempted and completed forced penetrative or oral sex,) and exploitative (sex in exchange for goods/money). RESULTS Overall, 23.9% (95%CI = 21.7%-26.1%) reported exposure to SV at some point in their lives: non-contact = 5.7%, contact = 9.0% and exploitative = 15.8%. While girls reported higher rates of exploitative (18.4% vs 12.3%; p < 0.001) and contact SV (12.3% vs 4.6%; p < 0.001), there were no differences in levels of non-contact SV by sex (6.5% vs 4.6%; p = 0.086). Exposure to any SV doubled in late adolescence (10-14 years = 7.0% vs ≥15 years = 31.7%; aIRR = 2.07; 95%CI = 1.82-2.37). Though level of SV were comparable between those living with HIV and those HIV-uninfected (22.9% vs 26.2%; p = 0.182), adolescents who recently acquired HIV were twice as likely to experience SV compared to adolescents who perinatally acquired HIV (42.3% vs 15.7%; aIRR = 2.03; 95%CI = 1.73-2.39). This association persisted when analysis was restricted to incidence SV during follow-up (aIRR = 1.53; 95%CI = 1.23-2.10). CONCLUSION Exposure to SV was high for both sexes, increased with age and more prevalent among adolescents who recently acquired HIV. SV prevention and response services must also be offered to boys and strengthened in HIV care services.
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Affiliation(s)
- Nontokozo Langwenya
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; Nuffield College, University of Oxford, Oxford, United Kingdom.
| | - Elona Toska
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; Centre for Social Science Research, University of Cape Town, Cape Town, South Africa; Department of Sociology, University of Cape Town, Cape Town, South Africa
| | - Heidi Stöckl
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Cerna-Turoff I, Nyakuwa R, Turner E, Nherera CM, Nhenga-Chakarisa T, Devries K. National COVID-19 lockdown and trends in help-seeking for violence against children in Zimbabwe: an interrupted time-series analysis. BMC Public Health 2022; 22:2116. [PMID: 36401183 PMCID: PMC9673211 DOI: 10.1186/s12889-022-14425-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/22/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND An estimated 1.8 billion children live in countries where COVID-19 disrupted violence prevention and response. It is important to understand how government policies to contain COVID-19 impacted children's ability to seek help, especially in contexts where there was limited formal help-seeking prior to the pandemic. We aimed to quantify how the national lockdown in Zimbabwe affected helpline calls for violence against children, estimated the number of calls that would have been received had the lockdown not occurred and described characteristics of types of calls and callers before and after the national lockdown. METHODS We used an interrupted time series design to analyse the proportion of violence related calls (17,913 calls out of 57,050) to Childline Zimbabwe's national child helpline between 2017 to 2021. We applied autoregressive integrated moving average regression (ARIMA) models to test possible changes in call trends before and after the March 2020 lockdown and forecasted how many calls would have been received in the absence of lockdown. In addition, we examined call characteristics before and after lockdown descriptively. RESULTS The proportion of violence related calls decreased in the 90 days after the lockdown and subsequently returned to pre-COVID-19 levels. We estimate that 10.3% (95% confidence interval [CI] 6.0-14.6%) more violence related calls would have occurred in this period had there not been a lockdown. Violence was increasingly reported as occurring in children's households, with fewer reports from children and formal child protection actors. CONCLUSIONS Lockdowns dramatically change everyday life and strain populations, which is unlikely to reduce violence prevalence but may reduce help-seeking. The three months after COVID-19 lockdowns may be key time periods when help-seeking for violence decreases drastically. Policy makers should ensure that in-person and remote services support help-seeking. Interventions and campaigns may additionally want to target adult female family members in encouraging reporting of suspected violence cases when they occur within households and are perpetuated by other family members. We suggest a composite approach of scaling-up remote reporting mechanisms that are accessible and geographically well-distributed, establishing non-traditional sites for help seeking within communities and continuing limited in-person home visitation for known cases of violence.
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Affiliation(s)
- Ilan Cerna-Turoff
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York City, NY, 10032, USA.
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | | | - Ellen Turner
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Karen Devries
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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'I went there in an effort to help the child, but you can see there is corruption in the world': Adults' conceptualisations and enactments of child protection in schools in a challenging context. PLoS One 2022; 17:e0275918. [PMID: 36264902 PMCID: PMC9584429 DOI: 10.1371/journal.pone.0275918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 09/26/2022] [Indexed: 11/19/2022] Open
Abstract
Schools have the potential to be sites of support for vulnerable children, but can also be sites of violence perpetration. In this qualitative study we explore how adult school stakeholders in and around two public Catholic primary schools in Zimbabwe conceptualise and enact child protection. We analysed our findings in light of the protracted economic crisis in Zimbabwe; the current policy context for child protection; and the Covid-19 pandemic. We conducted semi-structured interviews with 18 adult education stakeholders in and around one rural and one urban school in the Harare Archdiocese, from October 2020 to January 2021. This comprised 12 school-level stakeholders, including teachers (N = 4), parents (N = 4), school priests (N = 2), and headteachers (N = 2), who were the main focus of this study, and a further 6 high-level education actors. We employed thematic analysis. Adults in this study placed considerable responsibility on children to protect themselves, with often unreasonably high expectations of children's capacity to prevent abuse. At times they also blamed and stigmatised children, which was gendered, and particularly emerged around adolescent sexuality. Our findings suggest that this was linked to social norms around discipline, protection and gender, but in particular, the way these emerged in relation to the challenges of the context. Policy and interventions to promote child protection in schools in Zimbabwe should incorporate both an attention to the challenges teachers face in contexts of adversity, as well as address a tendency for adult school stakeholders to hold children responsible for their own protection.
