Children at the Intersection of HIV, Poverty, and Mental Health in Sub-Saharan Africa (SSA)

Ssewamala, Fred M.; Bahar, Ozge Sensoy

doi:10.1007/978-3-030-83707-5_1

Cited by 3 publications

(3 citation statements)

References 62 publications

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“…The study found that feeling safe was the only variable to have a significant direct effect on resilience and that none of the indirect effects were significant. This comparative study supports the need to utilize a contextually informed approach to understanding resilience (Höltge et al, 2021) and addressing adolescent mental health needs (Ssewamala and Bahar, 2022) in SSA. The comparative differences found across countries in the present study further support the concept that resilience is context-specific (Herrman et al, 2011), requiring an understanding of the locally available cultural resources and individual thoughts, feelings, and behaviors of adolescents (Ungar and Theron, 2020).…”

Section: Discussionsupporting

confidence: 64%

The significance of feeling safe for resilience of adolescents in sub-Saharan Africa

Bandeira,

Graham,

Ebersöhn

2023

Front. Psychol.

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IntroductionAdolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents.MethodsPurposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health).ResultsThis study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique.DiscussionThe results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.

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Section: Discussionsupporting

confidence: 64%

The significance of feeling safe for resilience of adolescents in sub-Saharan Africa

Bandeira,

Graham,

Ebersöhn

2023

Front. Psychol.

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“…Unregistered marriages, a lack of property rights for women, and limited or no sources of independent income mean that women are at the mercy of institutions for support. Future work should aim to identify additional effective routes for culturally appropriate support of victims and service providers who seek to support them, as well as build culturally appropriate integrated prevention programs focusing on strengthening family processes ( McKay et al, 1995 ), co-parenting and father involvement ( Cowan et al, 2005 ), and economic empowerment to improve family relationships and promote family well-being ( Ssewamala et al, 2022 ). These types of programs could be directly incorporated into school curricula and target young men and women as a prevention strategy to expose them to new norms and mental models through structured conversations and peer groups.…”

Section: Discussionmentioning

confidence: 99%

The Role of Culture in the Justification and Perpetuation of Domestic Violence: The Perspectives of Service Providers in Kyrgyzstan

Childress,

Shrestha,

Kenensarieva

et al. 2023

Violence Against Women

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The study explores the perspectives of service providers on cultural and social reasons used to justify domestic violence in Kyrgyzstan. Results indicate that cultural norms, notably patriarchal customs, immense pressure put on women to save the marriage, stigma of divorce, low status assigned to women, wide acceptance of violence as natural, and fear of retaliation were major reasons that perpetuated domestic violence. Scholars, policymakers, and service providers must collaborate to actively dispel widely accepted beliefs about gender, marriage, and women's status, and to break the cycle of abuse providing help at the individual and community levels.

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“…Not only is the gross domestic product (GDP) among the bottom quarter of regions in the world (World Bank, 2022) but also the Human Development Index (a measure of life expectancy, access to knowledge, and standard of living) is lower in many nations in SSA than in countries in other regions of the world (Mukherjee et al, 2016). These high rates of poverty and poor indicators of human development contribute to unique sociocultural and economic problems associated with childhood victimization such as extreme malnutrition and starvation as well as HIV/AIDS (Dako-Gyeke, 2019; Evidence to End FGM/C, 2018; Kassa & Grace, 2020; Ssewamala & Sensoy Bahar, 2022). Childhood victimization can be both a cause and a consequence of poverty and multilevel adversities experienced in such contexts.…”

Section: The Sub-saharan African Contextmentioning

confidence: 99%

Programs to Prevent Violence Against Children in Sub-Saharan Africa: A Systematic Review

Edwards

Kumar

Waterman

et al. 2023

Trauma, Violence, & Abuse

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Violence against children—which includes maltreatment (including physical, sexual, psychological and emotional violence, and neglect), bullying (including cyberbullying), youth violence (including physical assault with or without weapons), intimate partner violence (including exposure to domestic violence and direct involvement in teen dating violence), and sexual violence—continues to present itself as a significant public health crisis in Sub-Saharan Africa (SSA) leading to numerous short- and long-term deleterious outcomes. As such, the prevention of violence against children in SSA is a critical public health priority. In this systematic literature review, we identified 45 articles that reported on results from 22 programs that seek to reduce violence against children in SSA. Results suggested that programs that focus on (1) economic strengthening, (2) teachers schools, (3) entire families, (4) caregivers only, and (5) children only are generally effective in reducing violence against children by promoting focused action on the mechanisms of change (e.g., parenting skills, enhanced parent–child relationships, resistance skills for children). To date, no research in SSA has examined the impact of policy interventions on childhood victimization or community-level interventions to change norms and values that support violence against children. Future research is needed to examine the impacts of comprehensive efforts to prevent violence against children in SSA as well as factors that predict uptake and sustainability of such prevention efforts in SSA.

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Children at the Intersection of HIV, Poverty, and Mental Health in Sub-Saharan Africa (SSA)

Cited by 3 publications

References 62 publications

The significance of feeling safe for resilience of adolescents in sub-Saharan Africa

The significance of feeling safe for resilience of adolescents in sub-Saharan Africa

The Role of Culture in the Justification and Perpetuation of Domestic Violence: The Perspectives of Service Providers in Kyrgyzstan

Programs to Prevent Violence Against Children in Sub-Saharan Africa: A Systematic Review

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