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Parenting, mental health and economic pathways to prevention of violence against children in South Africa

Cluver, L., Shenderovich, Y. ORCID:, Meinck, F., Berezin, M.N., Doubt, J., Ward, C.L., Parra-Cardona, J., Lombard, C., Lachman, J.M., Wittesaele, C., Wessels, I., Gardner, F. and Steinert, J.I. 2020. Parenting, mental health and economic pathways to prevention of violence against children in South Africa. Social Science and Medicine 262 , 113194. 10.1016/j.socscimed.2020.113194

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Background Parenting programs based on social learning theory have increasing empirical evidence for reducing violence against children. Trials are primarily from high-income countries and with young children. Globally, we know little about how parenting programs work to reduce violence, with no known studies in low or middle-income countries (LMICs). This study examines mechanisms of change of a non-commercialized parenting program, Parenting for Lifelong Health for Teens, designed with the World Health Organization and UNICEF. A cluster randomized trial showed main effects on parenting and other secondary outcomes. We conducted secondary analysis of trial data to investigate five potential mediators of reduced violence against children: improved parenting, adolescent behaviour, caregiver mental health, alcohol/drug avoidance, and family economic strengthening. Methods The trial was implemented in rural South Africa with 40 sites, n = 552 family dyads (including adolescents aged 10–18 and primary caregivers). Intervention sites (n = 20) received the 14-session parenting program delivered by local community members, including modules on family budgeting and savings. Control sites (n = 20) received a brief informational workshop. Emotional and physical violence against children/adolescents and each potential mediator were reported by adolescents and caregivers at baseline and 9–13 months post-randomisation. Structural equation modelling was used to test simultaneous hypothesized pathways to violence reduction. Results Improvements in four pathways mediated reduced violence against children: 1) improved parenting practices, 2) improved caregiver mental health (reduced depression), 3) increased caregiver alcohol/drug avoidance and 4) improved family economic welfare. Improved child behaviour was not a mediator, although it was associated with less violence. Conclusions Simultaneously bolstering a set of family processes can reduce violence. Supporting self-care and positive coping for caregivers may be essential in challenging contexts. In countries with minimal or no economic safety nets, linking social learning parenting programs with economic strengthening skills may bring us closer to ending violence against children.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Additional Information: This is an open access article under the CC BY license (
Publisher: Elsevier
ISSN: 0277-9536
Date of First Compliant Deposit: 27 April 2021
Date of Acceptance: 5 July 2020
Last Modified: 03 May 2023 19:30

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