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This factsheet presents key findings from the second-ever Humanitarian Violence Against Children and Youth Survey conducted in refugee camps across Ethiopia.
This study examines domestic violence against children as a complex and largely hidden social phenomenon embedded in everyday family life. The focus is placed on various forms of child abuse, including physical and psychological violence, as well as their perception in public consciousness. Particular attention is given to the prevalence of such practices at the regional level and public attitudes towards them. The research explores the conditions under which violence is either condemned or partially justified as a method of child-rearing, along with the factors contributing to its persistence, including family traditions, cultural norms, and individual life experience. Special emphasis is placed on identifying the relationship between the social conditions of family life and the acceptability of violent practices in child upbringing. The empirical basis of the study consists of data obtained from a sociological survey conducted among the population of the Republic of Mordovia using a combined methodology, including face-to-face interviews and online questionnaires. The scientific novelty of the study lies in revealing the contradiction between the declared rejection of violence against children and the actual acceptance of certain forms of it in everyday parenting practices. The findings show that, despite general disapproval, some respondents consider the use of physical and psychological methods acceptable in specific situations. The study also demonstrates the influence of such factors as alcohol consumption within the family and personal experience of childhood abuse on the formation of tolerant attitudes toward violence. It is concluded that violent practices tend to be reproduced across generations, which highlights the need for preventive measures aimed at transforming social attitudes and strengthening child protection policies. The results contribute to a deeper understanding of the mechanisms that sustain violent behavioral patterns within the family environment.
Anna Ivanovna Efimova
Background Although health-promoting behaviors and health literacy may be protective factors against Social network addiction symptoms, little is known about the mechanisms underlying these interactions. This study aimed to investigate the relationship between health promotion and social network addiction symptoms among adolescents and to examine the mediating role of health literacy in this relationship. Methods A cross-sectional descriptive study was conducted among 475 adolescents aged 15–18 years recruited from four secondary schools in Beni-Suef Governorate, Egypt, using a multistage random sampling technique. A demographic questionnaire, the Short-Form Adolescent Health Promotion Scale (SF-AHPS), the Health Literacy for School-Aged Children (HLSAC) scale, and the Social Network Addiction Scale (SNAS) were used to gather data between February and April of 2026. Results The average scores were 30.04 ± 8.53 for social network addiction symptoms, 31.02 ± 4.85 for health literacy, and 70.61 ± 10.69 for health promotion. Health promotion was positively correlated with health literacy ( r = 0.327, p < 0.0001) and negatively correlated with social network addiction symptoms ( r = −0.117, p = 0.011). Health literacy was also negatively correlated with social network addiction symptoms ( r = −0.229, p < 0.001). A cross-sectional statistical mediation model showed that health promotion was positively associated with health literacy ( β = 0.299, p < 0.001), whereas health literacy significantly associated with lower social network addiction symptoms ( β = −0.277, p < 0 0.001). While the indirect effect through health literacy was significant [ β = −0.083, BootSE = 0.019, 95% CI (−0.122, −0.048)], suggesting a significant indirect association through health literacy, while the direct association was not statistically significant ( β = −0.020, p = 0.664). Conclusion Health literacy showed a significant indirect statistical association between health promotion and social network addiction symptoms among adolescents. Adolescents with higher health-promoting behaviors demonstrated better health literacy, which in turn was associated with lower levels of social network addiction symptoms.
Shaimaa Mohamed Amin, Sameer A. Alkubati, Halla Ali Abd El hie Ali et al.
Background The rapid expansion of online music streaming platforms has transformed adolescents’ everyday media practices, making music consumption increasingly individualized, algorithmically curated, and socially networked. While existing scholarship has established the importance of music in adolescent identity formation and emotional regulation, considerably less attention has been devoted to understanding how digitally mediated music listening influences communication within families. As digital-native adolescents increasingly consume music through platforms such as Spotify and YouTube, parents—many of whom remain digital immigrants—face new opportunities and challenges in maintaining meaningful communication with their children. This study investigates whether shared digital music listening constitutes a communicative practice capable of strengthening parent–adolescent relationships. Rather than examining music consumption solely as an individual behavior, the study conceptualizes shared streaming experiences as an interactional process through which emotional exchange, cultural identity, and intergenerational understanding are negotiated. Methods Drawing upon a mixed-methods dataset comprising 500 Turkish Cypriot adolescents aged 14–17 (400 quantitative; 100 qualitative), the study integrates responses from a 22-item Music Listening Habits Questionnaire, the Parent–Adolescent Communication Scale (PACS), and qualitative relational content analysis. Pearson correlation analysis was employed to examine associations between shared music listening practices and communication quality, while qualitative coding explored participants’ perceptions of family music experiences. Results Quantitative findings demonstrate a statistically significant moderate positive relationship between the frequency of shared music listening with parents and parent–adolescent communication quality ( r = 0.455, p < 0.01). Qualitative evidence further indicates that shared listening to culturally meaningful Turkish Cypriot music facilitates emotional openness, mutual understanding, and constructive family conversations. Although adolescents predominantly accessed music through Spotify and YouTube, the communicative value of music depended less on platform choice than on opportunities for shared engagement and discussion. Conclusion The study advances Uses and Gratifications Theory by extending its application from individual media gratification toward shared family media practices. It proposes that digital music streaming can function as an intergenerational communication resource capable of narrowing the communicative divide between digital-native adolescents and digital-immigrant parents. By integrating media studies, communication research, and music psychology, the article offers a culturally grounded framework for understanding how shared digital listening contributes to healthier family relationships in contemporary media environments.
