Child-and youth-friendly spaces have become a common feature of emergency humanitarian provision. This study reports on the outcomes of child and youth learning centres (CYLCs) in Ethiopia's Buramino Camp established for those fleeing conflict in Somalia. Eighty-five youths completed baseline assessments shortly after arrival and follow-up assessments three to six months later. Caregivers of 106 younger children completed similar appraisals. 693 children attending the CYLCs completed pre-and post-educational assessments, which indicated major gains-significant at p < 0.0001-in both literacy (younger children, t = 9.06; youth, t = 13.87) and numeracy (younger children, t = 13.94; youths, t = 17.10). Children's CYLC attendance increased reports of met needs among caregivers (t = 2.53, p < 0.05) and youths (t = 2.57, p < 0.05), and, among caregivers but not youths, significantly moderated protection concerns (t = 2.39, p < 0.05, and t =-1.90, p = 0.06, respectively). There was general improvement in psychosocial well-being over time for all children; CYLC attendance predicted greater reductions in reported difficulties only among younger children (t = 2.51, p < 0.05).

BackgroundThe establishment of Child Friendly Spaces (CFSs) has become a widespread intervention targeting protection and support for displaced children in humanitarian contexts. There is a lack of evidence of impact of these interventions with respect to both short‐term outcomes and longer‐term developmental trajectories.MethodsWe collected data from caregivers of Congolese refugee children residing in Rwamwanja Refugee Settlement at three timepoints. To assess short‐term impact of CFSs, we compared indicators assessed shortly after refugees’ arrival (baseline, T1) and endline (T2, three to six months after CFS implementation) amongst 430 CFS attenders and 161 nonattenders. Follow‐up assessments after the end of CFS programming were conducted 18 months post‐baseline (T3) with caregivers of 249 previous CFS attenders and 77 CFS nonattenders.ResultsIn the short‐term, attendance at CFSs was associated with better maintenance of psychosocial well‐being (PSWB; β = 2.093, p < .001, Cohen's d = .347) and greater increases in developmental assets (β = 2.517, p < .001, Cohen's d = .231), with significantly stronger impacts for girls. CFS interventions meeting higher programing quality criteria were associated with greater impact on both PSWB and development assets (β = 2.603 vs. β = 1.793 and β = 2.942 vs. β = 2.337 for attenders at higher and lower‐quality CFSs c.f. nonattenders, respectively). Amongst boys, benefits of program attendance were only indicated for those attending higher‐quality CFS (β = 2.084, p = .006 for PSWB). At follow‐up, however, there were no discernable impacts of prior CFS attendance on any measures. Age and school attendance were the only characteristics that predicted an outcome – developmental assets – at follow‐up.ConclusionsAttendance at CFSs – particularly involving higher‐quality programming – supported children's well‐being and development. However, sustained impact beyond active CFS programming was not demonstrated. Intervention goals and strategies in humanitarian contexts need to address the challenge of connecting children to other resources to facilitate developmental progress in conditions of protracted displacement.

Background Humanitarian crises present major threats to the wellbeing of children. These threats include risks of violence, abduction and abuse, emotional distress and the disruption of development. Humanitarian response efforts frequently address these threats through psychosocial programming. Systematic reviews have demonstrated the weak evidence-base regarding the impact of such interventions. This analysis assesses the impact of Child Friendly Spaces (CFS), one such commonly implemented intervention after humanitarian emergencies. Methods We completed baseline and endline (three-six months post-baseline) assessments regarding protection concerns, psychosocial wellbeing, developmental assets and community resources for a total of 1010 children and 1312 carers in catchment areas for interventions with humanitarian populations in Ethiopia, Uganda, Iraq, Jordan, and Nepal. We estimated intervention effect-sizes with Cohen’s d for difference in mean difference scores between attenders and non-attenders – who proved comparable on baseline measures – by site. We then pooled findings for a meta-analysis summarizing overall impacts across domains. Results Amongst children aged 6–11, significant intervention impacts were observed through site-level analysis for protection concerns (Ethiopia, Cohen’s d = 0.48, 95% CI 0.08–0.88), psychosocial wellbeing (Ethiopia, d = 0.51, 95% CI 0.10–0.91; and Uganda, d = 0.21, 95% CI 0.02–0.40), and developmental assets (Uganda, d = 0.37, 95% CI 0.15–0.59; and Iraq, d = 0.86, 95% CI 0.18–1.54). Pooled analyses for this age group found impacts of intervention to be significant only for psychosocial wellbeing ( d = 0.18, 95% CI 0.03–0.33). Among children aged 12–17, site-level analysis indicated intervention impact for protection concerns in one site (Iraq, d = 0.58, 95% CI 0.07–1.09), with pooled analysis indicating no significant impacts. Conclusion CFS can provide – albeit inconsistently - a protective and promotive environment for younger children. CFS show no impact with older children and in connecting children and carers with wider community resources. A major reappraisal of programming approaches and quality assurance mechanisms is required. Electronic supplementary material The online version of this article (10.1186/s12889-019-6939-2) contains supplementary material, which is available to authorized users.

