We aimed to complete a nationally representative study of sexual violence against children in South Africa, and its correlates, since we could identify no other such study. For this nationally representative, cross-sectional study in South Africa, households were selected by use of a multistage sampling frame, stratified by province, urban or rural setting, and race group, and schools were selected on the basis that they were closest to the area in which households were selected. Interviews and self-administered questionnaires in each location inquired into lifetime and last-year prevalence of sexual abuse, and its correlates among children aged 15-17 years, whose parents gave informed consent and they themselves gave informed assent. The final household sample was 5631 (94·6% participation rate). 9·99% (95% CI 8·65-11·47) of boys and 14·61% (95% CI 12·83-16·56) of girls reported some lifetime sexual victimisation. Physical abuse, emotional abuse, neglect, family violence, and other victimisations were all strongly associated with sexual victimisation. The following were associated with greater risk of sexual abuse (adjusted odds ratio [OR]); school enrolment (OR 2·12, 95% CI 1·29-3·48); rural dwelling (0·59; 0·43-0·80); having a flush toilet (1·43, 1·04-1·96); parental substance misuse (2·37, 1·67-3·36); being disabled (1·42, 1·10-1·82); female (but not male) caregivers' poor knowledge of the child's whereabouts, friends, and activities (1·07, 0·75-1·53) and poor quality of the relationship with the child (ie, poor acceptance; 1·20, 0·55-2·60). The child's own substance misuse (4·72, 3·73-5·98) and high-risk sexual behaviour (3·71, 2·99-4·61) were the behaviours most frequently associated with sexual abuse, with mental health conditions found to be less prevalent than these factors but still strongly associated with sexual victimisation (post-traumatic stress disorder 2·81, 1·65-4·78; depression 3·43, 2·26-5·19; anxiety 2·48, 1·61-3·81). Sexual violence is widespread among both girls and boys, and is associated with serious health problems. Associated factors require multisectoral responses to prevent sexual violence or mitigate consequences. UBS Optimus Foundation.

Background: Parenting programs suitable for delivery at scale in low‐resource contexts are urgently needed. We conducted a randomized trial of Parenting for Lifelong Health ( PLH ) for Young Children, a low‐cost 12‐session program designed to increase positive parenting and reduce harsh parenting and conduct problems in children aged 2–9. Methods: Two hundred and ninety‐six caregivers, whose children showed clinical levels of conduct problems (Eyberg Child Behavior Inventory Problem Score, >15), were randomly assigned using a 1:1 ratio to intervention or control groups. At t ₀ , and at 4–5 months ( t ₁ ) and 17 months ( t ₂ ) after randomization, research assistants blind to group assignment assessed (through caregiver self‐report and structured observation) 11 primary outcomes: positive parenting, harsh parenting, and child behavior; four secondary outcomes: parenting stress, caregiver depression, poor monitoring/supervision, and social support. Trial registration: ClinicalTrials.gov ( NCT 02165371); Pan African Clinical Trial Registry ( PACTR 201402000755243); Violence Prevention Trials Register ( http://www.preventviolence.info/Trials?ID=24 ). Results: Caregivers attended on average 8.4 sessions. After adjustment for 30 comparisons, strongest results were as follows: at t ₁ , frequency of self‐reported positive parenting strategies (10% higher in the intervention group, p  =   .003), observed positive parenting (39% higher in the intervention group, p  =   .003), and observed positive child behavior (11% higher in the intervention group, p  =   .003); at t _2, both observed positive parenting and observed positive child behavior were higher in the intervention group (24%, p  =   .003; and 17%, p  =   .003, respectively). Results with p ‐values < .05 prior to adjustment were as follows: At t ₁ , the intervention group self‐reported 11% fewer child problem behaviors, 20% fewer problems with implementing positive parenting strategies, and less physical and psychological discipline (28% and 14% less, respectively). There were indications that caregivers reported 20% less depression but 7% more parenting stress at t ₁ . Group differences were nonsignificant for observed negative child behavior, and caregiver‐reported child behavior, poor monitoring or supervision, and caregiver social support. Conclusions: PLH for Young Children shows promise for increasing positive parenting and reducing harsh parenting.