Ozgur Tosun
<p dir="ltr">Background: Violence against children undermines children's rights and their development into autonomous people. Public health agendas must prioritise our understanding of this preventable health threat and inform its prevention. The Sub-Saharan African (SSA) region has some of the highest prevalences of child violence-related injuries globally. Yet, knowledge of its burden and prevention is scarce in the region, including in Mozambique.</p><p dir="ltr">Aim: The thesis aims are twofold: to increase knowledge of the burden of violence- related injuries among children in the SSA region and Mozambique and to shed light on whether the prerequisites are in place for Mozambican stakeholders to engage and succeed in the prevention of all forms of violence against children. Each aim is addressed by two complementary studies.</p><p dir="ltr">Methods: The first two papers are register-based, and the following two are based on primary data gathered through interviews. Paper I is a cross-country (SSA region), ecological study based on data from the Global Burden of Disease 2019 study (latest data available at the time of the study). The outcome was the trend in child violence-related death and DALYs and its correlation with risk factors. Descriptive statistics compiled trends over the past 30 years and Spearman's rank correlation test for the association with alcohol consumption per capita. Paper II was cross-sectional and hospital-based. Outcomes were forms of child violence-related injuries presented at the paediatric emergency and forensic unit of the Maputo Central Hospital in Mozambique. Data were extracted from medical records (2019) using a standardised Case Report Form. Descriptive analysis and chi-square tests were performed. Paper III addressed community readiness to prevent child maltreatment based on the WHO Readiness Assessment for the Prevention of Child Maltreatment-Individual questionnaire with stakeholders from national agencies and in Maputo. The questionnaire-specific scoring system and descriptive analysis were performed. Paper IV was qualitative descriptive research exploring frontline practitioners' experiences with the implementation and enforcement of child protection laws in local services in Maputo City. An inductive approach and thematic analysis by Braun and Clarke were used.</p><p dir="ltr">Results: The SSA region registered a decline in child violence-related deaths and DALYs rates between 1990 and 2019, 22.5% and 22.3%, respectively. In Mozambique, death and DALYs rates declined 22.7% and 25.3%, respectively, that the country in 2019 to match the regional average rates in 2019. A significant correlation was seen between alcohol consumption and child interpersonal violence for both death and DALYs in 2019 (r=0.446, p<0.001 and r=0.435, p<0.001, respectively) (Paper I). Among the 321 cases of child violence-related injuries treated at the hospital over one year, sexual violence was the most common form (59.5%), followed by physical violence (40.5%). While girls were the most common victims of the former (female-to-male ratio of 6.35), boys were of the latter (male- to-female ratio of 1.95). Children of both sexes sustained multiple injuries but not severe injuries due to physical violence, mainly bruises to the head or upper limbs. Girls who were victims of sexual violence suffered more serious injuries, of the kind that required surgery or intensive care (Paper II). Mozambique is at the preparation stage of prevention of child maltreatment, with a total average score of readiness of 5.4 (for a maximum of 10) according to information from professionals in the child protection sector at national and local levels. Low scores were observed in resources, scientific data, and programmes (Paper III). Through interviews with frontline practitioners, two themes were identified. The first related to barriers encountered in the implementation and enforcement of child protection laws: limited resources, a weak organisational system, legal gaps and constraints, and norms and attitudes. The second theme concerned the facilitators: resourceful support from NGOs and a favourable working environment (Paper IV).</p><p dir="ltr">Conclusion: Findings from this thesis indicate that, albeit declining, the rates of child violence-related injuries remain higher both in SSA and in Mozambique than the global average, despite the significant reduction in death and DALYs rates in the past three decades. Sexual violence, typically sustained by girls, was the most frequent form of violence among child victims seeking hospital care in Maputo Central Hospital. Mozambique is in early stages of readiness to prevent child maltreatment. Child protection services in Maputo lack the capacity to implement and enforce child protection laws to protect children from violence, mainly at the local level.</p><h3>List of scientific papers</h3><p dir="ltr">I. Trends and demographic differences in interpersonal violence against children in sub-Saharan Africa: findings from the 1990-2019 Global Burden of Disease Study. <b>Sergio Nhassengo</b>, Lucie Laflamme, Mathilde Sengoelge, GBD 2019 SSA Child Interpersonal Violence. BMJ Open. 2025;15:e083070. <a href="https://doi.org/10.1136/bmjopen-2023-083070">https://doi.org/10.1136/bmjopen-2023-083070</a></p><p dir="ltr">II. Circumstances and Consequences of Violence-Related Injuries Presenting at Hospital. A Study at the Pediatric Emergency and Forensic Medicine Units of Maputo Central Hospital, Mozambique. <b>Sérgio Keita </b><b>Nhassengo</b>, Stela Ocuane Matsinhe, Eunice Jethá and Lucie Laflamme. Int. J. Environ. Res. Public Health. 