Multisectoral Responses Research Articles

The Nature and Scope of Reported Child Maltreatment in Euro-CAN Countries: Current Evidence and Future Opportunities

Most European Cooperation on Science and Technology (COST) affiliated countries aim to advance the goal of protecting children from maltreatment. However, despite the increasing numbers of population-based surveys, the development of administrative data systems has lagged. In this study, we aimed to examine the current state of development of administrative data systems in a sample of countries represented in the COST Action 19106 network, Multi-Sectoral Responses to Child Abuse and Neglect in Europe: Incidence and Trends (Euro-CAN). A structured questionnaire was distributed to researchers and professionals within Euro-CAN-affiliated countries, which captured economic, legislative, systemic, and data infrastructure characteristics. Thematic trends for 13 sampled countries were presented descriptively. The implementation of legislative measures such as banning corporal punishment varied substantially, with some countries decades apart. Almost all sampled countries mandate reports of suspected child maltreatment for all or some professionals in contact with children. In most countries, public child protection, health, or law enforcement systems are decentralized, and unsubstantiated/inconclusive incidents of suspected child maltreatment are not systematically collected at the national level. Child maltreatment data is not routinely collected in health sectors in all sampled countries. Where data is collected in different sectors, such as police and child protection agencies, different descriptions are often used. Systematic data linkage remains a seldom occurrence with only a few countries offering this capability. The call for Euro-CAN countries to develop multi-sectoral data systems to capture recorded instances of child maltreatment remains relevant.

A Thousand Catcalls: Survivors’ Experiences of Sexual Violence in Online Dating

There is growing academic interest in the leisure spaces of online dating as a specific avenue of technology-facilitated sexual violence (TFSV). Yet, limited attention is paid to survivors’ experiences and understandings of sexual violence intermediated by dating apps. Using feminist standpoint theory and an intersectional lens, in-depth interviews were conducted with 15 current and former dating app (e.g. Tinder, Grindr) users of diverse identities and backgrounds who previously experienced sexual violence. Sexual violence was found to take a multiplicity of forms spanning the “online-offline” continuum that often co-occur and mutually reinforce their effects, including sexual assault threats, image-based harassment, gender/sexuality-based hate speech, and in-person sexual coercion and/or aggression. Depending on the experience frequency and severity, psycho-social outcomes range from indifference/mild annoyance to emotional trauma and social withdrawal. Findings underscore the profound personal and collective impacts of TFSV and the urgent need for coordinated, multisectoral responses.

Incorporating One Health into a front-line field epidemiological training programme in Papua New Guinea: lessons learned.

Over the past two decades, there has been increased recognition of the importance of a more holistic approach to preventing, predicting, detecting and responding to public health threats. The COVID-19 pandemic highlighted the need to bring together environmental, human and animal health sectors in addressing public health threats and the need to develop skilled front-line workers to act as surge capacity during health emergencies. Papua New Guinea is a high-risk country for emerging and re-emerging pathogens. The effects of climate change, human-mediated encroachment on natural habitats and destructive land-use practices have threatened ecosystems and caused environmental damage. The movement of goods, animals and people over porous borders provides opportunities for the introduction and spread of new pathogens. In recognition of the importance of multisectoral responses to health threats in Papua New Guinea, and the need to train front-line workers, we designed and piloted a 3-month One Health in-service training programme for front-line workers from across all sectors. The co-creation of curricula was essential in ensuring the relevance of the programme to front-line workers from multiple sectors, and the development of provincial training teams was key to ensuring mentorship and programme sustainability. Bringing front-line workers together in joint trainings facilitated the building of relationships, the understanding of the roles and responsibilities of the various sectors, the identification of sectoral focal points and the development of informal networks. Papua New Guinea's One Health front-line Field Epidemiology Training Program demonstrated that investment in cross-sectoral training programmes can be a catalyst for the implementation of One Health approaches on the front line.