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Schwab-Reese LM, Cash SJ, Lambert NJ, Lansford JE. "They Aren't Going to Do Jack Shit": Text-Based Crisis Service Users' Perceptions of Seeking Child Maltreatment-Related Support From Formal Systems. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP19066-NP19083. [PMID: 34507498 PMCID: PMC9554280 DOI: 10.1177/08862605211043577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Many of the children reported to child protective services (CPS) exhibit signs and symptoms that allow others to recognize their abuse or neglect and intervene; others, especially adolescents, must disclose their experiences to be identified. Relatively little is known about young people's disclosure experiences, but individual, interpersonal, and cultural factors appear to influence when and how young people disclose. Technology-facilitated approaches, such as text- or chat-based hotlines or crisis services, may be one way to help young people share their maltreatment experiences and seek help. The current study contributes to the small body of literature that includes nonsexual maltreatment disclosures and sheds some light on how to support young people during their disclosures. We conducted a qualitative content analysis of all conversations from a text-based crisis service that resulted in a report to CPS (n = 244). Many of the texters had previously sought support from their peers or parents, and some had engaged with more formal systems. Many young people were hesitant to reach out to formal systems in the future, in part because of negative experiences during past disclosure experiences. Young people may be more likely to seek support through their preferred communication medium, so providing text- and chat-based communication may be one way to encourage and facilitate disclosure. As these resources become increasingly available, determining best practices for receiving disclosures through technology-facilitated platforms will be critical.
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Velloza J, Davies L, Ensminger A, Theofelus FM, Andjamba H, Kamuingona R, Nakuta J, Uiras W, Massetti G, Coomer R, Wolkon A, Forster N, O'Malley G. Disclosure and help-seeking behaviors related to sexual and physical violence in childhood and adolescence: Results from the Namibia Violence Against Children and Youth Survey. CHILD ABUSE & NEGLECT 2022; 128:105624. [PMID: 35381545 PMCID: PMC9119951 DOI: 10.1016/j.chiabu.2022.105624] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND Violence disclosure and help-seeking can mitigate adverse health effects associated with childhood violence, but little is known about facilitators and barriers of disclosure and help-seeking behaviors in sub-Saharan Africa. OBJECTIVE To understand factors associated with disclosure and help-seeking to inform care. PARTICIPANTS AND SETTING Participants aged 13-24 years old in the 2019 Namibia Violence Against Children and Youth Survey (VACS). METHODS We assessed the prevalence of victimization, disclosure, and help-seeking and examined factors associated with violence disclosure and help-seeking, separately, by gender. RESULTS 4211 girls and 980 boys participated in the Namibia VACS. The prevalence of childhood sexual violence differed significantly by gender (15.7% among girls, 9.8% among boys), but physical violence prevalence did not differ by gender. Among victims of sexual violence, 57.3% of girls disclosed and 10.4% sought help, compared with only 30.7% and 3.2% of boys. Among victims of physical violence, 61.1% of girls and 53.4% of boys disclosed, and 16.9% of girls and 17.7% of boys sought help. Older age, social support, and experiencing more types of violence were associated with sexual violence disclosure among boys, but none of these factors were associated with sexual violence disclosure among girls. Lower education, perpetrator type, and witnessing violence were associated with physical violence disclosure among girls, while peer support and perpetrator type were associated with physical violence disclosure among boys. CONCLUSIONS Factors associated with childhood violence differed by gender and violence type in Namibia, highlighting a need for gender-specific violence services to facilitate violence disclosure and help-seeking.
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Affiliation(s)
- Jennifer Velloza
- University of Washington, Department of Global Health, Seattle, WA, USA.
