Intimate partner violence (IPV) remains a major public health and human rights concern in South Africa, particularly among adolescent girls and young women (AGYW). While social support is widely recognized as a protective factor against IPV, its effectiveness may be compromised in contexts of alcohol use. This study investigated the influence of alcohol use on the risk of IPV and the moderating role of perceived social support in reducing this risk. This study used baseline data from the HERStory 1 study, a cross-sectional survey of 4,399 adolescent girls and young women aged 15-24 years. Social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). Multivariable logistic regression assessed main and interaction effects, with alcohol use as a moderator. Marginal effects and plots illustrated predicted IPV probabilities across social support and alcohol use levels. Emotional IPV (23.1%) was most prevalent, followed by physical (17.0%) and sexual (6.3%) IPV; 25.2% reported harmful alcohol use. Higher perceived social support was associated with reduced odds of emotional, physical, and sexual IPV across all support domains. Family and friends' support showed strong protective associations. For example, family support was associated with lower odds of emotional (aOR = 0.53, 95% CI: 0.42-0.66), physical (aOR = 0.59, 95% CI: 0.45-0.75), and sexual IPV (aOR = 0.41, 95% CI: 0.29-0.58). In contrast, support from a significant other was not significantly associated with sexual IPV. Harmful alcohol use increased the odds of all IPV forms and attenuated the protective effects of social support. Additional age-stratified analyses indicated that social support was more consistently protective against IPV among adolescents (15-19 years) than young adults (20-24 years). Social support, particularly from family and friends, plays an important role in reducing IPV risk among young women, but its protective effect is diminished when alcohol use is present. These findings highlight the need for integrated IPV prevention strategies that strengthen external support networks and also address harmful alcohol use.
The transition from adolescence to adulthood is a critical developmental period, particularly for young people experiencing mental health challenges. Arts-based interventions have shown promise in supporting mental wellbeing through creative engagement and community connection. This pilot study aimed to explore the experiences of participants in the Canvas to Change programme, a community-based creative arts initiative for young people aged 16-25 in Coventry, UK. A convergent parallel mixed-methods design was used. Qualitative data were gathered through focus groups, interviews, and open-ended surveys, and analysed using Reflexive Thematic Analysis. Quantitative data were collected using mental wellbeing measures and analysed using IBM SPSS Statistics 26.0. Qualitative analysis (n = 14) revealed four themes: initial engagement and comfort, mental health benefits, creative expression, and social connection. A total of 32 participants provided quantitative data, with 10 completing both baseline and follow-up measures. While statistical power was limited, trends suggested improvements in wellbeing indicators including feeling close to others, optimism about the future, and reduced loneliness. Recruitment challenges were addressed through relationship-building and using flexible, participant-led data collection approaches. Canvas to Change offers a promising, accessible alternative to traditional mental health services for young people. The programme's holistic, arts-based approach supports emotional resilience, social confidence, and self-awareness. As a pilot study, findings are exploratory and highlight the need for future research with larger samples and validated tools.
Vaccination prevents millions of child deaths annually, yet zero-dose children remain concentrated in settings of high-mortality and malnutrition. Understanding how community-level coverage influences adverse health outcomes across sub-Saharan Africa is crucial. We analysed Demographic and Health Surveys (2015-2023) from sub-Saharan Africa. We used generalised additive models (GAMs) to estimate non-linear associations between cluster-level vaccine coverage and outcomes, deriving coverage thresholds at which predicted stunting and mortality crossed policy-relevant benchmarks. Among similar to 180,000 children, zero-dose vaccine was significantly associated with higher risks of stunting (aOR:1.10), wasting (aOR:1.37), underweight (aOR:1.27), and anaemia (aOR:1.20). Community-level analyses showed substantial variations where stunting >35%, 65% of children were unvaccinated compared with 4% in clusters with stunting <20%. Results demonstrated monotonic, non-linear associations between coverage and outcomes, with the clear declines in stunting as coverage increase from similar to 60%-to->= 80%. For mortality, >= 85 coverage was often required to reduce mortality below 10%; the <= 5% benchmark was rarely reached. Higher vaccination coverage is strongly and non-linearly associated with reductions in stunting and under-five mortality in sub-Saharan Africa. Our findings showed the largest marginal health gains increase as clusters move from moderate (similar to 60%) to high (>= 80%) coverage, highlighting the need to close zero-dose gaps and sustain high-coverage.