Planning, implementing and governing systems-based co-creation: the DISCOVER framework

BackgroundIncreasingly, public health faces challenges requiring complex, multifaceted and multi-sectoral responses. This calls for systems-based approaches that facilitate the kind of collective and collaborative thinking and working required to address complexity. While the literature on systems thinking, system dynamics and the associated methodologies is extensive, there remains little clear guidance on how to plan, govern and implement participatory systems approaches within a co-creation process.MethodsWe used a three-step process to develop DISCOVER, a framework for implementing, and governing systems-based co-creation:Stage 1: We conducted a literature analysis of key texts to identify well-documented methods and phases for co-creation using a systems approach, as well as areas where gaps existed.Stage 2: We looked for the most appropriate methods and approaches to fill the gaps in the knowledge production chain.Stage 3: We developed the framework, identifying how the different tools and approaches fit together end-to-end, from sampling and recruiting participants all the way through to responding with an action plan.ResultsWe devised DISCOVER to help guide researchers and stakeholders to collectively respond to complex social, health and wider problems. DISCOVER is a strategic research planning and governance framework that provides an actionable, systematic way to conceptualise complex problems and move from evidence to action, using systems approaches and co-creation. In this article, we introduce the eight-step framework and provide an illustrative case study showcasing its potential. The framework integrates complementary approaches and methods from social network analysis, systems thinking and co-creation literature. The eight steps are followed sequentially but can overlap.ConclusionsDISCOVER increases rigour and transparency in system approaches to tackling complex issues going from planning to action. It is being piloted in environmental health research but may be suitable to address other complex challenges and could be incorporated into research proposals and protocols for future projects.

Consensus building on definitions and types of child maltreatment to improve recording and surveillance in Europe: protocol for a multi-sectoral, European, electronic Delphi study

IntroductionChild maltreatment (CM) is a complex global public health issue with potentially devastating effects on individuals’ physical and mental health and well-being throughout the life course. A lack of uniform...

Building a protective environment for street children in the global context of Coronavirus 2019 disease (COVID-19): lessons from the Democratic Republic of Congo

Violence against children is a global health problem of high significance. While the Coronavirus 2019 disease (COVID-19) pandemic has increased the risks of violence against children in global, there have been unparalleled effects on street children. Using the case of Democratic Republic of Congo (DRC), this article explores the prospects of building a protective environment for street children. First, we demonstrate how COVID-19 has changed the living conditions, livelihoods, and risks of violence against street children. Second, drawing on the lessons from the multisectoral responses to COVID-19, I explore the prospects and challenges for improving prevention and response programs for street children. The present article concludes by examining some factors of resilience that can inform existing interventions for street children in the DRC in global, drawing on the lessons from responses to COVID-19. The latter is a disease caused by a virus named SARS-CoV-2 which is contagious and spreads quickly. It can also cause respiratory illness in humans. This article is relevant because COVID-19 has led to reflective changes in different sectors that affect considerably children’s lives. Therefore, it will be significant to build protective measures to safeguard children after COVID-19 and not leave street children behind. How to reference using ASWNet style: Murhula, K. G. (2023). Building a protective environment for street children in the global context of Coronavirus 2019 disease (COVID-19): lessons from the Democratic Republic of Congo. African Journal of Social Work, 13(5), 235-243. https://dx.doi.org/10.4314/ajsw.v13i5.2 Visit journal website: https://ajsw.africasocialwork.net

‘One Health’ Approach to Infectious Diseases and Prevention of Antimicrobial Resistance: A Review

This review paper aims to provide an understanding on current concepts of ‘One Health’ approach in the field of public health with a special focus on infectious diseases and prevention of antimicrobial resistance. 'One Health' is an approach to designing and implementing programmes, policies, legislation, and research in which multiple sectors communicate and work together to achieve better public health outcomes. The scope of ‘One Health’ includes zoonotic diseases, antimicrobial resistance, food safety and security, vector-borne diseases that come from insect bites or animals, environmental contamination, and other health threats shared by people, animals, and the environment. The World Health Organization (WHO) is working closely with the Food and Agriculture Organization of the United Nations (FAO) and the World Organization for Animal Health (OIE) to promote multi-sectoral responses to food safety hazards, risks from zoonoses, and other public health threats at the human-animal-ecosystem interface and provide guidance on how to reduce those risks for a better living in our planet Earth. Our medical education curriculum should also offer a first exposure to both the concepts of ‘One Health’ and the collaborative processes required to manage issues associated with human, animal, and environmental health. Bangladesh Journal of Medical Microbiology, January 2022;16(1):25-30

SBCC Training in Francophone West Africa: Overview, Lessons Learned, Challenges and Future Directions

The study explores the SBCC training experience in Francophone West Africa and how training programs have been impacted by major pandemics that this region has experienced, COVID-19 particularly. To stay focused, we have selected Côte d’Ivoire as a case study because it is representative of Francophone African countries which faced political instability, pandemics and epidemics in the past two decades. Data were collected through desk review and interviews with key informants. Taking stock of the past to recent experience, both in long-term and academic training, and on-the-job and short-term training on one hand, and examining the influence of COVID-19 crisis on SBCC training in the country and sub-region on the other hand, lessons learned, and challenges ahead are identified. The paper focuses on multidisciplinary, multisectoral and sub-regional responses, e-learning, and professionalizing SBCC, as future directions.

