{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:52:25Z","timestamp":1789422745336,"version":"build-2803163510"},"reference-count":53,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Social Science & Medicine"],"published-print":{"date-parts":[[2012,5]]},"DOI":"10.1016\/j.socscimed.2012.01.030","type":"journal-article","created":{"date-parts":[[2012,3,9]],"date-time":"2012-03-09T12:01:30Z","timestamp":1331294490000},"page":"1504-1511","source":"Crossref","is-referenced-by-count":19,"title":["Interrelatedness of child health, protection and well-being: An application of the SAFE model in Rwanda"],"prefix":"10.1016","volume":"74","author":[{"given":"Theresa S.","family":"Betancourt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy P.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Kellner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Gebre-Medhin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Hann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Kayiteshonga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.socscimed.2012.01.030_bib1","doi-asserted-by":"crossref","DOI":"10.1111\/j.1467-7717.2008.01087.x","article-title":"Using the \u2018protective environment\u2019 framework to analyse children's protection needs in Darfur","author":"Ager","year":"2009","journal-title":"Disasters"},{"key":"10.1016\/j.socscimed.2012.01.030_bib2","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1002\/car.696","article-title":"Building community: a conceptual framework for child protection","volume":"10","author":"Barter","year":"2001","journal-title":"Child Abuse Review"},{"key":"10.1016\/j.socscimed.2012.01.030_bib3","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jadohealth.2010.09.021","article-title":"Sierra Leone's child soldiers: war exposures and mental health problems by gender","volume":"49","author":"Betancourt","year":"2011","journal-title":"Journal of Adolescent Health"},{"key":"10.1016\/j.socscimed.2012.01.030_bib4","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1080\/13548501003623997","article-title":"Children affected by HIV\/AIDS: SAFE, a model for promoting their security, health, and development","volume":"15","author":"Betancourt","year":"2010","journal-title":"Psychology, Health & Medicine"},{"key":"10.1016\/j.socscimed.2012.01.030_bib5","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1080\/09540260802090363","article-title":"The mental health of children affected by armed conflict: protective processes and pathways to resilience","volume":"20","author":"Betancourt","year":"2008","journal-title":"International Review of Psychiatry"},{"key":"10.1016\/j.socscimed.2012.01.030_bib6","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.socscimed.2011.06.053","article-title":"Nothing can defeat combined hands (Abashize hamwe ntakibananira): protective processes and resilience in Rwandan children and families affected by HIV\/AIDS","volume":"73","author":"Betancourt","year":"2011","journal-title":"Social Science & Medicine"},{"key":"10.1016\/j.socscimed.2012.01.030_bib7","first-page":"89","article-title":"Developing human rights-based strategies to improve health among female sex workers in Rwanda","volume":"12","author":"Binagwaho","year":"2010","journal-title":"Health and Human Rights"},{"key":"10.1016\/j.socscimed.2012.01.030_bib8","series-title":"The ecology of human development: Experiments by nature and design","author":"Bronfenbrenner","year":"1979"},{"key":"10.1016\/j.socscimed.2012.01.030_bib9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1023\/A:1007759112499","article-title":"Trauma exposure and psychological reactions to genocide among Rwandan children","volume":"13","author":"Dyregrov","year":"2000","journal-title":"Journal of Traumatic Stress"},{"key":"10.1016\/j.socscimed.2012.01.030_bib10","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1146\/annurev.publhealth.22.1.143","article-title":"The social-ecology of child health and wellbeing","volume":"22","author":"Earls","year":"2001","journal-title":"Annual Review of Public Health"},{"key":"10.1016\/j.socscimed.2012.01.030_bib11","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1038\/sj.jp.7211887","article-title":"Improving perinatal health: a novel approach to improve community and adult health","volume":"28","author":"Gaylord","year":"2008","journal-title":"Journal of Perinatology"},{"key":"10.1016\/j.socscimed.2012.01.030_bib12","series-title":"Letting girls learn: Promising approaches in primary and secondary education","author":"Herz","year":"1995"},{"key":"10.1016\/j.socscimed.2012.01.030_bib13","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/00020180220140091","article-title":"The materiality of everyday sex: thinking beyond \u2018prostitution\u2019","volume":"61","author":"Hunter","year":"2002","journal-title":"African Studies"},{"key":"10.1016\/j.socscimed.2012.01.030_bib14","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2307\/3583175","article-title":"Young