| | - Luke Davies
- University of Washington, Department of Global Health, Seattle, WA, USA; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
| | - Alison Ensminger
- University of Washington, Department of Global Health, Seattle, WA, USA; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
| | | | - Helena Andjamba
- Ministry of Gender Equality, Poverty Eradication and Social Welfare (formerly Ministry of Gender Equality and Child Welfare), Government of Namibia, Windhoek, Namibia
| | - Rahimisa Kamuingona
- Ministry of Gender Equality, Poverty Eradication and Social Welfare (formerly Ministry of Gender Equality and Child Welfare), Government of Namibia, Windhoek, Namibia
| | - Joyce Nakuta
- Ministry of Gender Equality, Poverty Eradication and Social Welfare (formerly Ministry of Gender Equality and Child Welfare), Government of Namibia, Windhoek, Namibia
| | - Wilhencia Uiras
- Ministry of Gender Equality, Poverty Eradication and Social Welfare (formerly Ministry of Gender Equality and Child Welfare), Government of Namibia, Windhoek, Namibia
| | - Greta Massetti
- Centers of Disease Control and Prevention, Division of Violence Prevention, Atlanta, GA, United States of America
| | - Rachel Coomer
- Centers for Disease Control and Prevention, Division of Global HIV & Tuberculosis, Windhoek, Namibia
| | - Adam Wolkon
- Centers for Disease Control and Prevention, Division of Global HIV & Tuberculosis, Windhoek, Namibia
| | - Norbert Forster
- University of Washington, Department of Global Health, Seattle, WA, USA; International Training and Education Center for Health (I-TECH), University of Washington, Windhoek, Namibia
| | - Gabrielle O'Malley
- University of Washington, Department of Global Health, Seattle, WA, USA; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
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Hoosen P, Adams S, Tiliouine H, Savahl S. Youth and Adolescents' Perceptions of Violence in Post-Apartheid South Africa: A Systematic Review of the Literature. CHILD INDICATORS RESEARCH 2022; 15:885-911. [PMID: 35069928 PMCID: PMC8767533 DOI: 10.1007/s12187-021-09890-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 06/14/2023]
Abstract
The history of South Africa is embedded in violence. Exposure to various forms of violence is a consistent experience of children, adolescents, and young people in this context, negatively impacting various aspects of their lives and overall quality of life. However, these experiences of violence have been narrated from an adult-centric perspective. The current study thus aims to systematically review and synthesis existing empirical studies focusing on youth and adolescents' perceptions of violence in post-apartheid South Africa. We identified 34 articles that were included in the final review, with study samples ranging from youth and adolescents between the ages of 8 to 27-years-old. The included studies were delineated into three overarching themes using thematic analysis, namely: exposure to violence; gender and sexual-based violence; and interpersonal and school violence. We found several contributing factors that resulted in violence, such as: low socio-economic conditions, hegemonic masculinity, and male entitlement over women; which can be linked to the corollaries of apartheid. At a grassroots level, more research is needed to gain deeper knowledge about how youth and adolescents understand, conceptualise, and contextualise violence through various frameworks. Moreover, violence prevention and intervention requires a collaborative approach to exact meaningful change that will be beneficial for all stakeholders. Supplementary Information The online version contains supplementary material available at 10.1007/s12187-021-09890-5.
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Affiliation(s)
- Phadiel Hoosen
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Cape Town, South Africa
| | - Sabirah Adams
- Language Development Group, Academic Development Programme, Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
| | - Habib Tiliouine
- Faculty of Social Sciences, University of Oran, Es Senia, Algeria
| | - Shazly Savahl
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Cape Town, South Africa
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Iezadi S, Gholipour K, Khanijahani A, Alizadeh M, Samadirad B, Azizi H, Azizinia F. Development, validation, and pilot implementation of the minimum datasheet for a domestic violence registry system: The case of a developing country. PLoS One 2022; 16:e0261460. [PMID: 34972149 PMCID: PMC8719697 DOI: 10.1371/journal.pone.0261460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background Domestic violence (DV) is a universal issue and an important public health priority. Establishing a DV Registry System (DVRS) can help to systematically integrate data from several sources and provide valid and reliable information on the scope and severity of harms. The main objective of this study was to develop, validate, and pilot-test a minimum datasheet for a DVRS to register DV victims in medical facilities. Materials and methods This study was conducted in two main phases. Phase one includes developing the datasheet for registration of DV in the DVRS. In phase two, the datasheet designed in the previous step was used in a pilot implementation of the DVRS for 12 months to find practical challenges. The preliminary datasheet was first developed using information on similar registry programs and guidelines of the World Health Organization (WHO) and then reviewed by four expert panels. Through a two-round Delphi technique, experts evaluated the instrument using the Content Validity Index (CVI) and Content Validity Ratio (CVR). The consistency of the responses was evaluated by test-retest analysis. Finally, two physicians in two forensic medical clinics registered the victims of physical and/or sexual violence perpetrated by a family member. Results Preliminary datasheet consisted of 31 items. In the first round of Delphi, fifteen items had good content validity (I-CVI and CVR) and were kept, and seven items were moved to the next round. Also, in the first round of Delphi, experts suggested adding three items, including history of the violence, custody of the child, and custody of the elderly. All items evaluated in the second round were kept due to good CVR and CVI scores. As a result of Test-retest correlation coefficients for self-reprted items, two items including perpetrator’s alcohol and drug use status were excluded (r(30) = +.43, and +.38, p< .01, two-tailed, respectively). Finally, 24 items were included in the datasheet including 15 items for individuals’ characteristics (victims’ characteristics and perpetrators’ characteristics), eight items for incidents’ characteristics, and one item for past history of violence experience. A total of 369 cases were registered from September 23, 2019, to July 21, 2020. The majority of the reported cases were female (82%) and were 19–40 years old. No physical and/or sexual violence was reported from rural areas, which calls upon researchers to explore how services for detecting and treating the victims can be made accessible to these areas. Conclusion DVRS can show trends in DV by age, sex, the context of the violence, and incidence characteristics at every point in time. This is particularly valuable in planning and prioritizing research areas and interventions for DV prevention. Additionally, DVRS can be linked to other disease registry programs which can contribute to continuity and coordination of care, and major research in the future. Although a DVRS can be a promising initiative in identifying the areas in need of urgent interventions, there is no guarantee for its proper implementation due to limited resources and other challenges.
