Abstract
The influence of household crowding on physical and mental health has been well documented. However, research on the influence of household crowding on violent discipline and neglect of children is scarce. Therefore, we aimed to investigate whether household crowding was associated with violent discipline and neglect of children in low- and- middle-income countries (LMICs). Cross-sectional data for 280,005 and 73,030 children in 26 LMICs surveyed using the Multiple Indicator Cluster Survey were analyzed for (1) violent discipline and (2) neglect, respectively. In each country, we used logistic regression models to estimate the effects of household crowding on multiple forms of violent discipline and stimulation activities (as a proxy of the level of child neglect). Estimates were pooled using random effects meta-analyses. After adjusting for confounding variables, household crowding was associated with higher odds of any violent discipline (odds ratio (OR) = 1.09, 95% CI 1.03 to 1.15, p = 0.002) and lower odds of engaging in four or more stimulation activities (OR = 0.88, 95% CI 0.83 to 0.94, p < 0.001). The associations were stronger for urban children and children living in low- and lower-middle-income countries. The findings suggest that screenings and interventions aimed at reducing the effects of household crowding might be effective in preventing and controlling violent discipline and neglect of children in LMICs.
Highlights
Maltreatment of children and adolescents is increasingly recognized as a significant social and public health problem
Estimates in low- and middle-income countries (LMICs) indicate that 220.4 million and 230.7 million children aged 2 to 4 years were exposed to physical punishment and psychological aggression, respectively, which corresponds to a prevalence of 62.5% and 65.4%, respectively [1]
Covariates, and household crowding data were available for 280,005 children, and complete stimulation activities, covariates, and household crowding data were available for 73,030 children (Table 1)
Summary
Maltreatment of children and adolescents is increasingly recognized as a significant social and public health problem. Increasing attention has been given to two forms of maltreatment: (1) violent discipline and (2) neglect. One of the forms of neglect that has been investigated extensively in LMICs is the inadequacy of home stimulation activities [2,3,4,5]. Victims of violent discipline and neglect in childhood are at higher risk of health problems, including depression, anxiety, suicidal behavior, and HIV infection [6]. Exposure to violent discipline and neglect in childhood is strongly associated with behavioral and social problems such as poor cognitive performance, alcohol and drug
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