1
|
Cook CJ, Howard SJ, Cuartas J, Makaula H, Merkley R, Mshudulu M, Tshetu N, Scerif G, Draper CE. Child exposure to violence and self-regulation in South African preschool-age children from low-income settings. CHILD ABUSE & NEGLECT 2022; 134:105944. [PMID: 36356426 DOI: 10.1016/j.chiabu.2022.105944] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/28/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
Biological and psychosocial stressors that have been associated with income include family dynamics such as household chaos, family conflict, maternal depression, harsh parenting, lower parental responsiveness, and exposure to violence. Research from high income countries has shown that exposure to violence may have detrimental effects on children's self-regulation, with possible flow-on implications for broad later-life outcomes, but less is known about such links in low- and- middle income countries, where many children live in violent communities and households and where physical punishment remains the norm. This study aimed to investigate exposure to violence, in addition to coercive parenting, and its associations with self-regulation among 243 3- to 5-year-olds (M = 4.7 ± 0.6; 51.9 % female) from low-income settings in Cape Town and who were not attending Early Childhood Care and Education (ECCE). Results showed that self-regulation was not associated with child exposure to community violence, but it was positively associated with coercive parenting (β = 0.17; p = 0.03). The null concurrent associations between exposure to violence and self-regulation suggest the need for additional research aimed at understanding later potential developmental sequelae. It is important that findings regarding coercive parenting are contextualised within local social norms around parenting styles, as well as the influence of living in dangerous communities on parenting practices.
Collapse
Affiliation(s)
- Caylee J Cook
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Steven J Howard
- Early Start and School of Education, University of Wollongong, Wollongong, NSW, Australia
| | - Jorge Cuartas
- Harvard Graduate School of Education, Cambridge, United States of America & Department of Psychology, Universidad de los Andes, Bogotá, Colombia
| | - Hleliwe Makaula
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rebecca Merkley
- Department of Cognitive Science, Carleton University, Ottawa, Canada
| | - Mbulelo Mshudulu
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nosibusiso Tshetu
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| |
Collapse
|
2
|
Violência emocional intrafamiliar contra crianças e adolescentes e suas repercussões. PSICO 2022. [DOI: 10.15448/1980-8623.2022.1.39085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
O objetivo deste estudo foi identificar as repercussões na infância, na adolescência e na vida adulta da violência emocional intrafamiliar vivenciada no período infanto-juvenil em artigos publicados entre 2009 e 2019, por meio de uma revisão sistemática de literatura. Para a organização dos dados, utilizou-se o software Zotero; para a sistematização e análises, o software SPSS (versão 2.3). Na infância e na adolescência, as principais repercussões foram sintomas internalizantes (ex.: ansiedade, depressão, problemas psicossomáticos, insegurança), problemas cognitivo-comportamentais e impactos no rendimento escolar. Na idade adulta, as principais repercussões foram sintomas externalizantes (ex.: agressividade, reprodução da violência) e sintomas internalizantes. Conclui-se que a violência emocional vivenciada na infância e na adolescência é transcultural, transgeracional e um fator de risco para o desenvolvimento, podendo ocasionar prejuízos cognitivo-comportamentais e interferir nos relacionamentos interpessoais ao longo do ciclo de vida. Tornar visível este tipo de violência contribui para enfrentamento e minimização dos efeitos negativos da violência.
Collapse
|
3
|
Wiggers M, Paas F. Harsh Physical Discipline and Externalizing Behaviors in Children: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14385. [PMID: 36361265 PMCID: PMC9656315 DOI: 10.3390/ijerph192114385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
There is growing debate in the parenting literature as to whether using physical punishment to discipline children is an effective strategy or leads to the development of aggressive behaviors and other antisocial attributes. The aim of the current literature review is to examine the association between harsh physical discipline and the development of externalizing behaviors in children, as well as the suggested moderators of this relationship. Secondly, the findings regarding the effects of harsh physical discipline on children's educational outcomes are reviewed. Articles were selected from relevant databases while maintaining an inclusion and exclusion criteria, with a total of 22 articles included in this review. Strong associations between parental corporal punishment and a range of child behaviors were indicated by the literature, and cultural normativeness was implicated as a moderator of these effects. Results regarding the role of parental warmth as a moderator did not provide a firm conclusion. Finally, the findings suggest that when a child is subjected to physical discipline in the home, their life at school may be adversely affected by impaired cognitive performance, peer isolation, and behavioral problems. The primary limitation of the studies reviewed is the use of self-report data and correlational analyses, ruling out the possibility of inferring causal relations. Nonetheless, the results indicate the necessity of encouraging parents and caregivers to avoid physical punishment as a disciplinary tactic while providing them with the tools to explore alternative practices.
Collapse
Affiliation(s)
- Marthe Wiggers
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands
| | - Fred Paas
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands
- School of Education/Early Start, University of Wollongong, Keiraville, NSW 2522, Australia
| |
Collapse
|
4
|
Grzejszczak J, Gabryelska A, Gmitrowicz A, Kotlicka-Antczak M, Strzelecki D. Are Children Harmed by Being Locked up at Home? The Impact of Isolation during the COVID-19 Pandemic on the Phenomenon of Domestic Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13958. [PMID: 36360840 PMCID: PMC9657348 DOI: 10.3390/ijerph192113958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The phenomenon of violence against children is a very complex one. There are many types of child abuse, and they are culturally dependent to a significant degree. Although studies show that children generally only suffer from mild COVID-19 infection, some social restrictions introduced during the pandemic, such as home isolation, may have many severe consequences on the population's mental health. Studies on this topic suggest that violence against children increased during lockdown due to the COVID-10 pandemic. This narrative review summarizes this available literature on the subject and discusses the different forms of violence against children, their cultural aspects, the impact of the COVID-19 pandemic on the phenomenon of violence, the long-term consequences of the above, and forms of assistance for abused minors.