people's relationships with sugar daddies and sugar mummies: what do we know and what do we need to know?","volume":"8","author":"Kuate-Defo","year":"2004","journal-title":"African Journal of Reproductive Health\/La Revue Africaine de la Sant\u00e9 Reproductive"},{"key":"10.1016\/j.socscimed.2012.01.030_bib15","first-page":"135","article-title":"Social work practice to support survival strategies in Sub-Saharan Africa","author":"Laird","year":"2006","journal-title":"British Journal of Social Work"},{"key":"10.1016\/j.socscimed.2012.01.030_bib16","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1353\/hrq.2005.0007","article-title":"The protective environment: development support for child protection","volume":"27","author":"Landgren","year":"2005","journal-title":"Human Rights Quarterly"},{"key":"10.1016\/j.socscimed.2012.01.030_bib17","series-title":"Human security: A framework for assessment in conflict and transition. CERTI: Crisis and transition tool kit","author":"Leaning","year":"2000"},{"key":"10.1016\/j.socscimed.2012.01.030_bib18","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1097\/01.aids.0000341774.86500.53","article-title":"Age-disparate and intergenerational sex in southern Africa: the dynamics of hypervulnerability","volume":"22","author":"Leclerc-Madlala","year":"2008","journal-title":"AIDS"},{"key":"10.1016\/j.socscimed.2012.01.030_bib19","series-title":"Positive indicators of child well-being: A conceptual framework, measures, and methodological issues","author":"Lippman","year":"2009"},{"key":"10.1016\/j.socscimed.2012.01.030_bib20","series-title":"Resilience and vulnerability: Adaptation in the context of childhood adversities","author":"Luthar","year":"2004"},{"key":"10.1016\/j.socscimed.2012.01.030_bib21","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1017\/S095457949800159X","article-title":"An ecological-transactional analysis of children and contexts: the longitudinal interplay among child maltreatment, community violence, and children's symptomatology","volume":"10","author":"Lynch","year":"1998","journal-title":"Development & Psychopathology"},{"key":"10.1016\/j.socscimed.2012.01.030_bib22","series-title":"Qualitative data analysis: An expanded sourcebook","author":"Miles","year":"1994"},{"key":"10.1016\/j.socscimed.2012.01.030_bib23","series-title":"From social assistance to social development: Targeted education subsidies in developing countries","author":"Morley","year":"2003"},{"key":"10.1016\/j.socscimed.2012.01.030_bib24","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1093\/ije\/dyn375","article-title":"Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide","volume":"38","author":"Neugebauer","year":"2009","journal-title":"International Journal of Epidemiology"},{"key":"10.1016\/j.socscimed.2012.01.030_bib25","first-page":"52","article-title":"The crisis of urbanisation in Sub-Saharan Africa","volume":"149","author":"Ogbu","year":"1995","journal-title":"Courier"},{"key":"10.1016\/j.socscimed.2012.01.030_bib26","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/j.1365-2206.2009.00663.x","article-title":"Active survival in the lives of unaccompanied minors: coping strategies, resilience, and the relevance of religion","volume":"15","author":"Raghallaigh","year":"2010","journal-title":"Child & Family Social Work"},{"key":"10.1016\/j.socscimed.2012.01.030_bib27","unstructured":"Republic of Rwanda. (2000). Rwanda vision 2020. In: Ministry of Finance and Economic Planning (Ed.). Kigali."},{"key":"10.1016\/j.socscimed.2012.01.030_bib28","unstructured":"Republic of Rwanda. (2003). National policy on orphans and vulnerable children. In: Ministry of Local Government, Information and Social Affairs (Ed.)."},{"key":"10.1016\/j.socscimed.2012.01.030_bib29","unstructured":"Republic of Rwanda. (2005a). National policy for family promotion. In: Minister in the Prime Minister's Office in Charge of Gender and Family Promotion (Ed.). Kigali."},{"key":"10.1016\/j.socscimed.2012.01.030_bib30","unstructured":"Republic of Rwanda. (2005b). Strategic plan for street children. In: Minister in the Prime Minister's Office in Charge of Family and Gender Promotion (Ed.). Kigali."},{"key":"10.1016\/j.socscimed.2012.01.030_bib31","unstructured":"Republic of Rwanda. (2007a). Economic development and poverty reduction strategy 2008\u20132012. In: Ministry of Finance and Economic Planning (Ed.). Kigali."},{"key":"10.1016\/j.socscimed.2012.01.030_bib32","series-title":"National five-year plan of action on child labour","author":"Republic of Rwanda","year":"2007"},{"key":"10.1016\/j.socscimed.2012.01.030_bib33","unstructured":"Republic of Rwanda. (2008). Education sector strategic plan 2008\u20132012. In: Ministry of Education (Ed.). Kigali."