Violence against children – prevention is possible, and better than cure

15 Dec 2022

The 16 Days of Activism is a palpable reminder of the horrible human cost of violence against children. But as we admit failure in ending violence through policing and the criminal justice system, underfunded prevention programmes are quietly changing communities and saving lives.

Every 16 Days of Activism, the media is awash with the heartbreaking stories of children whose lives have been changed by violence. According to Police Minister Bheki Cele, 558 children were killed in the six months between April and September 2022. In the three months between July and September, there were 294 attempted murders of children reported and 1,895 grievous bodily harm cases involving children.

Sobering as these stats are, we cannot fully appreciate the impact of violence without insight into the loss in human capital due to experiences of violence during childhood.

The World Bank Human Capital Index (HCI) measures the productivity and human capital potential of each child in the country given optimal health and education conditions. It captures the expected potential of children given the conditions in their country. On this measure, if a child born in South Africa today completed their education and had full health, they would only reach 43% of their potential productivity as an adult.

In 2015, a study by Save the Children South Africa estimated that this loss of human capital equated to roughly R238-billion (about 6% of 2015 GDP), “double what we are currently spending on the criminal justice system annually, and more than 10 times the cost of gender-based violence”.

According to an Institute of Security Studies policy brief in 2017, children who experience neglect and abuse, or witness violence, are at increased risk of negative health and behavioural outcomes, and of perpetrating violence.

Using data from the Birth to Thirty (Bt30) cohort study and the adverse childhood experience framework, researcher Sara Naicker found that violence represents a threat to development throughout the life course. Children exposed to a range of adversity in their homes and communities, including physical, emotional and sexual abuse, chronic unemployment, household substance abuse, community violence, and parent or household death, are likely to experience poor health and well-being as adults, an increase in harmful risky behaviours and reduced human capital.

The study confirmed that early adversity was linked to poorer health, well-being and social outcomes in young adulthood, and that the more adversities a child experienced, the greater their risk of suffering negative physical and mental health and social outcomes including criminality, psychological distress, incomplete schooling, illness, poverty and unemployment.

Disturbingly, 87% of the Birth to Thirty cohort had experienced exposure to at least four adverse childhood experiences by the age of 18.

While all adversities caused harm, the research found a particularly strong link between violence and poor outcomes. Physical abuse in childhood increased the likelihood of a child dropping out of school, being unemployed and experiencing social isolation, while exposure to community violence led to increased substance abuse and psychological distress as adults.

Bt30 data show that “in a single generation, just 28 years, children subjected to high levels of adversity and widespread violence were more likely to drop out of school, be unemployed, engage in crime, have mental health problems, be socially isolated and have poorer health”.

Naicker explains that “at the age of six, young children in the cohort who were exposed to high levels of community danger and intimate partner violence within the home were displaying symptoms of anxiety, depression, aggression and poor emotional adjustment, such as oppositional behaviour, or patterns of deviant and hostile behaviour and impairment of social relationships”. This exposure to violence was amplified in adolescence and young adulthood, especially among young women.

For this reason, preventing children from being subject to serious and persistent adverse childhood experiences (ACEs) is important for building human capital and promoting human development.

What is being done?

Given that intervening to prevent violent crime (especially interpersonal violence) and break entrenched cycles of violence is essential for growing the economy and improving the nation’s health, behavioural and social outcomes, and given the significant impact of violence on children’s mental health and development, what is being done to combat violence against children?

According to the ISS policy paper, in 2017, South Africa was spending R126.71-billion (9.68% of expenditure) on the criminal justice system and R45-billion on private security. But despite this, it reported “no apparent correlation between spending more on the criminal justice system, increasing the number of police, and a reduction in crime rates”.

By contrast, in the same year, the country spent just R9-billion (less than 1% of the Department of Social Development’s national and provincial budget) on violence prevention or early intervention.

