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Abstract
This article documents the increasing numbers of children impacted annually by 1 or more types of violence against children and describes the range of types of injuries and their immediate and long-term impacts on child outcomes. The article describes the growing number of international collaborations to decrease the numbers of children impacted by violence and to mitigate the consequences thereof, with a particular emphasis on children living in war zones.
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Affiliation(s)
- Bonita Stanton
- Hackensack Meridian School of Medicine, 340 Kingsland Street, Nutley, NJ 07110, USA.
| | - Brittney Davis
- New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, USA
| | - Danielle Laraque-Arena
- New York Academy of Medicine, Mailman School of Public Health, Columbia University, SUNY Upstate Medical University, 1216 Fifth Avenue, New York, NY 10029, USA
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Culbreth R, Masyn KE, Swahn MH, Self-Brown S, Kasirye R. The interrelationships of child maltreatment, alcohol use, and suicidal ideation among youth living in the slums of Kampala, Uganda. CHILD ABUSE & NEGLECT 2021; 112:104904. [PMID: 33385928 PMCID: PMC7855690 DOI: 10.1016/j.chiabu.2020.104904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND Youth living in the slums of Kampala face many adversities, such as dire environmental conditions, poverty, and lack of government infrastructure. OBJECTIVE The purpose of this study is to examine the interplay of alcohol use and child maltreatment on suicidal ideation among youth living in the slums of Kampala, Uganda. PARTICIPANTS AND SETTING The study sample includes service-seeking youth who were attending Uganda Youth Development Link (UYDEL) drop-in centers in spring 2014 (n = 1134). METHODS Indicators of child maltreatment included parental physical abuse, parental neglect, and sexual abuse. Problematic alcohol use was specified using a hybrid structural equation mixture model that distinguished current drinking status with the frequency and intensity of use among current drinkers. This novel approach is more flexible than restricting our analysis to only drinkers or analyzing only current drinking status. The primary outcome of interest was suicidal ideation. All associations controlled for gender and age, and all associations were estimated simultaneously. All analyses were conducted in SAS 9.4 and Mplus 7.4. RESULTS The overall prevalence of suicidal ideation was 23.5 % (n = 266). Overall, current drinking status (OR: 1.80; 95 % CI: 1.31, 2.46), the child maltreatment sum score (OR: 1.88; 95 % CI: 1.48, 2.39), and sexual abuse (OR: 2.88; 95 % CI: 1.52, 5.47) were statistically significantly associated with reporting suicidal ideation. CONCLUSIONS This study highlights a population that would potentially benefit from prevention efforts not only aimed at suicide prevention but also harm reduction in terms of alcohol use and experiences of child maltreatment.
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Affiliation(s)
- Rachel Culbreth
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 4019, Atlanta, GA, 30302-4019, United States.
| | - Katherine E Masyn
- Population Health Sciences, School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302-3995, United States
| | - Monica H Swahn
- Population Health Sciences, School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302-3995, United States
| | - Shannon Self-Brown
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA, 30302-3995, United States
| | - Rogers Kasirye
- Uganda Youth Development Link, P.O. Box 12659, Kampala, Uganda
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Enriching Service-Learning by Developing e-Tutoring in Foster Homes. SYSTEMIC PRACTICE AND ACTION RESEARCH 2018. [DOI: 10.1007/s11213-017-9423-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Institutions are not necessarily good environments for children. In the face of challenges such as HIV, Ebola, poverty, conflict and disaster the numbers have grown rather than reduced. Some countries have closed institutions down -driven by findings that cognitive developmental delay is associated with institutional care. Yet insight into abuse and violence within institutionalised settings is neglected. Maltreatment -violence and abuse -may be an issue. This systematic review series addresses violence and abuse experiences in institutionalised care, exploring firstly the frequency of abuse/violence in institutions, secondly any interventions to reduce such violence or abuse and thirdly the perpetrators of such violence or abuse. The final systematic review updates the findings on cognitive delay associated with institutionalised care. With a violence lens, cognitive delay may well be considered under the umbrella of neglect. Maltreatment and abuse may be a driver of cognitive delay. The keyword search covered several electronic databases and studies were included for data abstraction if they met adequacy criteria. Eight studies were identified on the prevalence of abuse in institutions and a further three studies reported on interventions. Only one study was identified documenting peer on peer violence in institutions. Sixty-six studies were identified examining cognitive development for institutionalised children. All but two of these record cognitive deficits associated with institutionalisation. Only two asked about violence or abuse which was found to be higher in institutionalised children. Overall the abuse experiences of children in institutions are poorly recorded, and in one study violence was associated with high suicidal attempts. The major intervention pathway for ameliorating cognitive challenge seems to be placement out of the institutions which shows benefits and redresses some cognitive outcomes - yet not a total panacea. The single study providing training and monitoring of harsh punishment and maltreatment showed immediate and decided reductions. This data suggest, despite the paucity of studies, violence and abuse, by commission or omission is prevalent in institutions, has an effect on child well-being and is amenable to intervention. Simple training or more complex structures to place children within conducive alternative environments (or to avoid institutionalised placements in the first place) seem to be the main pathway of intervention.
