Preventing and Addressing Violence Against Children
/
Violence, abuse, and neglect threaten children’s health and well-being. It is estimated that each year around 1 billion children worldwide experience interpersonal violence including corporal punishment, maltreatment, bullying, sibling or peer violence, trafficking, or sexual abuse (1). The Evidence for Better Lives Study (EBLS) aims to generate the knowledge required to support positive psychosocial development from early childhood. Its impact strategy will ensure that findings will be widely disseminated so they can inform international violence reduction policies and programmes. Activities will support the local expertise in each site, as well as strengthen their research infrastructure and collaborative networks.
Evidence for Better Lives Study
The Evidence for Better Lives Study (EBLS) is an interdisciplinary research project by a consortium of universities and institutions across the world—Babes-Bolyai University, University of Cape Town, University of Ghana - Legon, Health Services Academy, Islamabad, Hue University of Medicine and Pharmacy, Stellenbosch University, University of Cambridge, University of Edinburgh, Queensland University of Technology, University of Kelaniya, University College London, University of the Philippines and University of the West Indies—united in the aim to find effective approaches that reduce violence against children (2).
EBLS originated from recommendations following the 2014 conference “Global Strategies to Reduce Violence by 50% in 30 Years”, jointly organised by World Health Organization (WHO) and the Violence Research Centre, part of the Institute of Criminology at the University of Cambridge. It is designed to make a substantial contribution to the Sustainable Development Goals (SDGs), launched by the United Nations in 2016, which include the call on all nations to end violence against children and adolescents by 2030, and to promote their well-being (3).
EBLS aims to answer questions such as: What is the level of exposure to violence in a city and its communities? What are the risk factors for violence against children and their mothers? What is needed to reduce levels of violence against children and their mothers across entire cities? What resources do cities have to do this? How can they develop cost-effective strategies that respond to their needs?
Findings from the EBLS pilot study
Initial findings from the ‘Foundational Study’ stage of the project were officially presented on the November 25, 2019 Symposium, where two short films and a key report entitled Addressing Violence against Children: Mapping the Needs and Resources in Eight Cities across the World were launched (4).
This phase comprised two main elements: a survey based on convenience samples of at least 150 pregnant women in each of the eight study sites (all lower- and middle-income countries, with a total sample of N = 1208) and a needs and resources expert assessment based on interviews with 56 local stakeholders. The INSPIRE—‘seven strategies to end violence against children’—framework was adopted to structure the themes of the report (5).
We chose medium-size cities because cities are catalysts for progressive change due to their potential to cross-fertilise ideas, attract talent and expertise, and provide a testing ground for innovation: Kingston, Jamaica; Koforidua, Ghana; Worcester, South Africa; Cluj-Napoca, Romania; Tarlai, Pakistan; Ragama, Sri Lanka; Hue, Vietnam; and Valenzuela, Philippines. Cities are also crucial for achieving the United Nations’ Sustainable Development Goals (6). This is expressed, for example, in the inclusion of an urban goal (SDG Goal 11: “Make cities and human settlements inclusive, safe, resilient and sustainable”) and the New Urban Agenda adopted globally in 2016, which includes addressing violence, making cities safe and liveable spaces for all (7).
The survey data showed substantial variation across cities regarding exposure to violence but overall more than half of the pregnant women (54 percent) who participated remembered having been victims of violence (e.g., spanking, hitting with an object, slapping) at home before the age of 18. The rates were highest in Kingston (72 percent), Worcester (68 percent) and Ragama (67 percent), while expectant mothers in Tarlai and Hue reported lower rates (27 percent and 35 percent). A high proportion of women (57 percent) witnessed violence in their neighbourhoods, such as gang activity and fights in public spaces. While in Kingston and Worcester, over 80 percent identified this type of violence, the rate in Cluj-Napoca was 30 percent. Domestic violence—psychological, physical, or sexual violence from an intimate partner during pregnancy—averaged 30 percent across the study sites. This figure was highest in Kingston and in Worcester at 41 percent; however, even in Hue and Cluj-Napoca where the rates were at their lowest, 14 percent and 18 percent of women respectively reported experiencing domestic violence during pregnancy.