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Affiliation(s)
- Shabnam Iezadi
- Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Science, Tehran, Iran
| | - Kamal Gholipour
- Social Determinants of Health Research Center, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Science, Tabriz, Iran
- * E-mail: ,
| | - Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, United States of America
| | - Mahasti Alizadeh
- Social Determinants of Health Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Bahram Samadirad
- Forensic Medicine research center, Iranian Legal Medicine Organization, Tehran, Iran
| | - Hanie Azizi
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Azizinia
- School of medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Bordin IA, Handegård BH, Paula CS. Professional and informal help-seeking among low-income adolescents exposed to violence in the community and at school. CHILD ABUSE & NEGLECT 2022; 123:105382. [PMID: 34763186 DOI: 10.1016/j.chiabu.2021.105382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/20/2021] [Accepted: 10/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adolescents may seek help for many reasons beyond health needs, such as personal stress due to violence exposure. OBJECTIVE To investigate factors associated with receiving professional assistance and informal help due to violence exposure in the community and at school. PARTICIPANTS AND SETTING This study was conducted in Itaboraí, a low-income medium-size city in the State of Rio de Janeiro, Southeast Brazil, characterized by poverty, inequality and violence. It analyses data reported by 669 in-school adolescents (11-15-years, 51.7% girls). METHODS This is a cross-sectional study nested in a longitudinal study (Itaboraí Youth Study). The Itaboraí Youth Study involved a probabilistic community-based sample of 1409 6-to-15-year-olds based on a 3-stage probabilistic sampling plan that included a random selection of census units, eligible households and the target child. RESULTS Professional assistance was mainly received from psychologists (the Brazilian population has free access to health services). Family members were the main source of informal help. Correlates of professional assistance were having clinical emotional problems and not counting on an adult (if needing help) for community violence victims, and absent father for community and school violence victims. Correlates of informal help were female sex, maternal anxiety/depression and absent father for community violence victims, and younger age and higher maternal education for school violence victims. CONCLUSIONS The mental health needs of violence victims, and maternal difficulties to deal with the adolescent distress resulting from violence exposure (maternal increased burden due to father absence and/or having anxiety/depression) are important influences on the help-seeking process.
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Affiliation(s)
- I A Bordin
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, SP, Brazil.
| | - B H Handegård
- University of Tromsø, Faculty of Health Sciences, Tromsø, Troms, Norway
| | - C S Paula
- Universidade Presbiteriana Mackenzie, Programa de Pós-Graduação em Distúrbios do Desenvolvimento, São Paulo, SP, Brazil
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17
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Moreira DS, Fávero M, Oliveira S, Ribeiro FN, Sousa-Gomes V, Moreira D, Magalhães T. First Approach to Abused Children by Health and Educational Professionals. EUROPEAN PSYCHOLOGIST 2021. [DOI: 10.1027/1016-9040/a000412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The present review aims to address child abuse, a phenomenon to which society has become more aware and directed more efforts, and the role that health and education professionals can play in its prevention and intervention. Based on the premise that professionals with a primary role of working with children, who may have the first contact with them after a situation of abuse, are mostly in the fields of health and education, it is important to reflect on their practices in these cases, which have particular relevance in order to avoid potential situations of secondary victimization, contamination of speech, or even withdrawal of revelation. This review examines the preparation of these professionals to address the allegedly abused child and to report abuse if they feel fit to take appropriate action, focuses mainly on the context of Portugal. What the literature shows is that there are still difficulties in making decisions and taking action in situations where abuse is suspected, based on physical or behavioral evidence from the child, or before his/her disclosure. Further studies are needed on the knowledge of the actions to be taken, and on the actions taken before there is a referral to the competent entities by these professionals. Moreover, there is a discussion on the need to develop training as well as brief and structured protocols for action, in this first line of intervention, when facing potential situations of child abuse.
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Affiliation(s)
- Diana Sá Moreira
- Department of Social and Behavioral Sciences, Maia University Institute, Portugal
- Institute of Psychology and Neuropsychology of Porto – IPNP Health, Portugal
| | - Marisalva Fávero
- Department of Social and Behavioral Sciences, Maia University Institute, Portugal
- Unit I & D of the Justice and Governance Research Center of the Law School, University of Minho (JusGov/UM), Portugal
| | - Susana Oliveira
- Department of Social and Behavioral Sciences, Maia University Institute, Portugal
- Institute of Psychology and Neuropsychology of Porto – IPNP Health, Portugal
| | - Filipe Nunes Ribeiro
- Department of Social and Behavioral Sciences, Maia University Institute, Portugal
| | - Valéria Sousa-Gomes
- Department of Social and Behavioral Sciences, Maia University Institute, Portugal
- Institute of Psychology and Neuropsychology of Porto – IPNP Health, Portugal
- Unit I & D of the Justice and Governance Research Center of the Law School, University of Minho (JusGov/UM), Portugal
| | - Diana Moreira
- Institute of Psychology and Neuropsychology of Porto – IPNP Health, Portugal
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Portugal
| | - Teresa Magalhães
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
- IINFACTS, Department of Sciences, University Institute of Health Sciences (CESPU), Gandra, Portugal
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18
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Bhattacharyya A, Lev-Wiesel R, Banerjee M. Roles of Emotional Reactions and Potency in Coping with Abusive Experiences of Indian Adolescent. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:61-72. [PMID: 33708283 PMCID: PMC7900284 DOI: 10.1007/s40653-020-00312-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Victimized children's perceptions of the severity of abusive incidents have been found to be associated with their willingness to disclose. However, the relationship between perceptions, disclosure, and coping processes of abused Indian adolescents, has rarely been studied. To explore the roles of emotional reactions associated with disclosure, and potency on individuals' perception of the severity of abusive incidents, reluctance to disclose, and posttraumatic stress symptoms. A randomly selected sample, consisting of 324 adolescents (aged 12 to 16) in Kolkata, India was included. Of these, 170 adolescents disclosed incidents of abuse last year. Data were analyzed by conditional process modeling. A moderated mediation analysis (n = 170) revealed that the overall perception of the severity of abusive incidents predicted greater reluctance to disclose (B = .63, p < .0001) through heightened emotional reactions, especially with a higher potency level (B = .07, p < .05; B = .1, p < .05). Potency moderated (B = -.02, p = .01) the effect of reluctance on posttraumatic stress symptoms. When tested on the entire sample (324) the results replicated the sub-sample (170). Adolescents revealed similar results irrespective of their exposure. The reluctance to disclose abuse is discussed from an Indian cultural and societal perspective.