},{"key":"10.1016\/j.socscimed.2012.01.030_bib34","series-title":"Final report: The impact of PROGRESA on school enrollment","author":"Schultz","year":"2000"},{"key":"10.1016\/j.socscimed.2012.01.030_bib35","series-title":"Trauma and bereavement, symptomatology, aetiology and interventions: A case of young survivors of the 1994 genocide in Rwanda","author":"Sezibera","year":"2008"},{"key":"10.1016\/j.socscimed.2012.01.030_bib36","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1037\/0033-2909.129.2.216","article-title":"Searching for the structure of coping: a review and critique of category systems for classifying ways of coping","volume":"129","author":"Skinner","year":"2003","journal-title":"Psychological Bulletin"},{"key":"10.1016\/j.socscimed.2012.01.030_bib37","series-title":"Motivation and personality: Handbook of thematic content analysis","author":"Smith","year":"1992"},{"key":"10.1016\/j.socscimed.2012.01.030_bib38","series-title":"Urbanization, war, and Africa's youth at risk: Towards understanding and addressing future challenges","author":"Sommers","year":"2003"},{"key":"10.1016\/j.socscimed.2012.01.030_bib39","series-title":"Policy paper produced for the Canadian Department of Foreign Affairs and International Trade, the human security network, 3rd ministerial meeting, Petra, Jordan, 11\u201312 May","article-title":"Children facing insecurity: new strategies for survival in a global era","author":"Stichick","year":"2001"},{"key":"10.1016\/j.socscimed.2012.01.030_bib40","series-title":"Basics of qualitative research","author":"Strauss","year":"1998"},{"key":"10.1016\/j.socscimed.2012.01.030_bib41","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.socscimed.2007.12.001","article-title":"Barriers to the community support of orphans and vulnerable youth in Rwanda","volume":"66","author":"Thurman","year":"2008","journal-title":"Social Science & Medicine"},{"key":"10.1016\/j.socscimed.2012.01.030_bib42","series-title":"Rwanda 2008 country progress report","author":"UNGASS","year":"2008"},{"key":"10.1016\/j.socscimed.2012.01.030_bib43","series-title":"Girl's education: Regional perspectives","author":"UNICEF","year":"2001"},{"key":"10.1016\/j.socscimed.2012.01.030_bib44","series-title":"Africa's orphaned and vulnerable generations: Children affected by AIDS","author":"UNICEF","year":"2006"},{"key":"10.1016\/j.socscimed.2012.01.030_bib45","unstructured":"UNICEF. (2008). UNICEF child protection strategy. In United Nations Children's Fund Executive Board (Ed.), (p. 21)."},{"key":"10.1016\/j.socscimed.2012.01.030_bib46","series-title":"United Nations convention on the rights of the child","author":"United Nations","year":"1989"},{"key":"10.1016\/j.socscimed.2012.01.030_bib47","series-title":"Human development report 2011","author":"United Nations Development Programme","year":"2011"},{"key":"10.1016\/j.socscimed.2012.01.030_bib48","article-title":"Toward universal primary education: investments, incentives, and institutions","author":"United Nations Millenium Project","year":"2005","journal-title":"Task Force on Education and Gender Equality"},{"key":"10.1016\/j.socscimed.2012.01.030_bib49","series-title":"Youth in Rwanda and Burundi: Contrasting visions","author":"United States Institute of Peace","year":"2011"},{"key":"10.1016\/j.socscimed.2012.01.030_bib50","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/S0145-2134(03)00005-X","article-title":"Street children and political violence: a socio-demographic analysis of street children in Rwanda","volume":"27","author":"Veale","year":"2003","journal-title":"Child Abuse & Neglect"},{"key":"10.1016\/j.socscimed.2012.01.030_bib51","doi-asserted-by":"crossref","unstructured":"Williams, T., Binagwaho, A., & Betancourt, T. S. Transactional sex as a form of child sexual exploitation and abuse in Rwanda: implications for child security and protection. Child Abuse & Neglect, in press.","DOI":"10.1016\/j.chiabu.2011.11.006"},{"key":"10.1016\/j.socscimed.2012.01.030_bib52","series-title":"Adapting a systems approach to child protection: Key concepts and considerations","author":"Wulczyn","year":"2010"},{"key":"10.1016\/j.socscimed.2012.01.030_bib53","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1016\/j.socscimed.2010.01.017","article-title":"Don't let the suffering make you fade away: an ethnographic study of resilience among survivors of genocide-rape in southern Rwanda","volume":"70","author":"Zraly","year":"2010","journal-title":"Social Science & Medicine"}],"container-title":["Social Science & Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953612001505?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953612001505?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2018,11,25]],"date-time":"2018-11-25T06:21:26Z","timestamp":1543126886000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0277953612001505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5]]},"references-count":53,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2012,5]]}},"alternative-id":["S0277953612001505"],"URL":"https:\/\/doi.org\/10.1016\/j.socscimed.2012.01.030","relation":{},"ISSN":["0277-9536"],"issn-type":[{"value":"0277-9536","type":"print"}],"subject":[],"published":{"date-parts":[[2012,5]]}}}