C4D VAC Systematic Review Report
C4D VAC Systematic Review Report
C4D VAC Systematic Review Report
PAPER SERIES
© UNICEF/UNI167953/D’AKI
FOREWORD
D
espite a clear legal and ethical imperative to protect children, Violence
against Children (VAC) remains pervasive. It affects millions of children
every year, in their homes, communities, schools, workplaces, in detention
centres and childcare institutions, and online. It can have long lasting, and often
lifelong, negative effects. The vast majority of children never speak out about
their experiences and even fewer receive the services they need to recover.
When the global community adopted the Sustainable De- novation and best practice in shifting social norms related to
velopment Goals (SDGs) in 2015, targets were set to eradi- VAC. C4D is indeed integral to UNICEF’s VAC programmatic
cate all forms of violence, abuse, exploitation and trafficking approach under the Strategic Plan 2018-2021. Changing social
against boys and girls, as well as harmful practices by 2030. norms is also embedded in the VAC Theory of Change, as a
There is increasing recognition that VAC places a long-term stand-alone outcome, and as a cross-cutting strategy that influ-
burden on health and social services, undermines invest- ences all other outcomes.
ment and development in other sectors (such as health, early
childhood development, nutrition and education) and con- Even so, the evidence and documentation of C4D best practices
strains economic growth. Conversely, investment in ending to address VAC is limited. There is an urgent need to improve
violence against children and women can accelerate develop- access, dissemination, systematization, and use of data and evi-
ment across all the SDGs. dence on social and behavior change and community engage-
ment to promote protective practices. In recent years, several
Violence against children encompasses efforts have been undertaken to strengthen this. Yet there are
few such efforts focused on VAC.
“all forms of physical or mental
violence, injury and abuse, neglect or This report is part of a package of evidence and tools that
negligent treatment, maltreatment or includes this systematic review of C4D interventions to ad-
dress VAC, an evidence review of randomized controlled
exploitation, including sexual abuse"
(Article 19, United Nations Convention on the trials, a Technical Guidance for C4D programmes address-
Rights of the Child) ing VAC, and training materials related to the Guidance.
This suite of materials is a result of UNICEF’s investments
Transforming social norms that condone or facilitate VAC or in C4D capacity and its collaboration with Drexel Univer-
prevent child victims from accessing support, and reinforcing sity to strengthening the evidence-base on what works for
positive norms that protect children from violence, has been preventing and responding to VAC through C4D. Several
increasingly recognized as crucial by the global community – UNICEF offices are using these resources to develop coun-
it is, for example, one key strategy of the INSPIRE package for try roadmaps and strengthen their strategies to address VAC
ending violence against children (WHO, 2016). through robust C4D programming. We hope that more
UNICEF offices, governments, partner agencies, and others
UNICEF has a critical role to play in ending VAC and achieving working in this area will find this package useful. We hope
the SDGs. It is a leading global agency with the profile, reach, that it will also provide the hard evidence that governments
expertise and mandate to achieve impact at scale. Building on and development agencies need for scaling up efforts to re-
its expertise and technical leadership in Communication for duce violence against children.
Development (C4D), UNICEF is also well placed to lead on in-
2 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
Contents
Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
List of tables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
List of figures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Acknowledgements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1 Executive summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2 Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3 Structure of this report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
4 Methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Manuscript selection and sampling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
7 Overall recommendations 62
.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
End notes.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
3 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
Tables
TABLE 1: Key terms for the systematic review.....................................................................................................................................13
4 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
Figures
FIGURE 1: Overall recommendations based on the systematic review ................................... 11
5 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
Acknowledgements
RESEARCH TEAM
PRINCIPAL INVESTIGATOR: Suruchi Sood, Associate Professor, Dornsife School of Public Health,
Drexel University
RESEARCH STAFF: Carmen Cronin, Michelle Gordon, Jessica Lopez, Kelli Kostizak, Sarah Stevens
STUDENT ASSISTANTS: Joëlla Adams, Srinidhi Bhatt, Janay Brandon, Mena El Turky, Nina
Figueroa, Andrew Issa, Priyanka Padidam, Nikhil Shah, Anuja Thatte
UNICEF
MANAGEMENT TEAM:
• Neha Kapil, C4D Specialist, UNICEF Headquarters
• Charlotte Lapsansky, C4D Specialist, UNICEF Headquarters
• Clarice Da Silva e Paula, Child Protection Specialist, UNICEF Headquarters
• Marina Komarecki, IKM Specialist, UNICEF Headquarters
• Sophie Flynn, Child Protection Consultant, UNICEF Headquarters
• RyAnn Babcock Waldemarsen, Programme Support, UNICEF Headquarters
• Mercy Abgai, Programme Support, UNICEF Headquarters
OVERALL GUIDANCE:
• Theresa Kilbane, Senior Advisor, Child Protection, UNICEF Headquarters
• Rafael Obregon, Chief, C4D, UNICEF Headquarters
• Stephen Blight, Senior Advisor, Child Protection, UNICEF Headquarters
• Susan Bissell, Chief, Child Protection, UNICEF Headquarters
• Cornelius Williams, Chief, Child Protection, UNICEF Headquarters
6 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
UNICEF
REVIEWERS:
• Ketan Chitnis, C4D Chief, UNICEF Vietnam
• Rudrajit Das, C4D Specialist, UNICEF
• India Ayda Eke, Child Protection Specialist, UNICEF Headquarters
• Fabio Friscia, C4D Specialist, UNICEF WCARO
• Karin Heissler, Child Protection Specialist, UNICEF Headquarters
• Mika Kunida, C4D Specialist, UNICEF WCARO
• Paolo Mefalopulos, C4D Chief, UNICEF India
• Mario Mosquera, C4D Specialist, UNICEF India
• Joachim Theis, Child Protection Chief, UNICEF India
• Cristina del Valle, Child Protection Specialist, UNICEF WCARO
• Nance Webber, C4D Chief, UNICEF Bangladesh
• Clara Sommarin, Child Protection Specialist, UNICEF Headquarters
• Caroline Bacquet, Child Protection Specialist, UNICEF Headquarters
• Jennifer Keane, Child Protection Specialist, UNICEF Headquarters
• Child Protection Regional Advisors
EXTERNAL REVIEWERS
• Sue Goldstein, Programme Director at Soul City, Johannesburg Area, South Africa
• Lisa M. Jones, Ph.D. Research Associate Professor of Psychology, Crimes against
Children Research Center (CCRC), University of New Hampshire
• Catherine L. Ward, Ph.D.
Associate Professor, Department of Psychology, University of
Cape Town
7 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
1 Executive summary
T
“Violence against children cuts across he Programme Division at
boundaries of geography, race, class, UNICEF Headquarters in New
York initiated a research study
religion, and culture. [...] Violence against
to analyse the effectiveness of
children is never justifiable. Nor is it
© UNI CE F/NYHQ2 014 -0 328 /G RARUP
8 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
EXECUTIVE SUMMARY
al level of change. About 11 per cent use commu- framework. Often in these cases, programme
nity approaches and slightly less than 10 per cent objectives focus on the negative, whereas C4D
report using an ecological approach. messages for the same intervention focus on
positive changes. Overall programme objectives
While cognitive and individual-based behav- should be linked to communication objectives,
iour change approaches are valid and useful in which in turn yield C4D messages. The links
certain contexts, there is a growing realization between these overall programme objectives and
9 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
EXECUTIVE SUMMARY
terventions were individuals and did not report measurement indicators, which are further
segmenting audiences into primary, secondary, centred on low-order individual cognitive
or tertiary groups. Developing countries tended constructs. Lack of information on sampling
to utilize campaigns with mass media chan- frameworks, small sample sizes, and other
nels such as television, radio, and print, where- methodological issues bring to light the lack
as United States-based interventions (often led of specificity and sophistication in the evalu-
10 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
EXECUTIVE SUMMARY
ation data being collected. These issues ul- Moving forward, future research and practice
timately raise doubts about the quality of should consider the following 15 overall rec-
information utilized to examine effectiveness ommendations, categorised under three broad
of interventions. themes relevant to contextualisation and fram-
ing of the issue, programme design, implementa-
Local indicators (incidence and prevalence) on tion and evaluation, which are elaborated upon
VAC are not always readily available or acces- later on in the report.
sible. This being the case, an essential first step
to identifying the magnitude of VAC as a set of FIGURE 1: Overall recommendations based on the Systematic
issues deserving of global advocacy and ad- Review
equately resourced interventions would be the
creation of standardized definitions and mea-
Contextualisation and framing of the issue
surements of incidence and prevalence.
integral component of prevention efforts. The • Reconfigure programme and C4D/ communication objectives of VAC interventions
review pointed out the need to engage men and • Move beyond individually-focused knowledge, attitudes, and practices by
addressing social, emotional, and behavioural competencies
boys in gender transformative programmes.
While focusing on girls is important, it should
not be at the expense of boys, who are also vic- Programme implementation and evaluation
tims of violence.
In summary, it is essential to expand outcome • Position VAC as a 'glocal' issue through qualitative and
evaluation studies so as to enhance our under- quantitative measurement
standing of global best practices, which, in turn, • Enhance investment in research
need to be contextualized based on what works • Scale up promising interventions
at a local level to address VAC.
11 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
2 Background
T
This research study, initiated his study focuses specifically on the
© UNI CE F/LAO-20 15-NOORAN I- 0238/
12 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
BACKGROUND
This systematic review examines available There are differences among practitioners and
peer-reviewed publications and grey literature scholars on all the communication approach-
(reports and project documents) on C4D in- es and terms that constitute C4D. Therefore,
terventions addressing VAC within a 13-year the systematic review included several com-
time period (from 2000 to 2013). The research plementary terms such as behaviour change
question posed above requires a clear under- communication, social mobilization, media
standing of the population (children), issue campaigns, and advocacy. With respect to
of concern (VAC), and intervention approach forms of VAC, a mix of broad and specific is-
(C4D). Definitions for these terms are provid- sues is included (the complete list of key terms
ed below: used for this systematic review is presented in
Table 1).