Collapse
Affiliation(s)
- Jagoda Grzejszczak
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-151 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
| | - Agnieszka Gmitrowicz
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-151 Lodz, Poland
| | | | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
| |
Collapse
|
5
|
Vargas L, Vélez-Grau C, Camacho D, Richmond TS, Meisel ZF. The Permeating Effects of Violence on Health Services and Health in Mexico. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP10883-NP10911. [PMID: 33527877 PMCID: PMC8326291 DOI: 10.1177/0886260521990832] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Mexico's violence related to organized crime activity has grown to epidemic levels in the last 12 years. We interviewed 22 Mexican health care providers from five states to examine how violence impacts health care services and health. We transcribed and analyzed semi-structured interviews using framework analysis. Our findings describe the ways in which community violence in Mexico permeates health care services, impacting health care providers, and the health of patients. We developed a model to reflect our main themes that illustrate how violence permeates health care services over geographic space and time. We identified three thematic categories: (a) the impact of violence on health care facilities and service provision, (b) the impact of violence on providers, and (c) the impact of violence on the health of the community. Our model articulates a dynamic process of the spread and permeation of violence. Prior literature focuses on the impact of violence as an occupational hazard and the effect of war or civil conflict on health care services. We extend this literature by documenting the impacts of widespread violence on Mexican health care services and providers. We discuss how violence impacts services, providers, and health in a country that is not officially at war. We compare our findings to previous literature on occupational violence in health professions and the impacts on health services in official war zones. Finally, we highlight the implications for health care practice and policy. We suggest that violence should be considered throughout the care continuum in Mexico and make the case for violence as a structural contributor to health and health disparities in Mexico. We suggest additional research on this under-investigated topic.
Collapse
|
6
|
Raman S, Muhammad T, Goldhagen J, Seth R, Kadir A, Bennett S, D'Annunzio D, Spencer NJ, Bhutta ZA, Gerbaka B. Ending violence against children: What can global agencies do in partnership? CHILD ABUSE & NEGLECT 2021; 119:104733. [PMID: 32977985 PMCID: PMC7508190 DOI: 10.1016/j.chiabu.2020.104733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
Globally, the range, scale and burden of all forms of violence against children (VAC) have visibly increased. Yet VAC as a physical, mental, public and social health concern is only recently gaining the prominence it deserves. Addressing VAC is critical. Violence experienced early in life can result in short, medium, long-lasting, and/or even inter-generational negative health outcomes. Ample evidence shows that VAC is widespread and the most common forms are usually perpetrated by people with whom children interact every day in their homes, schools and communities. We report on an innovative collaboration between global agencies, led by the International Society for Social Pediatrics and Child Health (ISSOP), the International Society for Prevention of Child Abuse and Neglect (ISPCAN), and the International Pediatric Association (IPA), who were galvanized to respond to VAC using a child-rights and public health lens. This collaboration led to a position statement on VAC with an implementation plan. The strength of the position statement was the explicit incorporation of a rights-based expansive understanding of VAC, with a description of typologies of violence pertinent to children globally, including child labor, children in armed conflict, trafficking of children and gender-based violence; and the identification of strategies both in preventing violence from occurring and ameliorating the effects in its aftermath. We report on the challenges and successes of our collaborative action at regional and supra-national levels, including opportunistic action.
Collapse
Affiliation(s)
- Shanti Raman
- Department of Community Paediatrics, South Western Sydney Local Health District, University of New South Wales, Sydney, Australia; International Society for Social Pediatrics & Child Health, Switzerland.
| | - Tufail Muhammad
- International Society for Prevention of Child Abuse & Neglect, United States; Child Rights Committee, Pakistan Pediatric Association, Pakistan
| | - Jeffrey Goldhagen
- International Society for Social Pediatrics & Child Health, Switzerland; Division of Community and Societal Pediatrics, University of Florida College of Medicine, Jacksonville, United States
| | - Rajeev Seth
- International Society for Prevention of Child Abuse & Neglect, United States
| | - Ayesha Kadir
- International Society for Social Pediatrics & Child Health, Switzerland
| | - Sue Bennett
- International Society for Prevention of Child Abuse & Neglect, United States; Department of Pediatrics, Faculty of Medicine, Ottawa University, Ottawa, ON, Canada
| | - Danielle D'Annunzio
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Nicholas J Spencer
- International Society for Social Pediatrics & Child Health, Switzerland; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada; International Pediatric Association, United States
| | - Bernard Gerbaka
- International Society for Prevention of Child Abuse & Neglect, United States; Pediatric Department and Mother-and-Child Pole, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
7
|
Wang H, Chen J, Zhao X, Feng Y, Song Y. Physical Violence against Children by Parents among Primary School Students from a Rural Area in Shandong Province, China. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:392-404. [PMID: 33759717 DOI: 10.1080/19371918.2021.1896406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Physical violence (PV) against children by parents is a worldwide public health concern. Fewer studies explored the prevalence of PV in rural areas of China. We conducted a cross-sectional survey among primary school students' parents in five rural schools located in a town of Shandong Province. Data about parental PV behaviors against their children during the past 3 months and possible risk factors of parental PV behaviors were collected. Logistic regression analyses were carried out to investigate the risk factors of parental PV behaviors against their children. Of the 978 parents investigated, the parental self-reported prevalence of PV against their children was 50.0%. Parents' favorable attitudes toward the use of corporal punishment to discipline children were found to be associated with their increased use of PV. The findings of higher prevalence of parental PV behaviors against children identified in this sample suggests the need for programs aimed at improving parents' parenting skills in this rural area of China.
Collapse
Affiliation(s)
- Haixue Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jingqi Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xiaoxia Zhao
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yanan Feng
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Beijing, China
| |
Collapse
|
8
|
Herrero Romero R, Hall J, Cluver L, Meinck F, Hinde E. How Does Exposure to Violence Affect School Delay and Academic Motivation for Adolescents Living in Socioeconomically Disadvantaged Communities in South Africa? JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP3661-NP3694. [PMID: 29909713 DOI: 10.1177/0886260518779597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
To date, little is known about the effects of violence on the educational outcomes of adolescents in disadvantaged communities in South Africa. In response, self-report data were collected from a socioeconomically disadvantaged sample of 503 adolescents aged 10 to 18 participating in a child abuse prevention trial in the Eastern Cape. Adolescents were purposively selected in the trial. This study applies Latent Profile Analysis (LPA) to examine relationships between past-month exposure to violence, school delay, and academic motivation. About 93.8% of adolescents in the sample experienced poly-violence-exposure to at least two forms of violence in the past month. Results identified two distinct profiles in the socioeconomically disadvantaged sample: Profile 1, adolescents exposed to more frequent poly-violence, and Profile 2, adolescents exposed to less frequent poly-violence. Being exposed to more frequent poly-violence was associated with greater risk of school delay-based on age-appropriate grade in South Africa. However, being exposed to more frequent poly-violence was not associated with lower academic motivation-adolescents showed high rates of wanting to achieve. Our findings suggest that exposure to more frequent poly-violence increases risk of school delay among adolescents from disadvantaged communities, while not affecting their academic motivation. Thus, although adolescents maintained aspirations and goals to do well at school, exposure to high frequency of violence affected their capacity to fulfill these aims.
