Violence affecting children (VAC) is a significant global health and human rights issue. This article highlights a new qualitative methodology, the Round Robin, for understanding the drivers of violence against children. Traditionally, qualitative research exploring VAC has focused on identifying the risk and protective factors which affect the likelihood a child will experience or witness violence. In recent years, scholars have recognised the need to situate children in their socio-cultural context and consider what causes risk and protective factors; that is, what drives violence at the structural and institutional levels of society. The Round Robin methodology sits within the participatory paradigm and contributes not only to the field of violence research, but to qualitative research more broadly, as it can be adapted to fit diverse social issues and contexts. The Round Robin combines focus groups and participatory techniques in an intensive three-day workshop model inspired by the World Café. In this paper, we firstly introduce the Round Robin methodology and situate it in relation to other approaches. We then describe and critique how the Round Robin methodology was piloted with 136 young people in Zimbabwe to identify drivers of violence affecting children. We then justify the methods used to collect data, and the strategy for data recording and analysis. We conclude by identifying the strengths and weaknesses we uncovered piloting this new methodology in Zimbabwe.
Deborah Ann Fry, Tendai Nhenga-Chakarisa, Noriko Izumi et al.
Abstract. This study investigated the geospatial patterns and determinants of violence against children and young people in Namibia using data from 5,191 individuals aged 13–24 years, interviewed across 79 constituencies in the 2019 Violence Against Children and Youth Survey. We employed Global Moran’s I and Local Indicators of Spatial Autocorrelation to identify global spatial autocorrelation and hotspots. Ordinary least squares regression was used to identify significant area-level risk factors, whereas Geographically Weighted Regression was used to model local variations. We found significant regional variations in the prevalence of past-year sexual(SV), physical (PV), and emotional violence (EV), with the highest rates observed in constituencies in central and northern Namibia. Global spatial autocorrelation was evident for SV and EV but not for PV, suggesting distinct spatial patterns for each form of violence in the study area.Our findings also revealed notable spatial variations in risk factors, with area-level factors showing strong influences in certain areas, while being less impactful or negligible in others. These findings emphasise the need for geographically targeted interventions and policies to address localised risk factors and reduce violence against children and young people in Namibia.
Tobias Willem Shinyemba, Shino Shiode, Karen M. Devries
BACKGROUND: Parent-child communication about sexual issues can reduce risky sexual behaviour amongst adolescents. Risky sexual behaviour is of concern in sub-Saharan Africa where the prevalence of early pregnancy, unsafe abortion and HIV are high. Parent-child communication about sexual issues presents a feasible approach for reducing sexual risk amongst adolescents in sub-Saharan Africa but limited research exists from the region. This study from Zambia examines the sociodemographic and psychosocial factors that are associated with whether parents communicate with their daughters about sexual issues. METHODS: Data from a cluster randomized controlled trial examining the effect of interventions aiming to reduce teenage pregnancy and school drop out in Zambia was used. The data was collected between January-July in 2018 and consists of structured, face to face interviews with 4343 adolescent girls and 3878 parents. Cross sectional analyses examined the associations between parent-child communication about sexual issues and sociodemographic and psychosocial characteristics using univariate and multivariable logistic regression models. RESULTS: Adolescent girls who felt connected to their parents and those who perceived their parents to be comfortable in communicating about sex, were more likely to speak to their parents about sexual issues than those who did not (AOR 1.23, 95% CI 1.01-1.52; and AOR 2.94, 95% CI 2.45-3.54, respectively). Girls whose parents used fear-based communication about sexual issues, and those who perceived their parents as being opposed to education about contraception, were less likely to communicate with their parents about sex than those who did not (AOR 0.76, 95% CI 0.65-0.89; and AOR 0.76, 95% CI 0.63-0.91, respectively). Girls enrolled in school were less likely to communicate with their parents about sex than those out of school (AOR 0.56, 95% CI 0.44-0.71). CONCLUSION: Parenting style, children's perception of parental attitudes and parental communication styles are associated with whether parents and children communicate about sexual issues. This may imply that parents can improve the chances of communicating with their children about sex by conveying non-judgemental attitudes, using open communication styles with neutral messages and appearing comfortable whilst displaying positive attitudes towards communication around sex and contraceptive use. TRIAL REGISTRATION: ISRCTN registry: ISRCTN12727868 , (4 March 2016).
