Violence and educational outcomes among young children in South Africa and Malawi

Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi.

Sherr L, Hensels IS, Skeen S, Tomlinson M, Roberts KJ, Macedo A. Int Health. 2015 Dec 17. pii: ihv070. [Epub ahead of print]

Background: Violence during childhood may affect short and long-term educational factors. There is scant literature on younger children from resource poor settings.

Methods: This study assessed child violence experiences (harsh punishment and exposure to domestic or community violence) and school enrolment, progress and attendance in children attending community-based organisations in South Africa and Malawi (n=989) at baseline and at 15 months' follow-up, examining differential experience of HIV positive, HIV affected and HIV unaffected children.

Results: Violence exposure was high: 45.4% experienced some form of psychological violence, 47.8% physical violence, 46.7% domestic violence and 41.8% community violence. Primary school enrolment was 96%. Violence was not associated with school enrolment at baseline but, controlling for baseline, children exposed to psychological violence for discipline were more than ten times less likely to be enrolled at follow-up (OR 0.09; 95% CI 0.01 to 0.57). Harsh discipline was associated with poor school progress. For children HIV positive a detrimental effect of harsh physical discipline was found on school performance (OR 0.10; 95% CI 0.02 to 0.61).

Conclusion: Violence experiences were associated with a number of educational outcomes, which may have long-term consequences. Community-based organisations may be well placed to address such violence, with a particular emphasis on the challenges faced by children who are HIV positive.

Abstract  Full-text [free] access

Editor’s notes: There is substantial evidence that demonstrates the negative effects of the experience of violence in childhood on child mental health. However, there is little evidence on the impact of violence on educational outcomes. This is due to measurement and study design, such as data being primarily cross-sectional and studies being confined to adolescents, where younger children are excluded. This study reports data from a longitudinal study of young children aged 4–13 years affected by HIV enrolled at community-based organisations (CBOs) in South Africa and Malawi. The study examined the relationship between exposure to violence at home or in the community on educational outcomes at baseline and follow-up (12–15 months later). In particular, attention was given to HIV positive and HIV affected children in order to explore the effects of HIV as a factor of either violence experience or educational risk in this age group. HIV affected children are children who may not be HIV positive themselves, but living in a household with a HIV positive member.

In this sample of young children (n=989), close to 14% were HIV positive. School enrolment and attendance was high, although HIV positive children had slightly lower attendance and enrolment in the correct grade for their age, compared to HIV affected children. At baseline, overall exposure to violence at home and in the community was very high. Over half of the sample had been exposed to two or more types of violence, whereas less than one in six reported no violence exposure at all. At both baseline and at follow-up, there was no association found between community violence and school enrolment and attendance or grade progression. In terms of violence experienced at home (domestic violence), at baseline there was an association with grade progression for children in households with no HIV. At follow-up, in particular for children living with HIV, use of physical violence to discipline the child had a detrimental effect on grade progression. Furthermore, at follow-up, the use of psychological violence to discipline children had an effect on school enrolment. Hence, children of caregivers using psychological violence for discipline were significantly less likely to be enrolled in school at follow-up, if they were not enrolled at baseline. Thus, findings from this study highlight that despite high rates of violence exposure in this population, children who are HIV positive, in particular, appear to be most at risk of poor educational outcomes. This is likely to be due to a range of inter-related risk factors that affect educational outcomes: parental death, shifting care arrangements, change in school, illness-induced poverty and increased care-giving responsibilities.  All these factors might affect a child’s ability to access schooling and perform well in the context of HIV. As shown, educational outcomes were specifically linked to harsh punishment, as opposed to community or domestic violence. Thus, CBOs that provide services for children affected by HIV might be key to intervening on this issue. Furthermore, younger children in HIV endemic countries are particularly vulnerable and educational achievement in the early years is an important pre-requisite for ongoing educational milestones.  

Malawi, South Africa
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