Objectives of this study are to determine how the impact of socio-economic and health determinants differs between pre-2002 and post-2002 regimes, quantify the importance of each determinant, and provide regime-specific probabilistic forecasts. Panel data collected from the World Bank's World Development Indicators for the period 1960-2024 are used. Regime-based variation is measured using Fixed Effects Panel Regression. Neural Ordinary Differential Equation (NODE) is used to identify structural inflection points and probabilistic forecasts are generated using Regime-based Stochastic Differential Equation (SDE). SDE projections show a more rapid decline in fertility rates post-2002 regime and a reduction in forecast uncertainty of about 40%. Educational attainment, contraceptive use, and health expenditure are identified as the main determinants of the decline. The contribution of the study is to interpret the decline in adolescent fertility as a policy and structural transformation and to identify the combined impact of education, health and family planning policies.
Violence against women and children is widespread globally, especially among refugees and underprivileged populations. We investigated the prevalence of violence against children (VAC) and intimate partner violence (IPV) among Rohingya refugee families and families from the neighboring host communities in Cox's Bazaar, Bangladesh. We also explored the predictors of VAC and IPV. This was a cross-sectional survey embedded into the endline of a cluster-randomized controlled trial of an early childhood parenting intervention for families with children aged 6-16 months. Mothers and fathers were interviewed on their use of VAC and their attitudes towards VAC. Mothers were asked about their experience of IPV. Fathers reported on their use of IPV, their use of violence in front of children, and their attitudes to IPV. We interviewed 689 and 87 fathers from the Rohingya community, and 862 mothers and 90 fathers from the host community. In both communities, over 45% of mothers reported IPV, and over two-thirds reported VAC. Fathers reported higher levels of VAC (85.6% in host community; 77% in Rohingya community) and over a quarter reported use of IPV. In both communities, lower household wealth was associated with increased odds of mothers experiencing IPV, and mothers who experienced IPV were more than twice as likely to report use of VAC Conversely, higher maternal education increased the odds of both mother- and father-reported IPV in the Rohingya community and of father-reported IPV in the host community. Participation in an early childhood parenting intervention led to less agreement with the use of VAC by mothers in both communities, while also increasing the odds of mother-reported IPV. It is important to integrate evidence-based interventions to reduce VAC and IPV into early childhood development programs within these communities. Ensuring a combined focus on mothers and fathers is also recommended.
Refugee adolescents experience displacement and resettlement-related stressors that increase risk of poor psychosocial outcomes. This study aimed to understand the factors influencing the psychosocial adjustment of recently resettled refugee adolescents in Hamilton, Canada, drawing on the perspectives and lived experiences of adolescents themselves as well as service providers. We conducted virtual semi-structured interviews with 11 refugee adolescents aged 13-17 years old and 33 service providers from 14 organizations supporting refugee and immigrant communities in Hamilton. Thematic analysis was used to identify key themes and results from the service provider and adolescent interviews were reviewed to identify areas of convergence and dissonance. We identified four major themes related to the psychosocial adjustment of refugee adolescents: (1) social and material stressors including language barriers, discrimination, and economic insecurity; (2) trauma and family conflict; (3) relationships and recreation as protective resources; and (4) faith and hope for the future. Unlike adolescent participants who emphasized the positive role of caregivers and family in providing psychosocial support, service providers highlighted family conflict and communication gaps as sources of psychological distress. Results underscore the importance of strengthening protective resources at different ecological levels - from the family to the school and community - to promote positive psychosocial adjustment among recently resettled refugee adolescents. Bolstering these resources through culturally tailored family strengthening and school- and community-based interventions will help to ensure refugee youth can thrive in their new lives.
