Child Protection and Practice最新文献

Background

There is limited evidence regarding the associations between disability, childhood experiences of violence, and associated health outcomes in humanitarian settings.

Objective

We examined the prevalence of childhood sexual, physical, and emotional violence by disability status, explored associations between childhood violence and type of disability (limitation), perpetrator types, and the negative health outcomes associated with experiencing childhood violence by disability status.

Participant and Setting

Participants included 1338 females and 927 males aged 13–24 years living in refugee settings in Uganda.

Methods

Data were from a cross-sectional Humanitarian Violence against Children and Youth Survey (HVACS) conducted between March and April 2022 in Uganda. Analysis entailed cross-tabulation with a chi-square test and estimation of bivariate and multivariate logistic regression models.

Results

For both females and males, the prevalence of sexual violence in childhood was higher among those with disabilities compared to those without disabilities (23.2% vs. 11.5% for females; and 15.7% vs. 7.6% for males). The odds of experiencing sexual violence were higher among females with physical limitations (self-care [AOR:2.1; 95%CI-1.0-4.3] and task performance [AOR:2.5; 95%CI = 1.3–5.2]) and males with both physical [AOR:4.4; 95%CI = 1.4–13.7] and communication [AOR:4.1; 95%CI = 1.3–12.9] limitations compared to those without such limitations. Experiencing violence and having disabilities increased the odds of reporting negative health outcomes including severe mental distress and symptoms or being diagnosed with STI among females by three times.

Conclusion

In Uganda's refugee settings, the prevalence of childhood violence is higher among children and youth with disabilities compared to those without disabilities. Females with disabilities and who had experienced childhood violence were considerably more susceptible to negative health outcomes. These findings underscore the need for targeted child protection and response interventions to address the vulnerabilities of children and youth, and particularly for those with disabilities and female children.

Childhood sexual violence is a global problem that has far-reaching impacts on children, families and communities. Whilst there has been significant commitment and action to tackle this issue, research with young people consistently draws attention to gaps and limitations. Emerging research, and practice-based evidence, tells us that young survivors of childhood sexual violence hold essential knowledge and expertise about the impacts of, and solutions for addressing, this form of violence. Yet, despite widespread recognition that children and young people have a right to ‘be heard’, in practice there are limited examples where young survivors come together collectively to collaborate with professionals to inform and influence research, policy or practice interventions in this field. This discussion paper begins by reflecting on barriers to, and opportunities for, participatory engagement with young survivors. The article draws on a decade long international programme of work and shares three key elements that have helped ‘scaffold’ our participatory work with young survivors: forming the right partnerships; weighing up the potential risks and benefits of engagement; and putting in place support for all involved. In conclusion, we present potential ways forward, underscoring the importance of addressing structural barriers, the need for creativity, and the significance of support and training for those accompanying young people and facilitating their engagement in the future.

Background

Despite the widespread prevalence of bullying, a public health issue, there is limited understanding of factors that propel or reduce bullying behaviors among adolescents in Sub-Saharan Africa.

Objective

This research aims to investigate how psychological resilience moderates the association between exposure to interparental violence and bullying among adolescents in secondary schools.

Participants and settings

A sample of 609 (297 males and 312 females) senior secondary school students (Mean Age = 16.44, SD = 1.64, age range = 13–20 years) drawn from four schools in Nsukka, Nigeria.

Methods

Bullying was conceptualized and measured with its two dimensions namely, victimization and perpetration. Data was collected using the Peer Interactions in Primary School Questionnaire, Resilience Evaluation Scale, and Children's Perception of Interparental Conflict Scale, which was analysed using Pearson correlation and Hayes PROCESS Macro.

Results

Results indicated that interparental violence was positively associated with victimization (B = 0.07, p < 0.001) and perpetration (B = 0.07, p < 0.001), while psychological resilience was positively associated with perpetration (B = 0.09, p < 0.05) but not victimization (B = 0.02). Additionally, results showed that psychological resilience moderated the association of interparental violence with victimization (B = 0.01, p < 0.01) and perpetration (B = 0.01, p < 0.001) such that the positive association between interparental violence, victimization, and perpetration became stronger as levels of psychological resilience increased.

Conclusion

The study concludes that exposure to interparental violence is a potentially strong risk factor for bullying and should be taken into consideration by school psychologists and other stakeholders to reduce bullying behaviors among students.

Background

Mental health practitioners can play a role in identifying and responding to young people at risk of harm and connecting them with appropriate supports. However, little is known about how clinicians providing mental health services through digital platforms support young people disclosing experiences of violence.

Objective

This study sought to understand the perspectives of clinicians working within digital mental health services on supporting young people disclosing violence.

Participants and setting

This study recruited 19 practitioners who were currently or had recently worked within The Digital Mental Health Programs of an Australia-wide mental health service, which provides online chat, email, and phone support to young people aged 12–25.

Methods

Sixteen individual interviews and one focus group were recorded, transcribed, and analysed using a reflexive thematic analysis approach.

Findings

The analysis generated six themes relating to clinicians' experiences: balancing a client centered and empowering approach with clinicians’ duty of care; systemic or structural challenges; navigating a sense of dilemma and the impacts upon clinicians; tensions around anonymity; differing understandings of violence; and navigating the transparency continuum.