Collapse
Affiliation(s)
| | | | - Lucie Cluver
- University of Oxford, UK
- University of Cape Town, South Africa
| | - Franziska Meinck
- University of Oxford, UK
- North-West University, Vanderbijlpark, South Africa
| | | |
Collapse
|
9
|
Mejia-Pailles G, Berrington A, McGrath N, Hosegood V. Trends in the prevalence and incidence of orphanhood in children and adolescents <20 years in rural KwaZulu-Natal South Africa, 2000-2014. PLoS One 2020; 15:e0238563. [PMID: 33232331 PMCID: PMC7685426 DOI: 10.1371/journal.pone.0238563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/19/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In South Africa, large increases in early adult mortality during the 1990s and early 2000s have reversed since public HIV treatment rollout in 2004. In a rural population in KwaZulu-Natal, we investigate trends in parental mortality and orphanhood from 2000-2014. METHODS Using longitudinal demographic surveillance data for a population of approximately 90,000, we calculated annual incidence and prevalence of maternal, paternal and double orphanhood in children and adolescents (<20 years) and, overall and cause-specific mortality of parents by age. RESULTS The proportion of children and adolescents (<20 years) for whom one or both parents had died rose from 26% in 2000 to peak at 36% in 2010, followed by a decline to 32% in 2014. The burden of orphanhood remains high especially in the oldest age group: in 2014, 53% of adolescents 15-19 years had experienced the death of one or both parents. In all age groups and years, paternal orphan prevalence was three-five times higher than maternal orphan prevalence. Maternal and paternal orphan incidence peaked in 2005 at 17 and 27 per 1,000 person years respectively (<20 years) before declining by half through 2014. The leading cause of parental death throughout the period, HIV/AIDS and TB cause-specific mortality rates declined substantially in mothers and fathers from 2007 and 2009 respectively. CONCLUSIONS The survival of parents with children and adolescents <20 years has improved in tandem with earlier initiation and higher coverage of HIV treatment. However, comparatively high levels of parental deaths persist in this rural population in KwaZulu-Natal, particularly among fathers. Community-level surveillance to estimate levels of orphanhood remains important for monitoring and evaluation of targeted state welfare support for orphans and their guardians.
Collapse
Affiliation(s)
| | - Ann Berrington
- Department of Social Statistics & Demography, University of Southampton, Southampton, United Kingdom
| | - Nuala McGrath
- Department of Social Statistics & Demography, University of Southampton, Southampton, United Kingdom
- Department of Population Sciences & Primary Care, University of Southampton, Southampton, United Kingdom
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Victoria Hosegood
- Department of Social Statistics & Demography, University of Southampton, Southampton, United Kingdom
| |
Collapse
|
10
|
Intimate Partner Violence Against Low-Income Women in Mexico City and Associations with Child School Attendance: A Latent Class Analysis Using Cross-sectional Data. Matern Child Health J 2020; 24:360-368. [PMID: 31916142 DOI: 10.1007/s10995-020-02877-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Few studies have investigated how intimate partner violence (IPV), and patterns of IPV experiences, may impact children's school attendance in low- and middle-income countries. METHODS Using baseline data from a sub-sample of 659 women in Mexico City enrolled in a randomized controlled trial who reported having a child under age 18 and in school, multilevel latent class analysis (LCA) was used to classify women based on their reported IPV experiences. Multilevel risk regression analyses examined associations between latent class membership and IPV-related disruptions in children's schooling. Latent classes were identified in a prior study. RESULTS Overall, 23.3% of women reported their child's school attendance was disrupted due to IPV. LCA identified four distinct classes of IPV experiences: Low Physical and Sexual Violence (39.1%); Low Physical and High Sexual Violence class (14.8%), High Physical and Low Sexual Violence and Injuries (36.5%); and High Physical and Sexual Violence and Injuries (9.6%). Compared with women in the Low Physical and Sexual Violence class, women in the High Physical and Sexual Violence and Injuries class and women in the High Physical and Low Sexual Violence and Injuries class were at greater risk of IPV disrupting children's school attendance (ARR 3.39, 95% CI 2.34, 4.92; ARR 2.22, 95% CI 1.54, 3.19, respectively). No other statistically significant associations emerged. DISCUSSION High disruptions in children's school attendance due to IPV were reported and were differentially related to patterns of IPV experiences. Findings underscore the need to understand underlying mechanisms. Future work integrating both violence against women and violence against children is needed.
Collapse
|
11
|
Kobayashi LC, Farrell MT, Payne CF, Mall S, Montana L, Wagner RG, Kahn K, Tollman S, Berkman LF. Adverse childhood experiences and domain-specific cognitive function in a population-based study of older adults in rural South Africa. Psychol Aging 2020; 35:818-830. [PMID: 32700929 DOI: 10.1037/pag0000552] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Research on early life adversity and later-life cognitive function is conflicting, with little evidence from low-income settings. We investigated associations between adverse childhood experiences and cognitive function in an older population who grew up under racial segregation during South African apartheid. Data were from 1,871 adults aged 40-79 in the population-representative "Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" in 2015. The adverse childhood experiences were having a parent unemployed for > 6 months; having parents who argued or fought often; having a parent who drank excessively, used drugs, or had mental health problems; and physical abuse from parents. Executive function, language, visuospatial ability, and memory were assessed with the Oxford Cognitive Screen-Plus, a validated cognitive assessment designed for low-income, low-literacy settings. We estimated associations between adverse childhood experiences and latent cognitive domain z-scores using multiple-indicator, multiple-cause structural equation models. Childhood adversities were reported by 15% (parental unemployment for > 6 months), 25% (parents argued or fought often), 25% (a parent drank excessively, used drugs, or had mental health problems), and 35% (physical abuse from parent) of respondents. They were not associated with cognition, except that having a parent who drank excessively, used drugs, or had mental health problems was associated with lower memory z-scores (-0.07; 95% CI [-0.13, -0.01]). This is one of the first investigations into later-life cognitive outcomes associated with early adversity in a population with a historical context of pervasive trauma, and suggests that later-life memory may be vulnerable to early adversity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Lindsay C Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health
| | - Meagan T Farrell
- Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health
| | - Collin F Payne
- School of Demography, Research School of Social Sciences, Australian National University
| | - Sumaya Mall
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand
| | | | - Ryan G Wagner
- MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, University of the Witwatersrand
| | - Kathleen Kahn
- MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, University of the Witwatersrand
| | - Stephen Tollman
- MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, University of the Witwatersrand
| | - Lisa F Berkman
- Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health
| |
Collapse
|
12
|
Vidal HG, Caldas IM, de França Caldas A, de Miranda Coelho Júnior LGT, de Souza EHA, Pereira ML. Physical Violence Against Children and Adolescents in Porto: A 5-Year Study. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:2297-2315. [PMID: 29294707 DOI: 10.1177/0886260517700616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of the present study was to analyze the prevalence of physical violence against children and adolescents (PVCA) in a 5-year period in the city of Porto, Portugal. All forensic reports between 2009 and 2013 in the clinical services of the North Branch of the National Institute of Legal Medicine and forensic sciences were analyzed. Victims were classified according to sex, age, relationship with perpetrator, traumatic consequences of the event, and year of occurrence. Statistical analysis was performed using SPSS (Version 22.0). Continuous variables were described when appropriated frequencies were displayed. The association between variables was evaluated using chi-square, Fisher's exact test, or Kruskal-Wallis test, when appropriate and a logistic regression was performed. The margin of error for the statistical tests was 5.0%. A total of 2,148 occurrences were evaluated. Most subjects were male, and mean victim age was 13 years. The single most frequent perpetrator was an unknown individual, but most offenders were known to the victim. The majority site of injury was the face. The larger number of complaints of aggression maintained a similar frequency over the 5 years analyzed. A physical examination to confirm the reasons between the complaint and the type of aggression was performed and shown a high relationship. Adolescents were more susceptible to violence than younger children were. The most affected region was the face.