THE POPULATION FOCUS FOR THIS RE-
VIEW IS ON CHILDREN. The United Nations
Convention on the Rights of the Child (CRC)
defines a child as “a human being below the age
of 18 years, unless under the law applicable to
child, majority is attained earlier”.4
TABLE 1: Key terms for the systematic review
THE ISSUE FOCUS OF THIS REVIEW IS
Communication (for/ and) development
ON VAC. Article 19 of the CRC defines vi-
Behaviour change communication
olence as: “all forms of physical or mental
Social change communication
violence, injury or abuse, neglect or negli- Advocacy
gent treatment, maltreatment or exploitation, Social mobilization
including sexual abuse”. General Comment Community mobilization
no. 13 seeks to guide State Parties in un- Approaches Participatory communication
derstanding their obligations under article Communication campaigns
19 of the CRC to prohibit, prevent and re- Strategic communication
Media campaigns
spond to all forms of violence. It is based on
Social media
the fundamental assumption that: “No vio-
Interactive communication technologies
lence against children is justifiable; all vio-
lence against children is preventable”, and it Children
builds on existing guidance provided by the Minors
CRC Committee and on recommendations Girls
Populations Boys
coming from various United Nations mecha-
Adolescents
nisms and reports, including the Secretary-
Youth
General’s Study on Violence against Children
(United Nations, 2006). Child protection
Violence
THE INTERVENTION FOCUS OF THIS RE- Gender-based violence
VIEW IS ON COMMUNICATION FOR DE- Sexual abuse/ sexual violence/ sexual exploitation
Trafficking
VELOPMENT, which UNICEF broadly defines
Child Labour
as “an evidence-based and participatory pro-
Issues Child marriage/ early marriage
cess that facilitates the engagement of children, Honour killings
families, communities, the public and deci- Female genital mutilation/ cutting
sion makers for positive social and behavioural Discrimination
change in both development and humanitarian Corporal punishment
contexts through a mix of available communi- Bullying
Gang violence
cation platforms and tools” (UNICEF, 2019).
13 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
3 Structure of this report
14 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
STRUCTURE OF THIS REPORT
The key findings of this systematic review are 4. OVERALL PROGRAMME EVALUA-
organized into the five subsections below: TION PROCESSES: includes informa-
tion on overall programme evaluation
1. SAMPLING INFORMATION: includes processes such as evaluation design,
information about sampling for the sys- research methods, analysis frame-
tematic review. works, sampling, and indicators.
5.
4.
2. 3. Thematic
1. Overall
Programme Programme analysis of the
Sampling programme
design elements implementation key results by
evaluation
type of research
Year Conceptual frameworks Intended audiences Evaluation design Formative research
Impact assessment/
Summary Communication objectives Communication channels Analysis frameworks
evaluation
Summary Summary
15 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
4 Methods
16 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
METHODS
The list of databases included in this review is as well as the Communication Initiative data-
summarized below in Table 3. A majority of these bases, were all selected in order to include grey
databases include peer-reviewed literature, while literature.
others such as Google Scholar, ELDS and BLDS,
GOOGLE SCHOLAR Scholarly literature including theses, books, abstracts and articles
Boys queue to kick a foot-
ball during a recreation
ELDIS AND BLDS Institute of Development Studies, Sussex, United Kingdom
period at Sheikh Radwan
School in Gaza City on the
COMMUNICATION INITIATIVE Database of communication strategies and media for development
first day of the new school
year in the Gaza Strip.
© UNI CE F/NYHQ2 014 -1 508 /E L BABA
17 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
METHODS
I
n order to systematize the review process, anisms were employed at each stage. After data
the shortlisting of manuscripts involved entry was completed, the Principle Investigator on
three stages of review: the study identified a systematic random sample of
30 manuscripts (ensuring that at least two articles
1. TITLE REVIEW: Titles deemed relevant per student involved in data entry were included)
were shortlisted for abstract review. to calculate inter-rater reliability, which was manu-
2. ABSTRACT REVIEW: Shortlisted ab- ally calculated at 84 per cent, indicating statistically
stracts were scanned for relevance based substantial agreement. The kappa statistic was uti-
on their adherence to the inclusion criteria. lized to examine inter-rater agreement and yield-
ed a value of 0.69. According to Landis and Koch
3. FULL TEXT REVIEW: Full text manu- (1977), a value of 0.61 - 0.80 can be considered as
scripts of the relevant abstracts were read substantial agreement.
and entered into a database.
Selected for full text review: 414 articles; 119 reviews (total:533)
18 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
METHODS
2. 3. 4. 5.
1.
Programme Programme Programme Limitations and
Background
design implementation evaluation recommendations
19 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
5 Limitations of
this systematic review
20 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
LIMITATIONS OF THIS SYSTEMATIC REVIEW
T
he analysis presented in this system- • An intervention aimed at educating
atic review is based on a grounded adolescent girls on family life education
theory approach. In grounded the- issues in a village of Uttrakhand, India,
ory, categories and themes emerge was coded as part of the searches on
or are generated from the data and are further ‘social change approaches to address
refined and expanded throughout the data discrimination’ as well as ‘communica-
analysis process. This approach differs from a tion and development interventions to
quantitative categorization of the manuscripts. address child marriage’ (Saxena, Sriv-
Thus, it is hard to apply ‘rule-of-thumb’ criteria astava and Ahuja, 2009).
and classify manuscripts based on the strength
of the evidence presented. In order to quanti- The inherent complexity of C4D approaches and
tatively compare effectiveness, one of two cri- VAC makes it difficult to create mutually ex-
teria needs to be met: either specific common clusive categories for the reviewed manuscripts
outcomes need to be identified or approaches based on either approaches or issues. There-
need to be limited to examine their impact on fore, one cannot make broad generalizations of
a variety of outcomes.6 Otherwise there is no the terms C4D and VAC, but rather one needs
common ground upon which to make judg- to examine specific issues and approaches. At
ments about effectiveness. VAC encompasses the same time, this complexity is a key learning
a range of issues and C4D includes an array of upon which broad-based guidance on the con-
approaches. This systematic review combines ceptualization of VAC programmes can be built.
both VAC and C4D as an overall framework;
therefore the validity of such aggregation based The systematic review attempted to cast a wide
on strength of evidence is limited. On the one net and gather information from as many data
hand it is impossible to compare the effective- sources as possible by using multiple and dif-
ness of interventions addressing different is- ferent types of databases. Nevertheless, some
sues and using multiple approaches. At the relevant databases were inadvertently excluded
same time it is hard to take the interventions such as ERIC (Education Resources Informa-
included in the review and fit them into mu- tion Centre), while others were deliberately
tually exclusive categories based upon either omitted, for example, student theses and dis-
approach or issue. Sometimes interventions ad- sertations. The selection of key terms for the
dress multiple violence issues and/ or use sev- review was based on a review of several back-
eral approaches. ground documents and consensus among the
research team, as well as C4D and Child Pro-
Apart from the large number of approaches and tection teams at UNICEF Headquarters. This
issues being covered in this review, there were process resulted in a well-defined yet broad
overlaps between C4D approaches and different set of approaches and forms of violence. How-
forms of VAC as evidenced by the fact that the ever, some commonly used approaches such as
literature search revealed the same manuscripts information campaigns, IEC approaches, and
even after the related key terms were varied. For educational campaigns were not included in
example: the search terms because of their limited use in
academia.
• The evaluation of the first five years of
the California Wellness Foundation’s Vio- A key limitation of including a variety of key
lence Prevention Initiative was coded as terms to describe both C4D and child protection
an example of community mobilization, meant that in some cases it was difficult to parse
as well as a communication for develop- out the communication aspect of some of the
ment approach (Greenwood et al., 2001). manuscripts that were included in the review,
for example, counsellor training to address VAC
21 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
(Left to right) Nancy, a
therapist, uses a puppet or dance therapy for violence prevention. Simi- reported interventions are from industrialized
as an aid during a ses-
sion with nine-year-old
larly, in some instances the extent to which C4D countries. In some ways this is a function of the
Natalia (name changed), interventions were designed to address VAC academic nature of this systematic review and
at the CEPAT (Centro de
PrevenciÛn y AtenciÛn
was difficult to determine. An example of this reflects the biases associated with searching in
Terapéutica) therapeutic are programmes addressing HIV-related stigma United States-based databases and peer-review
care centre, in the city of
PotosÌ, capital of PotosÌ and discrimination, where VAC related preven- publications.7 At the same time it is important
Department, in Bolivia. tion and response is related to programmes de- to situate this systematic review in the context
© UNI CE F/NYHQ2 013 -1 500 /P IROZZI
signed to address issues pertinent to health and of other reviews of this nature. For example,
education. Mikton and Butchart (2009) while reviewing
child maltreatment programmes, noted in their
Another key limitation of this review could be results a woeful imbalance in the geographic
the fact that more than half of the information distribution of child maltreatment prevention
presented here is based on data from the devel- research with over 99 per cent of the publica-
oped world. Approximately 56 per cent of the tions coming from high-income countries.
22 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
LIMITATIONS OF THIS SYSTEMATIC REVIEW
These authors contend that their findings par- sufficient programmatic details as required by
allel the 10/90 gap in areas of health research.8 this systematic review database. It is important to
This review, in contrast, is therefore geographi- mention that the inclusion of both types of man-
cally robust given that 44 per cent of the manu- uscripts constitutes a limitation because exist-
scripts comes from developing countries. It is ing reviews/ analyses yield different results and
possible that the inclusion of multiple search have to be interpreted differently from individual
terms to define C4D and VAC, as well as the interventions.
use of multiple databases, resulted in the over-
all robustness of the sample. A final key limitation of this review was that it
only included peer-reviewed journal articles and
In addition, it is important to note that while the reports published in English between 2000 and
United Nations Secretary-General’s Study not- 2013. The 2000 onwards time frame was con-
ed that VAC happens everywhere and across all sidered appropriate as research associated with
social groups, specific types of VAC are related examining effectiveness of communication pro-
to social and cultural norms of a given society. grammes is relatively new. Therefore, looking at
According to UNICEF, the practice of female interventions and evaluations preceding the 13-
genital mutilation/ cutting (FGM/ C) is concen- year time frame was not likely to yield pertinent
trated in 29 countries in Africa and the Middle results. Finally, the utilization of communication
East.9 Any literature associated with FGM/ C is as a mechanism to address VAC has not been
therefore likely to come from these specific coun- conducted in a systematic manner focused on
tries. While the information from interventions evidence. While examining interventions previ-
implemented in industrialized countries might ous to this time frame may have been important
not be directly applicable to developing country from a historical perspective, it was considered
contexts, the information and data remain valid
sources from which to draw conclusions and rec-
ommendations regarding C4D approaches to ad- “While the United Nations Secretary-
dress VAC. A related limitation is that this review
General’s Study noted that VAC happens
focused specifically on VAC and did not attempt
to examine causal or contributing factors or out- everywhere and across all social groups,
comes associated with VAC such as alcohol abuse, specific types of VAC are related to social
or study the relationship of VAC with environ- and cultural norms of a given society.”
mental factors such as urbanization, migration,
and displacement.
