Violence against Children in Low- and- Middle- Income Countries: Developmental Consequences and Prevention

Abstract

Violence against children (VAC) is a widespread issue with profound consequences for individuals and societies. However, there is still controversy about the consequences of some forms of violence, like physical punishment, due to challenges establishing causality and generalizability in prior research. There are also knowledge gaps related to how to design and implement violence prevention interventions in low- and middle-income countries (LMICs), as most programs have been developed and evaluated in high-income countries. In this three-paper dissertation, I contribute to the ongoing conversations on the consequences of VAC for children living in LMICs and conduct formative research to inform a violence prevention parenting program (VPPP) designed for Colombia. The first chapter reports findings from a systematic review and state-of-the-art multilevel meta-analyses of 168 studies assessing the association between physical punishment experienced in childhood and individual outcomes in LMICs. Findings show that (1) there is extensive evidence from LMICs regarding these associations, (2) physical punishment is consistently associated with higher risk for detrimental outcomes (Cohen^' s d=-0.35), and (3) there is some variability in these associations due to contextual and study-level characteristics that warrant further examination. In the second chapter, I complement the meta-analysis by applying a child fixed-effects approach and robustness checks to longitudinal data from four LMICs to assess the links between spanking and young children’s development. Results show associations between spanking and negative cognitive, social-emotional, and motor outcomes for preschool-age children, but also reveal variation in estimates between sites. The third chapter presents formative research, including reviews of the literature and a descriptive qualitative study with Colombian policymakers, program facilitators, and parents to inform the design of Apapacho, a VPPP targeting caregivers of young children. Findings provide a template for and guidance to stakeholders interested in designing and implementing VPPPs in LMICs. Collectively, this dissertation provides novel, more internally- and- externally-valid evidence on the consequences of physical punishment and offers timely evidence to support the design of VPPP in LMICs. In doing so, this dissertation advances developmental research and informs stakeholders to support advocacy and programmatic efforts aimed at preventing VAC and promoting children’s development globally.