Journal Articles

The COVID-19 pandemic has exposed the urgent need to tackle the crisis of mental health among children and young people. We call for a multi-stakeholder Global Mental Health Alliance for Children, which would achieve the following objectives: to strengthen evidence and understanding of mental health and well-being, causes and risks for children and young people; to scale up investment in mental health programming for children and young people, and particularly expanding the global cadre of health workers, social workers and community workers, with a focus on prevention and promotion of mental health; to support youth-led, evidence- and rights-based initiatives; to expand advocacy and knowledge of mental health for children and young people among the wider public, and reduce stigma, marginalization and discrimination against those experiencing mental ill-health; and to enhance funding from both the public and private sectors for promotion of mental health, prevention of ill-health and treatment of mental health disorders.

Objetivo. Describir lo que se sabe acerca de la prevalencia nacional de la violencia por parte de la pareja íntima (VPI) contra las mujeres en las Américas, en los diversos países y en el transcurso del tiempo, incluida la cobertura geográfica, calidad y comparabilidad de los datos nacionales. 

Métodos. Se realizó una revisión sistemática y reanálisis de las estimativas nacionales de la VPI basadas en la población de 1998 a 2017 en las Américas. Las cifras se reanalizaron para comparabilidad o se extrajeron de los informes, incluida la prevalencia por tipo (física; sexual; o física y/o sexual), marco temporal (alguna vez;
durante el último año) y perpetrador (cualquiera pareja en la vida; pareja actual/más reciente). En los países con tres (3+) rondas de datos, se aplicaron las pruebas de Cochran-Armitage y de ji cuadrada de Pearson para evaluar si los cambios en el transcurso del tiempo fueron significativos (p < 0,05).

Resultados. Se encontraron encuestas elegibles en 24 países. Las mujeres reportaron haber sufrido alguna vez violencia física y/o sexual por parte de la pareja íntima con tasas que variaron desde el 14% a 17% en Brasil, Panamá y Uruguay hasta más de la mitad (58,5%) en Bolivia. La prevalencia de violencia física y/o sexual por parte de la pareja íntima durante el último año varió desde 1,1% en el Canadá hasta 27,1% en Bolivia. La evidencia preliminar sugiere una posible disminución en la prevalencia reportada para ciertos tipos de VPI en ocho países; sin embargo, algunos cambios fueron pequeños, ciertos indicadores no se modificaron significativamente y se observaron incrementos significativos en la prevalencia reportada de violencia física por parte de la pareja íntima durante el último año en la República Dominicana.

Conclusiones. La VPI contra las mujeres sigue siendo un problema de salud pública y de derechos humanos en las Américas; sin embargo, la base de evidencia al respecto tiene deficiencias, lo que apunta a la necesidad de datos de mejor calidad y más comparables, a fin de movilizar y monitorear a la prevención y la
respuesta ante la violencia.

• 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.

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.

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. 2003). 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 2007).

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

Evidence on whether the amount of time children spend online affects their mental health is mixed. There may be both benefits and risks. Yet, almost all published research on this topic is from high‐income countries. This paper presents new findings across four countries of varying wealth.

We analyse data gathered through the Global Kids Online project from nationally representative samples of Internet‐using children aged 9 to 17 years in Bulgaria (n  = 1,000), Chile (n  = 1,000), Ghana (n  = 2,060) and the Philippines (n  = 1,873). Data was gathered on Internet usage on week and weekend days. Measures of absolute (comparable across countries) and relative (compared to other children within countries) time use were constructed. Mental health was measured by Cantril’s ladder (life satisfaction). The analysis also considers the relative explanatory power on variations in mental health of children’s relationships with family and friends. Analysis controlled for age, gender and family socioeconomic status.

In Bulgaria and Chile, higher‐frequency Internet use is weakly associated with lower life satisfaction. In Ghana and the Philippines, no such pattern was observed. There was no evidence that the relationship between frequency of Internet use and life satisfaction differed by gender. In all four countries, the quality of children’s close relationships showed a much stronger relationship with their life satisfaction than did time spent on the Internet.