23 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
6 Key findings
Two girls read together from
a book during a class in the
UNICEF-supported Deari
Elementary School in the city
of Keren, capital of Anseba
Region, in Eritrea.
T
• SECTION 1: Sampling information he systematic review database in-
• SECTION 2: Programme design elements cluded background information
3: Programme implementation
© UNI CE F/NYHQ2 014 -3 552 /P IROZZI
• SECTION
about each manuscript such as: com-
• SECTION 4: Overall programme evaluation processes
plete citation, type, and year of pub-
• SECTION 5: Thematic analysis of the key results by
type of research lication. In addition, geographic location was
noted at increasing levels of specificity starting
with region, then country, and finally sub-na-
tional level. Information on year of publication
indicates that approximately half of the articles
24 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
20%
15%
10%
5%
0%
=8) n=13) (n=7) n=11) n=12) n=18) n=16) n=24) n=33) n=34) n=29) n=46) n=37) n=14)
0 (n 1( 2 3( 4( 5( 6( 7( 8( 9( 0( 1( 2( er
200 200 200 200 200 200 200 200 200 200 201 201 201 quart
s t
3 (1
201
reviewed (53 per cent) were published between scripts, 168 (over 50 per cent) came from in-
2008 and 2013 (see Figure 5). dustrialized countries with the United States of
America leading the list by a large margin with
Data on the geographic location of implemented 118 manuscripts (about 39 per cent). Some 31
interventions was categorized according to the manuscripts (10 per cent) were classified as being
UNICEF regional office classification. The re- global. In most cases these global manuscripts
sults indicate that 30 manuscripts (about 10 per reflected existing reviews and meta-analyses of
cent) were from the South Asian region – with a VAC programmes (Table 4).
majority coming from India (53 per cent). Some
18 manuscripts (6 per cent) were from Eastern Information on the location of the interventions
and Southern Africa. East Asia and the Pacific was also classified by geography ranging from
and the Middle East and North Africa each con- regional or province level to sub-regions. For
tributed approximately 15 manuscripts (roughly some countries (United States of America and
5 per cent). By far the largest number of manu- India), states were mentioned as being the focus
District 13 4.3
State 24 7.9
Urban centre 81 26.8
Rural areas 12 4.0
Multiple 80 26.5
25 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
proaches for VAC was promising, with are from urban rather than rural
a steady increase in the numbers of locations.
manuscripts published every year • 10 per cent of the manuscript repre-
since 2000. sent ‘global’ experiences, mainly ex-
• While the sample of manuscripts in- isting reviews and meta-analyses of
cluded in this review favoured devel- interventions addressing key VAC.
26 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
T
he information associated with pro- refer to other models as and when they came up
gramme design elements gleaned from during the course of data entry. The list of mod-
the systematic review includes the fol- els is summarized in Table 5.
lowing information:
There was limited evidence that manuscripts
• Conceptual (theoretical) frameworks included an explicit statement of conceptual
models to underpin described interventions. In
• Programme objectives fact, 129 (43 per cent) of the manuscripts did not
clearly reference any conceptual model.
• Communication objectives
Cognitive models, reported in 51 manuscripts
• Level of influence (17 per cent), were among the most commonly
mentioned. In some cases, interventions cre-
• Implementing agencies and partners ated their own frameworks/ models by building
upon existing theories of change. For example,
ASSESSMENT OF CONCEPTUAL two of the manuscripts from Finland’s KiVa
(THEORETICAL) FRAMEWORKS10 intervention employed the participant role ap-
Two types of analyses were undertaken to exam- proach to school bullying (Karna et al, 2011a;
ine the overall conceptual (theoretical) frame- Karna et al., 2011b). This approach (see Figure
works specified in the manuscripts. First, all of 7) builds upon constructs of social learning
the frameworks or models explicitly mentioned theory11 and stages of change.12 The review indi-
in the manuscripts were included in the data- cated that an additional 18 manuscripts focused
base. If more than one model/ framework was on individual steps and stages of change mod-
described, then the database included multiple els. Therefore, close to a quarter of the manu-
columns to note all of them. A second set of scripts explicitly relied on individually based
analyses pertained to the implicit inclusion of approaches to behaviour change.
27 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
Community approaches, on the other hand, interpreted given the subjective nature of this cod-
were explicitly mentioned in 34 manuscripts ing. However, it is interesting to note while only 24
(11 per cent). Twenty-four manuscripts (slightly of the manuscripts (8 per cent) explicitly stated us-
less than 10 per cent) reported utilizing an eco- ing an ecological approach, the coders found evi-
logical approach.13 One word of caution when dence of an ecological perspective in an additional
interpreting these results is that comprehensive 32 manuscripts (11 per cent).14 In another example,
models such as the ‘social ecological frame- only 11 manuscripts (4 per cent) made an explicit
work’ encompass various levels of influence reference to changes at the system or policy-level as
ranging from the individual level to the policy- their conceptual framework, but an additional 19
level. It is likely that the 24 manuscripts (8 per manuscripts (6 per cent) were thought to be im-
cent) that reported relying on the social ecolog- plicitly attempting to address policy-level changes
ical approach included elements from cognitive primarily through advocacy.
approaches stages of behaviour change, social
Finland’s KiVa intervention employed the participant a “positive change in the behaviours in classmates can
role approach to school bullying. According to this ap- reduce the rewards gained by bullies and consequent-
proach, bullying is perceived as a group phenomenon ly their motivation to bully in the first place” (Kärnä,
largely enabled and maintained by class members tak- 313). This is accomplished through skill-building exer-
ing on different participant roles. These roles include: cises emphasizing self-efficacy, anti-bullying attitudes,
assistants, reinforcers of the bully, outsiders or defend- and empathy as well as the establishment of a school
ers of the victim. These roles moderate behaviour with- mechanism to address instances of bullying immedi-
in the class social group by ‘peer group power’. The ately through counselling and small group discussions.
KiVa interventions encourage participants to take ac- In some ways the KiVa model combines both cognitive
tion against bullying by becoming defenders or helpers elements (role playing to build efficacy) and stages of
of victimized classmates. KiVa is based on the idea that change (moving individuals to serve as defenders).
28 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
The objectives related to policy frameworks were communication messages for the same inter-
written in broad and generalizable terms and ventions focused on raising the value of the girl
typically sought broad-based social and struc- child and changing gender-related attitudes. An-
tural change. This was especially true of child ti-bullying interventions worked in a very simi-
labour reduction and elimination programmes. lar fashion. Programme objectives were couched
The second set of broad programme objectives in terms of reducing bullying in schools, but the
addressed overall impact (measured in terms interventions themselves worked on issues of
of prevalence and incidence of violence against social support and peer relations, issues whose
children), and was most commonly designed linkages to bullying are not always readily ap-
to address issues such as bullying and/ or gang parent. Clarifying the links between overarching
violence. programme objectives and communication mes-
sages by establishing intermediate communica-
The specific programme objectives geared to- tion objectives would help determine how the
wards social change dealt with changes in at- communication messages contribute to achiev-
titudes and norms associated with harmful ing overall programme objectives.
practices such as FGM/ C and child marriage.
A large subcomponent of the social change ob- Of the 302 manuscripts, only one did not specify
jectives were written in ‘empowerment’ terms the programme objectives associated with the
and aimed to bring about changes in efficacy interventions being described. Interestingly, the
(both at individual and collective levels). analysis showed little to no evidence of the utili-
zation of SMART or SPICED15 criteria when de-
The final category of programme objectives fo- scribing programme objectives and subsequently
cused on individual level changes. The pro- indicators designed to measure these objectives.
gramme objectives geared towards individual
level changes comprised the single largest group ASSESSMENT OF COMMUNICATION
in terms of stated programme objectives. A large OBJECTIVES
proportion of these individually focused behav- Programme objectives are often broad and in-
iour change interventions appeared to address terventions utilizing C4D often have within
gaps in awareness and knowledge and therefore them communication objectives that specify
aimed at a fairly low level along an individual be- what the communication components of a given
haviour change continuum. project are designed to achieve. The communi-
cation objectives included in the manuscripts
Interestingly, the thematic analysis indicates were entered verbatim into the systematic re-
that the stated objectives of the individual be- view database. In order to analyse the content
haviour change interventions were universally of the communication objectives, elements were
designed to reduce or eliminate harmful prac- adapted from Bloom’s Taxonomy for cogni-
tices. Their objectives made little stated effort tive and affective learning objectives that were
to focus on positive changes, which individu- originally used in the field of education. The
als could undertake, yet the messaging for such cognitive domain has been defined as the area
interventions was positively framed. This find- of learning devoted to acquiring information,
ing points to a potential misalignment between knowledge and intellectual abilities (Morrison,
the negatively couched objectives and the posi- Ross and Kemp, 2007). Skills in the cognitive
tively framed messaging derived from those domain consist of six levels, from lowest order
negatively couched programme objectives. For processes to highest: knowledge, comprehension,
example, the programme objectives of interven- application, analysis, synthesis and evaluation.
tions addressing child marriage were couched in These skills are associated with qualitatively
terms of raising a community’s awareness of the measurable verbs that allow curriculum design-
harmful effects of child marriage or to reduce ers to explicitly indicate what the student must
the incidence of child marriage. Meanwhile, the do in order to demonstrate learning (Anderson
29 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
and Krathwohl, 2001; Krathwohl, 2002). For ex- ing’, and ‘evaluating’. Evidence has shown that
ample, knowledge is associated with verbs such only addressing the cognitive domain will not
as ‘remember’, ‘recognize’ and ‘recall’. Similarly, achieve sustainable change.