Collapse
|
13
|
Experiences of violence among adolescent girls and young women in Nairobi's informal settlements prior to scale-up of the DREAMS Partnership: Prevalence, severity and predictors. PLoS One 2020; 15:e0231737. [PMID: 32320405 PMCID: PMC7176122 DOI: 10.1371/journal.pone.0231737] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 03/30/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction We sought to estimate the prevalence, severity and identify predictors of violence among adolescent girls and young women (AGYW) in informal settlement areas of Nairobi, Kenya, selected for DREAMS (Determined Resilient Empowered AIDS-free, Mentored and Safe) investment. Methods Data were collected from 1687 AGYW aged 10–14 years (n = 606) and 15–22 years (n = 1081), randomly selected from a general population census in Korogocho and Viwandani in 2017, as part of an impact evaluation of the “DREAMS” Partnership. For 10–14 year-olds, we measured violence experienced either in the past 6 months or ever using a different set of questions from those used for 15–22 year-olds. Among 15–22 year-olds we measured prevalence of violence, experienced in the past 12 months, using World Health Organization (WHO) definitions for violence typologies. Predictors of violence were identified using multivariable logit models. Results Among 606 girls aged 10–14 years, about 54% and 7% ever experienced psychological and sexual violence, respectively. About 33%, 16% and 5% experienced psychological, physical and sexual violence in the past 6 months. The 10–14 year old girls who engaged in chores or activities for payment in the past 6 months, or whose family did not have enough food due to lack of money were at a greater risk for violence. Invitation to DREAMS and being a non-Christian were protective. Among 1081 AGYW aged 15–22 years, psychological violence was the most prevalent in the past year (33.1%), followed by physical violence (22.9%), and sexual violence (15.8%). About 7% experienced all three types of violence. Severe physical violence was more prevalent (13.8%) than moderate physical violence (9.2%). Among AGYW aged 15–22 years, being previously married/lived with partner, engaging in employment last month, food insecure were all risk factors for psychological violence. For physical violence, living in Viwandani and being a Muslim were protective; while being previously married or lived with a partner, or sleeping hungry at night during the past 4 weeks were risk factors. The odds of sexual violence were lower among AGYW aged 18–22 years and among Muslims. Engaging in sex and food insecurity increased chances for sexual violence. Conclusions Prevalence of recent violence among AGYW is high in this population. This calls for increased effort geared towards addressing drivers of violence as an early entry point of HIV prevention effort in this vulnerable group.
Collapse
|
14
|
McClinton Appollis T, Eggers SM, de Vries PJ, de Vries H, Lund C, Mathews C. The Impact of Participation in Research About Abuse and Intimate Partner Violence: An Investigation of Harms, Benefits, and Regrets in Young Adolescents in the Western Cape of South Africa. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:943-963. [PMID: 29294649 DOI: 10.1177/0886260517691522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is very little evidence whether recalling and answering questions about abuse or interpersonal violence has a positive or negative impact on participants of such research. This is an important ethical dilemma to ensure an appropriate risk-benefit ratio in research with young people is maintained. We assessed reported harms, benefits, and regrets of young adolescents who participated in a sensitive research project, and compared the harms and benefits in those who had and had not been victims and/or perpetrators of abuse or intimate partner violence. Participants were 3,264 adolescents aged 12 to 15 years in 41 public schools in the Western Cape, South Africa, who completed a survey about intimate partner violence, verbal, physical, and sexual abuse, as part of an HIV prevention cluster randomized controlled trial. The majority of participants reported research participation as beneficial (70.3%), while 27.7% reported harms and 14% regrets. Victims of abuse were more likely than non-victims to report benefits (71.9% vs. 67.1%; p = .02) and harms (31% vs. 20.9%; p < .01) and were less likely to report regret (13.1% vs. 16.7%; p = .02). Perpetrators of abuse were less likely than non-perpetrators to report benefits (67.4% vs. 72.8%; p = .01) and more likely to report harms (36.4% vs. 26.1%; p < .01) and regrets (17.4% vs. 13.3%; p = .01). Our findings suggested that research participation was more likely to have a positive rather than a negative emotional impact on young adolescents and that relatively few regretted participating. Victims and perpetrators of abuse were more likely to report benefits than harms, supporting the ethical appropriateness of ongoing research on abuse and violence. We recommend that further research is required to clarify and standardize terminology and instruments to quantify these kinds of evaluations, including measurement of the severity and intensity of reported benefits, harms and regrets, and the longer term impact of participation in sensitive research.