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Affiliation(s)
- Atreyee Bhattacharyya
- The Graduate School of Creative Arts Therapies and The Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Rachel Lev-Wiesel
- The Graduate School of Creative Arts Therapies and The Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Mallika Banerjee
- Department of Psychology, University of Calcutta, Kolkata, India
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Fouché A, Fouché DF, Theron LC. Child protection and resilience in the face of COVID-19 in South Africa: A rapid review of C-19 legislation. CHILD ABUSE & NEGLECT 2020; 110:104710. [PMID: 32938531 PMCID: PMC7473143 DOI: 10.1016/j.chiabu.2020.104710] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND & PURPOSE In response to the COVID-19 (C-19) pandemic, the South African government instituted strict lockdown and related legislation. Although this response was well intended, many believed it advanced children's vulnerability to abuse and neglect. This article interrogates these concerns. It investigates how C-19 legislation enabled, or constrained, South African children's protection from abuse and neglect and appraises the findings from a social-ecological resilience perspective with the aim of advancing child protection in times of emergency. METHOD The authors conducted a rapid review of the legislation, directives and regulations pertaining to South Africa's strict lockdown (15 March to 31 May 2020). They searched two databases (SA Government platform and LexisNexus) and identified 140 documents for potential inclusion. Following full-text screening, 17 documents were reviewed. Document analysis was used to extract relevant themes. FINDINGS The regulations and directives that informed South Africa's strict lockdown offered three protective pathways. They (i) limited C-19 contagion and championed physical health; (ii) ensured uninterrupted protection (legal and statutory) for children at risk of abuse; and (iii) advanced social protection measures available to disadvantaged households. CONCLUSION C-19 legislation has potential to advance children's protection from abuse and neglect during emergency times. However, this potential will be curtailed if C-19 legislation is inadequately operationalised and/or prioritises physical health to the detriment of children's intellectual, emotional, social and security needs. To overcome such risks, social ecologies must work with legislators to co-design and co-operationalise C-19 legislation that will not only protect children, but advance their resilience.
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Affiliation(s)
- Ansie Fouché
- School of Psychosocial Health, North-West University, Optentia, Private Bag x1174, Vanderbijlpark, South Africa.
| | - Daniël F Fouché
- School of Legal Sciences, Vaal University of Technology, Vanderbilpark, South Africa.
| | - Linda C Theron
- Department of Educational Psychology, University of Pretoria, South Africa.
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Cluver LD, Rudgard WE, Toska E, Zhou S, Campeau L, Shenderovich Y, Orkin M, Desmond C, Butchart A, Taylor H, Meinck F, Sherr L. Violence prevention accelerators for children and adolescents in South Africa: A path analysis using two pooled cohorts. PLoS Med 2020; 17:e1003383. [PMID: 33166288 PMCID: PMC7652294 DOI: 10.1371/journal.pmed.1003383] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/18/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The INSPIRE framework was developed by 10 global agencies as the first global package for preventing and responding to violence against children. The framework includes seven complementary strategies. Delivering all seven strategies is a challenge in resource-limited contexts. Consequently, governments are requesting additional evidence to inform which 'accelerator' provisions can simultaneously reduce multiple types of violence against children. METHODS AND FINDINGS We pooled data from two prospective South African adolescent cohorts including Young Carers (2010-2012) and Mzantsi Wakho (2014-2017). The combined sample size was 5,034 adolescents. Each cohort measured six self-reported violence outcomes (sexual abuse, transactional sexual exploitation, physical abuse, emotional abuse, community violence victimisation, and youth lawbreaking) and seven self-reported INSPIRE-aligned protective factors (positive parenting, parental monitoring and supervision, food security at home, basic economic security at home, free schooling, free school meals, and abuse response services). Associations between hypothesised protective factors and violence outcomes were estimated jointly in a sex-stratified multivariate path model, controlling for baseline outcomes and socio-demographics and correcting for multiple-hypothesis testing using the Benjamini-Hochberg procedure. We calculated adjusted probability estimates conditional on the presence of no, one, or all protective factors significantly associated with reduced odds of at least three forms of violence in the path model. Adjusted risk differences (ARDs) and adjusted risk ratios (ARRs) with 95% confidence intervals (CIs) were also calculated. The sample mean age was 13.54 years, and 56.62% were female. There was 4% loss to follow-up. Positive parenting, parental monitoring and supervision, and food security at home were each associated with lower odds of three or more violence outcomes (p < 0.05). For girls, the adjusted probability of violence outcomes was estimated to be lower if all three of these factors were present, as compared to none of them: sexual abuse, 5.38% and 1.64% (ARD: -3.74% points, 95% CI -5.31 to -2.16, p < 0.001); transactional sexual exploitation, 10.07% and 4.84% (ARD: -5.23% points, 95% CI -7.26 to -3.20, p < 0.001); physical abuse, 38.58% and 23.85% (ARD: -14.72% points, 95% CI -19.11 to -10.33, p < 0.001); emotional abuse, 25.39% and 12.98% (ARD: -12.41% points, 95% CI -16.00 to -8.83, p < 0.001); community violence victimisation, 36.25% and 28.37% (ARD: -7.87% points, 95% CI -11.98 to -3.76, p < 0.001); and youth lawbreaking, 18.90% and 11.61% (ARD: -7.30% points, 95% CI -10.50 to -4.09, p < 0.001). For boys, the adjusted probability of violence outcomes was also estimated to be lower if all three factors were present, as compared to none of them: sexual abuse, 2.39% to 1.80% (ARD: -0.59% points, 95% CI -2.24 to 1.05, p = 0.482); transactional sexual exploitation, 6.97% to 4.55% (ARD: -2.42% points, 95% CI -4.77 to -0.08, p = 0.043); physical abuse from 37.19% to 25.44% (ARD: -11.74% points, 95% CI -16.91 to -6.58, p < 0.001); emotional abuse from 23.72% to 10.72% (ARD: -13.00% points, 95% CI -17.04 to -8.95, p < 0.001); community violence victimisation from 41.28% to 35.41% (ARD: -5.87% points, 95% CI -10.98 to -0.75, p = 0.025); and youth lawbreaking from 22.44% to 14.98% (ARD -7.46% points, 95% CI -11.57 to -3.35, p < 0.001). Key limitations were risk of residual confounding and not having information on protective factors related to all seven INSPIRE strategies. CONCLUSION In this cohort study, we found that positive and supervisory caregiving and food security at home are associated with reduced risk of multiple forms of violence against children. The presence of all three of these factors may be linked to greater risk reduction as compared to the presence of one or none of these factors. Policies promoting action on positive and supervisory caregiving and food security at home are likely to support further efficiencies in the delivery of INSPIRE.
