Harnessing community participation in child abuse and neglect prevention programmes: a case study based on copessa, a community - based child abuse centre in Protea Glen, Soweto

Abstract

Introduction Child abuse and neglect (CAN) has reached epidemic proportions in South Africa (2014, Meinck et al., 2016, Petersen et al., 2005, Richter and Dawes, 2008, Jewkes et al., 2010a). This is despite many protective instruments such as the international treaties SA is a signatory to, and the laws it has promulgated as an obligation for signing such treaties (Government of South Africa, 1993, Government of South Africa, 1996a, Government of South Africa, 1996b, Government of South Africa, 1998, Government of South Africa, 2006, Republic of South Africa, 2013). Also, adverse childhood experiences are irreversible (O'Connor and Cailin, 2012). In light of this as well as the high prevalence of this social ill, there is consensus among experts in this field that the bulk of services should be focused on primary prevention (Daro and Dodge, 2009, MacLeod and Nelson, 2000, Richter and Dawes, 2008). Although most CAN preventive strategies have historically focused on improving parenting skills, there is evidence that broader community-based strategies are probably more effective and costbeneficial (Daro and Dodge, 2009, MacLeod and Nelson, 2000, Petersen et al., 2005). The aim of this study was to explore how to optimise community participation in CAN prevention programmes in Protea Glen, Soweto (PG) in 2017/18. This study drew on research that community participation can reduce CAN (World Health Organization, 2016) but the study purpose was not to examine the impact of community participation on CAN. Rather, the specific objectives were to: (1) describe how community members perceive CAN in PG; (2) describe the PG community’s own perspective on community participation in general; (3) describe community participation in COPESSA’s CAN prevention programmes; 4) describe factors that influence (enablers and barriers) community participation in CAN prevention programmes in PG; and 5) to explore how COPESSA can increase (recruit and maintain) community participation for CAN prevention programmes in PG, during the 2017/8 period. Methods A qualitative research study using a single case study approach which had descriptive, explanatory and exploratory components (Yin, 1994) was conducted at COPESSA, a child abuse and neglect centre in Protea Glen. The study was approved by the University of Witwatersrand Human Research Ethics Committee (HREC) and a clearance certificate number M170870 was issued on the 13th October 2017. The study population comprised PG community members who were older than 18 years of age and had resided in this community for at least the last three years. Participants were purposively sampled for maximum variation from three categories, namely: (a) community members that were currently participating in the COPESSA CAN prevention programmes; (b) those who had since left these programmes; and (c) those community members who had never participated in any of the programmes. This yielded a sample size of 32 participants, a majority (27) of which were females. Data were collected using focus group discussions and group discussions when there were not enough participants to constitute the former, between the 13th and 14th of November 2017. Data were electronically recorded, independently translated and transcribed and were coded using the MAXQDA software. Thematic content analysis was applied to analyse the qualitative data using a codebook, which was shared with the research supervisor for validity and intercoder reliability. Results With regards to the participants’ perspectives on CAN, there was a fair to good knowledge about the definitions of the various types of abuse. Participants tended to talk more about physical abuse and provision for physical needs than other types of abuse and provision for emotional needs. They also tended to conflate discipline and physical abuse. They identified a range of factors, which included societal, community, family and those pertaining to children, as responsible for the perceived CAN in the PG community. Chief among these were factors such as poverty and unemployment; government laws and policies that were biased towards children; drugs, alcohol and crime, and their own adverse lived experiences. There was a dominant negative narrative about children’s behaviour, with parents referring to them as unruly, conniving and even blaming them for their own abuse. The common thread about the identified factors was that they were external to participants and as a result they felt that they had little influence to change them for better. Levels of community participation (CP) varied between those who were involved in COPESSA CAN prevention programmes and those who were not actively involved. The latter group reported on generally lower levels of CP, limited to church going and community meeting attendance. Even involvement in these two activities was relatively superficial and just helping the participants to ‘get by.’ Various barriers, which again seemed out of the participants’ control, lack of money and community amenities, time constraints and lack of leadership were identified. In contrast, those who were involved in COPESSA CAN prevention programmes tended to report higher levels of CP and seemed to ‘get ahead’ as a consequence of their participation in these programmes. This group identified enablers such as financial and skills benefits, physical and emotional health benefits, and greater informal support networks. An unexpected finding was that knowledge, attitudes and practices were comparable between those involved in COPESSA CAN prevention programmes and those who were not. Discussion The mismatch between knowledge of and attitudes towards abuse and practices was not unique to our community (Mlekwa et al., 2016, Richter and Dawes, 2008). Corporal punishment at home, which seemed to be commonplace, was attributed, among other things, to cultural relativism that has been defined as an intersection of cultural norms, children’s rights and religious beliefs (Reading et al., 2009). The focus on meeting of physical needs in comparison to emotional needs could be explained by the fact that Africa in general is overwhelmed by complex and visible problems such as poverty, such that less apparent problems like emotional issues and mental health issues tend to be placed on the back-burner, a view that is supported by Thomas (2006). The relatively poor CP among those participants who were not involved with COPESSA CAN prevention programmes was attributable to the pervasive poverty, which is associated with poor quality and quantity of social capital (Block, 2008, Murayama et al., 2012, Thomas, 2006) and fatalism (Cidade et al., 2016) that are in turn associated with no collective efficacy to change existing circumstances for better (Campbell and Jovchelovitch, 2000, Daro and Dodge, 2009). Conclusion and recommendations Community participation, which is critical to preventing child abuse and neglect, can be harnessed by addressing determinants such as poverty that is interrelated to safety, security and crime, and which according to Maslow’s Hierarchy Model are all lower level needs. We have however, seen how social relations, which according to Maslow are at the third level, are able to propel poor communities forward. Further research is needed to establish the costefficiency and effectiveness of building of social capital as opposed to directly addressing structural determinants such as poverty, which by nature are hard to change, particularly in resource-strained countries such as South Africa. Also, future research should explore what forms of community participation can result in improved knowledge, attitudes and practices in CAN prevention.