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Palermo T, Logan-Greene P, Lima SM, Grooms K, Lillvis D. Systematic Review of the Impacts of US Social Safety Nets on Child Maltreatment. Am J Prev Med 2024:S0749-3797(24)00175-2. [PMID: 38844145 DOI: 10.1016/j.amepre.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION Children living in poverty are at an increased risk for maltreatment. Social safety net (SSN) programs with antipoverty objectives may reduce child maltreatment through pathways such as reduced food insecurity, lessened caregiver stress, and improved caregiving behaviors and ability to meet children's basic needs. The objective of this study is to conduct a systematic review of evidence on the ability of SSN programs to reduce child maltreatment in the United States (US). METHODS This systematic review was conducted using PRISMA protocol. Among studies published between 1996-2022, the initial search returned 1,873 articles, and 27 papers were included in the final analysis. Abstracts were identified primarily on June 24th, 2022, and extraction and synthesis of data was conducted in 2022-2023. RESULTS Of the 27 papers assessed, 16 studies found that SSN programs were protective against child maltreatment. Three of the reviewed studies found no effect of safety net programs, 4 studies presented mixed findings, and 4 studies found adverse impacts in terms of child maltreatment outcomes. When restricting to high-quality studies only, 10 out of 12 found protective impacts and none found adverse impacts on child maltreatment. DISCUSSION SSNs are associated with protective effects against child maltreatment. Expansion of SSN programs would likely have positive benefits beyond poverty-related objectives, including reducing incidence of child maltreatment.
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Affiliation(s)
- Tia Palermo
- Division of Health Services Policy and Practice, Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York.
| | | | - Sarah M Lima
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York
| | - Kaley Grooms
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Denise Lillvis
- Division of Health Services Policy and Practice, Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York
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Rogers K, Le Kirkegaard R, Wamoyi J, Grooms K, Essajee S, Palermo T. Systematic review of cash plus or bundled interventions targeting adolescents in Africa to reduce HIV risk. BMC Public Health 2024; 24:239. [PMID: 38245689 PMCID: PMC10799364 DOI: 10.1186/s12889-023-17565-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/21/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND HIV remains a leading cause of death for adolescents and young people aged 10-24 years. HIV prevention requires multisectoral approaches that target adolescents and young people, addressing HIV risk pathways (e.g., transactional sex, gender-based violence, and school attendance) through bundled interventions that combine economic strengthening, health capabilities, and gender equality education. However, best practices are unknown because evidence on multisectoral programming targeted to adolescents and combining these components has not been systematically reviewed. METHODS We conducted a systematic review to summarize the evidence on bundled interventions combining health and economic strengthening components for adolescents and young people and their effects on HIV/STI incidence and risk factors. We included studies from Africa published between 2005 and 2023, combining at least one economic strengthening and one health component, directed toward adolescents and young people aged 10-24 years. Included studies measured programmatic impacts on primary outcomes: HIV and STI incidence/prevalence; and mediators as secondary outcomes: sexual behaviours, sexual and reproductive health, school attendance, health-seeking behaviours, and violence. We conducted key word searches in PubMed, EMBASE, and Web of Science, imported titles/abstracts from the initial search, and reviewed them using the inclusion criteria. Full texts of selected articles were reviewed and information was extracted for analysis. Findings from the full texts identified were summarized. RESULTS We reviewed 58 studies, including 43 quantitative studies and 15 qualitative studies, evaluating 26 unique interventions. A majority of studies reviewed were conducted in Eastern and Southern Africa. Interventions reviewed showed a greater number of significant results in improving economic outcomes; mental health and psychosocial outcomes; sexual and reproductive health knowledge and services utilization; and HIV prevention knowledge and testing. They showed fewer significant results in improving outcomes related to HIV incidence/prevalence; sexual risk behaviours; gender-based violence; gender attitudes; education; STI incidence, prevalence and testing; and sexual debut. CONCLUSIONS Our review demonstrated the potential for bundled, multisectoral interventions for preventing HIV and facilitating safe transitions to adulthood. Findings have implications for designing HIV sensitive programmes on a larger scale, including how interventions may need to address multiple strata of the social ecological model to achieve success in the prevention of HIV and related pathways.
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Affiliation(s)
- Kate Rogers
- Policy Research Solutions LLC and University at Buffalo, Buffalo, NY, USA.
| | | | - Joyce Wamoyi
- National Institute for Medical Research, Mwanza, Tanzania
| | - Kaley Grooms
- Policy Research Solutions LLC and University at Buffalo, Buffalo, NY, USA
| | | | - Tia Palermo
- Policy Research Solutions LLC and University at Buffalo, Buffalo, NY, USA
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Sahay A, Dervišević E, Perova E. Conditional cash transfers and violence against women - Does the type of violence matter? Soc Sci Med 2023; 333:116136. [PMID: 37567018 DOI: 10.1016/j.socscimed.2023.116136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023]
Abstract
While there is scholarly consensus that cash transfer programs can reduce intimate partner violence (IPV), there is little evidence on the effect on other forms of violence against women (VAW). This study uses a regression discontinuity design to examine the effects of a conditional cash transfer (CCT) program in the Philippines on three types of VAW: (i) IPV, (ii) domestic violence excluding IPV (such as own and husband's relatives), and (iii) violence outside home. Although the study finds no significant impacts on IPV or violence outside of home, it reports a measurable decline in emotional domestic violence. Suggestive evidence indicates that the impact could be driven by an increase in household wellbeing, and women's empowerment, bargaining power, and social capital. This evidence confirms the potential of CCT programs to mitigate VAW beyond IPV, such as domestic violence. At the same time, the study suggests that CCT programs' design and context in which they operate may affect their ability to mitigate IPV.
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Rudgard WE, Obiesie S, Desmond C, Casale M, Cluver L. Assessing the cost-effectiveness of economic strengthening and parenting support for preventing violence against adolescents in Mpumalanga Province, South Africa: An economic modelling study using non-randomised data. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001666. [PMID: 37590179 PMCID: PMC10434898 DOI: 10.1371/journal.pgph.0001666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/06/2023] [Indexed: 08/19/2023]
Abstract
There is limited evidence around the cost-effectiveness of interventions to reduce violence against children in low- and middle-income countries. We used a decision-analytic model to evaluate the cost-effectiveness of three intervention scenarios for reducing adolescent emotional, physical, and sexual abuse in Mpumalanga Province, South Africa. The intervention scenarios were: 1) Community grant outreach to link households to South Africa's Child Support Grant (CSG) if they are eligible, but not receiving it; 2) Group-based parenting support; and 3) Group-based parenting support 'plus' linkage to the CSG. We estimated average cost-effectiveness ratios (ACERs) for intervention scenarios over a ten-year time horizon, and compared them to a South Africa-specific willingness-to-pay (WTP) threshold (USD3390). Health effects were expressed in disability-adjusted life years (DALYs) averted. Our model considered four combinations of routine service versus trial-based costing, and population-average versus high prevalence of violence. Under routine service costing, ACERs for grant outreach and parenting support were below the WTP threshold when considering a population-average prevalence of violence USD2850 (Lower: USD1840-Upper: USD10,500) and USD2620 (USD1520-USD9800) per DALY averted, respectively; and a high prevalence of violence USD1320 (USD908-USD5180) and USD1340 (USD758-USD4910) per DALY averted, respectively. The incremental cost-effectiveness of parenting support plus grant linkage relative to parenting support alone was USD462 (USD346-USD1610) and USD225 (USD150-USD811) per DALY averted at a population-average and high prevalence of violence, respectively. Under trial-based costing, only the ACER for grant outreach was below the WTP threshold when considering a high prevalence of violence USD2580 (USD1640-USD9370) per DALY averted. Confidence intervals for all ACERs crossed the WTP threshold. In conclusion, grant outreach and parenting support are likely to be cost-effective intervention scenarios for reducing violence against adolescents if they apply routine service costing and reach high risk groups. Combining parenting support with grant linkage is likely to be more cost-effective than parenting support alone.