Collapse
Affiliation(s)
- Tracy McClinton Appollis
- University of Cape Town, Rondebosch, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | | | | | | | - Crick Lund
- University of Cape Town, Rondebosch, South Africa
| | - Cathy Mathews
- University of Cape Town, Rondebosch, South Africa
- South African Medical Research Council, Cape Town, South Africa
| |
Collapse
|
15
|
Mbwayo AW, Mathai M, Kuria MW, Mutavi T, Stoep AV. PARENTS' AND TEACHERS' PERCEPTIONS OF FACTORS AFFECTING LEARNING IN KENYA. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2019; 7:245-256. [PMID: 33224713 PMCID: PMC7677963 DOI: 10.1007/s40609-019-00161-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Studies have shown that a child's learning in school is affected by several factors, some related to the school environment, others to the home and community while others are as a result of the individual characteristics of the child. This study sought to explore parents' and teachers' perceptions of factors that affect learning of children in primary schools in a rural County in Kenya. METHODS This was a qualitative study that adopted the phenomenological approach. It was conducted with parents and teachers of 7 primary schools in rural and semi-rural areas of Kiambu County in Kenya. Using a researcher developed guide, data was collected using focus group discussion with parents and teachers. The discussions were conducted as follows-four were conducted in English language, two in Kiswahili language, and three were conducted in the local language and all were audio taped. Research assistants also took notes during the discussions. Results were transcribed verbatim and those that needed to be translated into English were translated. In analysis, MA, MM and MT read the transcripts and coded the major themes. RESULTS Four themes perceived by both parents and teachers to affect a child's learning emerged. These were; school environment, home, community and factors within the child. CONCLUSION There is need for both teachers and parents to come together and discuss perceived factors that interfere with learning of the children. Those that form a consensus for both groups, means to address them be found for better academic success of the child.
Collapse
Affiliation(s)
- Anne Wanjiru Mbwayo
- Department of Psychiatry, College of Health Sciences, University of Nairobi; PO Box 19676 - 00202, Nairobi
| | - Muthoni Mathai
- Department of Psychiatry, College of Health Sciences, University of Nairobi; PO Box 19676 - 00202, Nairobi
| | - Mary Wangari Kuria
- Department of Psychiatry, College of Health Sciences, University of Nairobi; PO Box 19676 - 00202, Nairobi
| | - Teresia Mutavi
- Department of Psychiatry, College of Health Sciences, University of Nairobi; PO Box 19676 - 00202, Nairobi
| | - Ann Vander Stoep
- Child Health Institute, University of Washington, P.O. Box 354920, Seattle, Washington USA 98195
| |
Collapse
|
16
|
Vidal HG, Caldas IM, de França Caldas A, Toledo de Miranda Coelho LG, Alvim de Souza EH, Pereira ML. Physical violence against children and adolescents in Recife: a 5-year retrospective study. THE JOURNAL OF FORENSIC ODONTO-STOMATOLOGY 2019; 37:20-25. [PMID: 31187739 PMCID: PMC6875244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of the present study was to analyze the prevalence results of physical violence against children and adolescents in a 5-year period in Recife, Brazil. Inter-personal violence is one of the most recognizable forms of child aggression and has become as an imperative public health issue. All violence related forensic reports performed between 2009 and 2013 in the clinical services of the Institute of Legal Medicine Antônio Percivo Cunha were analyzed. Victims were classified according to sex, age, relationship with perpetrator, injuries and year of occurrence. Statistical analysis was performed using the SPSS (version 22.0). Continuous variables were described and when appropriate, frequencies were displayed and compared. The association between variables was evaluated using chi-square and Fisher's exact test. The margin of error for the statistical tests was 5.0%. A total of 9783 occurrences were evaluated, involving mainly male subjects (n=5447, 55.7%). Victims' mean age was 13.9 years, the most common perpetrators were victims' acquaintances (n=2538, 25.9%). Facial injuries were the most frequent affecting a little over a fifth of the total sample (n=3673, 20.1%). These findings support the important role dentists can play in identifying and reporting physical violence against children and adolescents.
Collapse
Affiliation(s)
- H G Vidal
- Department of Legal Medicine and Forensic Sciences of the Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
| | - I M Caldas
- Faculty of Dental Medicine, University of Porto (FMDUP), Porto, Portugal
| | - A de França Caldas
- University of Pernambuco Dentistry campus Arcoverde (UPE - FFPG), Pernambuco, Brazil
| | | | | | - M L Pereira
- Faculty of Dental Medicine, University of Porto (FMDUP), Porto, Portugal
| |
Collapse
|
17
|
Devlin AM, Wight D, Fenton C. Are parenting practices associated with the same child outcomes in sub-Saharan African countries as in high-income countries? A review and synthesis. BMJ Glob Health 2018; 3:e000912. [PMID: 30687520 PMCID: PMC6326425 DOI: 10.1136/bmjgh-2018-000912] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/17/2018] [Accepted: 08/09/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction There is increasing interest in the transferability of parenting interventions from high-income countries (HICs) to low-income countries (LICs) in order to improve child development and health outcomes. This is based on the premise that associations between parenting practices and child outcomes are similar in both settings. Many parenting interventions in HICs are evidence-based, but less evidence exists on associations of parenting practices with child outcomes in LICs, in particular, sub-Saharan African (SSA) countries. This review synthesises evidence on the association of parenting practices with child outcomes in SSA in order to compare findings with those from HICs. Methods We searched electronic databases—Web of Science, ASSIA, Embase, IBSS and PsycINFO—to identify studies from SSA that reported quantitative associations between parenting practices and child health or psychosocial outcomes (eg, sexual and reproductive health (SRH), mental health, conduct disorders). Due to inconsistent conceptual framing of parenting across studies, we used a modified version of the international WHO classification of parenting dimensions to guide synthesis of the results. Results Forty-four studies met our inclusion criteria. They were conducted in 13 SSA countries and included cross-sectional and longitudinal studies, and were predominantly descriptive studies rather than intervention research. Synthesis of results showed that associations between patterns of parenting (‘positive’/‘harsh’) and child outcomes (including SRH, mental health and conduct disorders) in studies from SSA were broadly similar to those found in HICs. Conclusions These findings suggest that the impacts of parenting practices on child outcomes are similar across contrasting global regions and, therefore, parenting interventions from HICs might be successfully transferred to SSA, subject to appropriate adaptation. However, this review also highlights the paucity of evidence in this area and the urgent need for higher quality studies to confirm these findings to help develop effective parenting interventions in SSA.