Read in Daily Maverick: “A call to action – it’s time to talk about child and adolescent mental health”

This is despite the link established by the Save the Children study between preventing children from witnessing and experiencing violence, and ensuring that they have a good start in life, with building an inclusive economy in the medium to long term and growth in GDP:

“Not investing sufficiently in preventing… violence against children contributes significantly and directly to lowered human capital, which severely impinges on our country’s economy. That is because children who experience neglect and abuse, or who witness violence, are likely to go on to repeat the cycle of deprivation and disadvantage. This is exacerbated by exposure to violence in the home, stressed parents, harsh corporal punishment at school and at home, and bullying at school. Together this creates a toxic mix that massively reduces human potential and lays the basis for continuing cycles of violence.”

According to Naicker, the country’s Violence Prevention Forum, which consists of research institutions, government departments and non-governmental organisations, recommends the adoption of the following violence prevention definition into approaches for development across all social, health and economic policies and practices:

“Violence prevention is the whole of society working deliberately and sustainably to remove sources of harm and inequality, and heal woundedness, by intentionally growing an ethic of mutual care and inclusion to build peace.”

But the government places the onus for violence prevention on NGOs which are notoriously erratically funded, making it hard to quantify how much money is being spent on these initiatives.

Nevertheless, many are making a significant impact in their communities and families, most notably the South African Parenting Programme Implementers Network (Sappin). A network of 12 core non-profit (NPO) members with shared values of collaboration, ethical and cultural sensitivity and support for staff, Sappin runs many research-based parenting programmes across the country to foster secure and non-violent home environments for children.

One such project is at Touwsranten near Wilderness in the Western Cape, an eight-year community intervention run by Sappin’s Seven Passes Initiative, the Institute of Security Studies and the UCT Psychology Department between 2012 and 2020.

Touwsranten is a rural community comprising 762 households and about 2,245 inhabitants. According to 2011 census data, almost half of the adults in the community were unemployed, not economically active or discouraged work seekers. Just nine residents had more than a matric certificate. In 2016, only 20% of residents weren’t receiving one or more government grant.

A 2013 survey found that 60% of families described running out of money to buy food four or more times in the past month.

It also reported that 12.7% of the children aged six to 18 suffered from anxiety or depression which should have been receiving treatment, and 15.3% of the children of the same age experienced behavioural problems that needed treatment. Parents’ inconsistent discipline and use of spanking and slapping were strongly related to children’s behavioural problems, and to their anxiety and depression.

A third of parents who had a partner described experiencing intimate partner violence and one-fifth of parents reported such high levels of parenting stress that they were classified as being at risk of child abuse.

Surveyed parents identified unemployment, illicit drugs, particularly methamphetamine (tik), public drinking, petty crime and a lack of recreational facilities as factors negatively impacting the safety of children. They noted that physical and verbal abuse, bullying and neglect of children were common.

The environment in this community was typical of many others in South Africa, with parents “stressed and disempowered by the very difficult socioeconomic circumstances in which they raise their children and the compounded effects of racialised intergenerational trauma and poverty”. Further, in Touwsranten, as is common across South Africa, violence in the home and community was undermining the safety and happiness of its children.

The longitudinal intervention which aimed to show that it’s possible to develop and support “positive, non-violent parenting skills that help parents keep their children safe in and outside the home, and reduce parenting stress”, consisted of four parenting programmes. These were designed to increase positive parenting, reduce corporal punishment and provide parents with social support.

Read in Daily Maverick: “North West school rape case confirms victims are being failed by the system”

The goal was improved parent mental health, reduced parenting stress, and better communication and relationships between caregivers and children. It also consisted of several community initiatives to clean up the community, fix play areas and infrastructure for children and encourage accountability for positive parenting choices.

Evaluation of the programmes found that an optimal return on investment for parenting programmes was impossible unless material conditions changed for parents, and there were reductions in intimate partner violence, substance abuse and mental health problems.

Nevertheless, the programme, attended by one-fifth of parents over its duration, resulted in decreases in parenting stress and in both children’s externalising behaviours (through which the child makes their distress visible to others such as fighting or stealing or related conduct problems) and internalising behaviours (when a child’s distress is kept internal and may manifest as anxiety and depression).

Behavioural problems among younger children decreased by 33%. It also saw a reduction in the use of corporal punishment, an increase in positive parenting (even among those who did not attend a programme), and a slight improvement in parents’ mental health.

Moreover, changes at family level were evident in Touwsranten. The Smit family* entered a parenting programme for teens shortly after their sons were returned to them eight years after they were removed and placed in foster care due to the parents’ abuse of alcohol. The family was reunited because one of the boys had begun using drugs and the foster family no longer wanted to foster them.