The last decade has been marked by increasing attention to rigor in the evaluation of interventions that seek to promote the mental health and psychosocial well-being of children in crisis contexts. One of the key markers of such rigor has been the increased adoption of strong quasi-experimental designs, where children receiving an intervention are compared to children not receiving the intervention. Although usually not randomly assigned to such conditions, children in the 'intervention' and 'comparison' groups are generally assumed to have had similar experiences other than in relation to exposure to the intervention. The use of such designs-when planned and implemented on a sound ethical basis-can significantly strengthen the capacity to make appropriate attribution of any changes observed by exploring the counterfactual case: what happens when there is no intervention? This question is usually supplementary to questions about the outcomes observed in children receiving the services being evaluated and crucial to inference regarding such outcomes. However, this paper argues that data from comparison groups has major value in its own right. Indeed, it represents a major untapped source of reflection on processes of resilience in humanitarian contexts. We use as a foundation for our analysis 3 studies completed over the last decade which examined the impact of protective and psychosocial interventions for war-affected children in Sierra Leone and Uganda. The interventions considered include programs fostering reintegration of formerly abducted children, prompting structured activities in schools, and establishing child-friendly spaces in refugee settlements. In each case, however, our focus is not on the group that received greatest attention in the original reports-the children receiving the intervention-but on those that did not. Analysis indicates the powerful forces which promote recovery in situations of conflict and the need for interventions to be more mindful that their core function is to bolster such engagement and not seek to drive recovery.

Background Child marriage is a human rights violation disproportionately impacting girls in low- and middle-income countries. In the Middle East region, conflict and displacement have prompted concerns that families are increasingly resorting to child marriage to cope with economic insecurity and fears from sexual violence. This study set out to examine child marriage among Syrian refugees residing in Egypt with the aim of understanding drivers of child marriage in this context of displacement as well as how child marriage affects refugee girls’ wellbeing. Methods This analysis draws from 15 focus group discussions (FGD) conducted with married and unmarried girls, as well as parents of adolescent girls in three governorates in Egypt. FGDs included a participatory ranking exercise and photo-elicitation. Additionally, we conducted 29 in-depth interviews with girls and mothers, as well as 28 key informant interviews with health providers, community leaders, and humanitarian actors. The data was thematically analyzed using a combination of inductive and deductive coding. Results A prevalent phenomenon in pre-war Syria, child marriage has been sustained after the influx of Syrian refugees into Egypt by pre-existing cultural traditions and gender norms that prioritize the role of girls as wives and mothers. However, displacement into Egypt engendered different responses. For some families, displacement-specific challenges such as disruptions to girls’ education, protection concerns, and livelihood insecurity were found to exacerbate girls’ vulnerability to child marriage. For others, however, displacement into urban areas in Egypt may have contributed to the erosion of social norms that favored child marriage, leading to marriage postponement. Among girls who were married early, we identified a range of negative health and social consequences, including lack of family planning use, disruption to schooling and curtailment of girls’ mobility as well as challenges with marriage and birth registration which accentuated their vulnerability. Conclusion Efforts to address child marriage among Syrian refugees must acknowledge the different ways in which displacement can influence child marriage attitudes and practices and should capitalize on positive changes that have the potential to catalyze social norm change. Moreover, targeted, focused and contextualized interventions should not only focus on preventing child marriage but also on mitigating its impacts.

No abstract

Objectives: This study assesses the prevalence of and risk factors for child marriage in Yemen, which was experiencing a nationwide conflict at the time of the study. Study Design: We conducted a survey of internally displaced persons (IDPs) and host communities using a stratified multistage cluster sampling design. Each household included an interview with a female adult (n=1210), a household roster (n=8400), and one female adolescent interview (n=1210). We used multivariate logistic regression to assess the association between child marriage and various risk factors. We also used data from focus groups (n=411) and key informant interviews (n=30) to explore community perspectives and understand contextual factors relating to child marriage. Results: Prevalence of child marriage among IDP females aged 10-19 was 18.1% compared to 12.7% among hosts. In the regression model, being older (aOR=1.95), never attending school (aOR=3.94), place of origin of Saada (aOR=4.41), and unemployment of the female adult (aOR=2.84) showed increased odds of child marriage. Head of household unemployment (aOR=0.58) and completed higher education (aOR=0.42) showed decreased odds. Qualitatively, economic factors were cited as central factors in decision-making, both for host communities and even more so for IDPs. Perceptions of marriage readiness and negative consequences of child marriage were dependent on gender normative expectations. Conclusions: Displaced girls experience child marriage more than boys or host girls . Displacement effects economic security and household power dynamics, which affects marriage decision-making and girl s ability to self-advocate. Efforts to address child marriage in Yemen should include livelihood support, with awareness and conflict management components that start in pre-adolescence and include married and unmarried girls.

Background The experiences of protracted conflict and displacement are clear threats to children’s developmental progress. Understanding the factors that shape the trajectories of children’s well-being and adjustment in such contexts is important for informing interventions. Methods We collected data at three time points from a sample of Syrian refugee and Jordanian children (n=650) residing in Zarqa, Jordan who met eligibility criteria for humanitarian programming. We assessed primary outcomes of protection concerns, caregiver stress, mental health, and developmental assets at three time points: baseline (T1), three months later (T2), and fifteen months after baseline (T3). Results Over the fifteen-month study period (T1-T3) child protection concerns and mental health symptoms improved, caregiver stress remained constant, and developmental assets deteriorated. School attendance was independently associated with improvements in protection concerns ( β = −1.05, P =0.01), caregiver stress ( β = −0.66, P =0.02), and developmental assets ( β = 3.84, P =0.02). Concern over lost livelihoods significantly predicted higher protection concerns ( β = 4.08, P <0.001) and caregiver stress ( β = 2.32, P <0.001). Attending child-focused programming did not significantly impact primary outcomes. Conclusions This study documents the capacity for adjustment and adaptation of children in the context of protracted displacement. The significant influences of attending school and concern over lost livelihoods on observed trajectories indicate the importance of addressing structural factors, such as education and employment, in supporting processes of resilience in these populations. Programmatic activities for children may secure valuable shorter-term impacts but here, as elsewhere, failed to impact outcomes longer-term.