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2017 ; 7
(2
): e013583
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Witnessing intimate partner violence and child maltreatment in Ugandan children:
a cross-sectional survey
#MMPMID28246136
Devries KM
; Knight L
; Child JC
; Kyegombe N
; Hossain M
; Lees S
; Watts C
; Naker D
BMJ Open
2017[Feb]; 7
(2
): e013583
PMID28246136
show ga
OBJECTIVES: Existing evidence, mainly from high-income countries, shows children
who witness intimate partner violence (IPV) at home are more likely to experience
other forms of violence, but very little evidence is available from lower income
countries. In this paper we aim to explore whether Ugandan children who witness
IPV at home are also more likely to experience other forms of maltreatment,
factors associated with witnessing and experiencing violence, and whether any
increased risk comes from parents, or others outside the home. DESIGN: A
representative cross-sectional survey of primary schools. PARTICIPANTS: 3427
non-boarding primary school students, aged about 11-14?years. SETTING: Luwero
District, Uganda, 2012. MEASURES: Exposure to child maltreatment was measured
using the International Society for the Prevention of Child Abuse and Neglect
Child Abuse Screening Tool-Child Institutional, and 2 questions measured
witnessing IPV. RESULTS: 26% of children reported witnessing IPV, but nearly all
of these children had also experienced violence themselves. Only 0.6% of boys and
1.6% of girls had witnessed partner violence and not experienced violence.
Increased risk of violence was from parents and also from other perpetrators
besides parents. Both girls and boys who witnessed and experienced violence had
between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds
of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12
(95% CI 5.15 to 12.80) times the odds of using physical or sexual violence
themselves. CONCLUSIONS: In this sample, witnessing IPV almost never occurred in
isolation-almost all children who witnessed partner violence also experienced
violence themselves. Our results imply that children in Uganda who are exposed to
multiple forms of violence may benefit from intervention to mitigate mental
health consequences and reduce use of violence. IPV prevention interventions
should be considered to reduce child maltreatment. Large numbers of children also
experience maltreatment in homes with no partner violence, highlighting the need
for interventions to prevent child maltreatment more broadly. TRIAL REGISTRATION
NUMBER: NCT01678846, results.