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Affiliation(s)
- Lorraine Sherr
- a Department of Infection & Population Health , University College London , London , UK
| | - Kathryn J Roberts
- a Department of Infection & Population Health , University College London , London , UK
| | - Natasha Gandhi
- a Department of Infection & Population Health , University College London , London , UK
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Petersen I, Evans-Lacko S, Semrau M, Barry MM, Chisholm D, Gronholm P, Egbe CO, Thornicroft G. Promotion, prevention and protection: interventions at the population- and community-levels for mental, neurological and substance use disorders in low- and middle-income countries. Int J Ment Health Syst 2016; 10:30. [PMID: 27069506 PMCID: PMC4827227 DOI: 10.1186/s13033-016-0060-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 03/23/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In addition to services within the health system, interventions at the population and community levels are also important for the promotion of mental health, primary prevention of mental, neurological and substance use (MNS) disorders, identification and case detection of MNS disorders; and to a lesser degree treatment, care and rehabilitation. This study aims to identify "best practice" and "good practice" interventions that can feasibly be delivered at these population- and community-levels in low- and middle-income countries (LMICs), to aid the identification of resource efficiencies and allocation in LMICs. METHODS A narrative review was conducted given the wide range of relevant interventions. Expert consensus was used to identify "best practice" at the population-level on the basis of existing quasi-experimental natural experiments and cost effectiveness, with small scale emerging and promising evidence comprising "good practice". At the community-level, using expert consensus, the ACE (Assessing Cost-Effectiveness in Prevention Project) grading system was used to differentiate "best practice" interventions with sufficient evidence from "good practice" interventions with limited but promising evidence. RESULTS At the population-level, laws and regulations to control alcohol demand and restrict access to lethal means of suicide were considered "best practice". Child protection laws, improved control of neurocysticercosis and mass awareness campaigns were identified as "good practice". At the community level, socio-emotional learning programmes in schools and parenting programmes during infancy were identified as "best practice". The following were all identified as "good practice": Integrating mental health promotion strategies into workplace occupational health and safety policies; mental health information and awareness programmes as well as detection of MNS disorders in schools; early child enrichment/preschool educational programs and parenting programs for children aged 2-14 years; gender equity and/or economic empowerment programs for vulnerable groups; training of gatekeepers to identify people with MNS disorders in the community; and training non-specialist community members at a neighbourhood level to assist with community-based support and rehabilitation of people with mental disorders. CONCLUSION Interventions provided at the population- and community-levels have an important role to play in promoting mental health, preventing the onset, and protecting those with MNS disorders. The importance of inter-sectoral engagement and the need for further research on interventions at these levels in LMICs is highlighted.
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Affiliation(s)
- Inge Petersen
- Centre for Rural Health, School of Nursing and Public Health and School of Applied Human Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Sara Evans-Lacko
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Maya Semrau
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Margaret M Barry
- World Health Organization Collaborating Centre for Health Promotion Research, National University of Ireland Galway, Galway, Ireland
| | - Dan Chisholm
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Petra Gronholm
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Catherine O Egbe
- School of Applied Human Sciences, University of KwaZulu Natal, Durban, South Africa ; Center for Tobacco Control Research and Education, University of California, San Francisco, USA
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Hillis S, Mercy J, Amobi A, Kress H. Global Prevalence of Past-year Violence Against Children: A Systematic Review and Minimum Estimates. Pediatrics 2016; 137:e20154079. [PMID: 26810785 PMCID: PMC6496958 DOI: 10.1542/peds.2015-4079] [Citation(s) in RCA: 515] [Impact Index Per Article: 64.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Evidence confirms associations between childhood violence and major causes of mortality in adulthood. A synthesis of data on past-year prevalence of violence against children will help advance the United Nations' call to end all violence against children. OBJECTIVES Investigators systematically reviewed population-based surveys on the prevalence of past-year violence against children and synthesized the best available evidence to generate minimum regional and global estimates. DATA SOURCES We searched Medline, PubMed, Global Health, NBASE, CINAHL, and the World Wide Web for reports of representative surveys estimating prevalences of violence against children. STUDY SELECTION Two investigators independently assessed surveys against inclusion criteria and rated those included on indicators of quality. DATA EXTRACTION Investigators extracted data on past-year prevalences of violent victimization by country, age group, and type (physical, sexual, emotional, or multiple types). We used a triangulation approach which synthesized data to generate minimum regional prevalences, derived from population-weighted averages of the country-specific prevalences. RESULTS Thirty-eight reports provided quality data for 96 countries on past-year prevalences of violence against children. Base case estimates showed a minimum of 50% or more of children in Asia, Africa, and Northern America experienced past-year violence, and that globally over half of all children-1 billion children, ages 2-17 years-experienced such violence. LIMITATIONS Due to variations in timing and types of violence reported, triangulation could only be used to generate minimum prevalence estimates. CONCLUSIONS Expanded population-based surveillance of violence against children is essential to target prevention and drive the urgent investment in action endorsed in the United Nations 2030 Sustainable Development Agenda.
