Browsing by Author "Skeen, Sarah"

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    Caregiver experiences of public services following child trauma exposure: a qualitative study
    (BioMed Central, 2018-04-10) Williamson, Victoria; Halligan, Sarah L; Coetzee, Bronwyne; Butler, Ian; Tomlinson, Mark; Skeen, Sarah; Stewart, Jackie
    Background: Many children in low and middle income countries (LMIC) are exposed to trauma. Contact with public services are a potential infuence on parent–child reactions and coping post-trauma. Little is known about how caregivers perceive these interactions. Methods: The aim of this study was to explore caregivers’ experiences of accessing and interacting with public services post-trauma and perceptions of needed improvements to public services in a LMIC context. Qualitative interviews were conducted with 20 female caregivers from a high-risk settlement in South Africa after child trauma exposure. Results: Three themes and seven sub-themes were identifed regarding caregivers’ perceptions of interactions with public services post-trauma. The key themes identifed related to (1) communication and exchanges with law enforcement, (2) consequences of an under-resourced justice system and (3) importance of communication and empathy in the healthcare system. Interactions with police were often positive. However, caregivers explained that police-family communication post-trauma could be improved and may help to lessen caregiver anxiety and concerns for the child’s safety post-trauma. Caregivers perceived the judicial system to be under-resourced as contact with the judicial system was often protracted and caused child anxiety and distress. Medical treatment was reportedly rushed, with extensive waiting times and little information provided to caregivers regarding the child’s injuries or treatment. Some medical staf were perceived as unsympathetic during the child’s treatment which was found to exacerbate caregiver and child distress post-trauma. Conclusions: This study provides insight into caregiver experiences of accessing public services following child trauma exposure in a high-risk LMIC context. Public services were perceived as oversubscribed and under-resourced and negative interactions often infuenced caregiver responses and appraisals of child safety. Given the impact of poor interactions with public services on families post-trauma, additional research is needed to investigate feasible improvements to public services in LMIC.
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    Open Access
    Early intervention: a foundation for lifelong violence prevention.
    (2015) Skeen, Sarah; Tomlinson, Mark; Ward, Catherine L; Cluver, Lucie; Lachman, Jamie M
    High levels of violence affect every family in South Africa. Exposure to violence starts early, in both the home and community. There are high levels of physical abuse of children,1 and the national under-five homicide rate is more than double that of other low- and middle-income countries.2 Rates of violence are particularly high in poorer communities in the country, and many children already made vulnerable by poverty are also at risk from increased exposure to violence
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    How effective is help on the doorstep? A longitudinal evaluation of community-based organisation support
    (Public Library of Science, 2016) Sherr, Lorraine; Yakubovich, Alexa R; Skeen, Sarah; Cluver, Lucie D; Hensels, Imca S; Macedo, Ana; Tomlinson, Mark
    Community-based responses have a lengthy history. The ravages of HIV on family functioning has included a widespread community response. Although much funding has been invested in front line community-based organisations (CBO), there was no equal investment in evaluations. This study was set up to compare children aged 9-13 years old, randomly sampled from two South African provinces, who had not received CBO support over time (YC) with a group of similarly aged children who were CBO attenders (CCC). YC baseline refusal rate was 2.5% and retention rate was 97%. CCC baseline refusal rate was 0.7% and retention rate was 86.5%. 1848 children were included--446 CBO attenders compared to 1402 9-13 year olds drawn from a random sample of high-HIV prevalence areas. Data were gathered at baseline and 12-15 months follow-up. Standardised measures recorded demographics, violence and abuse, mental health, social and educational factors. Multivariate regression analyses revealed that children attending CBOs had lower odds of experiencing weekly domestic conflict between adults in their home (OR 0.17; 95% CI 0.09, 0.32), domestic violence (OR 0.22; 95% CI 0.08, 0.62), or abuse (OR 0.11; 95% CI 0.05, 0.25) at follow-up compared to participants without CBO contact. CBO attenders had lower odds of suicidal ideation (OR 0.41; 95% CI 0.18, 0.91), fewer depressive symptoms (B = -0.40; 95% CI -0.62, -0.17), less perceived stigma (B = -0.37; 95% CI -0.57, -0.18), fewer peer problems (B = -1.08; 95% CI -1.29, -0.86) and fewer conduct problems (B = -0.77; 95% CI -0.95, -0.60) at follow-up. In addition, CBO contact was associated with more prosocial behaviours at follow-up (B = 1.40; 95% CI 1.13, 1.67). No associations were observed between CBO contact and parental praise or post-traumatic symptoms. These results suggest that CBO exposure is associated with behavioural and mental health benefits for children over time. More severe psychopathology was not affected by attendance and may need more specialised input.