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Affiliation(s)
- Lucie D. Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - William E. Rudgard
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Elona Toska
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Siyanai Zhou
- Department of Statistics and AIDS and Society Research Unit, University of Cape Town, Cape Town, South Africa
| | | | - Yulia Shenderovich
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Mark Orkin
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Medical Research Council Development Pathways to Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Chris Desmond
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - Alexander Butchart
- Violence Prevention Unit, Social Determinant of Health, Healthier Populations Division, World Health Organization, Switzerland
| | - Howard Taylor
- Global Partnership to End Violence Against Children, New York, New York, United States of America
| | - Franziska Meinck
- OPTENTIA Faculty of Health Sciences, North-West University, South Africa
- School of Social and Political Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Lorraine Sherr
- Health Psychology Unit, Institute of Global Health, University College London, United Kingdom
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Disclosure, reporting and help seeking among child survivors of violence: a cross-country analysis. BMC Public Health 2020; 20:1051. [PMID: 32616007 PMCID: PMC7331131 DOI: 10.1186/s12889-020-09069-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 06/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Violence against children is a pervasive public health issue, with limited data available across multiple contexts. This study explores the rarely studied prevalence and dynamics around disclosure, reporting and help-seeking behaviours of children who ever experienced physical and/or sexual violence. METHODS Using nationally-representative Violence Against Children Surveys in six countries: Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania, we present descriptive statistics for prevalence of four outcomes among children aged 13-17 years: informal disclosure, knowledge of where to seek formal help, formal disclosure/help seeking and receipt of formal help. We ran country-specific multivariate logistic regressions predicting outcomes on factors at the individual, household and community levels. RESULTS The prevalence of help-seeking behaviours ranged from 23 to 54% for informal disclosure, 16 to 28% for knowledge of where to seek formal help, under 1 to 25% for formal disclosure or help seeking, and 1 to 11% for receipt of formal help. Factors consistently correlated with promoting help-seeking behaviours included household number of adult females and absence of biological father, while those correlated with reduced help-seeking behaviours included being male and living in a female-headed household. Primary reasons for not seeking help varied by country, including self-blame, apathy and not needing or wanting services. CONCLUSIONS Across countries examined, help-seeking and receipt of formal services is low for children experiencing physical and/or sexual violence, with few consistent factors identified which facilitated help-seeking. Further understanding of help seeking, alongside improved data quality and availability will aid prevention responses, including the ability to assist child survivors in a timely manner.
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Cash SJ, Murfree L, Schwab-Reese L. "I'm here to listen and want you to know I am a mandated reporter": Understanding how text message-based crisis counselors facilitate child maltreatment disclosures. CHILD ABUSE & NEGLECT 2020; 102:104414. [PMID: 32070934 DOI: 10.1016/j.chiabu.2020.104414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/02/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Emerging research suggests technology-facilitated crisis services are a promising method to support young people during child maltreatment disclosure. Little is known about how employees/volunteers respond to child maltreatment disclosure in these platforms and how they may support young victims through the disclosure process. OBJECTIVES We sought to determine how crisis counselors respond to child maltreatment disclosures using a content analysis of all conversations within a text-based crisis organization that resulted in a mandatory report. METHODS We conducted an iterative team-based content analysis of 244 conversations (24,730 text messages) between a young person and a crisis counselor from an anonymous text-based crisis service. All conversations included in the sample resulted in a mandatory report to child protective services. RESULTS There were two crucial points in maltreatment disclosure conversations. The first occurred immediately after the disclosure. At this point, crisis counselors most often provided sympathy and affirmation. The second crucial point after disclosure was the discussion of mandatory reporting. In many cases, crisis counselors confirmed both parties understood mandatory reporting and encouraged young people to consider the repercussions of their decision to share identifiable information that would permit a mandatory report. CONCLUSION Understanding how crisis counselors responded to young people in one text-based crisis service, particularly characteristics of well-received conversations, may inform the policies and processes for other organizations. Continued exploration of crisis text-based services may improve the disclosure process for young victims.