2021, 18, 12125. <a href="https://doi.org/10.3390/ijerph182212125">https://doi.org/10.3390/ijerph182212125</a></p><p dir="ltr">III. Community readiness to prevent child maltreatment in Mozambique: An investigation among key informants at country level and from Maputo city. <b>Sergio Nhassengo</b>, Lucie Laflamme, Mathilde Sengoelge. Children and Youth Services Review. 176 (2025) 108400. <a href="https://doi.org/10.1016/j.childyouth.2025.108400">https://doi.org/10.1016/j.childyouth.2025.108400</a></p><p dir="ltr">IV. Frontline practitioners' perspective of the implementation of child protection laws and prevention of violence against children in Maputo, Mozambique. <b>Sergio Nhassengo</b>, Stela Ocuane Matsinhe, Eunice Jetha, Mathilde Sengoelge, Lucie Laflamme and Asli Kulane. [Submitted]</p>
Sergio Nhassengo
Introduction Preschool peer acceptance is a pivotal marker of social-emotional well-being and future adaptation. Although teacher–child relationship quality is a known correlate of children’s peer status, the mechanisms linking this vertical relationship to horizontal peer relations remain insufficiently understood. Methods This two-wave longitudinal study examined whether emotion understanding and social initiative were associated with the prospective link between teacher–child relationship quality and later peer acceptance. Data were collected from 319 Chinese preschool children across a 12-month interval. Teachers reported teacher–child closeness, conflict, and children’s social initiative; children completed an emotion understanding task; and peer acceptance was assessed using peer nominations. Structural equation models controlled for baseline levels of emotion understanding, social initiative, peer acceptance, and relevant covariates. Results Results showed that T1 teacher closeness positively predicted, whereas teacher conflict negatively predicted, T2 peer acceptance. Emotion understanding and social initiative each served as significant indirect pathways linking teacher–child relationship quality with later peer acceptance. In addition, a theory-informed serial indirect pathway from T1 teacher–child relationship quality to T2 peer acceptance via T2 emotion understanding and T2 social initiative was statistically significant. Discussion However, because the study was observational and because the mediators and outcome were all assessed at T2, the findings should be interpreted as prospective associations consistent with the proposed theoretical model rather than as evidence of causal or strictly temporal mechanisms. These findings suggest that supportive teacher–child relationships may be linked to peer acceptance through children’s socioemotional understanding and proactive peer engagement.
Yuebo Li, Haowen Dang, Yong Yang et al.
Background Oral diseases are among the most common noncommunicable conditions globally, yet oral health remains poorly integrated into primary health care (PHC) and universal health coverage, especially in fragile, low-limited settings. As Somalia rebuilds its health system through the Health Sector Strategic Plan III 2022–2026, the Essential Package of Health Services 2020, the Investment Case for the Somali Health Sector 2022–2027, and community health reforms, this study examined the place of oral health within national health policies. It identified barriers to integration and explored feasible pathways for strengthening PHC-based oral health. Methods The study used a qualitative policy and health-systems analysis combining documentary review with 13 key-informant interviews. Participants represented national policymakers, health-system technical advisers, regulators, academics, professional associations, and providers at public hospital, and private dental settings. Data were analyzed thematically and mapped against the WHO health-system building blocks, PHC principles, and the WHO Global Strategy and Action Plan on Oral Health 2023–2030. Results Somalia's policy environment offers opportunities for oral health integration, but stakeholders highlighted a persistent gap between policy recognition and implementation within routine PHC. Seven interrelated themes were identified: (1) policy recognition without operationalization; (2) fragmented governance, weak regulation, and limited coordination; (3) reliance on out-of-pocket financing and private-sector; (4) workforce, education, and task-sharing constraints; (5) predominantly curative, urban, hospital-based service with weak linkage to maternal and child health (MCH) and PHC; (6) limited oral health data and evidence generation; and (7) opportunities for phased integration through PHC, MCH, school health, community health workers, and NCD platforms Policymakers emphasized the need for stronger policy implementation, financing, regulation, standards, and data systems, while service providers highlighted unaffordable care, delayed care-seeking, workforce and infrastructure shortages, and missed opportunities for prevention. Conclusion Oral health integration in Somalia is a broader health system challenge rather than solely a dental-service issue. The most feasible approach is a phased, system-based model that prioritizes strengthened governance, a defined minimum oral health within PHC, workforce task-sharing, screening, counselling, referral pathways, private-sector regulation, essential commodities, and oral health indicators in District Health Information System 2 (DHIS2), followed by the gradual expansion of curative and rehabilitative services.