Collapse
Affiliation(s)
- Alison M Devlin
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Daniel Wight
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Candida Fenton
- Cochrane Vascular, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Medical School, Teviot Place, Edinburgh, United Kingdom
| |
Collapse
|
18
|
Decker MR, Wood SN, Ndinda E, Yenokyan G, Sinclair J, Maksud N, Ross B, Omondi B, Ndirangu M. Sexual violence among adolescent girls and young women in Malawi: a cluster-randomized controlled implementation trial of empowerment self-defense training. BMC Public Health 2018; 18:1341. [PMID: 30514264 PMCID: PMC6278011 DOI: 10.1186/s12889-018-6220-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 11/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, sexual violence is prevalent, particularly for adolescent women. This cluster-randomized controlled implementation trial examines empowerment self-defense (ESD) for sexual assault risk reduction among school-age women in Malawi. METHODS The unit of randomization and analysis was the school (n = 141). Intervention participants received a 12-h intervention over 6 weeks, with refreshers. Primary outcomes were past-year prevalence and incident rate of sexual violence. Secondary outcomes included confidence, self-defense knowledge, and, for those victimized, violence disclosure. Interaction effects on outcomes were evaluated with Poisson models with school-correlated robust variance estimates for risk ratios and incident rate ratios (baseline n = 6644, follow-up n = 4278). RESULTS Past-year sexual assault prevalence was reduced among intervention students (risk ratio [RR] 0.68, 95% CI 0.56, 0.82), but not control students (interaction effect p < 0.001). Significant increases in self-defense knowledge were observed solely among intervention students (RR 3.33, 95% CI 2.76, 4.02; interaction effect p < 0.001). Significant changes in sexual violence prevalence and knowledge were observed for both primary and secondary students. Favorable reductions were also observed in sexual violence incident rate among students overall (interaction effect p = 0.01). CONCLUSIONS This intervention reduced sexual violence victimization in both primary and secondary school settings. Results support the effectiveness of ESD to address sexual violence, and approach the elimination of violence against women and girls set forth with Sustainable Development Goal #5. Implementation within the education system can enable sustainability and reach. TRIAL REGISTRATION Pan African Clinical Trials Registry PACTR201702002028911 . Registered 09 February 2017. Retrospectively registered.
Collapse
Affiliation(s)
- Michele R Decker
- Department of Population, Family & Reproductive Health Director, Women's Health & Rights Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. .,Center for Public Health & Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E4142, Baltimore, MD, 21205, USA.
| | - Shannon N Wood
- Department of Population, Family & Reproductive Health Director, Women's Health & Rights Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Gayane Yenokyan
- Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | |
Collapse
|
19
|
Connolly EJ, Kavish N. The Causal Relationship between Childhood Adversity and Developmental Trajectories of Delinquency: A Consideration of Genetic and Environmental Confounds. J Youth Adolesc 2018; 48:199-211. [PMID: 30471056 DOI: 10.1007/s10964-018-0960-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/08/2018] [Indexed: 11/25/2022]
Abstract
An extensive line of research has found that children exposed to multiple forms of early life adversity are more likely to engage in high levels of delinquent behavior during adolescence. Several studies examining this association have used a range of multivariate statistical techniques capable of controlling for observable covariates. Fewer studies have used family-based research designs to additionally control for unobservable confounds, such as genetic and shared environmental influences, that may be associated with exposure to childhood adversity and delinquency. The current study analyzes self-report data on 2534 full-siblings (50% female) from the National Longitudinal Survey of Youth 1997 to conduct a sibling-comparison analysis to provide a rigorous test of the causal hypothesis that exposure to childhood adversity causes differences in developmental patterns of delinquent behavior. Results from multivariate latent growth curve models revealed that childhood adversity was associated with higher starting levels of delinquency during adolescence and slower rates of decline from adolescence to emerging adulthood. Results from multivariate sibling-comparison models, however, revealed that siblings exposed to higher levels of childhood adversity reported higher starting levels of delinquent behavior, but not slower declines over time, suggesting that childhood adversity may not be directly associated with long-term patterns of delinquent behavior after genetic and shared environmental factors are taken into account. Implications of these results for future research are discussed.
Collapse
Affiliation(s)
- Eric J Connolly
- Department of Criminal Justice and Criminology, Sam Houston State University, Huntsville, TX, 77340, USA.
| | - Nicholas Kavish
- Department of Psychology and Philosophy, Sam Houston State University, Huntsville, TX, 77340, USA
| |
Collapse
|
20
|
Baker-Henningham H, Francis T. Parents' use of harsh punishment and young children's behaviour and achievement: a longitudinal study of Jamaican children with conduct problems. Glob Ment Health (Camb) 2018; 5:e32. [PMID: 30455967 PMCID: PMC6236219 DOI: 10.1017/gmh.2018.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 05/01/2018] [Accepted: 06/13/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Harsh punishment by parents is common in low- and middle-income countries (LMIC), yet there is limited evidence from LMIC of the effects of harsh punishment on child outcomes. METHODS A longitudinal, prospective study was conducted with children with conduct problems to examine the associations between parents' use of harsh punishment during the preschool years on child behaviour and school achievement in grade one of primary school. As part of an efficacy trial in 24 preschools, 225 children with the highest level of teacher-reported conduct problems were evaluated and their parents reported on how often they used harsh punishment. Outcome measures in grade one included child conduct problems by independent observation, teacher and parent report, child social skills by teacher and parent report, direct tests of children's academic achievement and language skills, and tester ratings of child attention and impulse control. RESULTS Children had a mean age of 6.92 years and 61% were boys. All parents reported using harsh punishment. After controlling for child age and sex, socio-economic status, parents' involvement with child and maternal education, frequency of harsh punishment was associated with growth in child conduct problems by independent classroom observations (p = 0.037), parent (p = 0.018) and teacher (p = 0.044) report, a reduction in child social skills by teacher (p = 0.024) and parent (p = 0.014) report and poorer attention during the test session (p = 0.049). CONCLUSION The associations between frequency of parents' use of harsh punishment with their preschoolers with conduct problems and later child behaviour indicate a need to train parents in non-violent behaviour management.
Collapse
Affiliation(s)
- H. Baker-Henningham
- School of Psychology, Bangor University, Bangor, LL57 2AS, UK
- Caribbean Institute for Health Research, University of the West Indies, Kingston 7, Jamaica
| | - T. Francis
- Caribbean Institute for Health Research, University of the West Indies, Kingston 7, Jamaica
| |
Collapse
|
21
|
Pinto L, Lein A, Mahoque R, Wright DW, Sasser SM, Staton CA. A cross-sectional exploratory study of knowledge, attitudes, and practices of emergency health care providers in the assessment of child maltreatment in Maputo, Mozambique. BMC Emerg Med 2018; 18:11. [PMID: 29743037 PMCID: PMC5943990 DOI: 10.1186/s12873-018-0162-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 04/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Mozambique, and other low-income countries (LICs), there is little information on the burden of child maltreatment (CM). Emergency care services (ECS) play an important role in recognizing, treating, and intervening in situations of CM. We aim to identify knowledge, attitudes, and practices regarding CM among health care providers in ECS at Mavalane General Hospital in Maputo, Mozambique. METHODS This exploratory cross-sectional study evaluates the knowledge, attitudes, and practices of health care providers to diagnose and treat cases of CM. A 25 min, pilot-tested verbal interview questionnaire was administered to 49 physicians and nurses working in ECS at Mavalane General Hospital. Interviews were completed between October-November 2010. Data were managed and analyzed in SPSS 14.0 and descriptive statistics were generated. RESULTS Of 49 health care providers, 83.6% reporting receiving no, or very little CM education or training. Only 61.2% had knowledge of physical abuse as a main form of child maltreatment and 38.8% were able to identify corresponding symptoms of physical abuse. Sexual abuse as a main form of CM was mentioned by 26.5 and 2% cited its symptoms. While 87.7% of health care providers strongly agreed or agreed that they hold an important role in preventing CM, 51.1% also strongly disagreed or disagreed that they feel confident diagnosing and treating CM cases. In regards to follow-up, 14.3% strongly disagreed or disagreed that they know where to refer victims for further follow-up and an additional 14.3% did not know whether they agreed or disagreed. CONCLUSION This study revealed knowledge gaps in emergency health care provider knowledge of the main forms of CM and their symptoms. The fact that a majority of health care providers in our sample did not receive information specific to CM in their medical education and training could explain this gap, as well as their unawareness of where to refer victims. Given that health care providers believe they play an important role in identifying and treating CM, future research should focus on raising physician awareness of CM and developing education and training materials grounded in cultural contexts to build response capacity in Mozambique and other LICs.