This study examined how socioeconomic conditions affect cochlear implantation program in India, where government-funded implant schemes now provide access to children from lower economic backgrounds. A retrospective analysis of 213 children divided into low and high socioeconomic status (SES) groups based on family income. Age at identification, age at implantation, and outcomes at 2 years post-implantation were compared using auditory detection, speech identification, categorical auditory performance, Meaningful Auditory Integration Scale, and receptive/expressive language assessments. Age at hearing loss identification was similar between groups, but children from high SES families received implants at younger ages. Gender differences emerged between SES groups. Socioeconomic status significantly affected receptive and expressive language development but not auditory perception after two years of implant use. SES proved to be a significant predictor of language outcomes. Socioeconomic status influences age at cochlear implantation and language development rates in pediatric recipients. While government schemes improve access for lower-income families, disparities in implantation timing and language outcomes persist. These findings highlight the need for targeted interventions to address socioeconomic barriers and support optimal outcomes across all economic strata. Prospective studies are needed to validate these results and guide evidence-based policies for pediatric cochlear implant programs.
There is limited understanding of the circumstances leading street youth to rely on atypical resilience enablers. Atypical resilience enablers are unconventional strategies, often negatively judged by society or the law, which allow street youth to survive on the streets. We respond to this knowledge gap by documenting a 2REST study (Responsibilities for Resilience Embedded in Street Temporalities), exploring atypical resilience enablers of Harare street youth. We draw our findings from a three-year ethnographic study of 229 street youth (ages 14-24) in Harare, Accra and Bukavu, initially conducted for Growing Up on the Streets (GUOTS). We analysed secondary data accounts using a multisystemic resilience framework, a coding framework (created in NVivo) that included psychological resources of atypical informal work and problem solving. Findings showed that street youth navigated their hygiene and safety risks using a combination of atypical livelihoods and safety strategies ranging from theft, sex work, gambling to staying dirty to keep safe from violence. While these atypical resilience enablers supported their resilience, they also perpetuated negative stereotypes and limited positive interactions with their commu-nities. Our findings bring attention to how systemic neglect can be a catalyst for atypical resilience enablers. We use these findings to advance the need for systemic interventions in street contexts so that young people are not compelled to rely on atypical pathways. This would halt assumptions that typically scapegoat street youth. This is particularly important in Zimbabwe, where socioeconomic challenges push young people into the streets of Harare.
Adolescents living with HIV (ALWH) represent a vulnerable population with psychological and social challenges that can affect future orientation and goal-directed behaviours. Despite increasing access to antiretroviral therapy (ART) in sub-Saharan Africa, research on psychosocial determinants of future orientation in this group remains limited. This study examined how personality traits, depression and social support (belonging, esteem and self-development) predict future orientation among adolescents living with HIV in Ibadan, Nigeria. A cross-sectional design was used, with 144 adolescents aged 13-19 years (M = 16.04, SD = 2.02). The variables were assessed using the Future Orientation Scale, Big Five Personality Traits inventory, CESD-R, PSS-HIV and the Perceived Social Support in HIV (PSS-HIV) scale. Data were analysed using Pearson correlation and hierarchical multiple regression. Results showed that personality traits, depression and social support jointly predicted future orientation [F(12,123) = 8.02, R-2 = .27, Delta R-2 = .03, p < .001] and its dimensions. Independently, gender (beta = 0.16, t = 2.70, p < .01), age (beta = -0.46, t = -7.79, p < .001), duration of HIV (beta = 0.17, t = 2.97, p < .01), agreeableness (beta = -0.14, t = -2.09, p < .05), and esteem (beta = -0.27, t = -3.31, p < .01) significantly predicted future orientation. Depression and other social support factors were not significant. Components of future orientation (planning ahead, time perspective and anticipation of future consequences) were also significantly predicted by psychosocial factors. Conclusively, the findings indicate that future orientation among adolescents living with HIV is differentially influenced by demographic characteristics, psychosocial resources, and personality dispositions. Interventions should strengthen social support, foster positive personality traits, and promote future-oriented thinking to enhance psychosocial functioning.
