Combining parenting and economic strengthening programmes to reduce violence against children: a cluster randomised controlled trial with predominantly male caregivers in rural Tanzania.

Journal: BMJ global health

Volume: 5

Issue: 7

Year of Publication: 2021

Affiliated Institutions:  Department of Social Policy and Intervention, University of Oxford, Oxford, UK jamie.lachman@spi.ox.ac.uk. National Institute for Medical Research Mwanza Research Centre, Mwanza, Mwanza, United Republic of Tanzania. School of Social and Political Sciences, University of Glasgow, Glasgow, Glasgow, UK. MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. Department of Social Policy and Intervention, University of Oxford, Oxford, UK.

Abstract summary 

Parenting programmes may reduce the risk of violence against children and improve child well-being. However, additional economic support may be necessary in highly deprived rural communities in sub-Saharan Africa. Furthermore, delivering programmes within farmer groups may increase male caregiver recruitment and engagement.A parallel cluster randomised controlled trial examined the combined and separate effects of parenting and economic strengthening programmes on reducing violence against children aged 0-18 years in farming communities in Tanzania (n=248 families; 63% male caregivers). Eight villages were randomly assigned to four conditions (2:2:2:2): (1) 12-session parenting programme (n=60); (2) agribusiness training (n=56); (3) parenting and agribusiness combined (n=72); (4) control (n=60). Parent-report, child-report and early childhood observation assessments were conducted at baseline, mid-treatment and post-treatment. Primary outcomes were child maltreatment and parenting behaviour. Secondary outcomes included corporal punishment endorsement, parenting stress, parent/child depression, child behaviour, economic well-being and child development.At post-treatment, parents and children receiving the combined interventions reported less maltreatment (parents: incidence rate ratio (IRR=0.40, 95% CI 0.24 to 0.65; children: IRR=0.40, 95% CI 0.17 to 0.92). Parents reported reduced endorsement of corporal punishment ( =-0.43, 95% CI -0.79 to 0.07) and fewer child behaviour problems ( =-0.41, 95% CI -0.77 to 0.05). Parents in parenting-only villages reported less abuse (IRR=0.36, 95% CI 0.21 to 0.63) and fewer child behaviour problems ( =-0.47, 95% CI -0.84 to 0.11). Parents in agribusiness-only villages reported fewer child behaviour problems ( =-0.43, 95% CI -0.77 to 0.08) and greater household wealth ( =0.57, 95% CI 0.08 to 1.06). However, children in agribusiness-only villages reported increased physical abuse (IRR=2.26, 95% CI 1.00 to 5.12) and less positive parenting ( =-0.50, 95% CI -0.91 to 0.10). There were no other adverse effects.Parent training may be the active ingredient in reducing maltreatment in farmer groups with majority male caregivers, while agribusiness training programmes may have unintended negative consequences on children when delivered alone. Locating parenting support in existing farmer groups can engage much higher proportions of fathers than stand-alone programmes.ClinicalTrials.gov: NCT02633319.

Authors & Co-authors:  Lachman Jamie J Wamoyi Joyce J Spreckelsen Thees T Wight Daniel D Maganga Jane J Gardner Frances F

Study Outcome 

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Statistics
Citations :  Stoltenborgh M, Bakermans-Kranenburg MJ, van Ijzendoorn MH, et al. . Cultural-geographical differences in the occurrence of child physical abuse? A meta-analysis of global prevalence. Int J Psychol 2013;48:81–94. 10.1080/00207594.2012.697165
Authors :  6
Identifiers
Doi : e002349
SSN : 2059-7908
Study Population
Male,Fathers
Mesh Terms
Caregivers
Other Terms
cCluster randomised trial;child health;prevention strategies
Study Design
Case Control Trial,Cross Sectional Study
Study Approach
Country of Study
Tanzania
Publication Country
England