Collapse
Affiliation(s)
- Liliana Pinto
- Ordem dos Médicos de Moçambique (Mozambique Medical Council), Maputo, Mozambique
| | - Adriana Lein
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, North Carolina, 27710, USA
| | - Raquel Mahoque
- World Health Organization, Rua Pereira Marinho 280, CP 377, Maputo, Mozambique
| | - David W Wright
- Emory Department of Emergency Medicine, 531 Asbury Circle, Annex Building, Suite N340, Atlanta, GA, 30322, USA
| | - Scott M Sasser
- Department of Emergency Medicine, Greenville Health System, University of South Carolina School of Medicine Greenville, Greenville, SC, 29605, USA
| | - Catherine A Staton
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, North Carolina, 27710, USA. .,Division of Emergency Medicine, Department of Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, North Carolina, 27710, USA. .,Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Duke University Medical Center, 2301 Erwin Road, Durham, North Carolina, 27710, USA.
| |
Collapse
|
22
|
Meinck F, Fry D, Ginindza C, Wazny K, Elizalde A, Spreckelsen TF, Maternowska MC, Dunne MP. Emotional abuse of girls in Swaziland: prevalence, perpetrators, risk and protective factors and health outcomes. J Glob Health 2018; 7:010410. [PMID: 28607670 PMCID: PMC5460395 DOI: 10.7189/jogh.07.010410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Research on emotional child abuse in sub–Saharan Africa is scarce. Few studies thus far have examined prevalence, risk and protective factors for emotional child abuse or the associations between emotional abuse and girls’ health. Methods A nationally representative two–stage, cluster–sampled, household survey of females aged 13–24 years (n = 1244) on childhood abuse victimisation was conducted. Participants completed interviewer–assisted questionnaires. Associations between emotional abuse and putative risk, and protective factors and health outcomes were analyzed using separate logistic regression models accounting for sampling design. Marginal effects of cumulative risk factors for emotional abuse victimisation were examined. Results Lifetime prevalence of emotional abuse was 28.5% with 58.3% of these girls reporting many abusive incidents. The most common perpetrators were female (27.8%) and male (16.7%) relatives and, more rarely, biological parents. Risk factors associated with emotional abuse were frequent caregiver changes (odds ratio (OR) 1.42, 95% confidence interval (CI) 1.03–1.970, poverty (OR 1.51, 95% CI 1.12–2.03), and physical abuse (OR 1.98, 95% CI 1.45–2.71) and sexual abuse (OR 2.22, 95% CI 1.57–3.10) victimisation. Being close to one’s mother was a protective factor (OR 0.88, 95% CI 0.80–0.97). Risk for emotional abuse increased from 13% with no risk factors present to 58.4% –with all four risk factors present. Health outcomes associated with emotional child abuse were suicidal ideation (OR 1.85, 95% CI 1.30–2.63) and feeling depressed (OR 1.89, 95% CI 1.31–2.71). Conclusions Girls in Swaziland experience high levels of emotional abuse victimisation. Emotional abuse is associated with economic disadvantage, family factors, other types of abuse victimisation and poor mental health. Therefore, a holistic approach to prevention is needed, incorporating poverty reduction and programmes to improve parent–child relationships, reduce the use of harsh criticism, and change parenting social norms.
Collapse
Affiliation(s)
- Franziska Meinck
- University of Oxford, Oxford, England, UK.,OPTENTIA, School of Behavioural Sciences, North-West University, Vanderbijlpark, South Africa
| | - Deborah Fry
- Moray House School of Education, University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Kerri Wazny
- Moray House School of Education, University of Edinburgh, Edinburgh, Scotland, UK
| | - Aldo Elizalde
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | | | | | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
23
|
Abstract
Violence in childhood is a serious health, social and human rights concern globally, there is, however, little understanding about the factors that explain the various forms of violence in childhood. This paper uses data on childhood violence for 10,042 individuals from four countries. We report Odds Ratios from pooled logit regression analysis with country fixed effects model. There is no gender difference in the overall incidence of childhood violence. The data shows that 78% of girls and 79% of boys have suffered some form of violence before the age of 18 years. Odds of violence are higher among richer households, among individuals who have attended school and among individuals who have been married or in marriage-like arrangements. Individuals who justify wife beating have significantly higher likelihood of having faced violence themselves. Most perpetrators of violence against children - physical, emotional and sexual - are people known to them in their homes and community, and not strangers. There is limited understanding of the factors that explain violence in childhood. This study highlights some key factors that can explain this phenomenon.