comprehension is associated with verbs such as
‘distinguish’, ‘estimate’, ‘explain’, ‘generalize’, ASSESSMENT OF THE LEVEL OF
‘infer’, ‘interpret’, ‘paraphrase’, ‘rewrite’, ‘sum- INFLUENCE OF THE INTERVENTIONS
marize’, and ‘translate’. The affective domain has The systematic review database included a vari-
been defined as the area of learning devoted to able titled: ‘Level of influence’. This variable as-
attitudes and values (Morrison, Ross and Kemp, sessed the focus of the intervention in terms of
2007). Skills in the affective domain describe seven levels ranging from the individual to the
the way people react emotionally and their level global (see Figure 8).
of empathy. There are five levels in the affective
domain, from lowest order processes to highest: The results from the analysis of the level of influ-
receiving, responding, valuing, organizing and ence (see Figure 9) indicate that overall, a major-
characterizing. ity of the interventions, 253 manuscripts (over 80
per cent), focused on the individual level.16
Of the 302 manuscripts, 28 (9 per cent) did not
specifically provide any C4D objectives guiding Slightly less than two thirds, 186 manuscripts
the intervention. For multifaceted programmes, (62 per cent), addressed the interpersonal level
all of the objectives are rarely included. In many (for example, communication between parents
instances, the communication objectives noted in and children). Approximately half of the in-
a given manuscript related only to the specific in- terventions, 162 manuscripts (54 per cent), in-
tervention component being discussed. Another cluded organizational and community elements.
shortcoming that emerged while analysing com- The social/ environmental realm was included
munication objectives was that interventions did in approximately 36 manuscripts (12 per cent).
not distinguish between overall programme ob- A few of the manuscripts, especially those that
jectives and specific C4D objectives. In addition, consisted of reviews or analyses of individual
it is important to note that all the C4D objectives interventions, were categorized as belonging to
were written in ‘cognitive’ terms with no reference the ‘global’ realm as they attempted to summa-
to addressing the affective domain. As far as the rize and synthesize evidence from a wide range
cognitive objectives were concerned, the empha- of individual interventions. It is important to
sis was on lower-level domains such as knowledge note that although these are categorized as being
and comprehension. For example, verbs such as global in nature, the individual interventions be-
‘awareness’, ‘understanding’, and ‘increasing’ were ing reviewed were likely to belong to one of the
more commonly utilized as compared to higher other ‘levels of influence’.
order cognitive skills such as ‘examining’, ‘assess-
30 Communication for development approaches to address violence against children: A systematic review
KEY FINDINGS
80%
60%
40%
20%
31 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
The Inter-American Development Bank’s efforts in victims. There was no evaluation data to correlate
Colombia and Uruguay from 1996 to 2006 aimed reductions in violent behaviour with interventions
at rebuilding trust in criminal justice institutions working with at-risk youth, although the results sug-
and sought to: improve police performance; to im- gest moderate success in interventions that sought
prove the treatment of domestic violence victims; to to place youth, in the labour market and schooling.
strengthen civil society organizations; to reduce the The strategy to promote civil society’s involvement
potential for youth to become involved in crime; and included the creation of centres providing various
to raise social awareness. Results on strengthening legal services in both countries that met a large need
criminal justice systems, police reform and working as indicated by the significant cases handled by the
with victims of domestic violence in both countries centres. The results from the public awareness cam-
were positive. Police stations were effective in pro- paigns were mixed. Some campaigns changed at-
viding protection to victims, but were less adept at titudes towards violence while others were less
mediating cases of physical aggression against wom- successful. The main limitations noted by the authors
en. In Uruguay, project activities, including a public was that complex problems require multifaceted so-
awareness campaign and training of public officials, lutions, which can lead to the creation of ambiguous
resulted in a decrease in the number of households programs and less success. Moreover, these types of
reporting domestic violence incidents associated interventions can be less cost-effective than small-
with nine projects designed to improve services for scale and short-term interventions.
This campaign used a ‘Community Action Cycle’ comparison group design, indicated that programme
approach to contribute to the elimination of female exposure was associated with the expected improve-
genital cutting (FGC) in the project communities by ments in all the pertinent indicators and that the mul-
challenging individuals and communities to examine timedia communication programme was effective in
their beliefs and values around FGC and encourag- changing FGC-related attitudes and promoting the in-
ing action towards eliminating the practice. A robust tention not to perform it. The authors reported some
evaluation, using cross-sectional surveys from ran- policy-level impact, with the Enugu State House of
domly selected households based on an intervention- Assembly passing a bill in 2005 to abolish FGC.
Some 69 manuscripts (23 per cent) reported that Bank’s violence reduction programs in Colom-
they had a policy-level component and described bia and Uruguay from Alda, Buvinic and Lamas
communication efforts that had been utilized in (2006). In this example, the overall country pro-
changing policies either through the advocacy gramme was designed to reduce violence using
focus of the intervention itself or as a result of a multi-pronged approach. The second example
the success of communication campaigns. Two comes from Eastern Nigeria on a multimedia
pertinent examples are noted in Figure 10. The campaign contributed to policy change in Enugu
first describes comprehensive country-level ef- State (Babalola, Brasington, Agbasimalo, Hel-
forts in an overview of Neighbourhood Peace- land, Nwaguma and Onah, 2006).
keeping: The Inter-American Development
32 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
(N = 302) (N = 302)
33 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
• Close to half of the manuscripts did not explicitly reference a conceptual model.
• Social ecological models were largely implicit. It is possible that conceptual models
are implicitly followed but not explicitly stated.
• When mentioned, individual and cognitive conceptual models were most com-
monly utilized.
• Programme objectives did not follow measurable criteria.
• Programme objectives were universally designed to reduce or eliminate harmful
practices and traditions, yet the C4D messaging often focused on positive changes
individuals could undertake. Thus, this creates a potential misalignment. Without
clearly linking programme objectives and C4D messaging, it is hard to understand
what the role of C4D really is in promoting social and behaviour change.
• Communication objectives were not often specified and when mentioned focused on
individual and cognitive dimensions.
• The level of influence in a majority of interventions is individually focused.
• Collaboration and partnerships for implementation with international and national
non-governmental organizations working closely with government were reported
as the norm. The academic nature of a systematic review likely explains the large
(Right) a child at the front number of university-supported interventions.
of a queue of young chil-
dren mimics the actions
of a woman showing him
how to wash his hands
properly in a village in
Forécariah Prefecture, in
Guinea.
34 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
SECTION 3:
Programme implementation
T
he analysis of programme implementa-
tion focused on the intended audienc-
es for the interventions, the strategic
communication approach noted in the inter-
vention, as well as the specific communication
channels used for interventions.
Policymakers 75 24.8
Law enforcement 64 21.2
Caregivers 63 20.9
Health-care providers 46 15.2
General public 36 12.9
Perpetrators 2 0.7
35 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
FIGURE 12: Results on the strategic communication approaches from the systematic
review
100%
80%
60%
40%
20%
0%
Advocacy Mass media Community Interpersonal Capacity building Intermediated
(n=84) (n=93) (n=143) (n=181) (n=230) (n=6)
FIGURE 13: Results on the communication channels used in the systematic review
100%
80%
60%
40%
20%
0%
Television/ film Radio Print Internet Mobile Local media Counselling Public
(n=84) (n=39) (n=179) (n=48) technologies (n=48) (n=223) forums
(n=12) (n=63)
36 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
• In line with the programme design-related findings that interventions utilize individ-
ual conceptual/ theoretical models, the intended audience for most interventions is
directed towards individuals rather than dyads or groups.
• Interventions commonly targeted children and parents and did not report primary,
secondary and tertiary audience segments.
• Campaigns using media channels such as television, radio and print appear to be
more commonly utilized in developing countries – United States-based interventions
follow training/ capacity building trajectories led by university-based researchers fo-
cusing on violence in institutionalized settings, for example in schools or within small
community settings.
• The focused nature of and academic involvement in the interventions from industrial-
ized countries allows for higher levels of systematic evaluation and documentation.
• The most commonly utilized C4D approaches are interpersonal and capacity build-
ing. The communication channels most frequently utilized are also interpersonal.
• Interventions tend to use one or two channels of communication contrary to a multi-
ple-channel approach designed to reach a wider range of audiences.
• Utilization of mediated technologies show an increase over time.
37 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
T
he primary research question this re- additional 45 manuscripts (15 per cent) relied
view was designed to answer pertained on the most feasible and still robust programme
to effectiveness. Therefore, this sys- evaluation methodology: the pre and post with
tematic review placed substantial attention case-control design. An additional 41 manu-
on the evaluation components of the manu- scripts (14 per cent) used only a pre and post test
scripts. Specifically, it examined the following design and an even smaller number, 13 manu-
evaluation aspects of programmes: evaluation scripts (4 per cent), utilized a case control evalua-
designs, research methods, analysis frame- tion design without pre and post measurements.
works, sampling related information, and in- The most common evaluation design found in
dicators as reported in the manuscripts. 85 manuscripts (28 per cent) consisted of obser-
vational studies featuring qualitative data with
The evaluation information was broadly catego- an additional 12 manuscripts (4 per cent) includ-
rized as formative, process or impact.18 Of the 302 ing a combination of qualitative and quantitative
manuscripts included in the database, 51 (17 per methods.
cent) discussed formative research, 43 (14 per cent)
included information on process evaluation, and ASSESSMENT OF RESEARCH
227 (75 per cent) included impact evaluation infor- METHODS
mation. It is evident that there is little information The review also included a broad categoriza-
on formative and process evaluation utilized in the tion of different research methods: quantitative,
interventions being examined. Despite this limi- qualitative, mixed (combination of qualitative and
tation, wherever feasible, the information in this quantitative techniques) and, finally participatory
section is disaggregated by formative, process and methods. Methodological information was catego-
impact evaluation. rized by formative, process and impact assessment
(Table 9).
