title: School violence, mental health, and educational performance in Uganda.
abstract: BACKGROUND
  Violence against children from school staff is anecdotally common in low- and middle-income countries, but data on prevalence and associations with mental health and educational outcomes are lacking.
  
  
  METHODS
  We report data from a cross-sectional survey conducted in June and July 2012 in Luwero District, Uganda. Forty-two primary schools representing 80% of students in the district were randomly selected; 100% agreed to participate. The International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional; Strengths and Difficulties Questionnaire; and reading, spelling, and math tests were administered. We present descriptive statistics and logistic regression models, accounting for the complex sampling scheme used in the survey.
  
  
  RESULTS
  We surveyed 3706 students and 577 school staff members; 93.3% (SE 1.0%) of boys and 94.2% (SE 1.6%) of girls attending primary school reported lifetime experience of physical violence from a school staff member, and >50% reported experience in the past week. Past-week physical violence was associated with increased odds of poor mental health and, for girls, double the odds of poor educational performance (adjusted odds ratio = 1.78, 95% confidence interval = 1.19-2.66). For boys, significant interactions were present.
  
  
  CONCLUSIONS
  Despite a ban on corporal punishment in Ugandan schools since 1997, the use of violence against students is widespread and associated with poor mental health and educational performance. School violence may be an important but overlooked contributor to disease burden and poor educational performance in low- and middle-income settings.
authors.affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, United Kingdom. karen.devries@lshtm.ac.uk.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Devries
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Child
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Allen
authors.forename: Eddy
authors.initials: E
authors.lastname: Walakira
authors.forename: Jenny
authors.initials: J
authors.lastname: Parkes
authors.forename: Dipak
authors.initials: D
authors.lastname: Naker
mesh_terms: D000124:Achievement; D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004521:Educational Measurement; D005178:Faculty; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D011581:Psychological Tests; D011678:Punishment / Q000523:psychology; D012574:Schools; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology
keywords: Uganda; child maltreatment; corporal punishment; education; mental health; primary school; violence against children