Table 1Implementation of the 2010 and 2019 Kenya Violence Against Children and Youth Surveys
CDC=US Centers for Disease Control and Prevention. DCS=Kenya Department of Children’s Services. EA=enumeration area. IRB=institutional review board. KNBS=Kenya National Bureau of Statistics. NASSEP=National Sample Survey and Evaluation Program. UCSF=University of California, San Francisco.
Published studies have demonstrated psychometric properties, reliability, and validity of the violence questionnaire tools employed in VACS.
The VACS questionnaire contains sections on demographics, risk and protective factors, violence victimisation, violence perpetration, sexual behaviour, HIV testing and services, violence service knowledge and uptake, and health outcomes. For this study, the main outcome variables were violence victimisation, context of violence, and risk factors for violence. All analyses were done with the entire sample of 13–24-year-olds stratified by sex and survey year.
Both the 2010 and 2019 surveys assessed four forms of sexual violence: unwanted sexual touching, unwanted attempted sex, forced sex, and pressured sex. Lifetime sexual violence was defined as having experienced one or more of these forms of sexual violence at any age (0–24 years) by any perpetrator.
In 2010, physical violence questions were asked for three perpetrator types: (a) intimate partner, (b) parents, adult caregivers, and other adult relatives, and (c) adults in the community or neighbourhood. In 2019, peer physical violence was added, but this measure was not included in the present analysis (because there was no 2010 comparator). Lifetime physical violence was defined as having experienced physical violence at any age (0–24 years) from one or more of the three perpetrator types included in both surveys.
Both 2010 and 2019 VACS assessed emotional violence by adults, with the 2010 survey asking about any adults, whereas the 2019 survey asked specifically about parents, adult caregivers, and other adult relatives. The 2010 VACS assessed whether any adult had made the respondent feel humiliated or unwanted, or if the respondent had been threatened with or experienced actual abandonment. The 2019 VACS asked whether an adult relative ever made the respondent feel unloved, said hurtful words like they wished the respondent was dead or was never born, or ridiculed the respondent. To compare emotional violence between surveys, the 2010 questions on abandonment were excluded. Any lifetime emotional violence was defined as experiencing any emotional violence at any age (0–24 years) from an adult.
Any lifetime violence included those who had experienced lifetime sexual, physical, or emotional violence.
Both VACS assessed the age at the first incident of any form of sexual violence, and disclosure and service seeking (ie, told someone, knew a place to seek service, sought service, and received service, among those who experienced any lifetime sexual violence).
Both VACS assessed violence risk factors, including multiple sexual partners (two or more sexual partners in the past 12 months); infrequent condom use (sometimes or never used condoms in the past 12 months); never tested for HIV; sexually transmitted infection (ever had symptoms or diagnosis of sexually transmitted infection); and child marriage (marriage before age 18 years).
Both VACS assessed inequitable gender attitudes with the following yes or no statements: only men, not women, should decide when to have sex; if someone insults a boy or man, he should defend his reputation with force if he needs to; there are times when a woman should be beaten; women who carry condoms have sex with a lot of men; and a woman should tolerate violence to keep her family together. The surveys assessed attitudes towards acceptance of wife beating with the following yes/no statements: it is acceptable for a man to hit or beat his wife (i) if she goes out without telling him, (ii) if she neglects the children, (iii) if she argues with him, (iv) if she refuses to have sex with him, and (v) if she burns the food.
and adjusted difference using logistic regression analyses and controlling for age, educational attainment, marital status, orphan status, rural versus urban status, and previous pregnancy. Logistic regression models tested each violence variable independently while controlling for covariates and a dummy variable for year. Unadjusted logistic regression models were also run to show changes in estimates between the adjusted and unadjusted models (appendix p 5). Differences were considered statistically significant if the two-sided p value associated with the Pearson χ2 test or the logistic regression was less than 0·05.
Analyses used SAS software version 9.4, accounting for the complex survey design (weight, cluster, and strata) of the 2010 and 2019 Kenya VACS.
Source link : https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00457-5/fulltext
Publish date : 2021-11-22 23:30:11