ASSESSMENT OF THE OVERALL
EVALUATION DESIGNS Interestingly, the utilization of qualitative meth-
To assess the overall evaluation designs, manu- ods was more common at the formative and pro-
scripts were categorized based on the following cess phases than the use of quantitative methods
evaluation designs: randomized controlled trial; alone. Mixed methods are also utilized to a fair
pre- and post-test design; case control design; degree in these two evaluation phases. When it
observational study (quantitative); observational comes to impact evaluations, more manuscripts
study (qualitative). report using quantitative methods (116 manu-
scripts or 38 per cent) as compared to qualita-
38 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
tive methods (80 manuscripts or 27 per cent). To The results in Table 10 indicate that formative re-
some extent this might be a function of the fact search analysis tends to focus on thematic reviews
that specific journals prefer manuscripts uti- and involves univariate analyses, i.e. the descrip-
lizing quantitative methods. The utilization of tion of individual variables such as knowledge and
participatory methods was very low. Of the 302 attitudes. The high use of thematic analysis meth-
manuscripts analysed, only 24 (8 per cent) men- ods is not surprising given the high proportion of
tioned the use of participatory methods. Broken qualitative methodologies used during formative
down by type of evaluation: only 11 manuscripts research to uncover critical themes to be included
cited use of participatory methods during for- in interventions. However, the lack of comparative
mative evaluation, four during process evalua- bivariate or multivariate analysis indicates a lack
tions, and nine during impact evaluations. of specificity and sophistication in terms of under-
taking any causal or behavioural analysis. Process
ASSESSMENT OF ANALYSIS evaluation analysis methods focus on the use of
FRAMEWORKS univariate and comparative techniques. It appears
The systematic review database categorized that most process evaluations involve small sam-
commonly used statistical techniques for quanti- ple sizes and focus on descriptions of quantitative
tative studies as follows: univariate (frequencies, information and comparisons of qualitative data.
counts), bivariate (comparisons utilizing two Close to a third of the impact evaluations utilize
variables) and multivariate (three or more vari- multivariate techniques, indicating that mostly
ables controlling for background and confound- quantitative data is being analysed while control-
ing variables) techniques. Qualitative analysis ling for background and confounding variables.
frameworks included the following categories: Four out of 10 impact evaluation manuscripts (40
content analysis, thematic analysis and compara- per cent) relied on simple descriptive information
tive analysis methods. to make a case for effectiveness; this is worrisome
considering the complexity inherent in implement-
ing and evaluating interventions.
39 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
eficiaries and child welfare staff providing access selection. In less than 10 per cent of the cases, the
to foster parents and children. sampling unit was conceptualized at a larger level,
and units like a school or a community were uti-
Among the 43 manuscripts (14 per cent) that in- lized for sampling and subsequent analysis. One
cluded process information, a wide variation in notable exception was randomized controlled tri-
sampling information was observed. Addition- als based in schools, which were able to randomize
ally, a range of methods was used to gather data, sampling at the school or classroom level.
40 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
FIGURE 15: Indicators from the manuscripts included in the systemic review
100%
80%
60%
40%
20%
0%
Individual Interpersonal Community Structural Output
(n=228) (n=43) (n=56) (n=33) (n=45)
41 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
• An evaluation of a university-commu-
nity partnership to promote a safer
school environment through the estab-
lishment of a Safe School Task Force,
measured the accomplishments of this
task force through mapping solutions,
outreach activities, and a student-
led movie and message night (Adler,
Chung-Do, and Ongalibang, 2008).
Guinea Bissau. iours from baseline survey results. This interven- as: presenter body language and voice
tion utilized pre- and post-measures to compare tone, presenter behaviour manage-
the following indicators: perceptions of peer bul- ment, presenter explanation behaviour
lying, pro-bullying attitudes, personal bullying of and the giving of instructions, length
others, victimization as well as support for report- of turn-giving, listening and respond-
ing bullying to adults. ing, responding to and affirming disclo-
sures and adherence to content.
42 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
43 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
T
his section of the report provides infor- be involved in addressing the issue of
mation from a detailed thematic analy- child abuse (Schober, Fawcett and Ber-
sis of the key results and discussion nier, 2012).
sections of the manuscripts included in the sys-
tematic review. The information is presented in • Formative research on a proposed in-
the following categories: formative, process and tervention related to child labour and
impact assessment results. Again, key themes sexual exploitation of children in Thai-
were derived using a grounded theory approach land revealed that contrary to common
in which categories and themes emerge from misconception, birth position, parental
the coded textual data from each individual marital instability and educational at-
manuscript included in the systematic review. tainment were significant predictors of
a girl entering hazardous labour rather
Given the large number of themes that emerged, than parental wealth (Taylor, 2005).
the themes were further clubbed into theoretical,
programmatic and methodological domains. It is Unfortunately, there is little reported effort to
important to note that the categorization of themes understand social and structural determinants
into theoretical, operational and methodologi- of change. Research data clearly shows the nega-
cal domains is not meant to imply that these are tive consequences of leaving broader concerns
discrete categories. There is a great deal of overlap unaddressed. A review of 87 child sexual abuse
within the themes in each domain and it is evident programmes notes that failures in prevention in-
that themes have implications both for program- terventions are often due to a lack of attention to
ming and evaluation. These divisions are simply social and political realities rather than a measure
meant to provide an overall structure and guid- of intervention effectiveness (Plummer, 2001).
ance for future programming and research. These
themes are highlighted first and then followed by Interestingly, there is adequate evidence that
examples from the systematic review database that formative research focuses on barriers and so-
further illustrate key points. To the extent possible, lutions. Such examinations, however, are often
relevant examples both from industrialized and de- couched in terms of individual level barriers and
veloping countries have been provided to help the solutions rather than social and structural deter-
reader make contextual connections. minants. Some notable exceptions are:
44 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
child marriage protects the virtue of girls • Formative research from an anti-bul-
reinforces the practice (ICRW, 2011). lying intervention revealed that verbal
harassment and the use of derogatory
• In another example, formative research language is a pervasive problem in
from South Africa on perceptions of United States schools leaving students
gender-based violence revealed that withdrawn, distracted, wounded and
poverty, ubiquitous gendered violence, even ready to turn to physical violence
sexually exploited children and unsafe (Wessler and DeAndrede, 2006).
recreational spaces were major themes.
Youth were identified as being con- • In Australia, formative research on an
sumed by issues of safety rather than intervention designed to implement
pursuing other developmentally appro- community-based responses to child
priate markers (Mitchell, 2003). These abuse showed that while child abuse
authors note that formative research of- is a serious social problem, it is poorly
ten does not focus on underlying issues. understood by the public on a number
of levels including: its true extent and
SUMMARY OF FORMATIVE RESEARCH nature; the short- and long-term social
RESULTS: OPERATIONAL and financial costs of child abuse to
Formative research gives interventionists the children, families, and the community;
ability to understand intended audiences. This as well as knowledge of common per-
issue is critical for VAC interventions that ad- petrators of child abuse. In addition,
dress ‘perpetrators’ who may otherwise be sub- there was a significant level of anxiety
ject to unfair labels and blame. on the part of adults in accepting the
legitimacy of children’s rights. The au-
• A research study with United States mid- thors concluded that clear social and
dle school youth found that these youth political commitments to children are
have specific and strongly-held percep- necessary to prevent child abuse (Tuc-
tions about violence and perpetrators of ci, Mitchell and Goddard, 2001).
violence. However, despite acknowledg-
ing acts deemed violent by their own The literature suggests that formative research
definitions, these youth did not internal- can play an important role in terms of design-
ize these actions and did not view them- ing programmes that are community owned.
selves as ‘violent’. The authors conclude For example:
that this finding has significant implica-
tions for behaviour change, especially in • A comprehensive child protection forma-
a social marketing context (Quinn, Bell- tive research project in Northern Thai-
Ellison, Loomis and Tucci, 2007). land resulted in raising awareness of
child abuse, the creation of a volunteer-
• A South African intervention addressing led community child protection team,
male involvement in gender-based vio- and the development of a participatory
lence found that barriers to participation child protection model focusing on child
in the proposed intervention included protection at individual, family and com-
denial or minimization of gender-based munity levels. The model emphasized
violence (Ditlopo et al., 2007). participation from a variety of commu-
nity members and local organizations
Formative research can serve as a means to iden- (Auemaneekul, Senaratana, Juntarawijit,
tify key issues that must be addressed. Some ex- Sripichyakan and Ensign, 2009).
amples include:
45 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
• Formative research to help design a In addition, results from the systematic review
comprehensive violence prevention in- database demonstrate that formative research is
tervention at a city level found general especially important for programmes that wish
perceptions to be that youth violence is to utilize new communication technologies.
a complex problem with many risk fac-
tors. Many of the young people felt help- • Research by Constantino, Crane, Noll,
less to change the environment and were Doswell and Braxter (2007) on the effica-
doubtful that things would ever change. cy of utilizing email mediated interactions
This research resulted in the identifica- revealed that email is a feasible and ac-
tion of five areas of collaboration: create ceptable way to provide support and in-
after-school and summer programmes, formation to abused women (interviews
increase knowledge of existing resources with children also yielded similar results).
for violence prevention, promote positive Results showed that participants were
involvement of police with children, pro- interested in the device, compliant with
vide parent education to reduce violence, learning and using it, and responded to
and develop strategies for influencing interventionists’ email questions.
media portrayal and use of violence (Mey-
er, Cohen, Edmonds and Masho, 2008). • Recent survey research associated with
cyberbullying revealed that effective in-
Formative research focusing on audience prefer- terventions could involve taking away an
ences emerged as an important method of iden- offender’s computers and cell-phones
tifying communication channels that might not and restricting access to social network-
have been previously considered. For example: ing sites (Kraft and Wang, 2009).
• Research by Self-Brown et al. (2008) to Formative research can feed directly into mes-
assess participants’ comfort level with sage and material design. Analysis of the manu-
materials associated with the Darkness to scripts that include formative research report
Light (D2L) child sexual abuse prevention that pre-testing of pilot messages and materials
campaign found video-based informa- is a critical part of the formative research pro-
tion to be especially useful as a way to in- cess. Several examples from the systematic re-
crease knowledge about the issue; video view provide information to reinforce this point:
and print materials were seen as a viable
way to make the topic more approach- • Formative research designed to identify
able. At the same time participants ‘ideal’ foster parenting qualities was
wanted more information, specifically used to develop media messages cater-
on ways to talk to and educate children ing to identified characteristics of the
about the topic as well as culturally-ap- high-quality foster parents (Duerr Ber-
propriate materials in local languages. rick, Shauffer and Rodriguez, 2011).
