Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in Tanzania
Background Parenting programmes, including those delivered in the Global South, are effective strategies to reduce violence against children (VAC). However, there is limited evidence of their impact when implemented at scale within routine delivery systems. This study aimed to address this gap by ev...
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BMJ Publishing Group
2024-11-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/9/11/e015472.full |
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| author | Joyce Wamoyi Jamie Lachman Yulia Shenderovich Qing Han Mackenzie Martin Francisco Antonio Calderón Alfaro Samwel Mgunga Esther Nydetabura Nyasha Manjengenja Mwita Wambura |
| author_facet | Joyce Wamoyi Jamie Lachman Yulia Shenderovich Qing Han Mackenzie Martin Francisco Antonio Calderón Alfaro Samwel Mgunga Esther Nydetabura Nyasha Manjengenja Mwita Wambura |
| author_sort | Joyce Wamoyi |
| collection | DOAJ |
| description | Background Parenting programmes, including those delivered in the Global South, are effective strategies to reduce violence against children (VAC). However, there is limited evidence of their impact when implemented at scale within routine delivery systems. This study aimed to address this gap by evaluating the real-world delivery of Parenting for Lifelong Health for Teens in Tanzania.Methods Participating parents/caregivers and their adolescent girls were recruited by local implementing partners in 2020–2021 as part of a community-based HIV prevention initiative focused on addressing drivers of female adolescent HIV-vulnerability such as VAC, caregiver–adolescent relationships and sexual reproductive health communication. The 14-session, group-based parenting programme was delivered by trained teachers and community facilitators. Quantitative surveys administered by providers measured a variety of outcomes including child maltreatment (primary outcome) and multiple secondary outcomes linked to increased risk of VAC. Multilevel models examined pre–post effects as well as variation by attendance and baseline demographic variables.Results Pre–post data from 27 319 parent/caregiver–child dyads were analysed, of which 34.4% of parents/caregivers were male. Analyses showed large reductions in child maltreatment (parents/caregivers: IRR=0.55, (95% CI 0.54, 0.56); adolescents: IRR=0.57, (95% CI 0.56, 0.58)), reduced intimate partner violence experience, reduced school-based violence, increased communication about sexual health, reduced poor supervision, reduced financial insecurity, reduced parenting stress, reduced parent and adolescent depression, and reduced adolescent conduct problems. In contrast to these positive outcomes, parents/caregivers and adolescents also reported reduced parental positive involvement and support of education, with those experiencing greater adversity reporting less change than those with less adversity.Conclusions This study is the first to examine the large-scale implementation of an evidence-based parenting programme in the Global South. Although additional research is necessary to examine potential negative effects on positive parenting and parent support of education, findings suggest that Furaha Teens can sustain its impact on key outcomes associated with VAC when delivered at scale. |
| format | Article |
| id | doaj-art-24415a0231dc49ec8c975a8ccfbfb5a8 |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Global Health |
| spelling | doaj-art-24415a0231dc49ec8c975a8ccfbfb5a82025-08-20T02:36:09ZengBMJ Publishing GroupBMJ Global Health2059-79082024-11-0191110.1136/bmjgh-2024-015472Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in TanzaniaJoyce Wamoyi0Jamie Lachman1Yulia Shenderovich2Qing Han3Mackenzie Martin4Francisco Antonio Calderón Alfaro5Samwel Mgunga6Esther Nydetabura7Nyasha Manjengenja8Mwita Wambura9National Institute for Medical Research Mwanza Research Centre, Mwanza, Mwanza, Tanzania, United Republic ofDepartment of Social Policy and Intervention, University of Oxford, Oxford, UKCentre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK1 Department of Obstetrics, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, ChinaDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, CanadaDepartment of Social Policy and Intervention, University of Oxford, Oxford, UKDepartment of Sexual and Reproductive Health, National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania, United Republic ofPact Tanzania, Dar es Salaam, Tanzania, United Republic ofClowns Without Borders South Africa, Pietermaritzburg, South AfricaDepartment of Sexual and Reproductive Health, National Institute for Medical Research Mwanza Research Centre, Mwanza, Tanzania, United Republic ofBackground Parenting programmes, including those delivered in the Global South, are effective strategies to reduce violence against children (VAC). However, there is limited evidence of their impact when implemented at scale within routine delivery systems. This study aimed to address this gap by evaluating the real-world delivery of Parenting for Lifelong Health for Teens in Tanzania.Methods Participating parents/caregivers and their adolescent girls were recruited by local implementing partners in 2020–2021 as part of a community-based HIV prevention initiative focused on addressing drivers of female adolescent HIV-vulnerability such as VAC, caregiver–adolescent relationships and sexual reproductive health communication. The 14-session, group-based parenting programme was delivered by trained teachers and community facilitators. Quantitative surveys administered by providers measured a variety of outcomes including child maltreatment (primary outcome) and multiple secondary outcomes linked to increased risk of VAC. Multilevel models examined pre–post effects as well as variation by attendance and baseline demographic variables.Results Pre–post data from 27 319 parent/caregiver–child dyads were analysed, of which 34.4% of parents/caregivers were male. Analyses showed large reductions in child maltreatment (parents/caregivers: IRR=0.55, (95% CI 0.54, 0.56); adolescents: IRR=0.57, (95% CI 0.56, 0.58)), reduced intimate partner violence experience, reduced school-based violence, increased communication about sexual health, reduced poor supervision, reduced financial insecurity, reduced parenting stress, reduced parent and adolescent depression, and reduced adolescent conduct problems. In contrast to these positive outcomes, parents/caregivers and adolescents also reported reduced parental positive involvement and support of education, with those experiencing greater adversity reporting less change than those with less adversity.Conclusions This study is the first to examine the large-scale implementation of an evidence-based parenting programme in the Global South. Although additional research is necessary to examine potential negative effects on positive parenting and parent support of education, findings suggest that Furaha Teens can sustain its impact on key outcomes associated with VAC when delivered at scale.https://gh.bmj.com/content/9/11/e015472.full |
| spellingShingle | Joyce Wamoyi Jamie Lachman Yulia Shenderovich Qing Han Mackenzie Martin Francisco Antonio Calderón Alfaro Samwel Mgunga Esther Nydetabura Nyasha Manjengenja Mwita Wambura Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in Tanzania BMJ Global Health |
| title | Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in Tanzania |
| title_full | Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in Tanzania |
| title_fullStr | Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in Tanzania |
| title_full_unstemmed | Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in Tanzania |
| title_short | Reducing family and school-based violence at scale: a large-scale pre–post study of a parenting programme delivered to families with adolescent girls in Tanzania |
| title_sort | reducing family and school based violence at scale a large scale pre post study of a parenting programme delivered to families with adolescent girls in tanzania |
| url | https://gh.bmj.com/content/9/11/e015472.full |
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