Prevalence and correlates of children's exposure to domestic violence and abuse in low- and middle-income countries

Abstract

Background: children’s exposure to domestic violence and abuse (DVA) is associated with adverse outcomes in both childhood and adulthood. However, little is known about the scale and factors associated with exposure, especially in low- and middle-income countries (LMICs).

Objectives: this study aims to address this gap through the following research questions:

What is the prevalence of exposure to DVA in selected LMICs?
Which factors are associated with exposure to DVA within these countries?
Methods: The CDC Violence Against Children Surveys (VACS) were used to gain prevalence estimates of children’s exposure to DVA in ten LMICs across the regions of Sub-Saharan Africa, Latin America and the Caribbean, South-Eastern Asia, and Eastern Europe. Logistic regression was used to explore factors associated with DVA exposure within the ecological domains of individual, family, community and society, to explore what makes a child more likely to be exposed to DVA and the associated mental health outcomes.

Results: exposure to DVA ranged from 11.8% in Honduras to 30.7% in Malawi. Other countries with high prevalence included Zambia, Nigeria, and Lesotho. Regression analysis found the domain of community and society to be most important, with individual and family factors less so. Individuals exposed to community violence had much higher levels of exposure to DVA, while a relationship with societal acceptance of violence was also seen. Females were at significantly higher risk of exposure to DVA in four of the ten countries. At the family level, wealth produced mixed results across countries. Finally, individuals from Lesotho, Malawi, Namibia, and Zambia who lived in households with multiple children were also more likely to be exposed to DVA. When looking at mental health outcomes associated with exposure to DVA, bivariate analysis revealed a higher prevalence of internalising and externalising symptoms amongst those who had been exposed to DVA as a child when compared to those who had not. Regression analysis found that in all ten countries, those who had been exposed to DVA had a higher likelihood (ranging between 31%-161%) of experiencing psychological distress than those who had not been exposed to DVA in childhood. In nine of the countries (all countries explored except Nigeria), those exposed to DVA had a higher likelihood of having ever experienced suicidal thoughts. In five of the ten countries, those exposed to DVA as a child were more likely to engage in risky behaviours and perpetrate DVA. In six of the nine countries (it was not possible to assess in Cambodia), non-partnered violence perpetration was more common amongst those exposed to DVA as a child.

Conclusions and recommendations: many children are exposed to DVA within LMICs, and this study indicates that all ecological domains of a child’s life impact exposure. There is a significant association between exposure to DVA as a child and adverse mental health outcomes in adolescence and early adulthood. There was homogeneity in factors related to exposure across countries, with some exceptions that need further exploration. Policies related to DVA in LMICs need to acknowledge childhood exposure to mitigate its effects.

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Identifiers

ORCID for Rebecca Jane Harris: orcid.org/0000-0002-8537-7282

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