Collapse
Affiliation(s)
- Shamika Ravi
- a Development Economics , Brookings India , New Delhi.,b Governance Studies Program , Brookings Institution , Washington , DC , USA
| | | |
Collapse
|
24
|
Sherr L, Macedo A, Cluver LD, Meinck F, Skeen S, Hensels IS, Sherr LTS, Roberts KJ, Tomlinson M. Parenting, the other oldest profession in the world - a cross-sectional study of parenting and child outcomes in South Africa and Malawi. Health Psychol Behav Med 2017; 5:145-165. [PMID: 30221074 PMCID: PMC6135096 DOI: 10.1080/21642850.2016.1276459] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Parenting quality is important in child development. In the presence of HIV poverty and life stress, parenting may be challenged and child development affected. METHODS This study examines cross-sectional associations of situational factors such as poverty, mental health, HIV status, living with a biological parent, and stigma with good parenting and child outcomes (n=989; age=4-13 years) within the Child Community Care study (South Africa and Malawi). A parenting measure was created from 10 variables comprising 6 child and 4 parent ratings. These were highly correlated. Total parenting score was generated on a 10 point continuous scale, with a good parenting cut off then defined as >=8 out of a possible 10. RESULTS Five factors were associated with good parenting. Positively associated with good parenting were being the biological parent of the child, parental mental health and dwelling in households with multiple adults. Poverty and stigma were negatively associated with good parenting. Using multiple mediation analysis, a positive direct effect of good parenting was found on child self-esteem, child behaviour and educational risks with a partial mediation via child depression and trauma. CONCLUSIONS These data highlight possible intervention points. Influences on parenting could be seen through being the biological parent, parental mental health, poverty and stigma. In these challenging environments, health, nutrition, mental health, education, and treatment to keep parents alive are all clearly identified as potential pathways to ensure child well-being.
Collapse
Affiliation(s)
- L Sherr
- Department of Infection and Population Health, University College London, London, UK
| | - A Macedo
- Department of Infection and Population Health, University College London, London, UK
| | - L D Cluver
- Department of Social Policy & Intervention, Centre for Evidence-Based Interventions, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - F Meinck
- Department of Social Policy & Intervention, Centre for Evidence-Based Interventions, University of Oxford, Oxford, UK
| | - S Skeen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - I S Hensels
- Department of Infection and Population Health, University College London, London, UK
| | - L T S Sherr
- Department of Infection and Population Health, University College London, London, UK
| | - K J Roberts
- Department of Infection and Population Health, University College London, London, UK
| | - M Tomlinson
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
25
|
SHERR L, SKEEN S, HENSELS IS, TOMLINSON M, MACEDO A. The effects of caregiver and household HIV on child development: a community-based longitudinal study of young children. Child Care Health Dev 2016; 42:890-899. [PMID: 27514630 PMCID: PMC6086490 DOI: 10.1111/cch.12387] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/29/2016] [Accepted: 07/04/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Many studies that document child outcomes in the context of parental HIV - which has been established as a risk factor for child development - focus on older children/adolescents. Studies also concentrate on the status of the primary caregiver, not other household members who might be infected. DESIGN This study examined the effects of caregiver and household HIV on child development (4-13 years) in South Africa and Malawi (2011-2014). METHODS Data were gathered from 989 children and their primary caregivers at baseline and repeated at 12-15 months follow-up (86.5% follow-up rate). Only caregivers of a single child and caregiver/child dyads without missing data were included, providing a sample of 808 dyads for analysis. Children were divided into three groups according to caregiver-reported HIV burden: having an HIV-positive primary caregiver (19.8%), having HIV in the household (14.2%) or no HIV (66%). RESULTS The HIV burden was positively associated with an array of negative child outcomes, often mediated by caregiver depression levels. Family HIV burden at baseline affected child behavioural problems at follow-up indirectly through carer depression (B = 0.02; CI = 0.003, 0.06). Internalizing (B = 0.02; CI = 0.002, 0.05) and externalizing problems at follow-up (B = 0.01; CI = 0.0002, 0.03) were also indirectly affected by family HIV burden through caregiver depression. CONCLUSIONS The data suggest that family HIV can affect child development, emphasizing the important role of depression in the pathway to such an effect. Community-based interventions directed at alleviating parental depression in the presence of HIV may help to interrupt the cycle of family HIV and adverse child outcomes.
Collapse
Affiliation(s)
- Lorraine SHERR
- Department of Infection and Population Health, University College London, United Kingdom,Corresponding author: Prof Lorraine Sherr, Rowland Hill Street, London, NW3 2PF, United Kingdom,
| | - Sarah SKEEN
- Department of Psychology, Stellenbosch University, South Africa,Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Imca S. HENSELS
- Department of Infection and Population Health, University College London, United Kingdom,School of Psychological Sciences, University of Manchester, United Kingdom
| | - Mark TOMLINSON
- Department of Psychology, Stellenbosch University, South Africa
| | - Ana MACEDO
- Department of Infection and Population Health, University College London, United Kingdom
| |
Collapse
|
26
|
Skeen S, Macedo A, Tomlinson M, Hensels IS, Sherr L. Exposure to violence and psychological well-being over time in children affected by HIV/AIDS in South Africa and Malawi. AIDS Care 2016; 28 Suppl 1:16-25. [PMID: 27002770 PMCID: PMC4828604 DOI: 10.1080/09540121.2016.1146219] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/20/2016] [Indexed: 11/21/2022]
Abstract
Many of the risk factors for violence against children are particularly prevalent in families and communities affected by HIV/AIDS. Yet, in sub-Saharan Africa, where HIV rates are high, efforts to prevent or address violence against children and its long-lasting effects are hampered by a lack of evidence. We assessed the relationship between violence exposure and mental health among HIV-affected children attending community-based organisations in South Africa (n = 834) and Malawi (n = 155, total sample n = 989) at baseline and 12-15-month follow-up. Exposure to violence in the home and in the community was high. HIV-negative children who lived with an HIV-positive person experienced most violence overall, followed by HIV-positive children. Children unaffected by HIV experienced least violence (all p < .05). Interpersonal violence in the home predicted child depression (β = 0.17, p < .001), trauma symptoms (β = 0.17, p < .001), lower self-esteem (β = -0.17, p < .001), and internalising and externalising behavioural problems (β = 0.07, p < .05), while exposure to community violence predicted trauma symptoms (β = 0.16, p < .001) and behavioural problems (β = 0.07, p < .05). Harsh physical discipline predicted lower self-esteem (β = -0.18, p < .001) and behavioural problems for children (β = 0.24, p < .001). Exposure to home (OR: 1.89, 95% CI: 1.23-2.85) and community violence predicted risk behaviour (OR: 2.39, 95% CI: 1.57-3.62). Over time, there was a decrease in depressed mood and problem behaviours, and an increase in self-esteem for children experiencing different types of violence at baseline. This may have been due to ongoing participation in the community-based programme. These data highlight the burden of violence in these communities and possibilities for programmes to include violence prevention to improve psychosocial well-being in HIV-affected children.
Collapse
Affiliation(s)
- S. Skeen
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - A. Macedo
- Department of Infection and Population Health, University College London, London, UK
| | - M. Tomlinson
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - I. S. Hensels
- Department of Infection and Population Health, University College London, London, UK
| | - L. Sherr
- Department of Infection and Population Health, University College London, London, UK
| |
Collapse
|