Shada A Rouhani1, Jennifer Scott2, Ashley Greiner3, Katherine Albutt4, Michele R Hacker5, Philipp Kuwert6, Michael VanRooyen7, Susan Bartels8. 1. Harvard Humanitarian Initiative, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts; shada.rouhani@gmail.com. 2. Harvard Humanitarian Initiative, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of Women's Health and Departments of Obstetrics and Gynecology and. 3. Harvard Humanitarian Initiative, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; 4. Harvard Humanitarian Initiative, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; 5. Harvard Medical School, Boston, Massachusetts; Departments of Obstetrics and Gynecology and Harvard School of Public Health, Boston, Massachusetts; 6. Department of Psychiatry, HELIOS Hansehospital, University Medicine Greifswald, Stralsund, Germany; and. 7. Harvard Humanitarian Initiative, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard School of Public Health, Boston, Massachusetts; 8. Harvard Humanitarian Initiative, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Emergency Medicine, Queen's University, Ontario, Canada.
Abstract
BACKGROUND AND OBJECTIVES: Since armed conflict began in 1996, widespread sexual violence in eastern Democratic Republic of Congo has resulted in many sexual violence-related pregnancies (SVRPs). However, there are limited data on the relationships between mothers and their children from sexual violence. This study aimed to evaluate the nature and determinants of these maternal-child relationships. METHODS: Using respondent-driven sampling, 757 women raising children from SVRPs in South Kivu Province, Democratic Republic of Congo were interviewed. A parenting index was created from questions assessing the maternal-child relationship. The influences of social stigma, family and community acceptance, and maternal mental health on the parenting index were assessed in univariate and multivariable analyses. RESULTS: The majority of mothers reported positive attitudes toward their children from SVRPs. Prevalence of perceived family or community stigma toward the women or their children ranged from 31.8% to 42.9%, and prevalence of perceived family or community acceptance ranged from 45.2% to 73.5%. In multivariable analyses, stigma toward the child, as well as maternal anxiety and depression, were associated with lower parenting indexes, whereas acceptance of the mother or child and presence of a spouse were associated with higher parenting indexes (all P ≤ .01). CONCLUSIONS: In this study with a large sample size, stigma and mental health disorders negatively influenced parenting attitudes, whereas family and community acceptance were associated with adaptive parenting attitudes. Interventions to reduce stigmatization, augment acceptance, and improve maternal mental health may improve the long-term well-being of mothers and children from SVRPs.
BACKGROUND AND OBJECTIVES: Since armed conflict began in 1996, widespread sexual violence in eastern Democratic Republic of Congo has resulted in many sexual violence-related pregnancies (SVRPs). However, there are limited data on the relationships between mothers and their children from sexual violence. This study aimed to evaluate the nature and determinants of these maternal-child relationships. METHODS: Using respondent-driven sampling, 757 women raising children from SVRPs in South Kivu Province, Democratic Republic of Congo were interviewed. A parenting index was created from questions assessing the maternal-child relationship. The influences of social stigma, family and community acceptance, and maternal mental health on the parenting index were assessed in univariate and multivariable analyses. RESULTS: The majority of mothers reported positive attitudes toward their children from SVRPs. Prevalence of perceived family or community stigma toward the women or their children ranged from 31.8% to 42.9%, and prevalence of perceived family or community acceptance ranged from 45.2% to 73.5%. In multivariable analyses, stigma toward the child, as well as maternal anxiety and depression, were associated with lower parenting indexes, whereas acceptance of the mother or child and presence of a spouse were associated with higher parenting indexes (all P ≤ .01). CONCLUSIONS: In this study with a large sample size, stigma and mental health disorders negatively influenced parenting attitudes, whereas family and community acceptance were associated with adaptive parenting attitudes. Interventions to reduce stigmatization, augment acceptance, and improve maternal mental health may improve the long-term well-being of mothers and children from SVRPs.
Authors: Jocelyn Kelly; Justin Kabanga; Will Cragin; Lys Alcayna-Stevens; Sadia Haider; Michael J Vanrooyen Journal: Glob Public Health Date: 2011-06-09
Authors: Nicky McCreesh; Simon D W Frost; Janet Seeley; Joseph Katongole; Matilda N Tarsh; Richard Ndunguse; Fatima Jichi; Natasha L Lunel; Dermot Maher; Lisa G Johnston; Pam Sonnenberg; Andrew J Copas; Richard J Hayes; Richard G White Journal: Epidemiology Date: 2012-01 Impact factor: 4.822
Authors: Paul O'Callaghan; John McMullen; Ciarán Shannon; Harry Rafferty; Alastair Black Journal: J Am Acad Child Adolesc Psychiatry Date: 2013-03-06 Impact factor: 8.829
Authors: Judith K Bass; Jeannie Annan; Sarah McIvor Murray; Debra Kaysen; Shelly Griffiths; Talita Cetinoglu; Karin Wachter; Laura K Murray; Paul A Bolton Journal: N Engl J Med Date: 2013-06-06 Impact factor: 91.245
Authors: Jennifer Scott; Shada Rouhani; Ashley Greiner; Katherine Albutt; Philipp Kuwert; Michele R Hacker; Michael VanRooyen; Susan Bartels Journal: BMJ Open Date: 2015-04-08 Impact factor: 2.692
Authors: Shada A Rouhani; Jennifer Scott; Gillian Burkhardt; Monica A Onyango; Sadia Haider; Ashley Greiner; Katherine Albutt; Michael VanRooyen; Susan A Bartels Journal: Confl Health Date: 2016-04-06 Impact factor: 2.723
Authors: Jennifer Scott; Colleen Mullen; Shada Rouhani; Philipp Kuwert; Ashley Greiner; Katherine Albutt; Gillian Burkhardt; Monica Onyango; Michael VanRooyen; Susan Bartels Journal: Int J Ment Health Syst Date: 2017-10-18