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Affiliation(s)
- William E. Rudgard
- 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
| | - Sopuruchukwu Obiesie
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Chris Desmond
- School of Economics and Finance, University of Witwatersrand, Johannesburg, South Africa
| | - Marisa Casale
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - 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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Miedema SS, Chiang L, Annor FB, Achia T. Cross-time comparison of adverse childhood experience patterns among Kenyan youth: Violence Against Children and Youth Surveys, 2010 and 2019. CHILD ABUSE & NEGLECT 2023; 141:106153. [PMID: 37120969 PMCID: PMC10538442 DOI: 10.1016/j.chiabu.2023.106153] [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] [Received: 08/03/2022] [Revised: 11/01/2022] [Accepted: 03/17/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are a global public health concern. Many children experience multiple ACEs. Patterning of multiple ACEs may change over time. OBJECTIVE To assess latent classes of ACEs among male and female youth in Kenya and evaluate whether ACEs latent classes changed between surveys conducted in 2010 and 2019. PARTICIPANTS AND SETTING We used data from Kenya Violence Against Children and Youth Survey, a repeated nationally representative survey of male and female youth aged 13-24: 2010 (nf = 1227; nm = 1456) and 2019 (nf = 1344; nm = 788). METHODS Latent class analysis was used to estimate clustering of seven ACEs: orphanhood, experiencing physical intimate partner violence, physical violence by a parent/caregiver, physical violence by an adult community member, forced first sex, emotional (EV) and sexual violence (SV), stratified by sex and time. RESULTS For females in 2010, identified classes included (1) SV only, (2) household and community physical violence (PV), EV and SV, (3) household and community PV only, (4) low ACEs, and (5) EV only. In 2019, classes included (1) SV only, (2) household and community PV only, and (3) low ACEs. Among males in 2010, the four-class model included (1) household and community PV with EV, (2) low ACEs, (3) household and community PV with SV, and (4) household and community PV only. In 2019, identified classes included (1) orphanhood and SV, (2) orphanhood and PV, (3) low ACEs, and (4) household and community PV only. For both males and females, across the two survey years, some classes demonstrated continuity (low ACEs and caregiver and community PV for both males and females, and SV for females). Orphanhood emerged as relevant to the ACEs latent class structure in 2019 compared to 2010 among males. CONCLUSION Prevalence and changes in latent classes between 2010 and 2019 can point toward priority areas and subgroups for violence prevention and response in Kenya.
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Affiliation(s)
- Stephanie Spaid Miedema
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, United States.
| | - Laura Chiang
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, United States
| | - Francis B Annor
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, United States
| | - Thomas Achia
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Kenya
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Maara J, Cirillo C, Angeles G, Prencipe L, deMilliano M, Lima SM, Palermo T. Impacts of cash transfer and "cash plus" programs on self- perceived stress in Africa: Evidence from Ghana, Malawi, and Tanzania. SSM Popul Health 2023; 22:101403. [PMID: 37168249 PMCID: PMC10165453 DOI: 10.1016/j.ssmph.2023.101403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/26/2023] [Accepted: 04/11/2023] [Indexed: 05/13/2023] Open
Abstract
Poverty and poor mental health are closely linked. Cash transfers have significantly expanded globally. Given their objectives around poverty reduction and improving food security, a major chronic stressor in Africa, cash transfers may affect mental health outcomes. We examine impacts of three large-scale government cash transfer or cash plus programs in Ghana, Malawi, and Tanzania on self-perceived stress using an innovative, newly adapted measure for rural African settings. Linear regression models were used to estimate treatment impacts. We find that cash transfers reduced self-perceived stress in Malawi, but programs in Ghana and Tanzania had no impacts on self-perceived stress. These mixed findings, combined with recent reviews on cash transfers and mental health, suggest that cash transfers may play a role in improving mental health. However, cash alone may not be sufficient to overcome many challenges related to poverty, and complementary programming may also be needed to improve mental health.
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Affiliation(s)
- John Maara
- Department of Economics, University of Nairobi, Kenya
| | | | - Gustavo Angeles
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, USA
| | - Leah Prencipe
- Department of Public Health, Erasmus MC, University Medical Centre, the Netherlands
| | | | - Sarah M. Lima
- Department of Epidemiology and Environmental Health, University at Buffalo, USA
| | - Tia Palermo
- Division of Health Services Policy and Practice, Department of Epidemiology and Environmental Health, University at Buffalo, USA
- Corresponding author.
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Mnyanga M, Chirwa GC, Munthali S. Impact of Safety Nets on Household Coping Mechanisms for COVID-19 Pandemic in Malawi. Front Public Health 2022; 9:806738. [PMID: 35198534 PMCID: PMC8858801 DOI: 10.3389/fpubh.2021.806738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundCovid-19 pandemic induced various shocks to households in Malawi, many of which were failing to cope. Household coping mechanisms to shocks have an implication on household poverty status and that of a nation as a whole. In order to assist households to respond to the pandemic-induced shocks positively, the government of Malawi, with support from non-governmental organizations introduced Covid-19 Urban Cash Intervention (CUCI) and other safety nets to complement the existing social protection programs in cushioning the impact of the shocks during the pandemic. With these programmes in place, there is a need for evidence regarding how the safety nets are affecting coping. Therefore, this paper investigated the impact that safety nets during Covid-19 pandemic had on the following household coping mechanisms: engaging in additional income-generating activities, receiving assistance from friends and family; reducing food consumption; relying on savings; and failure to cope.MethodsThe study used a nationally representative panel data from the Malawi High Frequency Phone Survey on Covid-19 (HFPS Covid-19) and complemented it with the fifth Integrated Household Panel Survey (IHPS), also known as living standards measurement survey. Five Random Effects Probit Models were estimated, one for each coping mechanism.ResultsFindings from this study indicated that beneficiaries of safety net programs were more likely to rely on remittances from friends and family than the people who had no safety nets. Furthermore, the safety net recipients were less likely to reduce food consumption or rely on savings than the non-recipients. Despite the interesting findings, we also noticed that safety nets had no significant impact on household engagement in other income-generating activities in response to shocks.ConclusionThe results imply that safety nets in Malawi during the Covid-19 pandemic had a positive impact on consumption and prevented the dissolving of savings. Therefore, these programs have to be scaled up, and the volumes be revised upwards.