Statement: Multisectoral actions to build trust at the local and community level to promote vaccine acceptance

On 12 September 2022, attendees of the 16th Vaccine Congress in Riva del Garda, Italy were invited to attend a roundtable session entitled multi-sectoral actions to build trust at the local and community level to promote vaccine acceptance to participate in a discussion aimed at defining strategies and recommendations to support efforts that build community vaccine confidence. Presenters from the Vaccine Confidence Project and the New York Vaccine Literacy Campaign shared research and data point on the current state of vaccine confidence worldwide as well as global examples of “success stories” to prompt discussion. The group’s key recommendations include prioritizing multi-sectoral responses and trust-building through policy and legislation, engaging with trusted local stakeholders, improving convenience, combating misinformation and empowering healthcare professionals to improve vaccine confidence. This report summarizes the considerations, recommendations, and suggested strategies discussed during the session, as prepared by the presenters.

Use of a Sustainable Livelihood Framework-Based Measure to Estimate Socioeconomic Impact of Tuberculosis on Households.

Tuberculosis (TB) disproportionally affects impoverished members of society. The adverse socioeconomic impact of TB on households is mostly measured using money-centric approaches, which have been criticized as one-dimensional and risk either overestimating or underestimating the true socioeconomic impacts of TB. We propose the use of the sustainable livelihood framework, which includes 5 household capital assets (human, financial, physical, natural, and social) and conceptualizes that households employ accumulative strategies in times of plenty and coping (survival) strategies in response to shocks such as TB. The proposed measure ascertains to what extent the 5 capital assets are available to households affected by TB as well as the coping costs (reversible and nonreversible) that are incurred by households at different time points (intensive, continuation, and post-TB treatment phase). We assert that our approach is holistic and multidimensional and draws attention to multisectoral responses to mitigate the socioeconomic impact of TB on households.

Causes and contexts of childhood overweight and obesity in the Pacific region: a scoping review

Background: Non-communicable diseases (NCDs) are a major threat to health and development and account for 75% of deaths in the Pacific Islands Countries and Territories (PICTs). Childhood obesity has been identified as a main risk factor for NCDs later in life. This review compiled overweight and obesity (OWOB) prevalence (anthropometric data) for children aged six to 12 years old living in the Pacific region and identified possible related causes. Methods: We conducted a systematic search using PubMed, Google Scholar and ScienceDirect for articles published between January 1980 and August 2022. We also searched for technical reports from Ministries of Health. Guided by the eligibility criteria, two authors independently read the selected articles and reports to extract and summarise relevant information related to overweight and obesity. Results: We selected 25 articles, two worldwide analyses of population-based studies and four national reports. Information revealed that childhood OWOB prevalence reached 55% in some PICTs. This review also indicated that age, gender and ethnicity were linked to children’s weight status, while dietary practices, sleep time and level of physical activity played a role in OWOB development, as well as the living environment (socio-economic status and food availability), parenting practices and education level. Conclusion: This review highlighted that anthropometric data are limited and that comparisons are difficult due to the paucity of surveys and non-standardized methodology. Main causes of overweight and obesity are attributed to individual characteristics of children and behavioural patterns, children’s socio-economic environment, parenting practices and educational level. Reinforcement of surveillance with standardised tools and metrics adapted to the Pacific region is crucial and further research is warranted to better understand root causes of childhood OWOB in the Pacific islands. More robust and standardized anthropometric data would enable improvements in national strategies, multisectoral responses and innovative interventions to prevent and control NCDs.

'Voice needs teeth to have bite'! Expanding community-led multisectoral action-learning to address alcohol and drug abuse in rural South Africa.