Saido Gedi, Salma Ali Ossoble, Mohamoud M. Dahir et al.
Little is known about mothers’ and children's escape from violence and its aftermath when living in secure accommodation, especially with regard to children. The aim is to investigate mothers’ experiences of their escape, and their considerations regarding the well-being of their young children before or during their escape, based on 14 interviews. Using a narrative thematic analysis, the results show that the escape was often planned, but that the planning horizon varies. In many cases, the mothers’ social network served as a stepping-stone during the escape, before they continued by moving to a domestic violence shelter (DVS). Implications for policy and practice are offered.
Sara Thunberg, Linda Arnell
The Baobab Research Programme Consortium (Baobab) is an Africa- based, African-led consortium, spearheaded by the Population Council, Inc., in partnership with the Population Council–Kenya and the African Population and Health Research Centre (APHRC), that is reshaping the narrative around sexual and reproductive health and rights (SRHR) research in refugee settings. Across Africa’s most challenging humanitarian landscapes, Baobab is proving that evidence can ignite action. Starting with the first-ever Humanitarian Violence Against Children and Youth Surveys in Uganda and Ethiopia, Baobab turned data into solutions—co-designing a school-based sexual violence screening model with governments, UNHCR, and civil society. By embedding trained para-social workers (PSWs) in schools, this approach ensures proactive identification, on the spot psychological first aid, rapid referral (where needed), and consistent care for child survivors of sexual violence, all while strengthening existing systems. Uganda’s Ministry of Gender, Labour and Social Development co-designed the model, building upon its existing National PSW Programme, and integrating it into national training and guidance manuals, a bold step toward systemic change. With a proven model now embedded in national systems, Baobab is helping translate frontline success into wider policy influence by elevating Africa-led solutions onto the global stage. Baobab has partnered with the African Child Policy Forum to amplify Africa’s voice globally, shaping commitments from the first-ever Global Ministerial Conference to End Violence Against Children held in Bogota, to ARISE Africa: Accelerating Action to End Violence Against Children. This case study is a blueprint for scalable, replicable interventions that transform crises into opportunities for protection, accountability, and African leadership on the world stage.
Stella Muthuri
Background Neonatal pain remains inconsistently assessed, particularly in resource-limited settings. We assessed healthcare professionals’ knowledge and reported practices regarding postoperative neonatal pain assessment in Kinshasa, Democratic Republic of the Congo (DRC). Methods We conducted a multicenter cross-sectional survey from August 2025 to May 2026 in ten hospitals with pediatric surgical activity. Healthcare professionals completed a 20-item questionnaire developed through expert content review and pretesting. The primary outcome was self-reported use of a standardized neonatal pain-assessment tool. A four-item knowledge score (0–4) was constructed, with ≥3 indicating high knowledge as a pragmatic study-specific threshold. Multivariable logistic regression used hospital-level cluster-robust standard errors. Results Of 580 healthcare professionals approached, 536 returned the questionnaire; six were excluded because of >30% missing data, leaving 530 complete questionnaires for analysis. Although 86.8% recognized neonatal pain, only 10.0% reported using a standardized pain-assessment tool, and 15.3% reported postoperative pain assessment at regular intervals. Nearly all participants (99.8%) reported no dedicated neonatal pain training. The mean knowledge score was 2.16 ± 0.84, and 34.7% had high knowledge. Higher knowledge was independently associated with reported standardized tool use (adjusted OR 4.90, 95% CI 3.10–7.70; p < 0.001). In the prespecified sensitivity analysis using the reduced three-item knowledge score, the association remained significant but was attenuated (adjusted OR 1.93, 95% CI 1.23–3.03; p = 0.004). Conclusion Reported use of standardized neonatal pain-assessment tools and regular postoperative pain assessment were low despite widespread recognition of neonatal pain. Higher knowledge was associated with reported tool use, although the association was attenuated after excluding scale recognition from the knowledge score. These findings highlight gaps in neonatal pain assessment and training, while the cross-sectional design precludes causal interpretation.
Eriksson Landu, Joseph Nsiala, Arriel Makembi Bunkete et al.