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Blofield M, Knaul FM, Calderón-Anyosa R, Peterman A, Franzoni JM, O'Donnell M, Bustreo F. A diagonal and social protection plus approach to meet the challenges of the COVID-19 syndemic: cash transfers and intimate partner violence interventions in Latin America. Lancet Glob Health 2022; 10:e148-e153. [PMID: 34838201 PMCID: PMC8670753 DOI: 10.1016/s2214-109x(21)00444-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/07/2021] [Accepted: 09/15/2021] [Indexed: 01/07/2023]
Abstract
Latin America has been particularly hard hit by the COVID-19 syndemic, including the associated economic fallout that has threatened the livelihoods of most families. Social protection platforms and policies should have a crucial role in safeguarding individual and family wellbeing; however, the response has been insufficient to address the scale of the crisis. In this Viewpoint, we focus on two policy challenges of the COVID-19 syndemic: rapidly and effectively providing financial support to the many families that lost livelihoods, and responding to and mitigating the increased risk of intimate partner violence (IPV). We argue that building programmatic linkages between social protection platforms, particularly cash transfers, and IPV prevention, mitigation, and response services, creates synergies that can promote freedom from both poverty and violence.
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Affiliation(s)
| | - Felicia M Knaul
- University of Miami Institute for Advanced Study of the Americas, Miami, FL, USA,Correspondence to: Prof Felicia M Knaul, University of Miami Institute for Advanced Study of the Americas, Miami, FL 33124, USA
| | | | - Amber Peterman
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Palermo T, Prencipe L, Kajula L. Effects of Government-Implemented Cash Plus Model on Violence Experiences and Perpetration Among Adolescents in Tanzania, 2018‒2019. Am J Public Health 2021; 111:2227-2238. [PMID: 34878869 PMCID: PMC8667840 DOI: 10.2105/ajph.2021.306509] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/04/2022]
Abstract
Objectives. To examine the impacts of a government-implemented cash plus program on violence experiences and perpetration among Tanzanian adolescents. Methods. We used data from a cluster randomized controlled trial (n = 130 communities) conducted in the Mbeya and Iringa regions of Tanzania to isolate impacts of the "plus" components of the cash plus intervention. The panel sample comprised 904 adolescents aged 14 to 19 years living in households receiving a government cash transfer. We estimated intent-to-treat impacts on violence experiences, violence perpetration, and pathways of impact. Results. The plus intervention reduced female participants' experiences of sexual violence by 5 percentage points and male participants' perpetration of physical violence by 6 percentage points. There were no intervention impacts on emotional violence, physical violence, or help seeking. Examining pathways, we found positive impacts on self-esteem and participation in livestock tending and, among female participants, a positive impact on sexual debut delays and a negative effect on school attendance. Conclusions. By addressing poverty and multidimensional vulnerability, integrated social protection can reduce violence. Public Health Implications. There is high potential for scale-up and sustainability, and this program reaches some of the most vulnerable and marginalized adolescents. (Am J Public Health. 2021;111(12):2227-2238. https://doi.org/10.2105/AJPH.2021.306509).
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Affiliation(s)
- Tia Palermo
- Tia Palermo is with the the Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York. Leah Prencipe is a PhD candidate and is with the Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands, and the Social and Economic Policy Unit, United Nations Children's Fund (UNICEF) Office of Research‒Innocenti, Florence, Italy. Lusajo Kajula is with the Social and Economic Policy Unit, UNICEF Office of Research‒Innocenti
| | - Leah Prencipe
- Tia Palermo is with the the Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York. Leah Prencipe is a PhD candidate and is with the Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands, and the Social and Economic Policy Unit, United Nations Children's Fund (UNICEF) Office of Research‒Innocenti, Florence, Italy. Lusajo Kajula is with the Social and Economic Policy Unit, UNICEF Office of Research‒Innocenti
| | - Lusajo Kajula
- Tia Palermo is with the the Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York. Leah Prencipe is a PhD candidate and is with the Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands, and the Social and Economic Policy Unit, United Nations Children's Fund (UNICEF) Office of Research‒Innocenti, Florence, Italy. Lusajo Kajula is with the Social and Economic Policy Unit, UNICEF Office of Research‒Innocenti
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Falconer NS, Casale M, Kuo C, Nyberg BJ, Hillis SD, Cluver LD. Factors That Protect Children From Community Violence: Applying the INSPIRE Model to a Sample of South African Children. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:11602-11629. [PMID: 31948335 DOI: 10.1177/0886260519898425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Community violence is a prevalent form of interpersonal violence in South Africa for children living in low-income areas. Trauma arising from violence exposure is of concern in contexts where access to treatment is often unattainable. As simultaneous multisectoral strategies show higher potential to counter interpersonal violence than single interventions, the World Health Organization with partners created INSPIRE. INSPIRE takes an integrated approach coordinated across formal and informal settings of civil and private society. Responding to research paucity on methods that counter community violence in LMIC settings, this study employed a cross-sectional correlational design consisting of a sample of 2,477 children aged 10 to 17 years from the Young Carers 2009-2010 study conducted in a low-income, HIV-endemic province of South Africa highly affected by community violence. Multiple logistic regressions assessed individual and dose associations between four INSPIRE-based violence prevention strategies-positive parenting, basic necessities, formal social support, and school structural support-and direct and indirect community violence outcomes. Three strategies had significant associations with community violence outcomes: necessities (direct p < .001; adjusted odds ratio [AOR] = .57; indirect p < .01; AOR = .62), formal support (direct p < .05; AOR = .83; indirect p < .05; AOR = .73), and school support (direct p < .001; AOR = .53; indirect p < .001; AOR = .49). Combined interventions in direct and indirect community violence analyses demonstrated that children reporting a higher number of strategies were less likely to have experienced community violence. This outcome extends the results of longitudinal studies in South Africa highlighting social protection with care as a means to overcome structural deprivation strains, thereby reducing the likelihood of children's exposure to community violence. Moreover, these findings uphold the INSPIRE model as an effective cross-sectoral approach to prevent and reduce the community violence that children experience.
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Affiliation(s)
- N Suzanne Falconer
- GlobalFingerprints, Minneapolis, MN, USA
- Two Sparrows Consulting, Rockford, IL, USA
| | - Marisa Casale
- University of the Western Cape, Bellville, South Africa
- University of Oxford, UK
| | - Caroline Kuo
- Brown University School of Public Health, Providence, RI, USA
- University of Cape Town, South Africa
| | - Beverly J Nyberg
- Clemson University, SC, USA
- Common Root Consulting, Washington, DC, USA
| | - Susan D Hillis
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Meinck F, Orkin M, Cluver L. Accelerating Sustainable Development Goals for South African adolescents from high HIV prevalence areas: a longitudinal path analysis. BMC Med 2021; 19:263. [PMID: 34758838 PMCID: PMC8580740 DOI: 10.1186/s12916-021-02137-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents experience a multitude of vulnerabilities which need to be addressed in order to achieve the Sustainable Development Goals (SDGs). In sub-Saharan Africa, adolescents experience high burden of HIV, violence exposure, poverty, and poor mental and physical health. This study aimed to identify interventions and circumstances associated with three or more targets ("accelerators") within multiple SDGs relating to HIV-affected adolescents and examine cumulative effects on outcomes. METHODS Prospective longitudinal data from 3401 adolescents from randomly selected census enumeration areas in two provinces with > 30% HIV prevalence carried out in 2010/11 and 2011/12 were used to examine six hypothesized accelerators (positive parenting, parental monitoring, free schooling, teacher support, food sufficiency and HIV-negative/asymptomatic caregiver) targeting twelve outcomes across four SDGs, using a multivariate (multiple outcome) path model with correlated outcomes controlling for outcome at baseline and socio-demographics. The study corrected for multiple-hypothesis testing and tested measurement invariance across sex. Percentage predicted probabilities of occurrence of the outcome in the presence of the significant accelerators were also calculated. RESULTS Sample mean age was 13.7 years at baseline, 56.6% were female. Positive parenting, parental monitoring, food sufficiency and AIDS-free caregiver were variously associated with reductions on ten outcomes. The model was gender invariant. AIDS-free caregiver was associated with the largest reductions. Combinations of accelerators resulted in a percentage reduction of risk of up to 40%. CONCLUSION Positive parenting, parental monitoring, food sufficiency and AIDS-free caregivers by themselves and in combination improve adolescent outcomes across ten SDG targets. These could translate to the corresponding real-world interventions parenting programmes, cash transfers and universal access to antiretroviral treatment, which when provided together, may help governments in sub-Saharan Africa more economically to reach their SDG targets.