Conclusions

Mental health clinicians work to reconcile a client centered approach with their professional duty of care and at times legal mandate to report abuse concerns. Clinicians navigate structural challenges, the anonymous nature of an online service, and work to develop common ground with young people and communicate transparently. Despite challenges, online services may provide a space for young people experiencing violence to be heard, provided with information, and connected with supports.

This paper explores how to employ effective, community-engaged strategies to understand and address the underlying power asymmetries that fuel violence against women and children. Utilising Participatory Action Research and underpinned by Integral Activist Epistemology, the action research adopts a novel approach combining Theory U and Powercube frameworks to facilitate a comprehensive understanding and transformation of these power relations in Shinyanga district, Tanzania. The paper describes the journey of engaging the community in identifying and challenging the unwritten rules that perpetuate violence. Key to challenging the unwritten rules is the recognition of violence as a manifestation of deeply ingrained patriarchal power structures, which are sustained through coercion and social exclusion, yet are paradoxically fragile due to the pain these norms inflict on the whole community, including men. This understanding led to the development of practical, community-led interventions, or 'prototypes', aimed at reshaping these dynamics. Key messages from the action research highlight the critical role of local context in shaping interventions, the importance of reframing existing cultural practices so that they are more inclusive, and the necessity for long-term commitment from development actors for sustainable change. The implications extend beyond Shinyanga, offering insights for practitioners globally. This paper contributes to the academic discourse on violence prevention but also serves as a practical guide, providing tools and strategies for practitioners working towards creating safer, more inclusive communities.

Teachers are at an elevated risk of developing Secondary Traumatic Stress (STS) and Compassion Fatigue (CF) due to the increased number of children experiencing trauma and abuse in their care. The negative impacts of STS and CF on teachers' mental health impedes their abilities as child protectors and reduces child abuse reporting rates. Utilizing Snyders Hope Theory may combat CF and STS and empower educators in their roles as child protectors. Hope Theory and its components are discussed in this article and presented as a method to support teachers through mental health and child protection barriers.

Amid the COVID-19 (SARS-COV2) global pandemic, children and families faced a number of stresses. This practice insight case study describes a presentation of a child with a rash at the height of the pandemic shutdowns with the realization that the stress of closing school led to her presentation for medical care for a factitious disorder. This case shows that, while staff may initially suspect parents, children can also report factitious illness without the knowledge of their parents, and these reports were affected by the COVID-19 pandemic. While it is unclear whether actual child abuse and neglect increased during the pandemic, there is no question that the stresses placed on families resulted in a number of harms. This highlights the need for dedicated child protection teams and preexisting procedures to objectively and sensitively look beyond physical injury to best support children and families, especially during times of monumental community stress.

Levels of violence against children remain high worldwide. A focused commitment in the child protection sector and from health and development agencies worldwide has delivered impressive baseline metrics on the scope of and trends for violence against children. Alongside this data, agreement around global guidelines—INSPIRE: Seven strategies for Ending Violence Against Children—and a host of related practice, learning and advocacy products has ensured a steady supply of knowledge to the field. As a result, high level political awareness for the prevention of violence against children (VAC) grows, yet full scale endorsement for the implementation of evidence-based strategies still falls short. A brief history of how the INSPIRE global guidelines were incubated, developed, and disseminated worldwide helps assess how knowledge is positioned, generated, and analysed. A call for reflecting on how to balance the supply and demand of INSPIRE knowledge for the field is forwarded. This review of progress made, and the challenges ahead, is timely as INSPIRE undergoes revisions just short of the 2030 SDG deadline.

Background

Child sexual abuse (CSA) is prevalent in the Philippines. The Philippine General Hospital–Child Protection Unit (PGH-CPU) provides multidisciplinary management. Local literature on legal and secondary biopsychosocial outcomes of CSA is limited.

Objective

Determine legal and biopsychosocial outcomes among CSA survivors and determine factors associated with reaching court and perpetrator conviction.

Participants

CSA survivors evaluated at the PGH-CPU in 2009–2013.

Methods

A mixed transdisciplinary design to obtain data from medical records, court documents, and interviews of study participants and key informants.

Results

Factors associated with CSA cases reaching court were having multiple perpetrators (OR 5.26, 95% CI 1.45–19.05, p = 0.011) and an age difference of more than 10 years between child and perpetrator (OR 2.51, 95% CI 1.26–5.01, p = 0.009). A 10-year age difference between child and perpetrator was a significant determinant for conviction (OR 3.69, 95% CI 1.04–13.14, p = 0.044). Interviews showed that the child's testimony is the most significant factor for successful prosecution. CSA survivors have increased risks for negative biopsychosocial outcomes. Children who followed-up at PGH-CPU showed a significantly lower rate of suicide attempts (0% vs. 7.7% in children without follow-up, p = 0.023) and had lower odds of having multiple sexual partners (OR 0.12, 95% CI 0.03–0.49, p = 0.003) and being employed (OR 0.23, 95% CI 0.07–069, p = 0.009).

Conclusions

There is a need to strengthen capacities of professionals to optimize legal processes and outcomes. CSA survivors have varied long-term outcomes requiring continued holistic aftercare interventions.