Time spent on the Internet does not appear to be strongly linked to children’s life satisfaction, and results from one country should not be assumed to transfer to another. Improving the quality of children’s close relationships offers a more fruitful area for intervention than restricting their time online. Future research could consider a wider range of countries and links between the nature, rather than quantity, of Internet usage and mental health.

Violence against children is a pervasive public health issue, with limited data available across multiple contexts. This study explores the rarely studied prevalence and dynamics around disclosure, reporting and help-seeking behaviours of children who ever experienced physical and/or sexual violence.

Using nationally-representative Violence Against Children Surveys in six countries: Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania, we present descriptive statistics for prevalence of four outcomes among children aged 13–17 years: informal disclosure, knowledge of where to seek formal help, formal disclosure/help seeking and receipt of formal help. We ran country-specific multivariate logistic regressions predicting outcomes on factors at the individual, household and community levels.

The prevalence of help-seeking behaviours ranged from 23 to 54% for informal disclosure, 16 to 28% for knowledge of where to seek formal help, under 1 to 25% for formal disclosure or help seeking, and 1 to 11% for receipt of formal help. Factors consistently correlated with promoting help-seeking behaviours included household number of adult females and absence of biological father, while those correlated with reduced help-seeking behaviours included being male and living in a female-headed household. Primary reasons for not seeking help varied by country, including self-blame, apathy and not needing or wanting services.

Across countries examined, help-seeking and receipt of formal services is low for children experiencing physical and/or sexual violence, with few consistent factors identified which facilitated help-seeking. Further understanding of help seeking, alongside improved data quality and availability will aid prevention responses, including the ability to assist child survivors in a timely manner.

Times of economic uncertainty, civil unrest and disaster are linked to a myriad of risk factors for increased violence against women and children (VAW/C). Pandemics are no exception. In fact, the regional or global nature and associated fear and uncertainty associated with pandemics provide an enabling environment that may exacerbate or spark diverse forms of violence. Understanding mechanisms underlying these dynamics are important for crafting policy and program responses to mitigate adverse effects. Based on existing published and grey literature, we document nine main (direct and indirect) pathways linking pandemics and VAW/C, through effects of (on):(1) economic insecurity and poverty-related stress, (2) quarantines and social isolation, (3) disaster and conflict-related unrest and instability, (4) exposure to exploitative relationships due to changing demographics, (5) reduced health service availability and access to first responders, (6) inability of women to temporarily escape abusive partners, (7) virus-specific sources of violence, (8) exposure to violence and coercion in response efforts, and (9) violence perpetrated against health care workers. We also suggest additional pathways with limited or anecdotal evidence likely to effect smaller sub-groups. Based on these mechanisms, we suggest eight policy and program responses for action by governments, civil society, international and community-based organizations. Finally, as research linking pandemics directly to diverse forms of VAW/C is scarce, we lay out a research agenda comprising three main streams, to better (1) understand the magnitude of the problem, (2) elucidate mechanisms and linkages with other social and economic factors and (3) inform intervention and response options. We hope this paper can be used by researchers, practitioners, and policymakers to help inform further evidence generation and policy action while situating VAW/C within the broader need for intersectional gender- and feminist-informed pandemic response.

We provide evidence from the Transfer Project to show that methodological design is only one factor in determining credibility in the eyes of policymakers. Policymakers understand concerns around internal validity, but also value collaborative research engagement, which builds trust, allows co-creation of research questions, informs operations throughout the evaluation period and leverages national research expertise. Further, the mere act of engaging in a large-scale, transparent impact evaluation, across quasi- and experimental designs can change the culture of decision-making within an agency, leading to better policy choices in the long run. We advocate for a more inclusive approach to policy research that begins with identifying the most relevant research question and fitting the methods to the question rather than vice-versa. We challenge the field to engage more closely with policymakers to identify their evidence needs in order to prioritize the end objective of improving the lives of the poor—regardless of methodological design choices.