There is limited operational understanding of multisectoral action in health inclusive of communities as active change agents. The objectives were to: (a) develop community-led action-learning, advancing multisectoral responses for local public health problems; and (b) derive transferrable learning. Participants representing communities, government departments and non-governmental organisations in a rural district in South Africa co-designed the process. Participants identified and problematised local health concerns, coproduced and collectively analysed data, developed and implemented local action, and reflected on and refined the process. Project data were analysed to understand how to expand community-led action across sectors. Community actors identified alcohol and other drug (AOD) abuse as a major problem locally, and generated evidence depicting a self-sustaining problem, destructive of communities and disproportionately affecting children and young people. Community and government actors then developed action plans to rebuild community control over AOD harms. Implementation underscored community commitment, but also revealed organisational challenges and highlighted the importance of coordination with government reforms. While the action plan was only partially achieved, new relationships and collective capabilities were built, and the process was recommended for integration into district health planning and review. We created spaces engaging otherwise disconnected stakeholders to build dialogue, evidence, and action. Engagement needed time, space, and a sensitive, inclusive approach. Regular engagement helped develop collaborative mindsets. Credible, actionable information supported engagement. Collectively reflecting on and adapting the process supported aligning to local systems priorities and enabled uptake. The process made gains raising community 'voice' and initiating dialogue with the authorities, giving the voice 'teeth'. Achieving 'bite', however, requires longer-term engagement, formal and sustained connections to the system. Sustaining in highly fluid contexts and connecting to higher levels are likely to be challenging. Regular learning spaces can support development of collaborative.

A Report from LGBTI Philanthropy

A Report from LGBTI Philanthropy

Key knowledge gaps for One Health approach to mitigate nanoplastic risks

There are increasing concerns over the threat of nanoplastics to environmental and human health. However, multidisciplinary barriers persist between the communities assessing the risks to environmental and human health. As a result, the hazards and risks of nanoplastics remain uncertain. Here, we identify key knowledge gaps by evaluating the exposure of nanoplastics in the environment, assessing their bio-nano interactions, and examining their potential risks to humans and the environment. We suggest considering nanoplastics a complex and dynamic mixture of polymers, additives, and contaminants, with interconnected risks to environmental and human health. We call for comprehensive integration of One Health approach to produce robust multidisciplinary evidence to nanoplastics threats at the planetary level. Although there are many challenges, this holistic approach incorporates the relevance of environmental exposure and multi-sectoral responses, which provide the opportunity to identify the risk mitigation strategies of nanoplastics to build resilient health systems. • Nanoplastic is a complex and dynamic mixture of polymer, additive, and contaminant. • Knowledge gaps persist in exposure, bio–nano interactions, and potential risks. • A one health approach is critical to achieve environmental and human health. • Environmental exposure, multi-responses, and mitigation strategies are integrated.

Critical issues arising from litigating HIV/AIDS discrimination in Nigeria

The evolution of HIV/AIDS policy and legal frameworks in Nigeria has happened in distinct phases. The first period between 1986 when the first AIDS cases were reported and 1996 was uneventful and generally characterized by a distinct lack of appreciation of the spread and impact of the disease. During the following decade, notable achievements included the institutionalization of multisectoral responses at all levels of government and the introduction of national and sub-national policies and programmes. Comparable breakthroughs have been slow to occur in the legal environment despite evidence of widespread HIV/AIDS discrimination. This article analyses the legal mechanisms for addressing HIV/AIDS discrimination in Nigeria and argues that even with the emergence of HIV/AIDS-specific anti-discrimination legislation, the protection for persons living with or affected by HIV/AIDS is far from being secured.

Managing the Mental Health of Persons with Disabilities amid the COVID-19 Pandemic in the Philippines: Specific Factors and Key Actions

This paper discusses the specific factors and key actions in managing the mental health of persons with disabilities (PWDs) amid Coronavirus Disease 2019 (COVID-19) pandemic in the Philippines. It is a short report that discusses the continuous record of knowledge related to the management of the mental health of PWDs amid the COVID-19 crisis specifically in the Philippines. The specific factors such as inadequate information, negative social perceptions, and inaccessible medical services are found to exacerbate the situation. The key actions such as policy review, stakeholder participation, continued support, and inclusive research are cogently identified. This paper provides a contribution in understanding more about the mental health of PWDs amid the COVID-19 crisis in a developing country. With the PWDs in mind, it is suggested to reconsider current guidelines, involve stakeholders in multisectoral responses, sustain financial subsidy, and conduct inclusive research and census.

‘Endure and excuse’: a mixed-methods study to understand disclosure of intimate partner violence among women living with HIV in Uganda

