How common is violence against children in Uganda?

Report
Violence against primary school
children with disabilities in Uganda:
A cross-sectional study
Karen M Devries, PhD1*,
Nambusi Kyegombe, PhD1,
Maria Zuurmond, MSc1,
Jenny Parkes, PhD2, Jennifer C
Child, MSc1, Eddy J Walakira,
PhD3, Dipak Naker, MA4
1London
School of Hygiene & Tropical
Medicine, London, UK
2Institute of Education, London, UK
3Makerere University, Kampala, Uganda
4Raising Voices, Kampala, Uganda
Improving health worldwide
www.lshtm.ac.uk
Violence against disabled
children
• 150 million children live with disabilities globally
• A recent systematic review found 3 to 4 times the levels of violence
versus non-disabled children in high income countries
• Almost nothing is known about violence against disabled children in
lower income countries
• We used data from the Good Schools Study in Uganda to:
1) compare the prevalence of different types of violence in disabled and nondisabled students
2) describe the most common perpetrators of violence
3) to explore whether disability confers increased risk of violence after accounting
for demographic and mental health factors
Study setting and design
•
•
•
•
•
•
Design: baseline cross-sectional
survey from a cluster-randomised
controlled trial
42 primary schools, representing 1
district in Uganda
3700 students aged 11-14 and 500
staff interviewed in June 2012
Interviewer-administered
questionnaire using mobile phones
Measuring violence: ICAST-CI
Referral plan for children for
children who disclosed abuse
Measuring Violence:
Measuring Disability:
More than 40 items measuring specific acts
of emotional, physical, sexual violence and
neglect. “Have you ever been hit, slapped,
kicked, physically forced to have sexual
intercourse with someone, locked out, not
given food as punishment”
“Do you have any mental or physical
disability? For example, do you have trouble
seeing, walking, speaking, fits, or anything
else?” Response options: None, Trouble
seeing, Trouble hearing, Trouble walking/with
movement, Trouble with speech, Fits, Other.
Prevalence of disability
• 271 disabled and 3475 nondisabled students
• 8.8% of boys and 7.6% of girls
reported a disability.
• Difficulties:
–
–
–
–
2.8% with sight
1.4% with hearing
0.9% with movement
3.1% reported an ‘other’ form of
disability
– 1.0% of boys but only one girl
reported difficulties with speech
Levels of violence
Boys (n=1769)
Girls (n=1937)
•
Characteristic
Any violence from
any perpetrator
Physical
violence
Sexual violence
Emotional
violence and
neglect
Main
perpetrators
among disabled students
No disability,
%
Disabled, %
P
No disability,
%
Disabled, %
P
95.3
96.2
0.644
95.5
99.5
0.009
93.4
95.8
0.379
94.6
99.1
0.010
3.8
7.1
0.092
12.3
23.6
0.002
59.4
63.6
0.400
57.5
65.2
0.140
Physical: male peers
Sexual: ‘others’
Emotional: school staff
Physical: school staff
Sexual: ‘others’, male peers
Emotional: school staff
Increased risk of violence,
Associations
in
boys
adjusted for other factors
Emotional violence/neglect
versus no emotional
violence/neglect
Sexual violence versus no
sexual violence
Physical Violence from
non-school staff versus no
violence from non-school
staff
Past week physical
violence from school staff
versus no past week
violence from school staff
aORa (95%CI)
p
aORa (95%CI)
p
aORa (95%CI)
p
aORa (95%CI)
p
Girls
Disability
1.36 (0.86-2.13)
0.179
2.15 (1.33-3.48)
0.002
1.26 (0.80-1.99)
0.309
1.46 (1.002.12)
0.047
Boys
Disability
1.08 (0.74-1.56)
0.672
1.17 (0.80-1.69)
0.409
0.62 (0.480.81)
0.001
aAdjusted
for: age, number of meals eaten yesterday, household crowding, working outside home, mental health difficulties
What does it mean?
• High prevalence in all students
• Disabled girls (and probably boys) at even higher risk of sexual
violence
• Disabled girls in particular remain at high risk of sexual violence and
physical violence from school staff, even after accounting for other
factors
• School in a main environment of risk, but also for potential
interventions
• Tailored and accessible interventions needed
Thank you!
Research team:
Karen Devries, Louise Knight,
Jennifer Child, Nambusi
Kyegombe, Liz Allen, Charlotte
Watts, Diana Elbourne (LSHTM)
Jenny Parkes (IoE)
Eddy Walakira (Makerere University)
Dipak Naker (Raising Voices)
Donors:
DfID, UK MRC, Wellcome Trust,
Hewlett Foundation, Bernard van
Leer Foundation, Unicef Uganda
Raising Voices team:
Willington Sseskade and the
implemtation team
Janet Nakuti
Angel Miriembe
Good Schools Publications:
•Devries K, Kyegombe N, Zuurmond M et al. Violence against primary school children with disabilities in Uganda: A crosssectional study. BMC Public Health. forthcoming.
•Devries K, Allen E, Child J, et al. The Good Schools Toolkit to prevent violence against children in Ugandan primary schools: study
protocol for cluster-randomised controlled trial. Trials. 2013;14:232.
•Devries K, Child J, Allen E, et al. School violence, mental health and educational performance in Ugandan primary school
children: A cross-sectional survey. Pediatrics. 2014;133(1):1-9.
•Child J, Naker D, Horton J, Walakira E, Devries K. Responding to abuse: Children’s experiences of child protection in a central
district, Uganda. Child Abuse and Neglect 2014. http://dx.doi.org/10.1016/j.chiabu.2014.06.009

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