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Affiliation(s)
- Franziska Meinck
- School of Social and Political Sciences, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD UK
- OPTENTIA, Faculty of Humanities, North-West University, Vanderbijlpark, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Mark Orkin
- MRC-Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Lucie Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Bhatia A, Fabbri C, Cerna-Turoff I, Turner E, Lokot M, Warria A, Tuladhar S, Tanton C, Knight L, Lees S, Cislaghi B, Bhabha J, Peterman A, Guedes A, Devries K. Violence against children during the COVID-19 pandemic. Bull World Health Organ 2021; 99:730-738. [PMID: 34621091 PMCID: PMC8477433 DOI: 10.2471/blt.20.283051] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 01/24/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected children's risk of violence in their homes, communities and online, and has compromised the ability of child protection systems to promptly detect and respond to cases of violence. However, the need to strengthen violence prevention and response services has received insufficient attention in national and global pandemic response and mitigation strategies. In this paper, we summarize the growing body of evidence on the links between the pandemic and violence against children. Drawing on the World Health Organization's INSPIRE framework to end violence against children, we illustrate how the pandemic is affecting prevention and response efforts. For each of the seven INSPIRE strategies we identify how responses to the pandemic have changed children's risk of violence. We offer ideas for how governments, policy-makers, and international and civil society organizations can address violence in the context of a protracted COVID-19 crisis. We conclude by highlighting how the current pandemic offers opportunities to improve existing child protection systems to address violence against children. We suggest enhanced multisectoral coordination across the health, education, law enforcement, housing, child and social protection sectors. Actions need to prioritize the primary prevention of violence and promote the central role of children and adolescents in decision-making and programme design processes. Finally, we stress the continued need for better data and evidence to inform violence prevention and response strategies that can be effective during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Amiya Bhatia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Camilla Fabbri
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Ilan Cerna-Turoff
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Ellen Turner
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Michelle Lokot
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Ajwang Warria
- Department of Social Work, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Clare Tanton
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Louise Knight
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Shelley Lees
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Beniamino Cislaghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
| | - Jaqueline Bhabha
- Harvard T.H. Chan School of Public Health, FXB Center for Health and Human Rights, Cambridge, United States of America (USA)
| | - Amber Peterman
- Department of Public Policy, University of North Carolina, Chapel Hill, USA
| | | | - Karen Devries
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, England
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Theron L, van Breda A. Multisystemic enablers of sub-Saharan child and youth resilience to maltreatment. CHILD ABUSE & NEGLECT 2021; 119:105083. [PMID: 33931239 DOI: 10.1016/j.chiabu.2021.105083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/04/2021] [Accepted: 04/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The resilience of sub-Saharan children and youth to abuse and neglect is under-researched. In particular, the multisystemic and contextually sensitive nature of their resilience is under-appreciated. PURPOSE In response we conceptualized a discussion paper. Its intention is to make a case for a contextually relevant, multisystemic understanding of the resilience of sub-Saharan children and youth with exposure to maltreatment. METHOD This discussion paper draws on a critical analysis of pertinent peer-reviewed publications. It also draws on our lifelong residence in sub-Saharan Africa and related insight into this region's situational and cultural dynamics. RESULTS We advance three assertions regarding the multisystemic nature of sub-Saharan young people's resilience to abuse and neglect : (i) family↔communities are pivotal to sub-Saharan child and youth resilience to maltreatment; (ii) institutional supports matter too, particularly when multiple systems interact to provide networks of institutional support; and (iii) the resilience-enabling potential of built and natural environments is yet to be fully harnessed. CONCLUSION Interacting social and ecological system factors and processes matter for the resilience of sub-Saharan children and youth who experience abuse and neglect. Appreciation for their complexity and contextual fit are crucial to practice and policy efforts to advance the protection and wellbeing of sub-Saharan young people.
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Affiliation(s)
- Linda Theron
- Department of Educational Psychology, University of Pretoria, South Africa.
| | - Adrian van Breda
- University of Johannesburg, Department of Social Work, PO Box 524, Auckland Park, 2006, South Africa
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Kovler ML, Ziegfeld S, Ryan LM, Goldstein MA, Gardner R, Garcia AV, Nasr IW. Increased proportion of physical child abuse injuries at a level I pediatric trauma center during the Covid-19 pandemic. CHILD ABUSE & NEGLECT 2021; 116:104756. [PMID: 33004213 PMCID: PMC7518108 DOI: 10.1016/j.chiabu.2020.104756] [Citation(s) in RCA: 107] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND AND OBJECTIVES The Covid-19 pandemic has forced mass closures of childcare facilities and schools. While these measures are necessary to slow virus transmission, little is known regarding the secondary health consequences of social distancing. The purpose of this study is to assess the proportion of injuries secondary to physical child abuse (PCA) at a level I pediatric trauma center during the Covid-19 pandemic. METHODS A retrospective review of patients at our center was conducted to identify injuries caused by PCA in the month following the statewide closure of childcare facilities in Maryland. The proportion of PCA patients treated during the Covid-19 era were compared to the corresponding period in the preceding two years by Fisher's exact test. Demographics, injury profiles, and outcomes were described for each period. RESULTS Eight patients with PCA injuries were treated during the Covid-19 period (13 % of total trauma patients), compared to four in 2019 (4 %, p < 0.05) and three in 2018 (3 %, p < 0.05). The median age of patients in the Covid-19 period was 11.5 months (IQR 6.8-24.5). Most patients were black (75 %) with public health insurance (75 %). All injuries were caused by blunt trauma, resulting in scalp/face contusions (63 %), skull fractures (50 %), intracranial hemorrhage (38 %), and long bone fractures (25 %). CONCLUSIONS There was an increase in the proportion of traumatic injuries caused by physical child abuse at our center during the Covid-19 pandemic. Strategies to mitigate this secondary effect of social distancing should be thoughtfully implemented.
