Childhood exposure to domestic violence and abuse in low- and middle-income countries

Abstract

Childhood exposure to domestic violence and abuse (DVA) perpetrated between caregivers or other adults in the household is associated with a range of poorer outcomes in later life, including an increased risk of psychiatric disorders, substance misuse, and a higher likelihood of committing violent crimes in adulthood. However, the majority of research on this topic is based on studies conducted in high-income countries (HICs), and evidence on the scale, impact, and early appropriate interventions for children is extremely limited in low- and middle-income countries (LMICs), with many gaps in knowledge. Without this information, a potentially large number of children will grow up without their experiences being acknowledged or recorded, thereby limiting the potential interventions to reduce their risk of poor outcomes.
The overarching aim of this thesis is to enhance and develop the knowledge and understanding of childhood exposure to DVA in LMICs to address these critical gaps in knowledge. It does this by presenting a body of empirical research that explores key stages of the research process through four distinct, but closely linked research papers. These papers are ordered to form a comprehensive understanding of childhood exposure to DVA on a global level.
The papers start with exploring the current measurement scales of childhood exposure to DVA, and uses the COSMIN PROMs approach to question whether existing scales are appropriate for gaining global prevalence estimates of childhood exposure to DVA. The second investigation studies the prevalence of, and risk factors associated with, childhood exposure to DVA in LMICs. It does this through secondary data analysis of ten Violence Against Children Surveys (VACS). Paper Three builds explicitly on Paper Two by investigating the mental health outcomes of children exposed to DVA within ten LMICs, utilising the VACS, focusing on adverse internalising and externalising symptoms in adolescence and early adulthood. Finally, the last paper moves beyond a multi-country comparative approach and instead looks at one LMIC in detail: Nepal. It explores the current understanding and support available for childhood exposure to DVA.
Taken together, the findings in this thesis presents a comprehensive overview of the current state of understanding of childhood exposure to DVA in LMICs, highlighting where further research is required to ensure that children’s voices are heard, and appropriate policies and interventions are developed to ensure their protection. Implications for policy, practice, and research are addressed.

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Identifiers

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

ORCID for Amos Channon: orcid.org/0000-0003-4855-0418

ORCID for James Hall: orcid.org/0000-0001-8002-0922

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