46 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
Formative research has proven effective in deter- • An evaluation of the UNICEF-led Mee-
mining key audiences, as well as partners who na Programme in South Asia indicated
should be involved in interventions addressing that one key factor in its success was its
VAC. For example: underpinning in research and develop-
ment processes (Chesterton, 2004).
• Participants in formative research on the
feasibility of a mental health promotion SUMMARY OF FORMATIVE RESEARCH
intervention in American schools indi- RESULTS: METHODOLOGICAL
cated that participants ranked teachers Though rarely utilized in the literature reviewed,
as the key stakeholder group that would community-based participatory research (CBPR)
be most likely to support and implement has proven effective in obtaining a comprehen-
interventions (Evans, Mullett, Weist and sive picture of barriers and motivators when de-
Franz, 2005). signing interventions. Of note are the following
manuscripts:
• Research on ecological approaches to
designing interventions associated with • Leff et al. (2010) report on the results
youth violence showed that coalition- from primary and secondary data using
building in community-based interven- CBPR to develop a youth violence pre-
tions has a better chance of success vention intervention. The formative re-
when careful formative research is con- search consisted of focus groups to gain
ducted to understand social as well as a better understanding of the strengths
inter- and intra- organizational networks and challenges within the local commu-
(Bess, Speer and Perkins, 2012). nity and experiences with prior violence
prevention interventions, as well as to
• For community-based programmes, elicit specific indicators of programmatic
formative research in the form of com- and/ or community success in regard to
munity resource mapping is also criti- violence prevention. Literature reviews
cal to understand where and what and pilot testing of the initial interven-
47 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
tion revealed that most youth thought • Another noteworthy example focused
it would be easy to implement the skills on building social capital through neigh-
and strategies they had learned in the bourhood mobilization. Formative re-
intervention. Then, prior to implemen- search involved an asset mapping
tation, site partners and community component and service delivery compo-
partners along with the academic team nent, as well as institutional and organi-
members worked together to finalize the zational mapping. The data from these
intervention design and all additional ma- efforts was collected by community
terials. Large-scale implementation was members and housed in the centre to be
discussed at a community symposium. used by grassroots groups. Based on the
The academics wanted to conduct a ran- information generated from the forma-
domized controlled trial, but community tive research, intervention implemen-
participants expressed a strong desire tation involved a multi-pronged effort
that all sites should receive the full inter- including a dedicated space for social
vention. Thus, a staged cluster random- and community services and activities,
ized trial was developed instead. As this as well as educational initiatives for mar-
example shows, not just the intervention ginalized populations to improve collabo-
designs, but also the evaluation proce- ration between parents and schools in
dures were based on collaboration. order to best meet the needs of chil-
dren (Payne and Williams, 2008).
48 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
49 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
50 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
reduce teasing and unhealthy weight-
control behaviours, demonstrated that
outreach can be feasibly done, at a rela-
tively low cost, and can engage students,
parents and staff (Haines, Newmark-Sz-
tainer, Perry, Hannan and Levine, 2006).
51 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
THEORETICAL METHODOLOGICAL
Process evaluation allows interventions to make a • Process evaluation is commonly used as a way to
clear link between the intervention activities and im-
examine fidelity of implementation.
pact, which in turn makes a stronger case for employ-
ing C4D approaches. • Process evaluations can be conducted regardless
of the nature and scope of the intervention.
OPERATIONAL • Process evaluation helps identify Type 3 error
• Process evaluation is especially critical for large- (when interventions are not implemented accord-
scale interventions where implementation may ing to plan).
vary due to external reasons. • Process evaluation is useful in tracking changes in
• Process evaluation can disaggregate measurement outcomes and outputs.
of implementation among diverse audiences.
• Process evaluation can indicate initial success
and serve as a means to validate and expand
interventions.
52 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
53 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
54 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
risk students were in the opposite direc- individual level to the social context.
tion, thus suggesting a different pattern
of intervention is needed depending on Some specific examples of male involvement
risk. For example, combining school- from the systematic review include:
based programmes with family-based
programmes and tailoring interventions • Findings from the Men as Partners
based on risk status (low versus high) of (MAP) Programme in Soweto, South Af-
students (Simon et al., 2008). rica, indicated that the intervention was
successful in improving norms and at-
It is important to keep gender in mind as a key titudes supportive of gender egalitarian
variable in and of itself when designing pro- relations, among other positive chang-
grammes specifically for men and boys and as es (Ditlopo et al., 2007).
a potential evaluation confounder for research.
Gender focus in the manuscripts centered • Barker’s (2006) reflections on the im-
mainly on issues pertinent to girls and women. pact of engaging boys and men to
This was obviously true for FGM/ C, but also empower girls concluded that pro-
for global programmes dealing with child mar- grammes can be effective in changing
riage.24 A similar trend was noticed with regard attitudes and behaviours of men and
to descriptions of child trafficking interven- boys, which is positive for well-being
tions.25 Interestingly, the focus on girls was also of women and girls. He also noted
evident in programmes designed to promote that comprehensive, multi-theme pro-
empowerment.26 grammes focusing on norm transfor-
mation were the most effective.
The systematic review revealed only a few ex-
amples of interventions that specifically sought • Casey et al. (2013) more recently re-
to involve boys and men as key audiences to viewed the challenges associated with
support change. Nonetheless, the importance of global efforts to engage men in the pre-
such approaches has been highlighted. In a re- vention of violence against women us-
view of 58 programmes by Barker, Ricardo, Nas- ing an ecological perspective and came
cimento, Olukoya and Santos (2010), the authors to a similar conclusion.
categorized interventions working with men and
boys to improve health and gender roles as using • The review revealed some disaggrega-
a 1) gender-neutral approach, 2) gender-sensitive tion of reporting of differential impact on
approach, or 3) gender-transformative approach boys and girls. Haner, Pepler, Cummings
and concluded that few interventions go beyond and Rubin-Vaughn (2010) reported that in
a pilot stage or short-term. But there is compel- response to an arts-based curriculum on
ling evidence that well-designed interventions bullying prevention, boys reported less
with men and boys can lead to positive changes bullying than girls over time.
in their behaviours and attitudes related to sex-
ual and reproductive health; maternal, newborn We found only one reference to the need to ex-
and child health; their interaction with their pand awareness of boys’ issues and male gen-
children; their use of violence against women; der issues, expand boys’ participation, establish
their questioning of violence with other men; interventions and information for boys, or de-
and their health-seeking behaviour. Gender- velop outreach for boys (Frederick, 2010). The
transformative approaches and the promotion focus on VAC specific to girls is understandable,
of gender-equitable relationships between men given the higher levels of VAC that girls experi-
and women are more effective in producing be- ence. However, boys often get left out, which can
haviour change than narrowly focused interven- mean glossing over the forms of violence most
tions, as are interventions that reach beyond the pertinent to boys in terms of severity (e.g. child
55 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
labour and corporal punishment), and their spe- cessful school-based violence prevention pro-
cific vulnerabilities, as well as unique needs. gramme found that most of the violence was, in
fact, taking place in the family. An evaluation
Place-based programmes need to consider the of Kornblum’s body-based violence prevention
in-between spaces where VAC occurs. On the one curriculum using dance/ movement therapy for
hand, there is sufficient data to show that school- children showed a reduction in problematic be-
based programmes are successful in combating haviours (reported by teachers post-intervention),
some forms of VAC, especially bullying. On the but also revealed that the primary place where
other, place-based programmes tend to disre- children were facing problems was at home with
gard other non-discrete locations where bullying parents and siblings (Hervey and Kornblum,
may take place (e.g. social media sites). Smothers 2006). These collective findings therefore under-
and Smothers (2011) developed and evaluated a score the importance of addressing VAC in dis-
social ecological model of sexual abuse preven- crete and less discrete spaces.
tion that was implemented in a public school with
diverse urban youth. The results showed signifi- Several impact assessments on various issues
cant gains in knowledge in all areas assessed and relating to VAC highlight the importance of ad-
indicated that children and adolescents can be dressing VAC as part of early childhood devel-
Girls at Bhagyanagar taught healthy relationship skills that might pro- opment programmes. The systematic review
Children’s Home in India:
two nearby children’s tect them from predatory behaviours or maladap- yielded data on interventions that address is-
homes separately house tive peer relationships. Similarly, classroom-based sues pertinent to infants and young children
girls and boys mostly
between 6-14 years who instruction can reach both potential victims and such as neglect, maltreatment and abuse.
are orphans, children of
offenders while simultaneously training school
migrant labourers and
potential child labourers. staff and faculty. But in another example, a suc- • An analysis of child maltreatment pro-
grammes indicated that parent educa-
tion with a home-visiting component
show promising results. Factors lead-
ing to intervention success included:
the receipt of services before or as
close to birth of the first child as pos-
sible; services that focus on the child’s
particular development level; opportu-
nities for parents to model the behav-
iours being promoted; sufficient time
commitments; an emphasis on social
supports and the skills needed to ac-
cess these supports; a balance of home
and group-based alternatives; and rec-
ognition of cultural differences (Port-
wood, 2006).
56 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
ity to interpret a child’s motivations and ated with genital terminology (Kenny,
behaviours – as part of a programme Wurtele and Alonso, 2012).
to prevent child mistreatment among
medically at-risk infants. • The Pathways to Prevention Preschool
Intervention Program appeared to be
In addition, several examples of successful in- effective in improving levels of chil-
terventions specifically targeting preschool and dren’s behaviour over and above the
kindergarten children are provided below. effect of the regular preschool curricu-
lum. Case studies developed through
• An impact assessment among elemen- staff and participant interviews suggest
tary schoolchildren in Hawaii, USA, positive outcomes. Cost analysis re-
indicated that intervention participants vealed that the preventive project was
scored significantly higher on post- cheaper than remedial programmes
test measurements on knowledge of analysed, as well as more cost-effective
appropriate and inappropriate touch- (Leech, 2005).
ing as compared to controls. Chil-
dren participating in the intervention • There is some evidence that bullying
were also able to identify a response prevention programmes conducted as
to unwanted touching that many had early as in kindergarten can change
not known at pre-test (Baker, Gleason, teachers’ attitudes towards victimized
Naai, Mitchell and Trecker, 2013). children, increase teachers’ self-effi-
cacy in handling bullying, and prevent
• An examination of the long-term out- bullying from occurring (Alsaker and
comes of a randomized controlled trial Valkanover, 2012).
of Triple P, a universal prevention pro-
gramme associated with dysfunctional
“Impact assessments on various issues
parenting behaviours, showed that at
the two-year follow up, both mother relating to VAC highlight the importance of
and father participants reported sig- addressing VAC as part of early childhood
nificant reductions in such parenting. development programmes.”
