Factors Associated With Violence Against Children in Low- and Middle-Income Countries: A Systematic Review and Meta-Regression of Nationally Representative Data

Abstract

Background: This systematic review and meta-regression sought to identify the relative importance of factors associated with physical, emotional, and sexual violence against children in low- and middle-income countries. Understanding of factors associated with violence is important for targeted programming and prevention on the population level. Methods: We searched 17 electronic databases from 1989 to 2018 and reports from child violence surveys. Nationally representative studies that described evidence on potential factors associated with violence against children under 18 years old were included. The search was restricted to the English language. Factors were synthesized quantitatively using robust variance estimation, with 95% confidence intervals, for each violence type. Results: We identified 8,346 unduplicated studies, and 103 publications met our eligibility criteria. The data distribution was uneven across region, country income status, factors, and violence types. Of the 94 eligible studies quantitatively synthesized, no specific factors were significant for physical violence. Lower household socioeconomic status, being a girl, and primary education of mothers and adults in the household were associated with emotional violence, and being a girl was associated with sexual violence. Conclusion: A broad spectrum of factors merit consideration for physical violence policy and prevention among the general population of children in low- and middle-income countries. Conversely, a tailored approach may be warranted for preventing emotional and sexual violence. Information is unequally distributed across countries, factors, and violence types. Greater emphasis should be placed on collecting representative data on the general population and vulnerable subgroups to achieve national reductions in violence against children.

The Apapacho Violence Prevention Parenting Program: Conceptual Foundations and Pathways to Scale

“…Global research, including reviews [ 7 , 59 , 60 ] and cross-cultural studies [ 61 , 62 ], showed that multiple factors at the individual, family, community, and society levels predict VAC. Some of these factors include caregivers’ beliefs that children need physical punishment to be raised properly, caregivers’ mental health and self-regulation skills, caregivers’ own exposure to physical punishment in their childhood, low caregiver education, lower socioeconomic status, living in a violent context, living in rural vs. urban areas, and gender inequity, among others.…”

“…Some of these factors include caregivers’ beliefs that children need physical punishment to be raised properly, caregivers’ mental health and self-regulation skills, caregivers’ own exposure to physical punishment in their childhood, low caregiver education, lower socioeconomic status, living in a violent context, living in rural vs. urban areas, and gender inequity, among others. Several studies also conclude that children aged 3–5 years old are at higher risk of experiencing physical punishment relative to younger children, and there are mixed findings related to sex-related differences [ 59 , 61 ].…”

Global prevalence of physical and psychological child abuse during COVID-19: A systematic review and meta-analysis

“…Multiple telecommuting spouses who were also solely responsible for child care faced high stress as well, which sometimes led to increased rates of child abuse ( Blundell et al, 2020 ; Wong et al, 2021 ). Researchers have consistently identified that child abuse occurs disproportionately more often in groups of low socio-economic status, especially violence against children ( Cerna-Turoff et al, 2021 ; Department of Health and Human Services, 2021 ). The countries of Africa show among the most serious rates of child abuse in the world, and it seems necessary to conduct cross-cultural research across Africa to gain better understanding of abuse rates and causes across the continent ( Stoltenborgh et al, 2013 ).…”

“…We examined publication bias with Egger's test and the aid of a funnel plot. Then, depending on the type of variable, we conducted comprehensive statistical analyses ( Chan et al, 2021 ), specifically subgroup analysis and meta-regression, to identify and examine the moderating variables that cause differences in the global prevalence of child abuse ( Cerna-Turoff et al, 2021 ).…”

The pathways between natural disasters and violence against children: a systematic review

“…Identifying the junctures at which one can intervene and the mechanisms by which violence occurs facilitates better tailoring of protection programming. A robust evidence base from stable settings provides helpful insight on factors that can lead to violence against children; however, pathways to violence after natural disasters are less well understood [ 33 , 34 ]. Elsewhere, we conducted a meta-analysis which showed that there is inconclusive evidence of a direct association between natural disasters and violence against children, but noted that more nuanced research was needed to disentangle pathways to violence [ 35 ].…”