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Affiliation(s)
- Mark L Kovler
- Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | - Susan Ziegfeld
- Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Leticia M Ryan
- Division of Pediatric Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Mitchell A Goldstein
- Division of Pediatric Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rebecca Gardner
- Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Alejandro V Garcia
- Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Isam W Nasr
- Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Saran A, White H, Albright K, Adona J. Mega-map of systematic reviews and evidence and gap maps on the interventions to improve child well-being in low- and middle-income countries. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1116. [PMID: 37018457 PMCID: PMC8356294 DOI: 10.1002/cl2.1116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Despite a considerable reduction in child mortality, nearly six million children under the age of five die each year. Millions more are poorly nourished and in many parts of the world, the quality of education remains poor. Children are at risk from multiple violations of their rights, including child labour, early marriage, and sexual exploitation. Research plays a crucial role in helping to close the remaining gaps in child well-being, yet the global evidence base for interventions to meet these challenges is mostly weak, scattered and often unusable by policymakers and practitioners. This mega-map encourages the generation and use of rigorous evidence on effective ways to improve child well-being for policy and programming. OBJECTIVES The aim of this mega-map is to identify, map and provide an overview of the existing evidence synthesis on the interventions aimed at improving child well-being in low- and middle-income countries (LMICs). METHODS Campbell evidence and gap maps (EGMs) are based on a review of existing mapping standards (Saran & White, 2018) which drew in particular of the approach developed by 3ie (Snilstveit, Vojtkova, Bhavsar, & Gaarder, 2013). As defined in the Campbell EGM guidance paper; "Mega-map is a map of evidence synthesis, that is, systematic reviews, and does not include primary studies" (Campbell Collaboration, 2020). The mega-map on child well-being includes studies with participants aged 0-18 years, conducted in LMICs, and published from year 2000 onwards. The search followed strict inclusion criteria for interventions and outcomes in the domains of health, education, social work and welfare, social protection, environmental health, water supply and sanitation (WASH) and governance. Critical appraisal of included systematic reviews was conducted using "A Measurement Tool to Assess Systematic Reviews"-AMSTAR-2 rating scale (Shea, et al., 2017). RESULTS We identified 333 systematic reviews and 23 EGMs. The number of studies being published has increased year-on-year since 2000. However, the distribution of studies across World Bank regions, intervention and outcome categories are uneven. Most systematic reviews examine interventions pertaining to traditional areas of health and education. Systematic reviews in these traditional areas are also the most funded. There is limited evidence in social work and social protection. About 69% (231) of the reviews are assessed to be of low and medium quality. There are evidence gaps with respect to key vulnerable populations, including children with disabilities and those who belong to minority groups. CONCLUSION Although an increasing number of systematic reviews addressing child well-being topics are being published, some clear gaps in the evidence remain in terms of quality of reviews and some interventions and outcome areas. The clear gap is the small number of reviews focusing explicitly on either equity or programmes for disadvantaged groups and those who are discriminated against.
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Affiliation(s)
| | | | | | - Jill Adona
- Philippines Institute of Development StudiesManilaPhilippines
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16
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Pundir P, Saran A, White H, Subrahmanian R, Adona J. Interventions for reducing violence against children in low- and middle-income countries: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1120. [PMID: 37016609 PMCID: PMC8356324 DOI: 10.1002/cl2.1120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND More than half of the children in the world experience some form of interpersonal violence every year. As compared with high-income countries, policy responses in low- and middle-income countries (LMICs) are limited due to resource constraints and paucity of evidence for effective interventions to reduce violence against children in their own contexts, amongst other factors. OBJECTIVES The aim of this evidence and gap map (EGM) is to provide an overview of the existing evidence available and to identify gaps in the evidence base on the effectiveness of interventions to reduce violence against children in LMICs. This report covers evidence published in English; a follow-up study is under preparation focusing on evidence in five additional languages-Arabic, Chinese, French, Portuguese and Spanish. METHODS The intervention-outcome framework for this EGM is based on INSPIRE-Seven Strategies for Ending Violence against Children, published by WHO and other partners in 2016. The seven strategies include implementation and enforcement of laws; norms and values, safe environment; parent-child and caregiver support; income and economic strengthening; response and support services; education and life skills. The search included both academic and grey literature available online. We included impact evaluations and systematic reviews that assessed the effectiveness of interventions to reduce interpersonal violence against children (0-18 years) in LMICs (World Bank, 2018b). Interventions targeting subpopulation of parents, teachers and caregivers of 0-18 years' age group were also included. A critical appraisal of all included studies was carried out using standardised tools. RESULTS The map includes 152 studies published in English of which 55 are systematic reviews and 97 are impact evaluations. Most studies in the map are from Sub-Saharan Africa. Education and life skills are the most widely populated intervention area of the map followed by income and economic strengthening interventions. Very few studies measure impact on economic and social outcomes, and few conduct cost-analysis. CONCLUSION More studies focusing on low-income and fragile and conflict-affected settings (FCS) and studying and reporting on cost-analysis are required to address gaps in the evidence. Most interventions covered in the literature focused on addressing a wide range of forms of violence and harm, which limited understanding of how and for whom the interventions work in a given context, for specific forms of violence. More impact evaluation studies are required that assess specific forms of violence, gendered effects of interventions and on diverse social groups in a given context, utilising mixed methods.
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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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Chakrabarti A, Handa S, Angeles G, Seidenfeld D. A Cash Plus Program Reduces Youth Exposure to Physical Violence in Zimbabwe. WORLD DEVELOPMENT 2020; 134:105037. [PMID: 33633431 PMCID: PMC7904110 DOI: 10.1016/j.worlddev.2020.105037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Violence against children and adolescents, a highly prevalent problem, is a clear violation of child rights and has detrimental effects on later life outcomes. Programs that alleviate poverty address a structural determinant of child vulnerability and can thereby reduce child abuse. This paper investigates whether the Government of Zimbabwe's Harmonized Social Cash Transfer (HSCT) Program, which combines cash transfers with complementary services, affects youth exposure to physical violence. The analysis uses data from a non-experimental impact evaluation and a difference-in-differences approach. Results show a 19-percentage point decline in the incidence of physical violence among youth four years into the program. HSCT-induced enhancements in beneficiary households' purchasing capacity and food security, improvements in caregiver subjective well-being, and reductions in youth participation in economic work for pay could be mediating the program's effects on youth abuse. This paper adds to the relatively scarce evidence on the impacts of anti-poverty policies on young people's susceptibility to physical violence in developing countries.
