Improving lives by accelerating progress towards the UN Sustainable Development Goals for adolescents living with HIV: a prospective cohort study.

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Abstract

Low-income and middle-income countries (LMICs) face major challenges in achieving the UN's Sustainable Development Goals (SDGs) for vulnerable adolescents. We aimed to test the UN Development Programme's proposed approach of development accelerators-provisions that lead to progress across multiple SDGs-and synergies between accelerators on achieving SDG-aligned targets in a highly vulnerable group of adolescents in South Africa.

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Most cited references 18

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The Strengths and Difficulties Questionnaire: A Research Note

Robert Goodman (1997)

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Policy: Map the interactions between Sustainable Development Goals.

Måns Nilsson, Dave Griggs, Martin Visbeck (2016)

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The Good School Toolkit for reducing physical violence from school staff to primary school students: a cluster-randomised controlled trial in Uganda

Karen Devries, Louise Knight, Jennifer Child … (2015)

Summary Background Violence against children from school staff is widespread in various settings, but few interventions address this. We tested whether the Good School Toolkit—a complex behavioural intervention designed by Ugandan not-for-profit organisation Raising Voices—could reduce physical violence from school staff to Ugandan primary school children. Methods We randomly selected 42 primary schools (clusters) from 151 schools in Luwero District, Uganda, with more than 40 primary 5 students and no existing governance interventions. All schools agreed to be enrolled. All students in primary 5, 6, and 7 (approximate ages 11–14 years) and all staff members who spoke either English or Luganda and could provide informed consent were eligible for participation in cross-sectional baseline and endline surveys in June–July 2012 and 2014, respectively. We randomly assigned 21 schools to receive the Good School Toolkit and 21 to a waitlisted control group in September, 2012. The intervention was implemented from September, 2012, to April, 2014. Owing to the nature of the intervention, it was not possible to mask assignment. The primary outcome, assessed in 2014, was past week physical violence from school staff, measured by students' self-reports using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool—Child Institutional. Analyses were by intention to treat, and are adjusted for clustering within schools and for baseline school-level means of continuous outcomes. The trial is registered at clinicaltrials.gov, NCT01678846. Findings No schools left the study. At 18-month follow-up, 3820 (92·4%) of 4138 randomly sampled students participated in a cross-sectional survey. Prevalence of past week physical violence was lower in the intervention schools (595/1921, 31·0%) than in the control schools (924/1899, 48·7%; odds ratio 0·40, 95% CI 0·26–0·64, p<0·0001). No adverse events related to the intervention were detected, but 434 children were referred to child protective services because of what they disclosed in the follow-up survey. Interpretation The Good School Toolkit is an effective intervention to reduce violence against children from school staff in Ugandan primary schools. Funding MRC, DfID, Wellcome Trust, Hewlett Foundation.

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Author and article information

Journal

Journal ID (iso-abbrev): Lancet Child Adolesc Health

Title: The Lancet. Child & adolescent health

Publisher: Elsevier BV

ISSN (Electronic): 2352-4650

ISSN (Print): 2352-4642

Publication date (Electronic): Apr 2019

Volume: 3

Issue: 4

Affiliations

[1 ] Department of Social Policy and Intervention, University of Oxford, Oxford, UK; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Electronic address: lucie.cluver@spi.ox.ac.uk.

[2 ] Department of Social Policy and Intervention, University of Oxford, Oxford, UK; Medical Research Council Development Pathways to Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.

[3 ] Oxford Research South Africa, East London, South Africa.

[4 ] Department of Sociology, University of Cape Town, Cape Town, South Africa; AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, Cape Town, South Africa.

[5 ] HIV and Health Group, UN Development Programme, New York City, NY, USA.

[6 ] Department of Social Policy and Intervention, University of Oxford, Oxford, UK.

[7 ] Department of Global Health, University College London, London, UK.