Additionally, mothers also reported
an increase in positive parenting be-
haviour and significant reductions in
internalizing and externalizing child Impact assessment results showcased the im-
behaviour (Hahlweg, Heinrich, Kuschel, portance of long-running interventions. How-
Bertram and Naumann, 2010). ever, there was little emphasis on cost benefit
or effectiveness comparisons of interventions
• An evaluation of a personal safety based on duration. For example:
intervention with Latino preschool-
ers in the United States showed that • An evaluation of a bullying prevention
participants made greater knowledge intervention for elementary schools com-
gains than controls with regard to pared three schools with differing inter-
genital terminology, recognizing the vention lengths (one year versus two
inappropriateness of touch requests years versus three months). The authors
even when coming from ‘good’ peo- found that students in the two-year inter-
ple, and learning to recognize, resist vention reported more positive attitudes
and report inappropriate touching. towards bullying victims compared to
Children in the intervention retained students in the three-month intervention
knowledge gains except those associ- (Beran, Tutty and Steinrath, 2004).
57 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
58 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
INTRODUCTION
59 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
abuse in its many forms: child labour, tations arising from the method of data collec-
child battering or sexual exploitation. tion. Examples of the latter included the use of
However, this awareness has not trans- written questionnaires that children with low
lated into behaviour and social change, literacy and poor writing skills had difficulty
judging by continued widespread inci- filling out, or problems that arose due to the use
dence of child battering, child traffick- of translators.
ing, street hawking and begging. The
results also showed that addressing Of greater concern is the overwhelming majority
child abuse through television is a suc- of manuscripts lamenting the paucity of adequate
cessful advocacy tool, which resulted data. For instance, a review by Wessells (2009)
in many governmental and non-gov- concluded that the state of the evidence regard-
ernmental agencies becoming engaged ing child-focused community groups is anecdotal,
in activities to reduce the problem. In impressionistic, unsystematic and underdeveloped,
fact, the Edo State government passed and specifically pointed to the paucity of informa-
into law bills on human trafficking and tion from low and middle-income countries.
sexual exploitation. However, as the re-
port concludes, these efforts have not Interventions driven by methodological rigor alone
decreased the incidence of child abuse needed to contend with ethical concerns. It is im-
(Osakue Stevenson and Awosola, 2008). portant to consider the responsibilities associated
with withholding interventions that may be useful
SUMMARY OF IMPACT EVALUATION for control group participants. For example:
RESULTS: METHODOLOGICAL
There is a serious lack of evaluation data on the • A theory-driven alternative approach
effectiveness of interventions and strong evi- to school bullying that focused on so-
dence of the need for additional effectiveness cial emotional learning and positive
evaluations, specifically those from low and youth development was associated
middle-income countries. The systematic re- with significant reductions in bullying
view found that close to two thirds of the studies and victimization. However, even after
in the database noted at least one methodologi- controlling for gender, the researchers
cal limitation in the intervention. Lack of ran- found that the control group experi-
domization, the absence of a comparison or enced increases in bully and victim be-
control group, short observation periods and haviours (Domino, 2013).
lack of follow up were the most commonly listed
weaknesses concerning methodological design. • From an ethics standpoint, a review of
With regards to indicators, a large proportion sexual abuse and exploitation of boys in
of studies acknowledged problems of reliability South Asia noted the alarming absence
and validity associated with using self-report- of informed consent procedures, con-
ed data. They underscored the absence of vali- fidentiality protocols and other mecha-
dated measures, and often resorted to proxy nisms to ensure responsible and ethical
measures to assess intervention effectiveness, conduct in research (Frederick, 2010).
despite not being able to link improvements to
the intervention itself. Sampling issues included • Other ethical issues in the systematic
small sample sizes resulting in limited statisti- review concerned privacy and confi-
cal power, limited ability to generalize findings, dentiality issues when using technol-
and sampling bias, especially for voluntary inter- ogy-based or enhanced programmes,
ventions or when purposive sampling was used. especially with survivors of abuse
Several studies cited barriers relating to data (Constantino, Crane, Noll, Doswell and
collection, such as missing data due to untrained Braxter, 2007).
implementers; use of leading questions, or limi-
60 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
KEY FINDINGS
The scope of effectiveness evaluations can be ex- happy, with improved achievement mo-
panded to include both qualitative and participa- tivation and assertiveness. They had an
tory evaluation methods. This systematic review improved understanding of setting real-
yielded limited data on qualitative evaluations. istic goals, listened and reflected better,
and had improved insights about them-
• One of the few examples of a mixed selves that culminated in an improved
methods approach that has proven effec- perception and self-awareness.
tive is a study by John (2009) examining
the impact of a life skills development in- • The evaluation of Soul Buddyz Clubs
tervention on the behavioural aspects of in South Africa indicated that success-
children in need of care and protection. ful clubs actively realized the vision and
Statistically significant positive changes objectives of Soul Buddyz by mobiliz-
occurred in the intervention group, and ing children as agents of change in their
focus groups revealed that juveniles in own lives and that of the community
the intervention felt more relaxed and (Schmid, Wilson and Taback, 2011).
61 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
7 Overall
recommendations
62 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
OVERALL RECOMMENDATIONS
I
n an overview summarizing the major forms of violence mostly acknowledged the
achievements and remaining challenges nexus of VAC with violence against women
of the Convention on the Rights of the (VAW). There is overwhelming agreement that
Child, Doek (2009) reported that na- individuals directly engaged in or responsible
tional efforts addressing VAC have often been for violence at some point in time have been
hampered by a lack of financial and human victims themselves and that the negative rami-
resources or political will. In turn, this has fications of VAW are multiplied manifold if and
impeded the proper infrastructure to support when children are involved. However, strategies
children’s rights from forming. He concluded dealing with VAW do not often segment by age
that addressing VAC takes more than having or address VAC as a correlated issue. For exam-
the proper infrastructure, it requires having a ple, there is an absence of age-based disaggre-
culture that supports the rights of the child. gation in programmes addressing human
trafficking. Disaggregation by age would allow
C4D approaches can challenge social and cul- child trafficking to emerge as a separate issue
tural norms that perpetuate and condone vio- deserving focused attention.
lence. Approaches to tackle social norms have
been successfully used to reduce alcohol mis- EXPLORE LINKAGES BETWEEN
use and smoking behaviours; also, to change
attitudes of young males towards risky sexual
2 DIFFERENT FORMS OF VAC. The
overlap of manuscripts shortlisted
behaviours and bullying (WHO, 2009). Within across different search criteria highlights that the
UNICEF, C4D is integrated as a key cross-cut- different types of VAC cannot be pigeonholed by
ting strategy that promotes long-term behav- topic. Rather, they must be conceptualized as
iour and social change and is defined as: “an multiple forms or facets of violence. For example,
evidence-based and participatory process that child marriage and female genital mutilation/
facilitates the engagement of children, families, cutting and gender-based violence are intrinsical-
communities, the public and decision makers ly linked, as are corporal punishment and child
for positive social and behavioural change in abuse/ maltreatment. Similarly, child trafficking
both development and humanitarian contexts and sexual exploitation co-occur. No doubt this
through a mix of available communication overlap complicates both implementation and
platforms and tools” (UNICEF, 2019). Herein evaluation of programmes; however, it is impor-
lies the critical importance of exploring the tant that the interrelationships and complexities
role that a range of communication approaches between these issues be recognized and addressed
underlining C4D can play in addressing VAC. holistically. This is especially important given the
Key recommendations from this systematic re- magnitude of their prevalence, the plethora of
view that apply specifically to child protection mediating and causal factors involved, and the
programmes as a whole, and their C4D com- multitude of C4D approaches we have at our
ponents in particular, are categorised under the disposal to address VAC.
three broad themes below.
EXAMINE VAC ALONG A SPEC-
I. CONTEXTUALISING AND
FRAMING VAC
3 TRUM. THIS RECOMMENDATION
RELATES TO THE PREVIOUS ONE
SPECIFICALLY ADDRESS CHIL- REGARDING THE LINKAGES BETWEEN DIF-
63 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
OVERALL RECOMMENDATIONS
64 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
INTRODUCTION
level approaches has yielded positive results. dress the specific needs of marginalized
groups such as gay, bisexual and trans-
65 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
OVERALL RECOMMENDATIONS
negative unintended consequences, most notably Promoting a core understanding of what VAC is
by driving a practice underground, rather than in the form of a standardized definition and
creating sustained behaviour and social change. measurements of incidence and prevalence is an
essential first step to gauging the magnitude of
RECONFIGURE PROGRAMME AND VAC as an issue deserving of global advocacy
11 COMMUNICATION OBJECTIVES
OF VAC INTERVENTIONS. Many of
and concerted action. The United Nations Secre-
tary-General’s Study on VAC is a seminal effort
the interventions did not use the basic SMART to provide a detailed global overview of VAC,
and SPICED criteria when describing programme where it occurs, and ways to combat it. However,
objectives. It was also challenging to distinguish local indicators of VAC are not routinely acces-
between overall programme and C4D objectives. sible. This hinders the data comparison at global
VAC is an emotionally charged issue and yet levels and renders situation analyses for behav-
programme and communication objectives were iour and social change interventions difficult to
mainly couched in cognitive terms with little undertake.
reference to the power of emotions to promote
behaviour and social change. Cognitive objectives ENHANCE INVESTMENT IN RE-
could move beyond enhancing knowledge and
comprehension to ensuring the activation of
14 SEARCH. The grey literature con-
tains many examples of creative
higher-level cognitive changes associated with interventions addressing VAC, especially imple-
assimilation and evaluation of information. mented in low and middle-income countries.