Intimate partner violence and HIV remain significant health challenges among women living with HIV. Intimate partner violence has been linked to negative health outcomes and poorer HIV care engagement. This study examined intimate partner violence among Ugandan women living with HIV, their experiences disclosing such violence and how culturally normative factors affected disclosure-related outcomes. In a mixed-methods study conducted in Uganda in 2018, 168 women participated in interviewer-administered surveys; a sub-set who reported experiencing intimate partner violence participated in in-depth interviews (IDIs). Intimate partner violence was prevalent among women in the sample (68.0%); almost half experienced emotional violence (45.2%), while a smaller proportion had experienced physical (32.1%) and/or sexual violence (19.6%). Most women living with HIV (61.8%) had disclosed their experience of intimate partner violence to someone. Women who experienced intimate partner violence had higher odds of disclosure if they feared their partner and perpetrated violence against their partner. Thematic analysis of IDIs revealed enduring violence and blaming alcohol for men’s perpetration of violence. Traditional cultural and gender norms, especially concerning motherhood and partnership, influenced women's experiences of intimate partner violence and disclosure. Multi-sectoral responses to challenge and reform cultural norms that perpetuate violence are needed, including mobilising key stakeholders (e.g. family, community, policy-makers) to serve as catalysts for change and encourage resource- and safety-seeking for women living with HIV to escape violence.

Multi-sectoral response to child maltreatment in Switzerland for different age groups: Varying rates of reported incidents and gaps in identification

BackgroundAs many countries lack (multi-sectoral) data on the epidemiology of agency responses to child maltreatment, they do not know if children in different regions of the country have equal chances to receive help and protection. The Optimus Study, the first nationally representative Swiss study on multi-sectoral responses to child maltreatment, examines gaps in identifying children in need and reveals opportunities for improved support and protection. MethodsA stratified sample of 351 agencies (participation rate 81 %) in the social and health sector, public child protection, and the penal sector provided data on new cases between September 1 and November 30, 2016. The resulting study data on 7651 cases included information on the maltreatment incident, specifics of the report/referral, and child characteristics. The weighting procedure to produce national estimates was based on inverse sampling probabilities and inverse response rates. ResultsIn the 3-month period, an estimated 10,335 cases were referred/reported to agencies in multiple sectors of the child protection system in Switzerland. This corresponded to 66 cases per 10,000 children. Rates were highest for adolescents (aged 13+), with 69 cases per 10,000 children. Lower rates for school-aged children coincided with a relatively low percentage of reports/referrals from the schools (8 %). Regional variance was extensive, with rates more than quadrupling from a low of 26 cases to a high of 107 cases per 10,000 children. Types of child maltreatment handled by agencies in the different sectors varied. Gender distribution was lopsided for sexual abuse, with many more girls experiencing incidents of sexual abuse, and unequal for incidents of neglect and psychological maltreatment. ConclusionsThere are gaps in the identification of maltreated preschoolers. Promoting health checkups for this age group is a potential solution. However, school-aged children up to age 11 are underreported as well, as the schools contribute only marginally to child maltreatment reporting. The findings of the study are being used to initiate the implementation of continuous and multi-sectoral child maltreatment surveillance in Switzerland.

Coronavirus outbreak in Nigeria: Burden and socio-medical response during the first 100 days

BackgroundThe coronavirus disease of 2019 (COVID-19) pandemic shocked the world, overwhelming the health systems of even high-income countries. Predictably, the situation has elicited social and medical responses from the public and governments, respectively. Nigeria recorded an imported case from Italy on February 27, 2020. Hence, this paper assesses the early socio-medical response to COVID-19 in Nigeria in the first 100 days after the index case. The paper employs analytical methods and collates data from various media reports and official sources. FindingsThe incidence of COVID-19 grew steadily in Nigeria, moving from an imported case and elitist pattern to community transmission. The case fatality stood at 2.8%. The country recorded an upsurge (52% of total cases) in the transmission of COVID-19 during the short period the lockdown was relaxed. This paper presents a concise response framework to highlight some specific multisectoral responses to the pandemic. A combination of social and medical responses to a large extent helped Nigeria curtail the spread of the virus. ConclusionThe potential of overwhelming COVID-19 is still imminent in Nigeria as the country is attempting to hurriedly open the economy, which could sacrifice public health gains for temporary economic gains.

Deconstructing Characterizations of Rape, Marriage, and Custom in South Africa: Revisiting The Multi-Sectoral Campaign Against Ukuthwala

AbstractA critique of multi-sectoral responses to the customary practice ofukuthwala(the isiXhosa term for abduction for purposes of marriage) in South Africa highlights attention to gendered tropes pertaining to marriage, custom, and sexual assault. Karimakwenda deconstructs how, in its inflexible framing of customary practice, the multi-sectoral campaign against violent forms of ukuthwala lacks historicization and silences women’s narratives. By obscuring historical and locally-embedded linkages between marriage practices and rape, the myopic campaign energizes collective anxieties around representations of violence within Black communities, and fuels misconceptions surrounding marital rape. This critique contributes to debates about gender, violence, and state power by offering a counter-narrative to simplified characterizations of sexual violence and custom.