Youth Violence in Malawi, Nigeria, Uganda and Zambia: Victims Who Later Harm Others

Summary

• Violence against children is a major public health problem, with lasting consequences — including victims going on to harm others.
• Violence Against Children Surveys in four sub-Saharan African countries found that perpetrating violence ranged among males from 29.5% (Nigeria) to 51.5% (Malawi), and among females from 15.3% (Zambia) to 28.4% (Uganda).
• In every country, the more types of violence a young person had suffered in childhood, the higher their odds of perpetrating violence.
• Breaking the cycle takes long-term, comprehensive help for both victims and perpetrators.

Background

Violence kills more than 1.3 million people worldwide each year, yet population data on who commits physical and sexual violence are scarce, especially in low- and middle-income countries. From 2013 to 2015, CDC worked with Together for Girls — a partnership of host governments, the United Nations Children's Fund, the President's Emergency Plan for AIDS Relief and others — and the governments of Malawi, Nigeria, Uganda and Zambia on nationally representative household surveys of people aged 13–24.

How the surveys worked

• Face-to-face interviews at home by local interviewers trained by CDC and partners, with consent, strict confidentiality, a list of services for every participant and referrals for victims who asked for help. The questionnaire was translated into local languages, back-translated and piloted — from Chichewa and Tumbuka in Malawi to Hausa, Igbo and Yoruba in Nigeria, eight languages in Uganda and eight in Zambia.
• Perpetration (ever): physical — punching, kicking, whipping, beating, choking, smothering, threatening with a weapon, trying to drown or deliberately burning someone; sexual — forcing sex or other sex acts on someone.
• Childhood victimization (before 18): physical violence of the same kinds; emotional — being told by a parent or caregiver they weren't loved or wished they'd never been born, or being ridiculed or belittled; sexual — unwanted touching, attempted or forced sex, or pressured sex.

What they found

• Physical violence was more common than sexual violence in all four countries, among both sexes. It was most common in Uganda: 46.2% of young men and 26.8% of young women had ever physically attacked someone.
• Physical violence was more often against someone other than a partner; sexual violence more often against an intimate partner. It was most common among males in Malawi, where more than one in four (26.6%) reported forcing sex.
• Being male and having been a victim as a child consistently raised the odds of perpetrating.
• Childhood victimization was the strongest predictor everywhere: victims had more than five times the odds of perpetrating violence (adjusted odds ratios 5.4–7.0). Physical violence in childhood carried the highest odds (2.8–6.4), and victims of sexual or physical violence tended to commit the same kind.
• Dose-response: the more kinds of violence suffered, the higher the odds. In Zambia, people who had suffered physical, emotional and sexual violence before 18 were about 20 times as likely to perpetrate violence as those who had suffered none.

Odds of perpetrating violence by the number of types of violence experienced in childhood. Figure from the CDC report.

What it means

Violence is common among both young men and young women in these countries, and closely tied to what they suffered as children — which makes early intervention essential. Earlier studies of men in Brazil, Chile, Croatia, India, Mexico, Rwanda and South Africa put lifetime perpetration of partner violence at 24%–42%. Measuring and addressing perpetration matters, not least because violence is linked to consequences such as HIV transmission, and the findings fit a growing body of research tying adverse childhood experiences to later criminal violence, child abuse and partner violence.

Limits: a snapshot survey can't prove cause; answers were self-reported and may suffer from recall and reluctance to disclose sensitive acts; the frequency and timing of violence weren't measured; and young people not living in households — street children, those in institutions or school dormitories — weren't included.

Prevention

Violence is preventable. Strategies include better access to therapy and counseling, support and education for parents, reducing community violence and greater gender equity. Because each country's patterns differ, country-specific data matter. INSPIRE, a technical package, helps countries choose evidence-based programs and policies to prevent and respond to violence against children.

Sources

Based on Elizabeth A. Swedo, Steven A. Sumner, Susan D. Hillis and others, "Prevalence of Violence Victimization and Perpetration Among Persons Aged 13–24 Years — Four Sub-Saharan African Countries, 2013–2015," MMWR, Centers for Disease Control and Prevention; a work of the United States government in the public domain.