Latest findings from Uganda and Tanzania: four effective approaches to reducing violence against children

In 2019, the Evaluation Fund launched its third and final Call for Proposals to evaluate childhood violence prevention programs in Tanzania and Uganda. This Call had three main ambitions:

• project teams are be locally led, with researchers and practitioners based in Tanzania or Uganda;
• proposed evaluations are rigorous, with high quality research designs and an eye for implementation science;
• findings feed into policy-making and programming at national level on the prevention of violence against children in these two countries.

Four evaluative research projects were selected for funding and closed in mid-2022. You can explore each of these projects and their findings in detail below.

Results: four effective approaches for preventing violence against children in Tanzania and Uganda

The Good School Toolkit (GST), a whole-school approach, has been effective in reducing violence against children by transforming the operational culture of schools. Since its launch in 2008, the GST has been implemented in more than 1,000 public and private schools in 28 districts in rural and urban Uganda. A randomized controlled trial found that the GST led to a 42% reduction in risk of physical violence by school staff, promoted student voice and agency, and increased students’ sense of belonging.

The full GST includes over 60 activities, and while many schools have appreciated the full program, some have found it time intensive. To inform the design of a streamlined version called GST Agile, Raising Voices partnered with IDinsight to determine which components of the GST are most critical to reducing violence against children. The streamlined version will be more intuitive to implement and easier to scale, while ensuring fidelity to core components.

Key learnings from this study:

• Participants see the holistic GST model as effective. Nearly all study participants attribute positive changes in the school and surrounding communities to the GST, appreciate its holistic nature, report positive changes in teacher– student and student–student relationships within one year, and observe increased feelings of connectedness to the school with sustained implementation. While many consider the step-based approach to be useful, others prefer picking and choosing activities.
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• Meaningful change requires school-based protagonists. At least two teachers, referred to as ‘protagonists’ in the GST, must be trained in and committed to implementing the Toolkit if it is to be sustainable and effective. Training both female and male teachers maximizes sustainability and the engagement of both girls and boys, while frequent teacher transfers can threaten impact.
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• Impactful elements enhance student voice, positive discipline, and increased awareness. Student voice, feedback, and participation improve teacher– student and student–student relationships and increase a sense of belonging. Suggestion boxes, student courts, student committees and open meetings, for example, provide diverse opportunities for boys and girls to share concerns and resolve conflicts. Positive discipline helps to create a safe environment and freer communication in schools, while workshops and policies increase awareness and knowledge about violence against children.
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• Ongoing barriers limit participation. Stakeholders consider parent and community engagement to be impactful and important, but report only moderate success because of barriers such as transport and lack of incentives. Students need ongoing orientation from trained teachers in order to, for example, run student courts and understand zero-tolerance policies.
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Project partners:

Raising Voices (practitioners) & IDinsight (researchers)

Violence against children is a prevalent public health issue with serious short- and long-term consequences. Over 72% of children in Tanzania report experiencing physical violence by age 18. Caregivers, relatives, and teachers are the most common perpetrators, and corporal punishment is considered normative. However, substantial evidence shows that parenting programmes are successful in reducing violence against children and that they have the potential to do so at scale.

One such programme is Parenting for Lifelong Health for Teens (PLH-Teens), which is among few evidence-based and low-cost parenting programmes in low- and middle-income settings found to improve positive parenting and reduce violence against children. In 2020–2021, Pact Tanzania scaled up an HIV-enhanced version of PLH-Teens (locally known as Furaha Teens) across Tanzania.

The Furaha Adolescent Implementation Research (FAIR) Study examined the impact of PLH-Teens on preventing and reducing violence against children at scale in Tanzania, as well as assessed the quality, acceptability, appropriateness, feasibility, benefits, and challenges of programme delivery.

