Sexual violence against children (SVAC) is a complex, global challenge that negatively impacts the health and human rights of hundreds of millions of children. Over the last 50 years, SVAC has increasingly been viewed as a public health problem, and significant progress has been made in understanding its prevalence, identifying risk factors, and developing prevention approaches. While practitioners recognize that children’s experiences of sexual violence are diverse, there is an absence of evidence on different forms of SVAC. In this dissertation, I introduce the construct of “SVAC subtype,” which aims to capture the heterogeneity in children’s experiences of sexual violence. SVAC subtype refers to the characteristics associated with an SVAC experience, including the survivor’s characteristics (age, gender, etc.), the perpetrator’s characteristics (age, relationship to survivor, etc.), and the event’s characteristics (the location, the specific acts, etc.). Greater insight into SVAC subtypes provides policymakers, implementers, and researchers with information they can use to assess how well existing SVAC interventions prevent the identified subtypes, to tailor and target prevention interventions to better reach and meet the needs of children, and to improve research on SVAC and evaluations of prevention programs. In this dissertation, I describe how to identify and apply SVAC subtypes to ensure that no children are left behind in SVAC primary prevention efforts. I developed Chapters 1 and 2 in partnership with the AfriChild Centre, a Uganda-based research institute that promotes the well-being of African children.
In Chapter 1, I describe the application of the Latent Class Analysis (LCA) methodology to identify subtypes of children’s first SVAC incidents across five Eastern and Southern African countries (Kenya, Malawi, Mozambique, Uganda, and Zambia). This analysis used nationally representative Violence Against Children Survey (VACS) data to identify eight subtypes of first SVAC incidents, four among boys and four among girls. Among boys, the identified subtypes were Boys’ SVAC subtype 1: Peer-perpetrated sexual touching at school; Boys’ SVAC subtype 2: Preadolescent survivors, known perpetrator; Boys’ SVAC subtype 3: Partner-perpetrated, forced or pressured sex at survivor’s home; and Boys’ SVAC subtype 4: Older adolescent survivors, attempted forced sex on a road, estimated to represent 25%, 29%, 14% and 32% of boys’ first SVAC incidents, respectively. Among girls, the identified subtypes were Girls’ SVAC subtype 1: Peer-perpetrated sexual touching at school; Girls’ SVAC subtype 2: Preadolescent survivors in their own home, known perpetrator; Girls’ SVAC subtype 3: Partner-perpetrated forced or pressured sex at perpetrator’s home; and Girls’ SVAC subtype 4: Adolescent survivors, attempted forced sex on a road, estimated to represent 13%, 15%, 31% and 40% of girls’ first SVAC incidents, respectively. Experiencing emotional violence, physical violence, or parental absence prior to SV was predictive of experiencing certain SVAC subtypes compared to others.
In Chapter 2, the same approach was applied to understand SVAC subtypes in Uganda using VACS data. Among boys, the identified subtypes were: Boys’ SVAC subtype 1: Peer-perpetrated sexual touching at school; Boys’ SVAC subtype 2: Preadolescent survivors, forced or pressured sex, family member perpetrator; Boys’ SVAC subtype 3: Older adolescent survivors, repeated, partner-perpetrated SV, outdoors; and Boys’ SVAC subtype 4: Young adolescent survivors, attempted forced sex, neighbor perpetrator, estimated to represent 27%, 14%, 24% and 34% of boys’ first SVAC incidents, respectively. Among girls, four subtypes were identified: Girls’ SVAC subtype 1: Peer-perpetrated sexual touching at school; Girls’ SVAC subtype 2: Preadolescent survivors, attempted or forced sex, neighbor or family member perpetrator; Girls’ SVAC subtype 3: Older adolescent survivors, repeated, partner-perpetrated SV; and Girls’ SVAC subtype 4: Stranger-perpetrated SV, outdoors, estimated to represent 21%, 12%, 26% and 41% of girls’ first SVAC incidents, respectively. Among boys and girls reporting SVAC, physical violence or parental absence prior to SV significantly increased the odds of reporting SVAC subtype 2, compared to SVAC subtype 1.
Stakeholders in Eastern and Southern Africa can use the findings of Chapters 1 and 2 to assess how well existing SVAC interventions are expected to prevent the identified subtypes and take corrective actions to ensure any overlooked SVAC subtypes are prevented. In both chapters, I present brief, non-exhaustive assessments of this issue, which revealed misalignment between prevention programs and prevalent SVAC subtypes. Practitioners can also use the identified SVAC subtypes to target and tailor SVAC primary prevention programs in the region to increase their effectiveness and sustainability. Finally, researchers can use the findings to design surveys that better capture the heterogeneity of survivors’ experiences, allowing them to ascertain the prevalence of SVAC subtypes across time and settings and to determine which programs are effective in preventing specific subtypes.
In Chapter 3, I present additional recommendations for how identified SVAC subtypes can be utilized, introducing the Plan2Prevent roadmap, which provides guidance to implementers on how to consider SVAC subtypes and other contextual factors to design or refine SVAC prevention approaches. This chapter describes a partnership with Pathfinder Tanzania to pilot the Plan2Prevent roadmap to refine an SVAC prevention program in Zanzibar. Plan2Prevent has the potential to support practitioners to use data to design or refine SVAC prevention programs that are informed by evidence and aligned with the local context, with the aim of more effectively and sustainably preventing SVAC.
Analyzing data to better understand the heterogeneity of children’s experiences of sexual violence by identifying SVAC subtypes can support stakeholders to move away from viewing SVAC as a one-dimensional issue. Chapters 1 and 2 demonstrate the utility of LCA as a means of identifying SVAC subtypes, and all three chapters provide guidance on how SVAC subtypes can be used to improve SVAC primary prevention efforts. A deeper understanding of SVAC subtypes can help policymakers, implementers, and researchers to assess the state of SVAC prevention programming and improve SVAC prevention interventions, research, and evaluation. Overall, this dissertation posits that the application of more nuanced, data-based understanding of SVAC can improve prevention programs so that more children can live free from sexual violence.
| Identifer | oai:union.ndltd.org:columbia.edu/oai:academiccommons.columbia.edu:10.7916/8cq9-xt53 |
| Date | January 2024 |
| Creators | Boudreau, Courtney Leigh |
| Source Sets | Columbia University |
| Language | English |
| Detected Language | English |
| Type | Theses |
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