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Affiliation(s)
- Averi Chakrabarti
- Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, 90 Smith Street, Boston, MA 02120
| | - Sudhanshu Handa
- Department of Public Policy, University of North Carolina at Chapel Hill (UNC-CH)
| | - Gustavo Angeles
- Department of Maternal & Child Health, Gillings School of Global Public Health, UNC-CH
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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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Vineis P, Avendano-Pabon M, Barros H, Bartley M, Carmeli C, Carra L, Chadeau-Hyam M, Costa G, Delpierre C, D'Errico A, Fraga S, Giles G, Goldberg M, Kelly-Irving M, Kivimaki M, Lepage B, Lang T, Layte R, MacGuire F, Mackenbach JP, Marmot M, McCrory C, Milne RL, Muennig P, Nusselder W, Petrovic D, Polidoro S, Ricceri F, Robinson O, Stringhini S, Zins M. Special Report: The Biology of Inequalities in Health: The Lifepath Consortium. Front Public Health 2020; 8:118. [PMID: 32478023 PMCID: PMC7235337 DOI: 10.3389/fpubh.2020.00118] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/24/2020] [Indexed: 12/16/2022] Open
Abstract
Funded by the European Commission Horizon 2020 programme, the Lifepath research consortium aimed to investigate the effects of socioeconomic inequalities on the biology of healthy aging. The main research questions included the impact of inequalities on health, the role of behavioral and other risk factors, the underlying biological mechanisms, the efficacy of selected policies, and the general implications of our findings for theories and policies. The project adopted a life-course and comparative approach, considering lifetime effects from childhood and adulthood, and pooled data on up to 1.7 million participants of longitudinal cohort studies from Europe, USA, and Australia. These data showed that socioeconomic circumstances predicted mortality and functional decline as strongly as established risk factors currently targeted by global prevention programmes. Analyses also looked at socioeconomically patterned biological markers, allostatic load, and DNA methylation using richly phenotyped cohorts, unraveling their association with aging processes across the life-course. Lifepath studies suggest that socioeconomic circumstances are embedded in our biology from the outset-i.e., disadvantage influences biological systems from molecules to organs. Our findings have important implications for policy, suggesting that (a) intervening on unfavorable socioeconomic conditions is complementary and as important as targeting well-known risk factors, such as tobacco and alcohol consumption, low fruit and vegetable intake, obesity and a sedentary lifestyle, and that (b) effects of preventive interventions in early life integrate interventions in adulthood. The report has an executive summary that refers to the different sections of the main paper.
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Affiliation(s)
- Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Mauricio Avendano-Pabon
- Department of Social Sciences, Health and Medicine, King's College London, London, United Kingdom
| | - Henrique Barros
- EPIUnit – Institute of Public Health University of Porto, Porto, Portugal
| | - Mel Bartley
- Department of Epidemiology & Public Health, University College London, London, United Kingdom
| | - Cristian Carmeli
- Center for Primary Care and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland
| | | | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Giuseppe Costa
- Department of Clinical Science & Biology, Turin University Medical School, Turin, Italy
| | - Cyrille Delpierre
- UMR LEASP, Université de Toulouse III, UPS, Inserm, Toulouse, France
| | | | - Silvia Fraga
- EPIUnit – Institute of Public Health University of Porto, Porto, Portugal
| | - Graham Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Marcel Goldberg
- UMS 011 Inserm - UVSQ ≪ Cohortes épidémiologiques en population ≫, Villejuif, France
| | | | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Benoit Lepage
- UMR LEASP, Université de Toulouse III, UPS, Inserm, Toulouse, France
| | - Thierry Lang
- UMR LEASP, Université de Toulouse III, UPS, Inserm, Toulouse, France
| | - Richard Layte
- Department of Sociology, School of Social Sciences and Philosophy, Trinity College Dublin, Dublin, Ireland
| | - Frances MacGuire
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Johan P. Mackenbach
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Cathal McCrory
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Peter Muennig
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Wilma Nusselder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Dusan Petrovic
- Center for Primary Care and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland
| | - Silvia Polidoro
- Molecular Epidemiology and Exposomics Unit, Italian Institute for Genomic Medicine, Turin, Italy
| | - Fulvio Ricceri
- Department of Clinical Science & Biology, Turin University Medical School, Turin, Italy
- Department of Epidemiology, ASL TO3, Turin, Italy
| | - Oliver Robinson
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
| | - Marie Zins
- UMS 011 Inserm - UVSQ ≪ Cohortes épidémiologiques en population ≫, Villejuif, France
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Ninsiima AB, Michielsen K, Kemigisha E, Nyakato VN, Leye E, Coene G. Poverty, gender and reproductive justice. A qualitative study among adolescent girls in Western Uganda. CULTURE, HEALTH & SEXUALITY 2020; 22:65-79. [PMID: 32045321 DOI: 10.1080/13691058.2019.1660406] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 08/22/2019] [Indexed: 06/10/2023]
Abstract
Low socio-economic status has been consistently identified as a primary risk factor for sexual and reproductive health violations affecting young women. This study shows how poverty interacts with gender power relations to impact upon adolescent girls' sexual and reproductive lives in Western Uganda. Qualitative research with 147 participants was undertaken. This comprised 59 in-depth interviews and 11 focus group discussions with groups of 12-14 year-old young women, teachers and parents. Data were analysed manually using open and axial coding, and conclusions were generated inductively. Findings reveal that young women are restricted in exercising their sexual and reproductive rights not only by poverty and unequal gender relations, but also by corruption and poor service provision. In contrast to interventions using liberal rights-based approaches, we advocate the use of a 'marketplace of options' since access to sexual and reproductive health services is very limited for poor girls and not evenly distributed. Moreover, while poverty and unequal gender relations render girls vulnerable to sexual coercion and violence, the criminal justice system is often weak, leaving victims powerless. Investment in appropriate resources and inclusive and affordable access to justice is essential to advance young women's sexual and reproductive health.
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Affiliation(s)
- Anna B Ninsiima
- Research Centre on Gender, Diversity and Intersectionality, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Kristien Michielsen
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Elizabeth Kemigisha
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Viola N Nyakato
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Els Leye
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Gily Coene
- Research Centre on Gender, Diversity and Intersectionality, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Vineis P, Avendano-Pabon M, Barros H, Bartley M, Carmeli C, Carra L, Chadeau-Hyam M, Costa G, Delpierre C, D'Errico A, Fraga S, Giles G, Goldberg M, Kelly-Irving M, Kivimaki M, Lepage B, Lang T, Layte R, MacGuire F, Mackenbach JP, Marmot M, McCrory C, Milne RL, Muennig P, Nusselder W, Petrovic D, Polidoro S, Ricceri F, Robinson O, Stringhini S, Zins M. Special Report: The Biology of Inequalities in Health: The Lifepath Consortium. Front Public Health 2020. [PMID: 32478023 DOI: 10.3389/fpubh.2020.00118/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Funded by the European Commission Horizon 2020 programme, the Lifepath research consortium aimed to investigate the effects of socioeconomic inequalities on the biology of healthy aging. The main research questions included the impact of inequalities on health, the role of behavioral and other risk factors, the underlying biological mechanisms, the efficacy of selected policies, and the general implications of our findings for theories and policies. The project adopted a life-course and comparative approach, considering lifetime effects from childhood and adulthood, and pooled data on up to 1.7 million participants of longitudinal cohort studies from Europe, USA, and Australia. These data showed that socioeconomic circumstances predicted mortality and functional decline as strongly as established risk factors currently targeted by global prevention programmes. Analyses also looked at socioeconomically patterned biological markers, allostatic load, and DNA methylation using richly phenotyped cohorts, unraveling their association with aging processes across the life-course. Lifepath studies suggest that socioeconomic circumstances are embedded in our biology from the outset-i.e., disadvantage influences biological systems from molecules to organs. Our findings have important implications for policy, suggesting that (a) intervening on unfavorable socioeconomic conditions is complementary and as important as targeting well-known risk factors, such as tobacco and alcohol consumption, low fruit and vegetable intake, obesity and a sedentary lifestyle, and that (b) effects of preventive interventions in early life integrate interventions in adulthood. The report has an executive summary that refers to the different sections of the main paper.