Children growing up in structurally disadvantaged contexts face increased risks of delayed language development, yet evidence from the Latin American Caribbean remains limited. This study examined how personal, prelinguistic, and contextual factors jointly shape expressive language among young children in Caribbean Colombia, a setting marked by sociocultural diversity, poverty, and inequality. A cross-sectional sample of 174 children aged 8-30 months attending early childhood development centers together with their primary caregivers, who completed caregiver-reported versions of the Colombian adaptation of the MacArthur - Bates Communicative Development Inventories. As an exploratory approach, Random Forest regression models were estimated separately for children aged 8-16 months (expressive vocabulary) and 16-30 months (vocabulary size and phrase complexity), including child characteristics, prelinguistic abilities, family composition, and socioeconomic indicators as candidate predictors. In the 8-16-month group, prelinguistic skills (gesture use, imitation, phrase comprehension), age, and caregiver education emerged as key contributors to expressive vocabulary, alongside markers of lower economic burden. In the 16-30-month group, model performance was weaker and less stable; exploratory patterns suggested a growing influence of socioeconomic disadvantage and caregiver education on vocabulary and early syntax, which requires cautious interpretation. Overall, findings highlight how early communicative environments, prelinguistic abilities, and structural constraints intersect in vulnerable communities. Strengthening context-sensitive early stimulation, supporting caregivers living in poverty, and improving access to linguistically rich services may help prevent the consolidation of language and learning inequalities in early childhood.
Adolescents and youth living with HIV (AYLHIV) face increased health risks and need targeted support to optimally engage in treatment. The Supporting Adolescents to be Resilient and Thrive (S-SMART) programme is a digitally enabled, peer-supported self-management intervention designed to enhance psychosocial and treatment engagement outcomes among AYLHIV. This pilot study evaluated the feasibility and acceptability of S-SMART among AYLHIV aged 15-21 years who received HIV treatment at two public primary care clinics in the Cape Town Metropole, South Africa. Thirteen AYLHIV received smartphones, mobile data, and access to the S-SMART app from September to December 2024. The pilot programme for S-SMART included activities, peer group sessions, and coaching by four peers living with HIV. Focus groups were conducted before (n = 17) and after (n = 12), to assess usability and their user experiences. Activity and programme completion was > 95%. Participants found the app user-friendly overall, though some faced issues with navigation, language and understanding certain content. Engagement was strengthened through peer support and facilitation. While the programme promoted psychosocial empowerment, HIV-related challenges such as stigma and disclosure fears need ongoing support.
This case study explores a photovoice-based project within an international social work education program, involving two vulnerable groups: five children with autism from Israel and 11 children without parental care from India. The children created photovoices on the theme 'What would I like to tell the world about myself?' A total of 32 photovoices were analyzed, revealing four themes: Beyond Vulnerability, Positive Self-Identity, Dreams for the Future, and Gratitude. The study concludes that photovoice is an effective participatory methodology, enabling children to express their experiences in educational and social contexts.
This study aimed to determine the prevalence and statistically associated factors with inadequate supervision of children under five in Bangladesh. Data for this purpose were collected from the 2019 Multiple Indicators Cluster Survey. The sample included 23,099 children under five years old. A mixed-effects logistic regression model was employed to identify the determinants of inadequate supervision. Approximately 11.1% of children experienced inadequate supervision. The model indicated that age, mother's education, functional difficulties, ethnicity, and wealth index were significantly associated with inadequate supervision of children.
