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UNICEF Innocenti's complete catalogue of international peer reviewed journals

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11 - 20 of 99
Uptake of HIV testing among adolescents and associated adolescent-friendly services

AUTHOR(S)
Jennifer Waidler, Rachel Kidman, Tia Palermo

Published: 2020

HIV testing remains low among adolescents. Making public health services more adolescent-friendly is one strategy used to encourage testing. However, it remains unclear whether government-led initiatives have a meaningfully impact. The current study is observational and utilizes two sources of data (health-facility and adolescent-level) from one round of data collection of an on-going, longitudinal impact evaluation of a pilot cash plus program targeting adolescents. This study linked data from adolescent surveys (n = 2191) to data collected from nearby government-run health facilities (n = 91) in two rural regions of Tanzania. We used log binomial regression models to estimate the association between specific adolescent-friendly health service (AFHS) characteristics and adolescents’ uptake of 1) HIV testing and 2) visiting a health care facility in the past year for sexual and reproductive health (SRH) services.

Most adolescents (67%) lived in a village with a health facility, and all offered HIV services. We find, however, that AFHS have not been fully implemented. For example, less than 40% of facilities reported that they had guidelines for adolescent care. Only 12% of facilities had a system in place for referral and follow-up with adolescent clients, yet this was an important predictor of both past-year HIV testing (RR = 1.28, p < 0.1) and SRH visits (RR = 1.44, p < 0.05). Less than half (44%) offered services for survivors of gender-based violence (GBV), a significant predictor of past-year HIV testing (RR = 1.20, p < 0.05) and SRH visits (RR = 1.41, p < 0.01) among sexuallyactive adolescents.

We find that national guidelines on AFHS have not been fully translated into practice at the local level. We highlight particular gaps in adolescent referral systems and GBV services. Scaling up these two essential services could encourage greater HIV testing among a high-risk population, in addition to providing much needed support for survivors of violence.

Measurement of Multidimensional Child Poverty

AUTHOR(S)
Alessandro Carraro, Lucia Ferrone

Published: 2020

Multidimensional child poverty defines children who experience a state of poverty that is more complex than that defined by a unidimensional measure of poverty, but encompasses child material needs and human rights, in a holistic way.

The definition of child poverty agreed by the UN General Assembly was used by Gordon, Townsend, and their colleagues from the University of Bristol for their study on child poverty in the developing world (Gordon et al. ). It gives full weight to material deprivation as the main element of child poverty, stating that children living in poverty are deprived in multiple domains of their lives (i.e., nutrition, water and sanitation, education, shelter, and protection among others) and that the lack of goods and access to services can represent a severe threat for their growth and development (United Nations General Assembly ).

Multidimensional child poverty encompasses the various deprivations experienced by children in their daily lives....

The evolving picture of SARS-CoV-2 and COVID-19 in children: critical knowledge gaps
Published: 2020

  • The initial impression that paediatric infection is uncommon and generally mild has been replaced by a more nuanced understanding of infectious manifestations in children across countries and by income group, with recognition of a widening disease spectrum.
  • Critical knowledge gaps remain that have significant public policy and programme implications.
  • Insufficient age and race/ethnicity disaggregated data are hindering efforts to assess fully the prevalence of SARS-CoV-2 infection and COVID-19 in children and the role of children in transmission.
  • Potential biologic differences in susceptibility to infection and transmissibility between children and adults need to be explored.
  • Determination of mother-to-child SARS-CoV-2 transmission requires appropriate samples obtained with proper timing, lacking in most studies.
  • Predictors of disease progression and morbidity and mortality in children need to be determined, particularly as the pandemic moves to low-income and middle-income countries.
  • The full spectrum of SARS-CoV-2 infection in children remains to be defined, and surveillance for and investigation of the pathogenesis of postinfectious sequelae, such as multisystem inflammatory syndrome, are vital.

Modelling the Effect of the COVID-19 Pandemic on Violent Discipline Against Children

AUTHOR(S)
Alessandra Guedes

Published: 2020
The COVID-19 pandemic could increase violence against children at home. However, collecting empirical data on violence is challenging due to ethical, safety, and data quality concerns. This study estimated the anticipated effect of COVID-19 on violent discipline at home using multivariable predictive regression models. Under a “high restrictions” scenario there would be a 35% to 46% increase in violent discipline scores in Nigeria, Mongolia and Suriname, and under a “lower restrictions” scenario there would be between a 4% to 6% increase in violent discipline scores in these countries. Policy makers need to plan for increases in violent discipline during successive waves of lockdowns.
COVID-19 response measures and violence against children
Published: 2020
In the early stages of the coronavirus disease 2019 (COVID-19) response, children were described as invisible carriers who posed a risk of infection to others. Here we outline how responses to COVID-19 may increase children’s exposure to violence and neglect. We also highlight ongoing efforts to address violence against children and argue for continued action and research on violence prevention within the COVID-19 response.
Risk Factors for Childhood Violence and Polyvictimization: A Cross-Country Analysis from Three Regions

AUTHOR(S)
Tia Palermo, Audrey Pereira, Naomi Neijhoft, Ghaji Bello, Robert Buluma, Pierre Diem, Rocio Aznar Daban, Inah Fatoumata Kaloga, Aminul Islam, They Kheam, Birgithe Lund-Henriksenj, Nankali Maksudk, Mary Catherine Maternowska, Alina Potts, Chivith Rottanak, Chea Samnangm, Mary Shawan, Miho Yoshikawa, Amber Peterman

