Combining parenting and economic strengthening programmes to reduce violence against children: a cluster randomised controlled trial with predominantly male caregivers in rural Tanzania

Lachman, Jamie M.; Wamoyi, Joyce; Spreckelsen, Thees F.; Wight, Daniel; Maganga, Jane; Gardner, Frances

doi:10.1136/bmjgh-2020-002349

Cited by 32 publications

(19 citation statements)

References 27 publications

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“…Parenting support programmes improve both positive and supervisory caregiving [41], and household food security may be increased by either cash transfers or other nutrition-sensitive programmes [33,42]. Combining parenting support with economic strengthening is also an effective way to address these household-level factors in an integrated way [43][44][45][46]. Before strong policy recommendations can be made, a number of further research steps are necessary.…”

Section: Plos Medicinementioning

confidence: 99%

Violence prevention accelerators for children and adolescents in South Africa: A path analysis using two pooled cohorts

et al. 2020

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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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Section: Plos Medicinementioning

confidence: 99%

Violence prevention accelerators for children and adolescents in South Africa: A path analysis using two pooled cohorts

et al. 2020

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“…This study also provided empirical evidence for the advantages of combining social learning-based parenting programmes and economic strengthening interventions to accelerate impacts across multiple Sustainable Development Goal targets. 20 In comparison to treatment as usual families, caregivers who underwent MaPa reported significant post-intervention reductions in dysfunctional parenting; for secondary outcomes, there were reductions in daily child problem behaviours. These results are consistent with research on other effective parenting interventions that use social learning-based strategies, including praising children's positive actions, setting limits, and addressing child misbehaviours consistently and with regulated emotions.…”

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Effectiveness of a parenting programme to reduce violence in a cash transfer system in the Philippines: RCT with follow-up

Lachman

Alampay

Jocson

et al. 2021

The Lancet Regional Health - Western Pacific

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Background: Parenting interventions and conditional cash transfer (CCT) programmes are promising strategies to reduce the risk of violence against children, but evidence of the effectiveness of combining such programmes is lacking for families in low-and middle-income countries with children over two years of age. This study examined the effectiveness of a locally adapted parenting programme delivered as part of a government CCT system to low-income families with children aged two to six years in Metro Manila, Philippines. Methods: Participants were randomly assigned (1:1) to either a 12-session group-based parenting programme or treatment-as-usual services ( N = 120). Participation in either service was required among the conditions for receiving cash grants. Baseline assessments were conducted in July 2017 with one-month post-intervention assessments in January-February 2018 and 12-month follow-up in January-February 2019. All assessments were parent-report (ClinicalTrials.gov: NCT03205449). Findings: One-month post-intervention assessments indicated moderate intervention effects for primary outcomes of reduced overall child maltreatment ( d = -0.50 [-0.86, -0.13]), emotional abuse ( d = -0.59 [-0.95; -0.22]), physical abuse (IRR = 0.51 [0.27; 0.74]), and neglect (IRR = 0.52 [0.18; 0.85]). There were also significant effects for reduced dysfunctional parenting, child behaviour problems, and intimate partner violence, and increased parental efficacy and positive parenting. Reduced overall maltreatment, emotional abuse, and neglect effects were sustained at one-year follow-up. Interpretation: Findings suggest that a culturally adapted parenting intervention delivered as part of a CCT programme may be effective in sustaining reductions in violence against children in low-and middleincome countries.

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“…Increasing policy interest in optimising parenting influence provides a great opportunity for the early prevention of GBV. Evidence is emerging that parenting programmes in LMICs to reduce child maltreatment, if delivered by trained facilitators, can improve child outcomes ( Engle et al, 2011 ; Knerr et al, 2013 ; Lachman et al, 2018 , 2020 ; Shenderovich et al, 2019 ; Singla et al, 2015 ). Given the shared risk factors for VAC and GBV, such programmes may also reduce subsequent GBV.…”

Section: Step 1: Defining the Problem And Causesmentioning

confidence: 99%

A Ugandan Parenting Programme to Prevent Gender-Based Violence: Description and Formative Evaluation

Wight¹,

Sekiwunga²,

Namutebi³

et al. 2022

Research on Social Work Practice

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Purpose: To develop a culturally-sensitive intervention for the early prevention of gender-based violence (GBV) in Uganda. Methods: Programme design followed the 6SQuID model of intervention development and multi-sectorial advice. A formative evaluation was conducted in two communities with six groups and 138 participants. Findings: Four familial predictors of GBV were identified as potentially malleable: poor parent–child attachment, harsh parenting, inequitable gendered socialization and parental conflict. A community-based parenting programme was developed to address them. Its programme theory incorporates Attachment Theory, the concept that positive behavioural control develops emotional control, and Social Learning Theory. Its rationale, structure and content are presented using the TIDieR checklist. A formative evaluation showed the programme to be widely acceptable, culturally appropriate, and perceived to be effective, but also identified challenges. Conclusion: The careful development of this community-based parenting programme shows promise for the early prevention of GBV.

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Combining parenting and economic strengthening programmes to reduce violence against children: a cluster randomised controlled trial with predominantly male caregivers in rural Tanzania

Cited by 32 publications

References 27 publications

Violence prevention accelerators for children and adolescents in South Africa: A path analysis using two pooled cohorts

Violence prevention accelerators for children and adolescents in South Africa: A path analysis using two pooled cohorts

Effectiveness of a parenting programme to reduce violence in a cash transfer system in the Philippines: RCT with follow-up

A Ugandan Parenting Programme to Prevent Gender-Based Violence: Description and Formative Evaluation

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