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Affiliation(s)
- Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Mauricio Avendano-Pabon
- Department of Social Sciences, Health and Medicine, King's College London, London, United Kingdom
| | - Henrique Barros
- EPIUnit - Institute of Public Health University of Porto, Porto, Portugal
| | - Mel Bartley
- Department of Epidemiology & Public Health, University College London, London, United Kingdom
| | - Cristian Carmeli
- Center for Primary Care and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland
| | | | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Giuseppe Costa
- Department of Clinical Science & Biology, Turin University Medical School, Turin, Italy
| | - Cyrille Delpierre
- UMR LEASP, Université de Toulouse III, UPS, Inserm, Toulouse, France
| | | | - Silvia Fraga
- EPIUnit - Institute of Public Health University of Porto, Porto, Portugal
| | - Graham Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Marcel Goldberg
- UMS 011 Inserm - UVSQ ≪ Cohortes épidémiologiques en population ≫, Villejuif, France
| | | | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Benoit Lepage
- UMR LEASP, Université de Toulouse III, UPS, Inserm, Toulouse, France
| | - Thierry Lang
- UMR LEASP, Université de Toulouse III, UPS, Inserm, Toulouse, France
| | - Richard Layte
- Department of Sociology, School of Social Sciences and Philosophy, Trinity College Dublin, Dublin, Ireland
| | - Frances MacGuire
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Johan P Mackenbach
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Cathal McCrory
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Peter Muennig
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Wilma Nusselder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Dusan Petrovic
- Center for Primary Care and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland
| | - Silvia Polidoro
- Molecular Epidemiology and Exposomics Unit, Italian Institute for Genomic Medicine, Turin, Italy
| | - Fulvio Ricceri
- Department of Clinical Science & Biology, Turin University Medical School, Turin, Italy
- Department of Epidemiology, ASL TO3, Turin, Italy
| | - Oliver Robinson
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
| | - Marie Zins
- UMS 011 Inserm - UVSQ ≪ Cohortes épidémiologiques en population ≫, Villejuif, France
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Özler B, Hallman K, Guimond MF, Kelvin EA, Rogers M, Karnley E. Girl Empower - A gender transformative mentoring and cash transfer intervention to promote adolescent wellbeing: Impact findings from a cluster-randomized controlled trial in Liberia. SSM Popul Health 2019; 10:100527. [PMID: 31890847 PMCID: PMC6928354 DOI: 10.1016/j.ssmph.2019.100527] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 10/17/2019] [Accepted: 12/01/2019] [Indexed: 01/21/2023] Open
Abstract
Background We evaluated Girl Empower – an intervention that aimed to equip adolescent girls with the skills to make healthy, strategic life choices and to stay safe from sexual abuse using a cluster-randomized controlled trial with three arms: control, Girl Empower (GE), and GE+. Methods GE delivered a life skills curriculum to girls aged 13–14 in Liberia, facilitated by local female mentors. In the GE + variation, a cash incentive payment was offered to caregivers for girls’ participation in the program. We evaluated the impact of the program on seven pre-specified domains using standardized indices: sexual violence, schooling, sexual and reproductive health (SRH), psychosocial wellbeing, gender attitudes, life skills, and protective factors. Findings Participation rates in the program were high in both GE and GE+, with the average participant attending 28 out of 32 sessions. At 24 months, the standardized effects of both GE and GE+, compared to control, on sexual violence, schooling, psychosocial wellbeing, and protective factors were small (β, ≤ 0.11 standard deviations [SD]) and not statistically significant at the 95% level of confidence. However, we found positive standardized effects on Gender Attitudes (GE: β, 0.206 SD, p<0.05; GE+: β, 0.228 SD, p<0.05), Life Skills (GE: β, 0.224 SD, p<0.05; GE+: β, 0.289 SD, p<0.01), and SRH (GE: β, 0.244 SD, p<0.01; GE+: β, 0.372 SD, p<0.01; F-test for GE = GE+: p = 0.075). Interpretation Girl Empower led to sustained improvements in several important domains, including SRH, but did not reduce sexual violence among the target population. Violence against women and children are closely linked global epidemics that have lifelong impacts on human welfare. This study examines the impact of adding cash transfers to a mentoring intervention targeted to girls in early adolescence. Girl Empower has positive impacts on some important outcomes, but is ineffective in protecting girls from sexual violence. Cash transfers, tied to attendance, enhanced program impacts on child marriage, teen pregnancy, and risky sexual behavior. Future research is needed to understand whether cash affects these outcomes directly or through an interaction effect.
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Affiliation(s)
- Berk Özler
- The World Bank, 1818 H Street, NW, Washington, DC, 20433, United States
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24
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Pundir P, Saran A, White H, Adona J, Subrahmanian R. PROTOCOL: The effectiveness of interventions for reducing violence against children: An evidence and gap map in low- and middle-income countries. CAMPBELL SYSTEMATIC REVIEWS 2019; 15:e1040. [PMID: 37016721 PMCID: PMC8356504 DOI: 10.1002/cl2.1040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Affiliation(s)
- Prachi Pundir
- Campbell Collaboration2nd Floor, West Wing, ISID Complex, Vasant KunjDelhi110070India
| | - Ashrita Saran
- Campbell Collaboration2nd Floor, West Wing, ISID Complex, Vasant KunjDelhi110070India
| | - Howard White
- Campbell Collaboration2nd Floor, West Wing, ISID Complex, Vasant KunjDelhi110070India
| | - Jill Adona
- Asian Development BankManilaPhilippinesPhilippines
| | - Ramya Subrahmanian
- UNICEF Office of Research‐ InnocentiPiazza SS. AnnunziataFlorence12 50122Italy
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25
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An Intelligent Advisory System to Support Managerial Decisions for A Social Safety Net. ADMINISTRATIVE SCIENCES 2019. [DOI: 10.3390/admsci9030055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Social investment programs are designed to provide opportunities to the less privileged so that they can contribute to the socioeconomic development of society. Stakeholders in social safety net programs (SSNPs) target vulnerable groups, such as the urban poor, women, the unemployed, and the elderly, with initiatives that have a transformative impact. Inadequate policy awareness remains a challenge, resulting in low participation rates in SSNPs. To achieve all-inclusive development, deliberate policies and programs that target this population have to be initiated by government, corporate bodies, and public-minded individuals. Artificial intelligence (AI) techniques could play an important role in improving the managerial decision support and policy-making process of SSNPs and increasing the social resilience of urban populations. To enhance managerial decision-making in social investment programs, we used a Bayesian network to develop an intelligent decision support system called the Social Safety Net Expert System (SSNES). Using the SSNES, we provide an advisory system to stakeholders who make management decisions, which clearly demonstrates the efficacy of SSNPs and inclusive development.
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26
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Burneo-Garcés C, Cruz-Quintana F, Pérez-García M, Fernández-Alcántara M, Fasfous A, Pérez-Marfil MN. Interaction between Socioeconomic Status and Cognitive Development in Children Aged 7, 9, and 11 Years: A Cross-Sectional Study. Dev Neuropsychol 2018; 44:1-16. [PMID: 30537871 DOI: 10.1080/87565641.2018.1554662] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The socioeconomic status (SES) of parents has a crucial influence on the cognitive development of children, but it is not clear whether this effect varies as a function of the children's age. The objective of this study was to investigate the development of children aged 7, 9, and 11 years of parents with extremely low SES in a developing country (Ecuador). Participating children were divided between a medium-SES group and a low-SES group. Statistically significant differences were observed as a function of SES group and age in verbal memory, language, and executive function, observing wider between-group differences among the 11-year-olds.