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Affiliation(s)
- Scottye J Cash
- The Ohio State University, College of Social Work, Columbus, OH, USA
| | - Lauren Murfree
- Purdue University, Department of Health and Kinesiology, West Lafayette, IN, USA
| | - Laura Schwab-Reese
- University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; Purdue University, Department of Public Health, West Lafayette, IN, USA.
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Musiwa AS. Intrafamilial Child Sexual Abuse: A Unique Silent Epidemic. Perspectives of Victim-Friendly Court Professionals in Marondera District, Zimbabwe. JOURNAL OF CHILD SEXUAL ABUSE 2019; 28:860-884. [PMID: 31211664 DOI: 10.1080/10538712.2019.1627689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/02/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
Intrafamilial child sexual abuse is the commonest, though the under-reported, form of child sexual abuse in Marondera District and Zimbabwe generally. However, little is known about what drives it and what practitioners know about it. This study explored the factors associated with the incidence of intrafamilial child sexual abuse in Marondera based on perceptions of Victim-Friendly Court professionals in the district. A semi-structured questionnaire was administered to twenty-five professionals from thirteen agencies implementing the Victim-Friendly Court initiative in Marondera. Relevant court records of intrafamilial child sexual abuse cases were also reviewed. Data were analyzed using thematic analysis, descriptive statistics and document analysis. The study revealed that intrafamilial child sexual abuse in Marondera is associated with very subtle structural factors which put children at risk of abuse, prevent children, families, and communities from reporting, and reduce the accessibility of formal systems of social control. There are 'conflicts' between normative/legal and traditional socio-cultural value systems such that there is no shared understanding of the fundamental issues driving this phenomenon. Policy/practice responses need to take cognizance of these peculiarities. As a basic first step, a comprehensive national prevalence study is required. Further in-depth research of the socio-cultural determinants of intrafamilial child sexual abuse is also recommended.
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Schwab-Reese L, Kanuri N, Cash S. Child Maltreatment Disclosure to a Text Messaging-Based Crisis Service: Content Analysis. JMIR Mhealth Uhealth 2019; 7:e11306. [PMID: 30907745 PMCID: PMC6452289 DOI: 10.2196/11306] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 11/20/2018] [Accepted: 12/09/2018] [Indexed: 11/20/2022] Open
Abstract
Background Disclosure is a difficult but important process for victims of child maltreatment. There is limited research on child maltreatment disclosure. Young people have been reluctant to disclose victimization to adults, but short message service (SMS) crisis services may represent one novel method of engaging young people around sensitive topics. Objective The purpose of this study was to determine characteristics of child maltreatment disclosure to an SMS-based crisis service. Methods We conducted a content analysis of all conversations (N=244) that resulted in a mandatory report by an SMS-based crisis service between October 2015 and July 2017. We coded characteristics of the disclosure process, including the reason for initial contact, phrase used to disclose abuse, perpetrator, type of abuse, and length of victimization. After identifying terms used by young people to disclose child abuse, we randomly selected and analyzed 50 conversations using those terms to determine if use of the terms differed between conversations that did and did not result in mandatory report. Results Parents were the most common perpetrator. Physical abuse was the most common form of abuse discussed in the initial abuse disclosure (106/244, 43.4%), followed by psychological abuse (83/244, 34.0%), sexual abuse (38/244, 15.6%), and neglect (15/244, 6.1%). More than half of the texters discussed abuse or other significant family issues in the first message. An explicit description of the experience or definite language, such as abuse, rape, and molested, was common in disclosures. Conclusions Early disclosure, combined with explicit language, may suggest at least a portion of young victims are actively seeking safe ways to talk about their experiences with abuse, rather than incidentally sharing experiences while seeking support for other issues. SMS text messaging may be a valuable way to engage with young people around sensitive topics, but these approaches will require careful consideration in their development, implementation, and evaluation to ensure a positive experience for young people.