Katja Jezkova Isaksen, Patrick Musonda, Ingvild Fossgard Sandøy
A substantial proportion of adolescent girls in Zambia lack the ability to decide their reproductive future. We examined the role of agency in early and unwanted adolescent childbearing. Using latent transition analysis, we characterized a multi-dimensional profile of adolescent agency annually over a four-year period. We investigated the influence of early life access to resources and time-varying predictors (school retention, violence, early marriage and unwanted/mistimed pregnancy and childbearing) on agency profile membership as well as transitions in agency status over time. Four agency profiles were identified, with differences by age cohort (10–14 years vs. 15–19 years). Three profiles identified in both age cohorts were: Low-moderate agency, Self-assured gender conformers, and High agency. Unique to younger girls was the Gender conscious, low belief in abilities status, while among older girls was the Self-assured selective gender conscious status. While younger girls were likely to transition to the highest agency status over time, high agency membership declined among older girls. Early life resources were associated with augmented agency while exposure to negative events, particularly early marriage, were associated with detraction from high agency status. Girls who expressed high self-efficacy but gender-conforming values were most at risk of early marriage and unwanted/mistimed pregnancy while High agency girls were at comparatively low risk. Results show agency is dynamic but less mutable with increasing age. Early adolescent strategies which address inequitable gender norms and limit early marriage, may guard against losses to agency which contribute to unwanted fertility outcomes.
Katharine J. McCarthy, Katarzyna Wyka, Diana R. Romero et al.
Zambia is ranked 16th among countries with the highest rate of child marriage in the world. According to some studies conducted, child marriage rates in the country stand at 42 per cent of women aged between 20 and 24 years married by the attainment of the age of 18 years old. The main objective of this study was to investigate social cultural norms associated with sexuality and child marriages among adolescents in Chadiza district, Eastern province of Zambia. The mixed method design both quantitative and qualitative was used because it provides the researcher with a more comprehensive view of the phenomena being studied in this case, social cultural norms associated with sexuality and child marriages. A Systematic sampling technique was used where every third household was selected for inclusion in the study sample and 150 respondents from which 100 girls and 50 boys were selected by applying a fixed interval. The study findings indicated that most cultural practices in the study area especially initiation ceremonies provoked a girl child to opt for an early sexual debut and early marriage. On the age at first sexual debut, results showed that the minimum age to engage in sexual intercourse by the respondents was 12 years while the maximum age was 22 years for both genders. The study further unearthed the reality that girls’ initiation ceremonies exposed most girls to risk behaviours. After graduating from initiation ceremonies girls wanted to experiment whether they were really sexually able to handle any man since that is what they were taught in their initiation ceremonies a situation which led to early sexual debut among young girls and subsequently to early or teenage pregnancies and early marriages. The study recommends that the Zambian government through the responsible Ministry should regulate initiation ceremonies that pass on bad cultural practices to the adolescents and girls in particular. While appreciating the role initiation ceremonies play in preparing the adolescents for adult responsibilities, there is need to restructure the curriculum for initiation ceremonies to include sexual reproductive health rights and responsibilities.