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Affiliation(s)
- Susan Hillis
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | | | - Adaugo Amobi
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Boothby N, Balster RL, Goldman P, Wessells MG, Zeanah CH, Huebner G, Garbarino J. Coordinated and evidence-based policy and practice for protecting children outside of family care. CHILD ABUSE & NEGLECT 2012; 36:743-751. [PMID: 23107455 DOI: 10.1016/j.chiabu.2012.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 09/07/2012] [Indexed: 06/01/2023]
Affiliation(s)
- Neil Boothby
- United States Agency for International Development, Washington, DC 20523, USA
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Higgs ES, Zlidar VM, Balster RL. Evidence acquisition and evaluation for a U.S. Government Evidence Summit on Protecting Children Outside Family Care. CHILD ABUSE & NEGLECT 2012; 36:689-700. [PMID: 23083899 DOI: 10.1016/j.chiabu.2012.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 09/07/2012] [Indexed: 05/27/2023]
Abstract
Recognizing the need for evidence to inform policies, strategies, and programs to care for vulnerable children, the U.S. Government convened an Evidence Summit on Protecting Children Outside of Family Care on December 12-13, 2011, in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used to achieve the goals of the Summit. A multistep process was undertaken to identify the appropriate evidence for review. It began by identifying crucial focal questions intended to inform low and middle income governments and the U.S. Government about effective systems for protecting children outside family care. This was followed by a systematic attempt to gather relevant peer reviewed and gray literature that would inform these focal questions. The search processes, methods used for screening and quality reviews are described. In addition, members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliographies. These teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. This was the first U.S. Government Evidence Summit originating in the U.S. Agency for International Development Global Health Bureau and valuable lessons were learned on the identification and assessment of evidence informing complex development challenges.
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Affiliation(s)
- Elizabeth S Higgs
- Global Health Bureau, U.S. Agency for International Development, Washington, DC, USA.
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Boothby N, Wessells M, Williamson J, Huebner G, Canter K, Rolland EG, Kutlesic V, Bader F, Diaw L, Levine M, Malley A, Michels K, Patel S, Rasa T, Ssewamala F, Walker V. What are the most effective early response strategies and interventions to assess and address the immediate needs of children outside of family care? CHILD ABUSE & NEGLECT 2012; 36:711-721. [PMID: 23084623 DOI: 10.1016/j.chiabu.2012.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 09/07/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Children outside of family care face increased risk of threats to their well-being, have lower educational achievement, and experience adverse developmental outcomes. While it is generally accepted that early response and intervention is critical to reducing the risk of harm for children who have been separated from their families, it is not always clear what the most effective early response strategies are for assessing and addressing their immediate needs. The purpose of this review was to identify evidence-based early response strategies and interventions for improving the outcomes of children outside of family care, including children of and on the street, institutionalized children, trafficked children, children affected by conflict and disaster, and who are exploited for their labor. METHODS A multi-phased, systematic evidence review was conducted on peer-reviewed and gray literature, which yielded a total of 101 documents that met the inclusion criteria and were reviewed. RESULTS Overall there is a weak evidence base regarding assessment and early response interventions for children living outside of family care. Few studies included careful outcome measures or comparison groups. Although few proven interventions emerged, the review identified several promising early interventions and approaches. In emergency settings, family tracing and reunification is a highly effective response in regard to separated children, whereas placing children in institutional care is problematic, with the possible exception of time-limited placements of formerly recruited children in interim care centers. Livelihood supports are promising in regard to preventing and responding to children living outside family care. Other promising interventions include psychosocial support, including the use of traditional cleansing rituals as appropriate, educational supports such as Child Friendly Spaces, the maintenance of family connectedness for children of or on the streets, the use of community-based approaches that aid social integration, and approaches that enable meaningful child participation. A recurrent theme was that to be effective, all assessments and interventions must fit the context. CONCLUSION A strong need exists for strengthening the evidence base regarding the effectiveness of early assessments and responses to children living outside family care and for using the evidence to guide operational policy and practice. Recommendations regarding policy, practices, and research emerged from the review process.
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Affiliation(s)
- Neil Boothby
- Columbia University, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
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Maholmes V, Fluke JD, Rinehart RD, Huebner G. Protecting children outside of family care in low and middle income countries: what does the evidence say? CHILD ABUSE & NEGLECT 2012; 36:685-688. [PMID: 23092938 DOI: 10.1016/j.chiabu.2012.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 09/07/2012] [Indexed: 06/01/2023]
Affiliation(s)
- Valerie Maholmes
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health and Human Services, Rockville, MD 20852, USA
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