Ashleigh Howard is a global health epidemiologist with expertise in violence and HIV. She began her work with the Centers for Disease Control and Prevention (CDC) Zimbabwe country office in 2011 focusing on issues of violence and gender.
Throughout her career, Ashleigh has worked closely with the Violence Against Children and Youth Surveys (VACS). These are nationally representative household surveys of males and females designed to measure the prevalence, past 12-month incidence, and circumstances surrounding sexual, physical, and emotional violence in childhood, adolescence, and young adulthood.
Here Ashleigh shares her top 10 things you should know about the Violence Against Children and Youth Surveys.
A unique aspect of the survey’s methodology is that when a country elects to do a VACS, households from across the country are surveyed and anyone aged 13-24 has a chance of being selected to participate. This process means the survey is nationally representative of the experiences related to violence facing children and young people within the country.
The most recent VACS funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) in Sub-Saharan Africa, including Botswana, Zimbabwe, Côte d’Ivoire, Lesotho, Kenya, Namibia, and Mozambique now include updated questions related to violence, sexual risks, and HIV testing. These will greatly improve understanding of the links between experiencing violence and HIV.
VACS interviewers are trained to support and refer individuals who disclose recent violence or exploitation, are in danger, and ask for help with violence-related issues to appropriate services.
Data collection teams work with a response plan coordinator to link participants who are seeking services to a social worker who can then connect them to ongoing services within their communities. In past surveys, services provided have included medical care for injuries, HIV testing and counseling, psychosocial counseling, and reunification of exploited youth with their families.
The most critical safeguard for VACS interviewers is protecting the confidentiality of study participants. Because perpetrators may retaliate against individuals who disclose violence, VACS takes measures to ensure no one else in the community is aware that the survey is about violence or can overhear participants’ responses to the survey. Additionally, VACS does not collect personally identifiable information and only presents group data.
Data collection staff are often surprised at the willingness and strength of study participants to share extremely difficult experiences they have faced. Interviewers have been encouraged by study participants who have expressed relief in disclosing sensitive experiences in hopes that their story will help to improve the situation for children in their country.
It can also be an empowering experience for interviewers to offer response services to participants, many of whom never knew assistance was available.
To encourage widespread use of VACS data, survey datasets are made available by the Centers for Disease Control and Prevention (CDC) (generally one year after the survey is complete), with permission of the respective country governments.
These datasets provide an excellent opportunity for universities and independent researchers to conduct ongoing analyses of the rich, detailed data and help increase our understanding of and ability to prevent and respond to the pandemic of violence against children.
Each country’s approach to addressing violence is different. A helpful tool that guides countries and programs toward evidence-based interventions and action plans is the INSPIRE framework, which provides seven strategies with the greatest potential to reduce violence against children.
For example, in Uganda, VACS data indicated high levels of harmful gender norms leading to violence between young children. Using the INSPIRE framework, country-level partners decided to focus on implementing community-level programs for youth throughout the country, specifically targeting areas with the highest levels of sexual violence against girls. Partner organizations also engaged with boys’ sports teams through Futures Without Violence mentoring program, “Coaching Boys into Men,” to teach boys to challenge harmful gender attitudes, reduce violence perpetration and intervene when they see violence happening.
Subsequent VACS can both update current estimates as well as provide information for a country’s understanding of the epidemic of violence over time. To date, two VACS countries, Kenya and Zimbabwe, have conducted follow up surveys which explore estimates of violence in areas with high HIV prevalence.
The VACS country report is only the beginning of addressing the greater problem of violence against children.
The country of Nigeria is one of many governments which has continued to use VACS data to move forward in addressing the issue of violence against children over time. Following dissemination of its country report in 2014, the Nigerian government launched a Year of Action to End Violence Against Children, including state-level priorities. This was followed by a Roadmap to End Violence Against Children and Pathfinding status with the Global Partnership to End Violence Against Children. Nigeria has continued to demonstrate its commitment to responding to and using the VACS findings, including most recently in the publication of a 2019 report on The economic burden of violence against children.
The VACS is a powerful tool to help countries take evidence-based actions that help prevent and respond to violence against children.