Center for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway
General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
BMJ Open. 2022 May 6;12(5):e055231. doi: 10.1136/bmjopen-2021-055231.
National violence against children (VAC) surveys in Tanzania and Kenya reported that approximately three-quarters of children in Tanzania experienced physical violence while 45.9% of women and 56.1% of men experienced childhood violence in Kenya. In response to VAC, Investing in Children and their Societies-Strengthening Families & Protecting Children (ICS-SP) developed the whole school approach (WSA) for reducing VAC in and around schools. Objectives of this evaluation are to: (1) determine intervention's feasibility and (2) the extent to which the WSA reduces prevalence and incidence of VAC in and around schools in Kenya and Tanzania; (3) gain insights into changes in stakeholders' knowledge, attitudes and practices in relation to VAC following intervention implementation and (4) provide evidence-based recommendations for refining intervention content, delivery and theory of change (ToC).
The study is a mixed-methods, controlled before-and-after, quasi experimental pilot designed to assess the delivery and potential changes in knowledge, attitudes, behaviours and VAC prevalence and incidence in and around schools following the WSA intervention implementation in Kenya and Tanzania. The preintervention phase will entail stakeholder enhancement of the WSA ToC and baseline cross-sectional surveys of teaching and non-teaching staff and parents (knowledge, attitude and practices), pupils (VAC incidents and school climate) and school safety audits. The WSA intervention implementation phase will include an intervention delivery process assessment and random school visits. In the postintervention phase, end-line surveys will be conducted similarly to baseline. Focus group discussions and in-depth interviews will be held with ICS-SP staff, training facilitators, teachers, parents and pupils to gain insights into acceptability, delivery and potential intervention effects. Quantitative and qualitative data will be analysed using SPSS V.25 and NVIVO V.12, respectively.
Ethics approvals were received from Amref Health Africa in Kenya (AMREF-ESRC P910/2020) and National Health Research Ethics Committee (NatHREC) in Tanzania (NIMR/HQ/R.8a/Vol.IX/3655). Dissemination will be through research reports.
坦桑尼亚和肯尼亚的全国针对儿童的暴力(VAC)调查显示,坦桑尼亚约四分之三的儿童经历过身体暴力,而肯尼亚 45.9%的女性和 56.1%的男性在儿童时期经历过暴力。针对 VAC,投资于儿童及其社会——加强家庭和保护儿童(ICS-SP)为减少学校内外的 VAC 开发了全学校方法(WSA)。本次评估的目的是:(1)确定干预措施的可行性,(2)WSA 在肯尼亚和坦桑尼亚减少学校内外 VAC 的流行率和发生率的程度;(3)了解利益相关者在干预实施后与 VAC 相关的知识、态度和实践的变化,(4)为改进干预内容、交付和变革理论(ToC)提供循证建议。
本研究采用混合方法、对照前后、准实验性设计,旨在评估肯尼亚和坦桑尼亚实施 WSA 干预措施后,教学和非教学人员以及家长(知识、态度和实践)、学生(VAC 事件和学校氛围)和学校安全审计的 WSA 交付情况以及知识、态度、行为和 VAC 的流行率和发生率的潜在变化。在预干预阶段,将涉及利益相关者增强 WSA 的 ToC 和基线横断面调查,包括教学和非教学人员以及家长(知识、态度和实践)、学生(VAC 事件和学校氛围)和学校安全审计。WSA 干预实施阶段将包括干预交付过程评估和随机学校访问。在干预后阶段,将进行类似基线的期末调查。将与 ICS-SP 工作人员、培训协调员、教师、家长和学生进行焦点小组讨论和深入访谈,以了解可接受性、交付和潜在的干预效果。将使用 SPSS V.25 和 NVIVO V.12 分别分析定量和定性数据。
肯尼亚的非洲健康行动 Amref(AMREF-ESRC P910/2020)和坦桑尼亚的国家健康研究伦理委员会(NatHREC)已获得伦理批准。传播将通过研究报告进行。