Child street hawking is prevalent in Nigeria and has been widely researched from an economic perspective. However, existing research has overlooked the cultural dimensions of this phenomenon. Therefore, this study explored the cultural and personal factors shaping parental views on child street hawking in Osogbo, a Yoruba city in southwestern Nigeria, with the aim of understanding the phenomenon and informing interventions. An exploratory research design was used, and face-to-face in-depth interviews were conducted with 32 participants who were purposively selected in four popular marketplaces, which were randomly selected within Osogbo. The participants were parents who permitted their children to engage in street hawking. Reflexive thematic and content analyses were applied to the data. The study found that child street hawking represents a culturally significant practice in Yoruba society, serving as a symbol of responsibility, practical skills development, money management, a form of social investment, a conduit for instilling entrepreneurial values, a symbol of answered prayers, and a contemporary expression of traditional values on children's economic roles, among other cultural meanings. The study concludes that child street hawking is a complex phenomenon, shaped by both cultural and personal factors, and that cultural analysis is essential for understanding its broader implications and informing policies and interventions.
Child nutritional status is an essential component of a country's overall human development. It continues to be widespread in a population of more than 200 million children under five (one in three children) in developing countries. To improve the nutritional status and living conditions in communities, it is necessary to determine the nature, magnitude and cause of malnutrition. To assess the magnitude and factors associated with nutritional status in children under 5 years of age in Gondar city administration, Gondar town. A structured questionnaire was used to collect data from 796 children paired with their mothers. Bivariate and multivariate logistic regression analyses were conducted to identify determinants of nutritional status. The degree of association was assessed using OR and 95% CI. Statistical association was declared as a p-value less than 0.05. The prevalence of severe stunting, underweight and wasting was 20.2%, 6% and 3.9% respectively. The presence of diarrhea, being male by sex, uneducated fathers and the total number of children ever born to a mother were significantly associated with underweight. The presence of diarrhea, being male by sex, pre-lacteal feeding and not using family planning methods were significantly associated with stunting. As the prevalence of malnutrition was high, it is recommended that intervention should focus on prevention and control of diarrheal disease through improving access to safe and adequate water supply, immunization, housing, sanitation and hygiene practices and on improving promotion of nutrition education and utilization of family planning.
In low- and middle-income countries, structural poverty continues to shape educational pathways and outcomes. Adverse Childhood Experiences (ACEs), often exacerbated by socioeconomic vulnerability, are linked to long-term psychological and academic challenges. This study examines the indirect relationship between ACEs and student engagement in the context of Indonesian higher education, with self-esteem and sense of belonging proposed as mediating variables. Drawing on a cross-sectional survey of 796 university students from diverse institutions across Indonesia, data were analyzed using serial mediation models (Smart PLS 4). The results reveal that ACEs significantly reduce self-esteem (beta = -0.04, p < 0.01) but have no direct effect on emotional engagement (beta = -0.02, p > 0.05) or sense of belonging (beta = 0.01, p > 0.05). However, self-esteem positively predicts engagement (beta = 0.30, p < 0.01), and a significant indirect pathway is identified via self-esteem and belonging (beta = 0.010, p < 0.05). These findings suggest that psychological sequelae of childhood adversity may hinder students' capacity to engage meaningfully in higher education, even in the absence of direct institutional exclusion. The study underscores the urgency for universities in developing contexts to adopt proactive psychosocial support mechanisms - particularly for students with histories of adversity - to foster inclusion, resilience, and equitable learning outcomes.
Early chronic exposure to stress from internal armed conflict related experiences may influence the development of cognitive functions and externalizing behavior problems in child victims. This cross-sectional comparative study aimed to evaluate differences in inhibitory control, cognitive flexibility, post-traumatic symptomatology, anger control problems, challenging behaviors, personal resources index and emotional intelligence in a sample consisting of 54 victims (56.3%) and 42 non-victims (43.7%) aged 8 to 11 years (Mdn = 9, IQR = 3) from low socioeconomic backgrounds in the Colombian region of Quind & iacute;o. The instruments used were the Wisconsin Card Sorting Test, the Stroop Test, and the Child and Adolescent Evaluation System. Shared difficulties were found in inhibitory control, with a significant p-value and small-to-moderate effect size; post-traumatic symptoms were present in both groups, with greater severity in the victim group; challenging behaviors were identified in the victim group; and problems with anger control, personal resources, and emotional intelligence showed small-to-moderate effect sizes. These results highlight the impact of armed conflict on executive functioning and externalizing behaviors in child victims and indicate possible influence of daily stressors associated with social vulnerability, combined with acute stress conditions derived from traumatic experiences.