Key results:

1. Researchers found that PLH-Teens reduced overall child maltreatment (physical and emotional abuse) by 45%, intimate partner violence (IPV) perpetration by 19%, IPV victimisation by 14%, school violence by 16%, and improved sexual health communication by 86%.
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2. Caregivers noticed improvements in communication with their children, conflict resolution, connectedness, anger management, and planning for family economic resources. Caregivers and teens also reported improvements in child behaviour, such as children showing higher levels of respect, greater contribution to family decision-making, and more frequently confiding in and seeking advice from their caregivers.
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3. Caregivers and teens attended an average of 91% of sessions. Teachers and community workers delivered the programme to a high degree of quality, based on a facilitator assessment tool used during live observation of sessions.
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Project partners:

National Institute for Medical Research (researchers); University of Oxford (researchers); Cardiff University (researchers); PACT Tanzania (practitioners); Clowns Without Borders South Africa (practitioners)

Uganda is committed to accelerating evidence-based action to prevent and respond to violence against children. However, childhood violence remains prevalent: a 2018 national survey found that 75% of children had experienced violence before the age of 18. 

The AfriChild Centre, together with ChildFund International, evaluated an intervention that aimed to equip children with the knowledge, confidence and skills to speak up about violence in their schools and communities and advocate for prevention and response.

Key learnings:

1. Children in the intervention area understood the various forms of violence against children – physical, emotional and sexual abuse – more clearly and were more aware of their rights and what to expect from parents. For example, children in Kitgum could identify and define types of violence appropriately following the intervention. Quantitative results revealed an increase in children’s identification of violence by about 10%, as well as an increase in reported instances of violence against children by 3% and referral of cases by 10.7% at endline compared to baseline.

2. The intervention augmented children’s agency in community sensitization and identifying, reporting and referring cases of violence against children. For example, in response to whether children would continue to carry out prevention and response services after the end of the intervention, one child said,

   “I will continue to advise children and to impart knowledge and information because, with the information I received, I must help other children.”

3. As compared to the control group, more children considered child rights clubs to be helpful in preventing violence against children through reporting perpetrators, referring cases and sensitizing the community about children’s rights and the negative effects of violence. 

Project partners:

AfriChild Centre (researchers); ChildFund Uganda (practitioners)

The Parenting for Respectability (PfR) Programme in Uganda represents a home-grown, culturally-relevant parenting intervention that aims to prevent violence against children. The PfR programme is a carefully developed, theoretically-based 16-session programme with 10 single sex and 6 mixed sex sessions, delivered once a week by local community-based facilitators.

The programme has been disseminated widely in Uganda, and both government and NGOs have expressed interest to scale it. As a result, the Ugandan Parenting for Respectability Implementation Science Evaluation (UPRISE) project seeks to address two critical elements through their research: 

the optimal way to scale up the intervention in a ‘real-world setting’,

whether the evidence of effectiveness would be confirmed through a more rigorous, experimental, evaluation.

This project examines how three implementation variables – rural vs peri-urban locality, previously established groups vs new groups, and professional vs non-professional facilitators – affect participation, programme fidelity, and quality of delivery. 

In addition, and thanks to support from Oak Foundation, the UPRISE project has been expanded to address the second challenge: to build evidence of effectiveness through a rigorous randomised control trial (RCT) evaluation.

As a result of this exciting new development, this project has been extended and final results are expected in early 2023. 

Preliminary results:

• Geographic Location: Rural participants registered a higher attendance than peri-urban across the two study districts. In addition, it was more difficult to mobilise urban parents than rural, in part because of the cosmopolitan nature of residents and the nature of occupation in urban areas.
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• Facilitation Type: Facilitators and parents demonstrated a commitment to the programme evident through participant testimonies and regular attendance. Irrespective of type, most facilitators’ showed commitment through their positivity and sense of responsibility towards their work and in maintaining good relationships with participants.

  It was observed that peer facilitators were stronger at social relationships, interactions and guiding discussions while the professionals show better adherence to the manual (follow steps). Professional facilitators, on the other hand, were mostly constrained by work pressures because many of them had returned to their official job. This affected the preparation for session processes and availability to deliver the sessions.

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• Age of facilitators – While gender of facilitator was not associated with quality of delivery, age was: older facilitators were associated with less quality delivery, which is confirmed by qualitative findings in which the older facilitators were known to cling to certain normative cultural values which affected their ability to challenge inequitable gendered norms.
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Project partners:

Child Health & Development Centre (CHDC), Makerere University (researchers); SOS Children’s Villages Uganda (practitioners); University of Glasgow (researchers)