These factors created a high-risk environment, making intervention critical. The programme gave them the skills as a family to handle difficult relationships in the family and cope with stress.

The intervention helped the father, Dan*, to control his anger and become calmer. He started fishing with the boys, cooking for them and cleaning the garden together. The boys responded by praising their dad. Their mom, Marie*, the breadwinner, began to spend more time with her sons and praise them for their positive behaviour. The family now love talking and doing activities together.

In KwaZulu-Natal, the NGO Give a Child a Family tells the story of two little girls, Sindi and Thembi*, who were placed in their care after being removed from their mother. When the organisation’s social worker met their mom, Bongi Thola*, to try to assist her to be reunified with her daughters, she confessed to feeling like she had nothing to give her girls. She was struggling to make ends meet, lived in a tiny home and her boyfriend had no interest in her children. She had lost hope of having her daughters returned.

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The social worker offered her assistance, inviting her to a parenting skills programme. Bongi initially declined, but within a week she had changed her mind. She broke up with her boyfriend and joined the course. To the children’s delight, they were returned to her soon thereafter with supervision and follow-up meetings.

Six months later, the social worker was visiting Sindi and Thembi’s school when she was hailed by the principal. “What have you done with Mrs Thola?” he asked. “She has found her voice. She is talking to the other parents and telling them to get involved with their homework and school activities, she is telling the parents how to discipline their children.”

The course she attended convinced Bongi that money, or the lack thereof, was not significant. She learnt the importance of connecting with her children and how being an adult who is crazy about them helps them thrive.

Nor is it just at-risk children who have been placed in statutory services whose lives can be changed by parenting interventions. The Seven Passes Initiative tells many stories about families in Touwsranten where the programmes came in time to help parents deal with stress, anger and risky behaviours, saving the children from the adverse impact of poor parenting.

Its mom and baby parenting programme transformed a teenager’s experience of motherhood. Teenage moms experiencing a crisis pregnancy may abandon, neglect or abuse their baby. Tami* was a 15-year-old mom who was not interested in her baby or parenting the child. With the help of Tami’s mom, the parenting facilitator who ran the programme supported her to be able to go back to school and balance school with caring for her baby.

Violence a language of love

Dr Dee Blackie who runs Courage, a long-term community engagement change-management programme focused on prevention and early intervention in child protection, echoes Sappin’s concern that high levels of violence perpetrated against children in South Africa are exacerbated by people’s desire for quick fixes, instead of meaningful long-term approaches to behaviour change.

Courage workshops help communities envision the kind of world they would like to create for their children. They then identify the child protection challenges in their community, understand and prioritise these challenges, and develop empowered solutions to address them. Courage helps them understand the legal child protection and safeguarding process, identify community partners, and the values that will drive the achievement of their vision, and ultimately to create a community-based action plan.

Blackie tells a story from a workshop she ran in Alberton, Gauteng, about a young girl who spent the night out with her boyfriend. On her return, her father beat her so badly she ended up in hospital for a month. When social workers asked the father, who was imprisoned for the crime, why he did it, his response was, “because I love her”.

The programme helped the community understand that violence had become a language of love. It made them realise that especially among parents, they had to teach a new language of care and empathy to resolve conflict, instead of violence.

Similarly, in a workshop run with children in Diepsloot, a notoriously violent township in Johannesburg, a young man explained that he now had words to describe children’s daily reality. Violence was so normalised in his community that children weren’t aware that the violence perpetrated against them was problematic.

Prevention interventions allowed the community to finally “speak up” and advocate for change.

Policing is a much easier sell than prevention. But it is parenting programmes like those run by Sappin, and community mapping processes like Courage, that can minimise violence against children and child homicide. If care for individual children isn’t sufficiently motivating, the cost to the country and human capital of adverse childhood experiences, especially violence, should drive funds to prevention interventions.

As we pack up our 16 Days of Activism pins and posters for another year, and return to a lived experience where violence against children and its impact are routine and mostly invisible, we should require nothing less. DM

* Names changed to protect their privacy.

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What is being done?

Violence a language of love