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Affiliation(s)
- Carlos Burneo-Garcés
- a Mind, Brain and Behavior Research Center (CIMCYC-UGR) , University of Granada , Granada , Spain.,b Universidad de Otavalo , Otavalo , Ecuador
| | - Francisco Cruz-Quintana
- a Mind, Brain and Behavior Research Center (CIMCYC-UGR) , University of Granada , Granada , Spain
| | - Miguel Pérez-García
- a Mind, Brain and Behavior Research Center (CIMCYC-UGR) , University of Granada , Granada , Spain
| | - Manuel Fernández-Alcántara
- a Mind, Brain and Behavior Research Center (CIMCYC-UGR) , University of Granada , Granada , Spain.,c Department of Health Psychology , University of Alicante , Alicante , Spain
| | - Ahmed Fasfous
- a Mind, Brain and Behavior Research Center (CIMCYC-UGR) , University of Granada , Granada , Spain.,d Department of Social Sciences , Bethlehem University , Bethlehem , Palestine , State of Palestine
| | - Mª Nieves Pérez-Marfil
- a Mind, Brain and Behavior Research Center (CIMCYC-UGR) , University of Granada , Granada , Spain
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27
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Peterman A, Palermo TM, Ferrari G. Still a leap of faith: microfinance initiatives for reduction of violence against women and children in low-income and middle-income countries. BMJ Glob Health 2018; 3:e001143. [PMID: 30588347 PMCID: PMC6278915 DOI: 10.1136/bmjgh-2018-001143] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/16/2018] [Accepted: 10/23/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Amber Peterman
- Social and Economic Policy Unit, UNICEF Office of Research--Innocenti, Florence, Italy
- Department of Public Policy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Tia M Palermo
- Social and Economic Policy Unit, UNICEF Office of Research--Innocenti, Florence, Italy
| | - Giulia Ferrari
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
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28
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Miller GF, Chiang L, Hollis N. Economics and violence against children, findings from the Violence Against Children Survey in Nigeria. CHILD ABUSE & NEGLECT 2018; 85:9-16. [PMID: 30201521 PMCID: PMC6257999 DOI: 10.1016/j.chiabu.2018.08.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/24/2018] [Accepted: 08/31/2018] [Indexed: 05/30/2023]
Abstract
This study seeks to assess the impact of economic factors on sexual, emotional, and physical violence on Nigerian children and adolescents aged 13-24 years. Data collected from the Nigerian Violence Against Children Survey (VACS), a national, cross-sectional household survey of females and males aged 13-24 years were used to examine sexual, emotional, and physical violence victimization. Data were collected on household economic status, e.g., flooring and roofing materials, transportation. A poverty index was developed using the Simple Poverty Scorecard™ for Nigeria to determine the impact that economic factors have on these violence measures. Children aged 13-17 years in households with high economic status (ES) were 1.81, 1.78, and 4.91 times, more likely to experience sexual, emotional, and physical violence, respectively, within the last 12 months than those in the lowest ES. Individuals aged 18-24 years in households with high ES were 1.62 and 1.41 times more likely to experience emotional and physical violence, respectively, prior to age 18 than those in the lowest ES. Individuals aged 18-24 years in households with middle or high ES were 1.65 and 1.96, respectively, times more likely to experience physical violence prior to age 18 than those in the lowest ES. Highest tertile ES was significantly associated with sexual, emotional, and physical violence among Nigerians aged 13-24 years. Further research is needed to determine the cause of increased violence amongst high ES households. Targeted interventions towards this ES class are recommended to reduce violence against children in Nigeria.
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Affiliation(s)
- Gabrielle F Miller
- Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway MS F-64, Atlanta, GA 30341, United States.
| | - Laura Chiang
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway MS F-64, Atlanta, GA 30341, United States.
| | - NaTasha Hollis
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway MS F-64, Atlanta, GA 30341, United States.
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29
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Kilburn KN, Pettifor A, Edwards JK, Selin A, Twine R, MacPhail C, Wagner R, Hughes JP, Wang J, Kahn K. Conditional cash transfers and the reduction in partner violence for young women: an investigation of causal pathways using evidence from a randomized experiment in South Africa (HPTN 068). J Int AIDS Soc 2018; 21 Suppl 1:e25043. [PMID: 29485746 PMCID: PMC5978692 DOI: 10.1002/jia2.25043] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/12/2017] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Evidence has shown that the experience of violence by a partner has important influences on women's risk of HIV acquisition. Using a randomized experiment in northeast South Africa, we found that a conditional cash transfer (CCT) targeted to poor girls in high school reduced the risk of physical intimate partner violence (IPV) in the past 12 months by 34%. The purpose of this analysis is to understand the pathways through which the CCT affects IPV. METHODS HPTN 068 was a phase 3, randomized controlled trial in rural Mpumalanga province, South Africa. Eligible young women (aged 13-20) and their parents or guardians were randomly assigned (1:1) to either receive a monthly cash transfer conditional on monthly high school attendance or no cash transfer. Between 2011 and 2015, participants (N = 2,448) were interviewed at baseline, then at annual follow-up visits at 12, 24 and 36 months. The total effect of the CCT on IPV was estimated using a GEE log-binomial regression model. We then estimated controlled direct effects to examine mediation of direct effects through intermediate pathways. Mediators include sexual partnership measures, the sexual relationship power scale, and household consumption measures. RESULTS We found evidence that the CCT works in part through delaying sexual debut or reducing the number of sexual partners. The intervention interacts with these mediators leading to larger reductions in IPV risk compared to the total effect of the CCT on any physical IPV [RR 0.66, CI(95%):0.59-0.74]. The largest reductions are seen when we estimate the controlled direct effect under no sexual debut [RR 0.57, CI(95%):0.48-0.65] or under no sexual partner in the last 12 months [RR 0.53, CI(95%):0.46-0.60]. CONCLUSIONS Results indicate that a CCT for high school girls has protective effects on their experience of IPV and that the effect is due in part to girls choosing not to engage in sexual partnerships, thereby reducing the opportunity for IPV. As a lower exposure to IPV and safer sexual behaviours also protect against HIV acquisition, this study adds to the growing body of evidence on how cash transfers may reduce young women's HIV risk.
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Affiliation(s)
| | - Audrey Pettifor
- University of North CarolinaChapel HillUnited States
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)University of the WitwatersrandJohannesburgSouth Africa
| | | | - Amanda Selin
- University of North CarolinaChapel HillUnited States
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)University of the WitwatersrandJohannesburgSouth Africa
| | - Catherine MacPhail
- University of WollongongWollongong NSWAustralia
- Wits Reproductive Health and HIV InstituteUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Ryan Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)University of the WitwatersrandJohannesburgSouth Africa
- Umeå Centre for Global Health ResearchUmeå UniversityUmeåSweden
| | - James P Hughes
- Statistical Center for HIV/AIDS Research and Prevention (SCHARP)SeattleUnited States
- University of WashingtonSeattleWashington
| | - Jing Wang
- Statistical Center for HIV/AIDS Research and Prevention (SCHARP)SeattleUnited States
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)University of the WitwatersrandJohannesburgSouth Africa
- INDEPTH NetworkAccraGhana
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