Published: 2019
Understanding risk factors is important to ending childhood violence and meeting Sustainable Development Goal 16.2. To date, no study has examined patterns of risk factors across countries comprehensively for different types of childhood violence, and there is a dearth of evidence of polyvictimization in lower- and middle-income settings. We analyse risk factors of childhood emotional (EV), physical (PV), sexual violence (SV) and polyvictimization for children aged 13–17 from nationally-representative Violence Against Children Surveys across six countries. We examine risk factors at the community-, household-, and individual- levels for each violence type, stratified by gender using multivariable logistic regression models. Across countries, school enrolment increased violence risk among females and males (three countries), but was protective against violence among females (one country), and among males (three countries). Among females, increasing age was associated with increased risk of SV (five countries) and polyvictimization (three countries); among males this relationship was less salient. Non-residence with a biological father emerged as a risk factor for SV among girls. Few or inconsistent associations were found with other factors, including number of household members, wealth, and urban residence. These results underscore on the one hand, the need for country-specific research on risk factors to inform prevention strategies, as well as increased investment in data collection to provide a more complete and robust basis for evidence generation. High levels of polyvictimization highlight overlapping vulnerabilities children face, and may provide insights for policymakers and practitioners in designing strategies to protect children at greatest risk of abuse.
Exploring Impacts of Community-Based Legal Aid on Intrahousehold Gender Relations in Tanzania

AUTHOR(S)
Valerie Mueller, Amber Peterman, Lucy Billings, Ayala Wineman

Published: 2019
Community-based legal aid (CBLA) has been promoted as a promising intervention to reach rural marginalized populations who face barriers to accessing formal legal services and is increasingly implemented with the specific goal of protecting women's rights. This study evaluates the impact of a twelve-month CBLA program in northwestern Tanzania on intrahousehold gender relations using a clustered-randomized control trial across 139 villages. Among 1,219 women, the study finds those in treatment villages are more likely to refer others to paralegals for a variety of domestic issues; however, there are no measureable impacts on aggregate knowledge of marital law, intrahousehold decision making, or reported experience of twelve-month intimate partner violence. These overall results are robust to a number of other sensitivity analyses, including accounting for spillovers, attrition bounds, and modeling choices. While these results indicate limited potential for intrahousehold and gender-progressive change, program duration and intensity likely affected measurable positive impacts.
Government of Malawi's unconditional cash transfer improves youth mental health

AUTHOR(S)
Gustavo Angeles, Jacobus de Hoop, Sudhanshu Handa, Kelly Kilburn, Annamaria Milazzo, Amber Peterman

Published: 2019
We explore the impacts of Malawi's national unconditional cash transfer program targeting ultra-poor households on youth mental health. Experimental findings show that the program significantly improved mental health outcomes. Among girls in particular, the program reduces indications of depression by about 15 percentage points. We investigate the contribution of different possible pathways to the overall program impact, including education, health, consumption, caregiver's stress levels and life satisfaction, perceived social support, and participation in hard and unpleasant work. The pathways explain from 46 to 65 percent of the program impact, advancing our understanding of how economic interventions can affect mental health of youth in resource-poor settings. The findings underline that unconditional cash grants, which are used on an increasingly large scale as part of national social protection systems in Sub-Saharan Africa, have the potential to improve youth mental wellbeing and thus may help break the vicious cycle of poverty and poor mental health.
Social Protection in Contexts of Fragility and Forced Displacement: Introduction to a Special Issue

AUTHOR(S)
Tilman Brück, Jose Cuesta, Jacobus de Hoop, Ugo Gentilini, Amber Peterman

Published: 2019
Effective social protection is increasingly as essential to supporting affected populations in situations of protracted instability and displacement. Despite the growing use of social protection in these settings, there is comparatively little rigorous research on what works, for whom, and why. This special issue contributes by adding seven high-quality studies that raise substantially our understanding of the role of social protection in fragile contexts and in settings of forced displacement and migration. Together, these studies fill knowledge gaps, help support informed decision-making by policy-makers and practitioners, and demonstrate that impact evaluation and the analysis of social protection in challenging humanitarian settings are possible. The studies provide evidence that design choices in implementation, such as which population to target, choice of transfer modality or which messages are delivered with programmes, can make a substantial difference in the realisation of positive benefits among vulnerable populations. Furthermore, the findings of the studies underline the relevance of tailoring programme components to populations, which may benefit more or less from traditional programme implementation models.
School Feeding or General Food Distribution? Quasi-Experimental Evidence on the Educational Impacts of Emergency Food Assistance during Conflict in Mali

AUTHOR(S)
Elisabetta Aurino, Jean-Pierre Tranchant, Amadou Sekou Diallo, Aulo Gelli

Published: 2019
This study relies on a unique precrisis baseline and five-year follow-up to investigate the effects of emergency school feeding and generalised food distribution (GFD) on children’s schooling during conflict in Mali. It estimates programme impact on child enrolment, absenteeism, and attainment by using a difference in differences weighted estimator. School feeding led to increases in enrolment by 10 percentage points and to around an additional half-year of completed schooling. Attendance among boys in households receiving GFD, however, declined by about 20 per cent relative to the comparison group. Disaggregating by conflict intensity showed that receipt of any food assistance led to a rise in enrolment mostly in high-intensity conflict areas and that the negative effects of GFD on attendance were also concentrated in the most affected areas. School feeding mostly raised attainment among children in areas not in the immediate vicinity of conflict. Programme receipt triggered adjustments in child labour. School feeding led to lower participation and time spent in work among girls, while GFD raised children’s labour, particularly among boys. The educational implications of food assistance should be considered in planning humanitarian responses to bridge the gap between emergency assistance and development by promoting children’s education.
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