Child marriage is not an ancient practice, or one that only affects developing countries. Rather, it is a practice that is still rampant even in the modern world today, and Malaysia is not an exception. Throughout the years, that has been a constant push for Malaysia to put a stop to child marriage, by not only local NGOs, but also inter-governmental organizations such as UNICEF and UN. Malaysia is a signatory of both the Convention on the Rights of Child (CRC) and the Convention on the Elimination of Discrimination Against Women (CEDAW), with certain reservations on both the international treaties. However, the national legislation governing the issue of child marriage is not in line with what has been stipulated in the international human rights laws that we have subscribed to. The national laws also contain exceptions which become loopholes for child marriages to occur. As a result, children are being married off due to various reasons, causing them to lose their rights. The method used in this study was qualitative research, in which interviews were the primary source of data. The research discusses on the international instruments and Malaysia's adherence to them, the loopholes in Malaysia's legislation on child marriage, as well as various measures that should be taken to eliminate the issue of child marriage in the country.
Adolescents in lower-resource countries face a high burden of eye health problems. This study in Tanzania aimed to 1) estimate the prevalence of distance vision impairment among young adolescents, 2) describe academic performance by distance visual acuity status, and 3) examine facilitators and barriers to school-facilitated vision screenings and receiving eye care. Participants (primary school students in Standard 7) in the intervention arm of the Vijana Tambua Afya, translated as 'Youth Health Check', clinical trial (n = 509) attended school-facilitated, clinic-based health check-ups that included distance vision screening (presenting acuity). Data included adolescent surveys, medical record extraction, and Primary School Leaving Examination scores. Semi-structured interviews with parents and focus groups with school and clinic staff were conducted. Analyses included descriptive statistics and qualitative thematic analysis. Overall, based on their worse eye, 6.9% of students had mildly reduced vision and 4.3% had impaired vision on screening. 71.9% of students with mildly reduced or impaired vision scored a C or lower on the PSLE compared to 59.9% with normal vision. Less than 10% of students referred received follow-up care. School-based vision screenings were deemed largely successful by clinicians and teachers, but there were challenges related to follow-up care including referral linkages, households' financial barriers to vision care, and insufficient parental knowledge on the importance of timely pediatric eye care. Given the prevalence of visual impairment and its potential link to academic performance, governments should consider requiring school-based distance vision screenings. Further research on screening implementation strategies and strengthening follow-up care is needed.
Cumulative trauma, which is devastating can lead to severe psychological outcomes. Exposure to various kinds of trauma, especially in childhood is even more harmful than the sheer volume of experience. Children experiencing cumulative trauma are at greater risk of developing callous unemotional traits. This study examined the mediating role of callous unemotional traits and the moderating role of resilience, in the association between cumulative trauma and behavioral problems among children. A survey of 314 vulnerable children, aged 13 to 17 years (girls = 167; boys = 147) was conducted at seven different institutes in Assam, India. The results indicated that the children experienced 16 different types of trauma during their developmental phases. The mediating model indicated a strong facilitating effect of callous-unemotional (CU) traits in the relationship between cumulative trauma and behavioral problems: externalizing (beta = .01; p < .05); internalizing problems (beta = .03; p < .01); personal adjustment (beta = .03; p < .01); and school problems (beta = .04; p < .01). Additionally, resilience did not moderate the association between trauma and behavioral problems. This study strengthens the evidence associating childhood cumulative trauma with an increased risk for the development of CU traits, supporting the notion that these traits could potentially reduce resilience.