Despite global shifts toward prevention of school corporal punishment, the practice remains widespread. This systematic review focused on (a) prevalence, (b) associated mental health and behavioral factors, and (c) correlates that may be risk or protective factors. Studies included in this review were peer-reviewed, published in English between 1980 and July 2017, and quantitative in design. Fifty-three papers met the inclusion criteria. All were cross-sectional surveys, predominantly of moderate quality and conducted in the United States (US) and on the African continent. Results indicated that school corporal punishment is prevalent across the globe (including where bans are in place) and does not appear to be decreasing over time, although measurement differences preclude firm conclusions. It is associated with physical, academic, mental health, and behavioral problems for children. Boys, Black students (in the US), and students exposed to violence at home were most at risk of corporal punishment. It is unclear whether disability puts a student at risk. Schools with high rates of other disciplinary practices were more likely to use corporal punishment, while those who employed a mental health professional and trained staff in safety procedures were less likely to use corporal punishment. Teacher attitudes favoring corporal punishment, and their use of violence in other contexts, increased risk. Low socioeconomic status (of the student or the school environment) increased risk, while high levels of state social capital reduced risk. Future research must include areas where corporal punishment is banned and focus on developing effective interventions to prevent school corporal punishment.

Exposure to violence puts children at risk for developing a variety of problems, including depression, anxiety, and conduct problems. The extent to which children's individual, family, school, and peer group characteristics influence resilient responses to violence exposure was investigated amongst Grade 6 students living in a high-violence community in Cape Town. The majority (68.44%) reported both witnessing and being a victim of violence. Both witnessing and victimisation by violence were found to be positively associated with anxiety and depression, but only victimisation was positively associated with conduct problems. Peer delinquency was positively associated with both depression and conduct problems. Involvement in conventional after-school activities was negatively associated with anxiety, and school support was negatively associated with both depression and conduct problems. No association was identified between parent support and any of anxiety, depression, or conduct problems. However, this latter finding may be related to measurement problems, or to participants' reports that they were most likely to be victimised in their homes (rather than at school or in the neighbourhood). While this study is limited by its cross-sectional nature, it implies that key sites for intervention are after-school activities, school support, peer delinquency, and home life.

Child abuse prevention research has been hampered by a lack of validated multi-dimensional non-proprietary instruments, sensitive enough to measure change in abuse victimization or behavior. This study aimed to adapt the ICAST child abuse self-report measure (parent and child) for use in intervention studies and to investigate the psychometric properties of this substantially modified tool in a South African sample. First, cross-cultural and sensitivity adaptation of the original ICAST tools resulted in two preliminary measures (ICAST-Trial adolescents: 27 items, ICAST-Trial caregivers: 19 items). Second, ICAST-Trial data from a cluster randomized trial of a parenting intervention for families with adolescents (N = 1104, 552 caregiver-adolescent dyads) was analyzed. Confirmatory factor analysis established the hypothesized 6-factor (adolescents) and 4-factor (caregivers) structure. Removal of two items for adolescents and five for caregivers resulted in adequate model fit. Concurrent criterion validity analysis confirmed hypothesized relationships between child abuse and adolescent and caregiver mental health, adolescent behavior, discipline techniques and caregiver childhood abuse history. The resulting ICAST-Trial measures have 25 (adolescent) and 14 (caregiver) items respectively and measure physical, emotional and contact sexual abuse, neglect (both versions), and witnessing intimate partner violence and sexual harassment (adolescent version). The study established that both tools are sensitive to measuring change over time in response to a parenting intervention. The ICAST-Trial should have utility for evaluating the effectiveness of child abuse prevention efforts in similar socioeconomic contexts. Further research is needed to replicate these findings and examine cultural appropriateness, barriers for disclosure, and willingness to engage in child abuse research.