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Affiliation(s)
- Laura Schwab-Reese
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Nitya Kanuri
- Crisis Text Line, New York, NY, United States.,Yale School of Management, Yale University, New Haven, CT, United States
| | - Scottye Cash
- College of Social Work, The Ohio State University, Columbus, OH, United States
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25
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Meinck F, Boyes ME, Cluver L, Ward CL, Schmidt P, DeStone S, Dunne MP. Adaptation and psychometric properties of the ISPCAN Child Abuse Screening Tool for use in trials (ICAST-Trial) among South African adolescents and their primary caregivers. CHILD ABUSE & NEGLECT 2018; 82:45-58. [PMID: 29860107 DOI: 10.1016/j.chiabu.2018.05.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/24/2018] [Accepted: 05/26/2018] [Indexed: 05/14/2023]
Abstract
Child abuse prevention research has been hampered by a lack of validated multi-dimensional non-proprietary instruments, sensitive enough to measure change in abuse victimization or behavior. This study aimed to adapt the ICAST child abuse self-report measure (parent and child) for use in intervention studies and to investigate the psychometric properties of this substantially modified tool in a South African sample. First, cross-cultural and sensitivity adaptation of the original ICAST tools resulted in two preliminary measures (ICAST-Trial adolescents: 27 items, ICAST-Trial caregivers: 19 items). Second, ICAST-Trial data from a cluster randomized trial of a parenting intervention for families with adolescents (N = 1104, 552 caregiver-adolescent dyads) was analyzed. Confirmatory factor analysis established the hypothesized 6-factor (adolescents) and 4-factor (caregivers) structure. Removal of two items for adolescents and five for caregivers resulted in adequate model fit. Concurrent criterion validity analysis confirmed hypothesized relationships between child abuse and adolescent and caregiver mental health, adolescent behavior, discipline techniques and caregiver childhood abuse history. The resulting ICAST-Trial measures have 25 (adolescent) and 14 (caregiver) items respectively and measure physical, emotional and contact sexual abuse, neglect (both versions), and witnessing intimate partner violence and sexual harassment (adolescent version). The study established that both tools are sensitive to measuring change over time in response to a parenting intervention. The ICAST-Trial should have utility for evaluating the effectiveness of child abuse prevention efforts in similar socioeconomic contexts. Further research is needed to replicate these findings and examine cultural appropriateness, barriers for disclosure, and willingness to engage in child abuse research.
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Affiliation(s)
- Franziska Meinck
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford Barnett House, 32 Wellington Square, Oxford, OX1 2ER, United Kingdom; OPTENTIA, Faculty of Health Sciences, North-West University, 1174 Hendrick Van Eck Boulevard, 1900 Vanderbijlpark, South Africa.
| | - Mark E Boyes
- Faculty of Health Sciences, School of Psychology, Curtin University, Perth, Australia.
| | - Lucie Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford Barnett House, 32 Wellington Square, Oxford, OX1 2ER, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Catherine L Ward
- Department of Psychology and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa.
| | - Peter Schmidt
- Institut für Politikwissenschaft, Justus-Liebig-Universität Gießen, Gießen, Germany.
| | - Sachin DeStone
- Warwick Medical School, University of Warwick, Coventry, United Kingdom.
| | - Michael P Dunne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
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Hsiao C, Fry D, Ward CL, Ganz G, Casey T, Zheng X, Fang X. Violence against children in South Africa: the cost of inaction to society and the economy. BMJ Glob Health 2018. [PMID: 29515918 PMCID: PMC5838395 DOI: 10.1136/bmjgh-2017-000573] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Despite the extent and magnitude of violence against children in South Africa, political and financial investments to prevent violence against children remain low. A recent costing study investigating the social burden and economic impact of violence against children in South Africa found notable reductions to mental and physical health outcomes in the population if children were prevented from experiencing violence, neglect and witnessing family violence. The results showed, among others, that drug abuse in the entire population could be reduced by up to 14% if sexual violence against children could be prevented, self-harm could be reduced by 23% in the population if children did not experience physical violence, anxiety could be reduced by 10% if children were not emotionally abused, alcohol abuse could be reduced by 14% in women if they did not experience neglect as children, and lastly, interpersonal violence in the population could be reduced by 16% if children did not witness family violence. The study further estimated that the cost of inaction in 2015 amounted to nearly 5% of the country’s gross domestic product. These findings show that preventing children from experiencing and witnessing violence can help to strengthen the health of a nation by ensuring children reach their full potential and drive the country’s economy and growth. The paper further discusses ways in which preventing and ending violence against children may be prioritised in South Africa through, for instance, intersectoral collaboration and improving routine monitoring data, such as through the sustainable development goals.
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Affiliation(s)
- Celia Hsiao
- Save the Children South Africa, Pretoria, South Africa.,Faculty of Health Sciences, MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Deborah Fry
- Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa.,Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa
| | - Gary Ganz
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Tabitha Casey
- Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - Xiaodong Zheng
- College of Economics and Management, China Agricultural University, Beijing, China
| | - Xiangming Fang
- College of Economics and Management, China Agricultural University, Beijing, China.,School of Public Health, Georgia State University, Atlanta, Georgia
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Wekerle C, Black T. Gendered violence: Advancing evidence-informed research, practice and policy in addressing sex, gender, and child sexual abuse. CHILD ABUSE & NEGLECT 2017; 66:166-170. [PMID: 28364956 DOI: 10.1016/j.chiabu.2017.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Tara Black
- McMaster University, University of Toronto, Canada
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28
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Shiva Kumar AK, Stern V, Subrahmanian R, Sherr L, Burton P, Guerra N, Muggah R, Samms-Vaughan M, Watts C, Mehta SK. Ending violence in childhood: a global imperative. PSYCHOL HEALTH MED 2017; 22:1-16. [DOI: 10.1080/13548506.2017.1287409] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | | | | | - Lorraine Sherr
- Research Department of Infection and Population Health, University College London, London, UK
| | - Patrick Burton
- Centre for Justice and Crime Prevention, Cape Town, South Africa
| | - Nancy Guerra
- Department of Psychology and Social Behavior, University of California at Irvine, Irvine, CA, USA
| | | | - Maureen Samms-Vaughan
- Department of Child and Adolescent Health, University of West Indies, Kingston, Jamaica
| | - Charlotte Watts
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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