Parenting, mental health and economic pathways to prevention of violence against children in South Africa

Cluver, Lucie; Shenderovich, Yulia; Meinck, Franziska; Berezin, McKenzie; Doubt, Jenny; Ward, Catherine L.; Parra‐Cardona, José Rubén; Lombard, Carl; Lachman, Jamie M.; Wittesaele, Camille; Wessels, Inge; Gardner, Frances; Steinert, Janina

doi:10.1016/j.socscimed.2020.113194

Cited by 27 publications

(22 citation statements)

References 45 publications

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“…A drawback of this observational approach is that it is unable to say whether identified relationships between self-reported protective factors and violence outcomes are causal. In relation to existing literature, study findings are supported by evidence that positive and supervisory caregiving are important mediators of the effects of parenting support interventions on physical abuse, emotional abuse, and behaviour problems [31]. They are also consistent with growing observational evidence linking parenting to adolescent violence victimisation and perpetration across settings [32].…”

Section: Plos Medicinesupporting

confidence: 81%

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 Medicinesupporting

confidence: 81%

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

et al. 2020

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“…30 , are needed to tackle harmful cultural norms that perpetuate violence among boys and decrease tolerance of violence overall 31,32 . These programs should target both boys and girls, men and women, as parents play a key role in the reduction of violence against children and teens 16 .…”

Section: Discussionmentioning

confidence: 99%

“…Sex and gender become increasingly important when assessing vulnerability to violence 12 and the social factors and biological changes that take place during adolescence, as these result in gendered differences in experiences of violence 13 . Current research highlights that girls are at higher risk of sexual violence compared to boys 12,14,15 , however, few papers report on risk factors associated with ever experiencing violence 16 .…”

Section: Introductionmentioning

confidence: 99%

Experiences of violence among female and male grade eight learners: baseline findings from the Girls Achieve Power (GAP Year) trial across three South African townships

et al. 2021

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Background: South African adolescents experience disproportionally high rates of violence, with lifelong health, social and economic impacts. Few papers present risk factors associated with experiences of adolescent violence. Methods: A baseline cross-sectional survey was done (April 2017 – Sept 2018) with 3432 grade 8 learners in the Girls Achieve Power (GAP Year) trial from 26 high schools in three townships (Soweto and Tembisa, Gauteng and Khayelitsha, Western Cape). Collected data on lifetime experiences of different types of violence, perpetrators, and place of violence. Descriptive statistics and logistic regression were used to enumerate experiences of, and factors associated with violence. Results: A total of 2383 respondents are included. Most (63.1%) were girls, 81.5% aged 12-14. In total 26% had ever experienced violence, higher among boys (p=<0.001). Physical violence was most common (35.7%), then psychological (21.8%), sexual (13.1%), neglect (10.6%), cyberbullying (7.6%), corporal punishment (6.5%) and economic abuse (4.8%). Boys experienced more physical violence (36.0%); girls experienced more psychological violence (22.2%). Gauteng had double the reports of sexual violence (18.4% vs 7.6%, p<0.001). Violence happened most at school (27.4%), followed by the park (19.8%) or their friends’ home (12.9%). Multivariate analysis showed that boys (aOR 1.57; 95% CV 1.27-1.94; p=0.000), those aged 15-17 years (aOR 1.41; 95% CV 1.07-1.84; p=0.013), those who ever used substances (aOR 1.92; 95% CI 1.54-2.37; p=0.000), and those who sometimes feel worthless (aOR 1.35; 95% CI 1.10-1.64, p=0.003) were at higher odds of ever experiencing violence. Those who had never had sex were less likely to have ever experienced violence (aOR 0.66; 95% CI 0.51-0.83; p=0.001). Conclusion: Urgently need wider adoption, scaling, and sustaining of evidence-based primary violence prevention and structural interventions are required to reduce the high burden of adolescent violence. Stakeholders across the ecological model are needed to tackle harmful cultural norms that perpetuate violence.

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“…93 Previous epidemiological studies of school-age children in developing countries used selfreport. [94][95][96][97][98] Previous studies measured the relationship between children's self-reported gastrointestinal (and respiratory) diseases and school WaSH: Weaver and others, 81 who measured self-reported diarrhea and vomiting; Otsuka and others, 72 who measured selfreported diarrhea and respiratory symptoms; Chard and Freeman, 99 who measured selfreported diarrhea and respiratory symptoms and STH infection (unspecified method of assessment). Previous studies (employing a cross-sectional study design) used children's self-report to assess knowledge, attitudes, and practices (KAP) about STH infection, prior to implementing a school-based intervention.…”

Section: Limitationsmentioning

confidence: 99%

Diarrhea, Helminth Infection, Dehydration, and Malnutrition Associated with Water, Sanitation, and Hygiene Facilities and Poor Handwashing in Schools in Metro Manila, Philippines: A Cross-Sectional Study

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et al. 2020

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Diarrhea, soil-transmitted helminth (STH) infection, and malnutrition threaten the lives of millions of children globally but particularly in the Global South, where inadequate water, sanitation, and hygiene (WaSH) drive disease risk. The aim of our study was to identify environmental and behavioral risk factors of these diseases among schoolchildren in Metro Manila, Philippines. We analyzed data from a multistage cluster sample of grade 5-10 students to investigate WaSH facilities and hygiene practices. Outcomes were self-reported diarrhea and STH infection and observed malnutrition (stunting, undernutrition, over-nutrition); we used logistic regression models to explore correlates. We included 1,558 students from 15 schools in 3 cities. Over 14% (212) of students experienced diarrhea only, 29.7% (438) experienced STH infection only, and 14% (207) experienced both diarrhea and STH infection. Over 15% (227) of students were stunted, ∼6% (87) were undernourished, and 21% (306) were over-nourished. While diarrhea was associated with poor handwashing, avoiding school restrooms, and lack of a restroom cleaning policy, STH infection was associated with students’ dissatisfaction with school restrooms. Risk of having both diarrhea and STH infection increased when school restrooms lacked water or were unclean. Being only stunted was associated with diarrhea, while being both stunted and undernourished was associated with STH infection. These findings demonstrate that adequate water supply and cleanliness of school WaSH facilities must be achieved and maintained to prevent disease. Future school-based WaSH interventions are recommended to provide clean WaSH facilities that have water, promote handwashing, and discourage avoidance of school toilets.

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Parenting, mental health and economic pathways to prevention of violence against children in South Africa

Cited by 27 publications

References 45 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

Experiences of violence among female and male grade eight learners: baseline findings from the Girls Achieve Power (GAP Year) trial across three South African townships

Diarrhea, Helminth Infection, Dehydration, and Malnutrition Associated with Water, Sanitation, and Hygiene Facilities and Poor Handwashing in Schools in Metro Manila, Philippines: A Cross-Sectional Study

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