The study also investigated norms and attitudes on corporal punishment. In the interview questionnaires, statements were included indicating that spanking is harmless, it is a sign of parental love and a strategy to support children’s learning. A third of the mothers overall (34 percent) believed that spanking does not harm children. The highest rates of agreement were observed in Worcester (63 percent), Hue (55 percent) and Ragama (40 percent), the lowest in Cluj-Napoca (9 percent). A high percentage of mothers supported the idea that spanking is a sign of parental love: 40 percent overall; the highest rates in Worcester (75 percent), Valenzuela (52 percent) and Tarlai (48 percent), the lowest in Cluj-Napoca (5 percent). The last statement, “children learn best when parents use corporal punishment” was supported by 28 percent of women overall. Half of the participants from Worcester (51 percent) and Hue (49 percent) displayed favourable attitudes toward spanking. In Cluj-Napoca, Kingston and Ragama, the support of this belief was marginal.
The INSPIRE scheme reinforces the importance of living in safe environments, characterised by low levels of contamination, the absence of psychological distress, such as vandalism, and the availability of public services like police stations and care facilities. Across the EBLS cities, 60 percent of participants reported problems with litter on the streets surrounding their homes. The highest rates were observed in Valenzuela (75 percent) and Worcester (69 percent). Around half of the participants consistently reported that litter was a problem. Vandalism was reported to be lower for all sites (39 percent), ranging from 20 percent for Tarlai to 58 percent for Valenzuela.
To examine the needs for support during pregnancy, pregnant mothers’ mental health was assessed. Overall, 24 percent of respondents reported symptoms of depression with the highest prevalence displayed in Kingston (40 percent) and Tarlai (38 percent). Mothers were also requested to report their self-perceived levels of stress. Overall, 21 percent of expectant mothers reported experiencing feelings of stress. In Ragama, Hue and Cluj-Napoca, less than 10 percent of the mothers reported them, contrasted by Kingston (35 percent), Valenzuela (32 percent) and Worcester (29 percent).
Public services such as health care and social welfare were also assessed. Overall, 70 percent of the women interviewed had their first check-up within the first three months of pregnancy. Kingston (26 percent) and Worcester (40 percent) reported the lowest rates of attendance in the first three months across the sites. Data suggested that those who had access to health services reported high compliance with regular check-ups (97 percent) during pregnancy.
Conclusions and Next Steps
Building on these initial findings, data collected from the survey will be used to contribute further to the knowledge base on how to both prevent and mitigate the harms of exposure to violence and other forms of adversity during pregnancy (8). It will be used to examine the pathways that link adversity during pregnancy to maternal and birth outcomes, and the leverageable factors that can be targets of intervention. The roles of factors such as maternal adverse childhood experiences, substance use, stress, mental and physical illness, and maternal-foetal attachment will be examined, among others. In two of the sites, father interviews will be analysed to better understand their roles from their own perspective, helping to address under-representation of fathers in previous studies.
Following the success of this initial phase, which was designed to pilot core data collection procedures and instruments, the team is also seeking to scale up the project to involve larger numbers of participants and to follow the participating families for the first 1,000 days of their children’s lives.
Finally, the EBLS project aims to deliver policy impact involving lawmakers and governmental organisations at the local and national level. It also includes a capacity-building strategy, aimed at promoting knowledge exchange among countries and supporting early career academics, especially postdoctoral students in developing countries.
Manuel Eisner, Ph.D., is a professor and Principal Investigator (PI) and Director of the EBLS at the Violence Research Centre in the Institute of Criminology at the University of Cambridge.
Aja Murray, Ph.D., is a Co-PI and Deputy Director of the EBLS, at the University of Edinburgh.
Dr. Simone Castello is the Research Administrator at the Violence Research Centre in the Institute of Criminology at the University of Cambridge.
(1) Hillis, S., Mercy, J., Amobi, A., & Kress, H. (2016). Global prevalence of past-year violence against children: a systematic review and minimum estimates. Pediatrics, 137(3), e20154079
(2) EBLS Study
(3) United Nations (2016). Sustainable Development Goals
(5) INSPIRE: Seven Strategies for Ending Violence Against Children
(6) Van der Heijden, J., Patterson, J., Juhola, S. & Wolfram, M. (2019) Special section: advancing the role of cities in climate governance – promise, limits, politics. Journal of Environmental Planning and Management, 62(3), 365-375
(7) Valencia, S.C., Simon, D., Croese, S., Nordqvist, J., Oloko, M., Sharma, T., Buck, N.T. & Versace, I. (2019) Adapting the Sustainable Development Goals and the New Urban Agenda to the city level: Initial reflections from a comparative research project. International Journal of Urban Sustainable Development, 11(1), 4-23
(8) The British Academy and Wolfson Foundation announce six new Fellowships for early career researchers