BACKGROUND: Child marriage has long been a public health concern around the world, because it has the potential to deprive adolescent girls of their sexual reproductive health rights and limits their ability to reach their full potential in life. The prevalence of child marriage has been consistently higher in sub-Saharan Africa than elsewhere. However, fewer studies have explored the influence of both individual and community-level influences on early marriage in sub-Saharan Africa. This study, therefore, examined individual and community-level factors associated with child marriages in Zambia. METHODS: Data came from the Zambia Demographic and Health Surveys (ZDHS) conducted in 2007, 2013-14 and 2018. A pooled weighted sample of 9990 women aged 20-29 years was used in the analysis. Stata software version 17 was used to perform statistical analysis, taking into account complex survey design. The association between individual- and community- level factors and early marital behavior was assessed using multilevel logistic regression models. RESULTS: The prevalence of child marriage among women aged 20-29 was 44.4 percent (95% CI: 42.1, 46.7) in 2018, declining from 51.5 percent (95% CI: 48.9, 54.0) in 2007. Women with secondary or higher level of education [aOR = 0.36, 95% CI = 0.26-0.49] and [aOR = 0.07, 95% CI = 0.03-0.18] and those whose age at first birth was (15-19 year) or (20-29 years) were associated with less likelihood of experiencing child marriage. Communities with a high percentage of women who gave birth at a young age [aOR = 1.36, 95% CI = 1.15-1.62] were more likely to experience child marriage. Individual and community-level characteristics accounted for 35% of the overall variations in communities' likelihood of experiencing early marriage. Even after controlling for both individual and community-level influences, the intra-class correlation revealed that around 4.5 percent of the overall variations remained unexplained. CONCLUSION: Prevalence of child marriage has reduced over the years but is still high in Zambia. Both individual and community- level factors influenced child marriage in Zambia. There is a need to strengthen strategies that keep girls in school to delay their exposure to early sexual debut and child marriage. Designing of reproductive health interventions in the country should consider integration of community factors such as economic insecurity and access to reproductive health information.
Million Phiri, Emmanuel Musonda, Liness Shasha et al.
Marriage is one of society's most significant institutions because it establishes familial relationships. Adults should contact this institution. A girl under 15 can now marry an adult guy. Worldwide, especially in Africa, child marriage is a major concern. Zambia is one of the twenty global hotspots for child marriages, like many African nations. Thus, this study examined the consequences of child marriage on girls in Mangamu, Katongo, and Nakatindi elementary schools in Sesheke. A qualitative case study was performed to obtain data from 60 female participants 45 grade six girls. Five female instructors from each school participated. We employed questionnaires, depth interviews, and conversations to gather data. The findings showed that poverty, economic difficulty, cultural beliefs, and susceptibility of some youngsters induce girl-child marriages. The study also found that early marriages cause pregnancy and health issues. Educational rights are also taken away by child marriage. The report advised communities to educate each other about the effects of child marriage on girl children's academic advancement and stakeholders to warn the community.
Defilement and adolescent pregnancy is considered as an emerging epidemic which required urgent solutions. This early pregnancy took a toll on a girl’s health, education and human rights and prevented her from realising her potential. Teenage pregnancy resulted in increased illiteracy levels among women, baby dumping, infanticide, higher numbers of street kids and stigmatisation, and given that most girls get married to much older men, early marriage renders them susceptible to physical, emotional and sexual abuse, as well as early widowhood, among others. Therefore, in 2013 Zambia launched a campaign against girl-child-marriage. The capacity of the media to be a watchdog, act as a voice for the voiceless, reach diverse audiences and influence people’s attitudes and behaviours cannot be doubted. However, in Zambia it is not clear how the media has been involved in this fight.
So the objective of this research is to find out how the media has been involved in protecting the girl-child from sexual abuse in Zambia. The study applied a qualitative method by conducting a content analysis of the textual material. The researcher analysed the Zambia Daily Mail and the Times of Zambia newspapers, special committee reports and special letters through social media. This research applied the purposeful/ judgemental sampling techniques because the researcher knew the target group. Basically it was the non-academic world which included the Zambian first ladies because they are the ones who are in the forefront against the girl-child sexual abuse, the United Nations, the National Assembly of Zambia, the Ministry of Gender and some Non-Governmental Organisations. Then two theories were used in guiding the researcher. These were the Muckraking Theory and the Ecology of News Model. This muckraking imagery implies that investigative journalists unearth evidence of a problem. The exposure of the problem leads to the mobilisation of a changed public opinion which leads to a ripple e˙ect in that legislators and administrators initiate a policy. Then the ecology of news model is a theory that says that the press and government actors exist in a ‘mutually constituted’ ecology in which, when interests merge, coalitions are formed. Consequently, the press and public oycials establish quid pro quo relationships so that they collaborate and work together to uproot this scourge.
