title: Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi.
abstract: BACKGROUND
  Violence during childhood may affect short and long-term educational factors. There is scant literature on younger children from resource poor settings.
  
  
  METHODS
  This study assessed child violence experiences (harsh punishment and exposure to domestic or community violence) and school enrolment, progress and attendance in children attending community-based organisations in South Africa and Malawi (n=989) at baseline and at 15 months' follow-up, examining differential experience of HIV positive, HIV affected and HIV unaffected children.
  
  
  RESULTS
  Violence exposure was high: 45.4% experienced some form of psychological violence, 47.8% physical violence, 46.7% domestic violence and 41.8% community violence. Primary school enrolment was 96%. Violence was not associated with school enrolment at baseline but, controlling for baseline, children exposed to psychological violence for discipline were more than ten times less likely to be enrolled at follow-up (OR 0.09; 95% CI 0.01 to 0.57). Harsh discipline was associated with poor school progress. For children HIV positive a detrimental effect of harsh physical discipline was found on school performance (OR 0.10; 95% CI 0.02 to 0.61).
  
  
  CONCLUSIONS
  Violence experiences were associated with a number of educational outcomes, which may have long-term consequences. Community-based organisations may be well placed to address such violence, with a particular emphasis on the challenges faced by children who are HIV positive.
authors.affiliation: Department of Infection and Population Health, University College London, London, UK l.sherr@ucl.ac.uk.
authors.forename: L
authors.initials: L
authors.lastname: Sherr
authors.affiliation: Department of Infection and Population Health, University College London, London, UK.
authors.forename: I S
authors.initials: IS
authors.lastname: Hensels
authors.affiliation: Department of Psychology, Stellenbosch University, South Africa Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors.forename: S
authors.initials: S
authors.lastname: Skeen
authors.affiliation: Department of Psychology, Stellenbosch University, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Tomlinson
authors.affiliation: Department of Infection and Population Health, University College London, London, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Roberts
authors.affiliation: Department of Infection and Population Health, University College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Macedo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D000069581:Exposure to Violence / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008295:Malawi; D008297:Male; D013019:South Africa; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: Children and young people; Educational outcomes; Malawi; Maltreatment; South Africa; Violence