However, much of this creative programming is
MOVE BEYOND INDIVIDUALLY unaccompanied by information on the effective-
66 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
8 Conclusions
I
The wealth of n addition to secondary analysis of data
information included in collated for the purpose of this review,
this systematic review there is also room for further improve-
© UNI CE F/NYH Q2 014 -3 635 /N ESBIT T
67 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
CONCLUSIONS
size the key trends and findings to highlight ventionists and practitioners, as well as their
some imperatives that intervention planners research counterparts on the ground, can uti-
and evaluators need to keep in mind in order lize to plan, implement and evaluate interven-
to move the field forward. As such, it serves as tions using C4D approaches to address VAC
the first step. The next steps are clearly to de- that are grounded in the local realities while
vise a series of practical guidelines that inter- being informed by global best practice.
Future research
Additional studies
• Examine grey literature to contextualize the review within the context of the outcomes
of and contributors to VAC (e.g. alcohol abuse, the effects of urbanization, and other
environmental factors such as migration and displacement).
• Update the bibliography on an ongoing and periodic basis in order to have easy access
to current information.
68 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
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END NOTES
1. UNICEF defines communication for development lence’ is used in the broad sense to include all
as ‘an evidence-based and participatory process forms of violence, abuse, and exploitation.
that facilitates the engagement of children, fami-
4. Available at: https://www.ohchr.org/en/profes-
lies, communities, the public and decision makers
sionalinterest/pages/crc.aspx
for positive social and behavioural change in both
development and humanitarian contexts through 5. As famously noted by Richard Horton, the editor
a mix of available communication platforms and in chief of The Lancet: “We portray peer review
tools’. In this study, the term communication for to the public as a quasi-sacred process that helps
development (C4D) is used to cover a wide variety to make science our most objective truth teller.
of communication approaches and strategies, as But we know that the system of peer review is
detailed in Table 1. Key terms of the systematic biased, unjust, unaccountable, incomplete, easily
review. fixed, often insulting, usually ignorant, occasion-
ally foolish, and frequently wrong” [Horton, R.
2. The overarching research question of the study
(2000). ‘Genetically modified food: consternation,
was: ‘What are the effects of communication for
confusion and crack up.’, Medical Journal of Aus-
development (C4D) approaches to address vio-
tralia, 2000, 172 (4): 148-9.]
lence against children?’.
6. Some pertinent examples include: a recent re-
3. For the purpose of this assignment, the term ‘vio-
view of efficacious nutrition interventions (dif-
73 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
END NOTES
ferent approaches) in addressing child mortality stages of change: Precontemplation is the stage at
(single outcome), for which the authors catego- which individuals are unaware of their problem and
rize 10 evidence based nutrition interventions that have no intention to change behavior in the fore-
impact child mortality [Bhutta, Z.A. et al. (2013). seeable future. Contemplation is the stage in which
Evidence based interventions for improvement people are aware of the problem and are seri-
of maternal and child nutrition: what can be done ously thinking about overcoming it but have not yet
and at what cost. The Lancet, 382 (9890). 452- made a commitment. Preparation is a stage when
477]. Similarly a 2010 study by Wakefield, Loken individuals are intending to take action. Action
and Hornik, examined specifically the use of mass is the stage in which individuals modify their be-
media campaigns (single approach) to change havior, experiences, or environment to overcome
health behavior (multiple outcomes) [Wakefield, their problems. Maintenance is the stage in which
M. Loken, B. and Hornik, R. (2010). Use of mass people work to prevent relapse and consolidate the
media campaigns to change health behavior. The gains attained during action.
Lancet, 376. 1261-1271].
13. Bronfenbrenner’s (1994) social ecological model
7. Data on the type of publication indicates that over postulates that the entire ecological system in
75 per cent of the manuscripts reviewed belonged which growth occurs needs to be taken into ac-
to the ‘peer-reviewed category’ comprised pri- count in order to understand human development.
marily of peer-reviewed journal articles, and to This system is composed of five socially orga-
some extent book chapters and literature re- nized and interrelated subsystems: microsys-
views. Only 25 per cent of the systematic review tem, mesosystem, exosystem and macrosystem.
consisted of project reports. [Bronfenbrenner, U (1994). Ecological Models of
Human Development. In International Encyclope-
8. The 10/90 gap popularized by the Global Forum for
dia of Education, Vol. 3 2nd Ed. Oxford: Elsevier.]
Health Research posits that health research ap-
plied to the needs of low and middle income coun- 14. As with any systematic review, some subjectivity
tries is grossly under resourced with less than is to be expected when coding data. For example,
10 per cent of the world’s resources for health when entering data on the implicit conceptual
research being applied to the health problems of frameworks/ models the coders may have found
low and middle income countries where over 90 the implicit reference to the social ecological
per cent of the world’s preventable deaths occur. model as reflecting their personal commitment to
the social ecological approach, a big focus of the
9. Available at: http://childinfo.org/fgmc_progress.
MPH programme at Drexel.
html
15. SMART is a mnemonic for criteria used to guide
10. See National Cancer Institute (2005). Theory at
the setting of objectives. The letters broadly con-
a Glance: A Guide for Health Promotion Practice
form to the words: Specific – Measurable – Attain-
(second edition) for a summary of conceptual
able - Relevant and Time-bound (Poister, 2003).The
frameworks utilized in this review.
SPICED approach is a useful tool for thinking about
11. Social Learning Theory: Albert Bandura’s social how project objectives can be set in a participa-
learning theory states that human behaviour is tory and inclusive way with local communities. The
learned by observing the actions of others while letters broadly conform to the words: Subjective
being influenced by the environment and person- - Participatory - Interpreted and communicable -
al qualities of the person. Another key concept Cross-checked and compared - Empowering - Di-
within social learning theory is modeling, which verse and disaggregated (Roche, 1999).
involves four steps: paying attention, retaining
16. Some manuscripts mentioned various levels of
details about a behavior, ability to reproduce the
influence, therefore the totals do not add up to
behaviour for example through practice and fi-
a 100 per cent.
nally motivation to engage in a behaviour. A final
contribution of social learning theory is the idea 17. Despite the fact that some behaviours are crimi-
of self-efficacy or an individual’s confidence that nalized, a research and treatment project from
they are capable of performing a behaviour. Germany, encouraged self-identified paedophiles
and hebephiles to seek professional help. The
12. The term ‘stages of change’ is a central construct
first results from this Prevention Project Dun-
in the transtheoretical model. The stages examine
kelfeld (PPD) published in 2009 by Beier et al.
an individual’s readiness to act on a new healthier
found that a notable portion of men who admit
behavior, and provides strategies, or processes
to being attracted to minors could be success-
of change to guide the individual through the five
74 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
END NOTES
fully reached via a media campaign. The authors 22. Ideation refers to new ways of thinking and the
concluded that many could be encouraged to diffusion of those ways of thinking by means of
seek clinical diagnosis and a majority had already social interaction in local, culturally homoge-
sought professional help. Another intervention neous communities. The ideation approach has
from Canada specifically targeted maltreating been used to assess the behavioural impact of
fathers by providing counselling and training. various issues including female genital cutting
The objectives were to change abusive parent- (Babalola et al., 2006). The theory of ideation sug-
ing strategies, attitudes and beliefs that support gests that ‘ideation’ variables determine the likeli-
unhealthy parenting, and increase the men’s ap- hood of a person adopting a particular behaviour.
preciation of the impact of violence on children The more favourable the ideation variables re-
among men who have maltreated their children lated to a particular behaviour, the more likely
and/ or who have exposed their children to abuse a person is to adopt and practice the behaviour.
of their mother. The intervention achieved a high Ideation variables include cognitive (knowledge,
number of referrals indicating a high level of felt belief, values, etc.), emotional (emotional re-
need for such interventions. The evaluation of this sponse, self-efficacy) and social (social influence
intervention found that fathers’ level of hostil- and personal advocacy) factors.
ity, denigration, and rejection of their child and
23. For more information on the PRECEDE-PROCEED
their level of angry arousal towards the child and
Model see: http://ctb.ku.edu/en/tablecontents/
family situations decreased significantly over the
sub_section_main_1008.aspx
course of the intervention. Men’s level of stress
was also reported to have decreased although not 24. For more information on global child marriage in-
significantly (Scott and Crooks, 2007). terventions see: Amin, 2005; Erulkar, 2009; Erulkar
and Ayuka, 2007; Gage, 2009; Governance and
18. Formative evaluation is used to design an evidence-
Social Development Research Centre, 2011; Graft,
based intervention. Process evaluation is more
Haberland and Goldberg, 2003; Gupta, Mukherjee,
commonly referred to as monitoring and commonly
Singh, Pande and Basu 2008; and International
used to determine if an intervention is being deliv-
Centre for Research on Women (ICRW), 2001.
ered according to plan and to provide a means to
make mid-course corrections. Impact evaluation is 25. For example, Evans and Bhattarai (2000) provide
used to determine effectiveness of a intervention. a comparative analysis of anti-trafficking inter-
vention approaches in Nepal and Kaufman (2011)
19. See for example: Law and Shek, 2012; Vuijk, van
reviews research and activism addressing sex
Lier, Crijnen and Huizink, 2006; Simon et al., 2008;
trafficking in Nepal.
Malti, Ribeaud and Eisner, 2011.
26. See Brady (2007) for an examination of an inter-
20. For a summary of FGM/ C programmes, see Berg
vention in rural Egypt and Jeejeebhoy, Acharya,
and Denison, 2013.
Kalyanwala, Nathani and Bala (2009) for the eval-
21. A Type 1 error is when an effect is detected when uation findings of a life skills education interven-
in fact none exists. Conversely, a Type 2 error re- tion in rural Uttar Pradesh, India.
fers to the failure to detect an effect when one is
present. A Type 3 error occurs when an interven-
tion is not implemented according to plan.
75 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
Boys at Bhagyanagar Chil-
dren’s Home in India: two near-
by children’s homes separately
house girls and boys mostly
between 6-14 years who are
orphans, children of migrant
labourers and potential child
labourers.
76 Communication for Development Approaches to Address Violence Against Children: A Systematic Review
Communication for Development Section
Programme Division
UNICEF New York
Email: c4dhq@unicef.org
Website: www.unicef.org/cbsc