The researcher undertook an analysis of the Special Committee Report for the 2014 National As-sembly of Zambia committee on youth and sport for the third session of the eleventh national assembly which carried out a research on the girl-child sexual abuse and how this could be brought to an end; analysed the programmes being implemented by Government, Cooperating Partners including the United Nations, and Civil Society Organisations to prevent and mitigate the e˙ects of teenage pregnancy in the country; analysed the speeches of the First Ladies and Minister through the Public Print Media on Child Marriages in Zambia; analysed the 2014 Media Brief by Panos Institute Southern Africa on ending child marriages in Zambia; analysed social media over the letters which were written by female pupils from Kasama Girls Secondary School and Chipembi Girls Secondary School. In all the e˙orts being undertaken to eradicate this scourge, the media is not mentioned as a stakeholder, but just reporting. Hence, the major role of the media in Zambia in fighting this scourge is by and large to expose girl-child abusers by reporting. The research concluded by making some recommendations of how the media can be involved in defending the girl-child other than just by reporting.
After observing continued loss of lives by the children who are below the age of five years old, World Health Organisation through its branch of public health saw the needs to strengthen immunisation program for under five children among member states. This was the birth and origin of expanded program on immunisation (EPI). Owing to the scarce of data on the status of immunization in the rural parts of Zambia such as Mumbwa District. This research paper was conducted to explore, determine, as well as describing the factors that influence and the status of full coverage of immunisation of under-five children in Nangoma Constituency of Mumbwa District. A cross-sectional study comprised of 134 participants from 5 randomly selected health facilities in Nangoma Constituency was conducted. The data was collected using kobocollect toolbox and analysed using version 23.0 of SPSS and MS Excel 365. The factors that were determined to be statistically significant according to the study included marital status (0.05 >p-value = 0.07), education attainment of the mother (p-value = 0.049), age of the child (0.05 >p-value = 0.013) and knowledge of immunisation (p-value = 0.021). Additionally, the study established that seasons play a critical role in taking a child for immunization especially when it is planting season when families are casting their seeds in the soil which also affect the roads. Distance to the health facility or delivery point, long queues, myths, traditions and culture, as well as availability of money to access the needed health service are among the many factors that affect full immunization coverage in Nangoma Constituency.
Despite South Africa's substantial investments in and efforts at ensuring universal access to immunisation services, progress has stalled and remains suboptimal across provinces and districts. An additional challenge is posed by the ongoing coronavirus disease 2019 (COVID-19) pandemic, which has disrupted immunisation services globally, including in South Africa. While there is growing evidence that missed opportunities for vaccination (MOV) are a major contributor to suboptimal immunisation progress globally, not much is known about the burden and determinants of MOV in the South African context. Herein, we make a case for assessing MOV as a strategy to address current immunisation coverage gaps while mitigating the adverse impacts of the COVID-19 pandemic on immunisation services. We illustrate a practical implementation research approach to assessing the burden of MOV among children in primary care settings; for understanding the factors associated with MOV; and for designing, implementing, and evaluating context-appropriate quality improvement interventions for addressing missed opportunities. Such efforts are vital for building health system resilience and maintaining immunisation programme capacity to optimally deliver essential health services such as routine childhood immunisation, even during pandemics.
Chukwudi A Nnaji, Charles Shey Wiysonge, Maia Lesosky et al.
