{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:19:20Z","timestamp":1789183160497,"version":"build-2803163510"},"reference-count":29,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,12,13]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Existing evidence, mainly from high-income countries, shows children who witness intimate partner violence (IPV) at home are more likely to experience other forms of violence, but very little evidence is available from lower income countries. In this paper we aim to explore whether Ugandan children who witness IPV at home are also more likely to experience other forms of maltreatment, factors associated with witnessing and experiencing violence, and whether any increased risk comes from parents, or others outside the home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A representative cross-sectional survey of primary schools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>3427 non-boarding primary school students, aged about 11\u201314\u2005years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Luwero District, Uganda, 2012.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Exposure to child maltreatment was measured using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional, and 2 questions measured witnessing IPV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>26% of children reported witnessing IPV, but nearly all of these children had also experienced violence themselves. Only 0.6% of boys and 1.6% of girls had witnessed partner violence and not experienced violence. Increased risk of violence was from parents and also from other perpetrators besides parents. Both girls and boys who witnessed and experienced violence had between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12 (95% CI 5.15 to 12.80) times the odds of using physical or sexual violence themselves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this sample, witnessing IPV almost never occurred in isolation\u2014almost all children who witnessed partner violence also experienced violence themselves. Our results imply that children in Uganda who are exposed to multiple forms of violence may benefit from intervention to mitigate mental health consequences and reduce use of violence. IPV prevention interventions should be considered to reduce child maltreatment. Large numbers of children also experience maltreatment in homes with no partner violence, highlighting the need for interventions to prevent child maltreatment more broadly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NCT01678846, results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013583","type":"journal-article","created":{"date-parts":[[2017,2,28]],"date-time":"2017-02-28T20:40:34Z","timestamp":1488314434000},"page":"e013583","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8935-2181","authenticated-orcid":false,"given":"Karen M","family":"Devries","sequence":"first","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Knight","sequence":"additional","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer C","family":"Child","sequence":"additional","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nambusi","family":"Kyegombe","sequence":"additional","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazeda","family":"Hossain","sequence":"additional","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Lees","sequence":"additional","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Watts","sequence":"additional","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipak","family":"Naker","sequence":"additional","affiliation":[{"name":"Raising Voices, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,2,28]]},"reference":[{"key":"2025121407310647000_7.2.e013583.1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1240937"},{"key":"2025121407310647000_7.2.e013583.2","unstructured":"WHO. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO, 2013."},{"key":"2025121407310647000_7.2.e013583.3","doi-asserted-by":"crossref","unstructured":"Garcia-Moreno CJ , Ellsberg H , Heise M , et al . WHO multi-country study on womens health and domestic violence against women. Geneva: WHO, 2005.","DOI":"10.1126\/science.1121400"},{"key":"2025121407310647000_7.2.e013583.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-8624.2009.01279.x"},{"key":"2025121407310647000_7.2.e013583.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.dr.2005.12.001"},{"key":"2025121407310647000_7.2.e013583.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-3737.2000.00640.x"},{"key":"2025121407310647000_7.2.e013583.7","first-page":"419","article-title":"Children's exposure to intimate partner violence: impacts and interventions","volume":"18","author":"Wathen","year":"2013","journal-title":"Paediatric Child Health"},{"key":"2025121407310647000_7.2.e013583.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61706-7"},{"key":"2025121407310647000_7.2.e013583.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2010.03.001"},{"key":"2025121407310647000_7.2.e013583.10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.24.3089"},{"key":"2025121407310647000_7.2.e013583.11","doi-asserted-by":"crossref","unstructured":"Krug E, ed. World report on violence and health. Geneva: WHO, 2002.","DOI":"10.1016\/S0140-6736(02)11133-0"},{"key":"2025121407310647000_7.2.e013583.12","doi-asserted-by":"publisher","DOI":"10.1002\/jts.21724"},{"key":"2025121407310647000_7.2.e013583.13","doi-asserted-by":"publisher","DOI":"10.1037\/a0018787"},{"key":"2025121407310647000_7.2.e013583.14","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0467"},{"key":"2025121407310647000_7.2.e013583.15","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-14-232"},{"key":"2025121407310647000_7.2.e013583.16","doi-asserted-by":"crossref","first-page":"E378","DOI":"10.1016\/S2214-109X(15)00060-1","article-title":"The Good School Toolkit for reducing physical violence from school staff to primary school students: a cluster-randomised controlled trial in Uganda","volume":"3","author":"Devries","year":"2015","journal-title":"Lancet Glob Health"},{"key":"2025121407310647000_7.2.e013583.17","unstructured":"International Society for the Prevention of Child Abuse and Neglect. ICAST-C: The ISPCAN Child Abuse Screening Tool- Child Version. Manual and Proposed Guidelines for Pilot Administration: International Society for the Prevention of Child Abuse and Neglect, 2006."},{"key":"2025121407310647000_7.2.e013583.18","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.177.6.534"},{"key":"2025121407310647000_7.2.e013583.19","unstructured":"Department of Health. Strengths and difficulties questionnaire. London, UK: Department of Health, no date."},{"key":"2025121407310647000_7.2.e013583.20","first-page":"3","article-title":"svy1: Some basic concepts for design-based analysis of complex survey data","volume":"31","author":"Eltinge","year":"1996","journal-title":"Stata Tech Bull"},{"key":"2025121407310647000_7.2.e013583.21","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2007"},{"key":"2025121407310647000_7.2.e013583.22","unstructured":"UNICEF Tanzania, Centers for Disease Control and Prevention, Muhimbili University of Health and Allied Sciences. Violence against Children in Tanzania: Findings from a National Survey, 2009. Summary Report on the Prevalence of Sexual, Physical and Emotional Violence, Context of Sexual Violence, and Health and Behavioural Consequences of Violence Experienced in Childhood. Dar es Salaam, Tanzania: UNICEF Tanzania, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Muhimbili University of Health and Allied Sciences, 2011."},{"key":"2025121407310647000_7.2.e013583.23","unstructured":"United Nations Children's Fund Kenya Country Office, Division of Violence Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Kenya National Bureau of Statistics. Violence Against Children in Kenya. Findings from a 2010 National Survey. Nairobi, Kenya: United Nations Children's Fund Kenya Country Office, Division of Violence Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Kenya National Bureau of Statistics, 2012."},{"key":"2025121407310647000_7.2.e013583.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2013.12.008"},{"key":"2025121407310647000_7.2.e013583.25","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617709990464"},{"key":"2025121407310647000_7.2.e013583.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2012.12.006"},{"key":"2025121407310647000_7.2.e013583.27","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1521\/pdps.2012.40.3.397","article-title":"The effects of intimate partner violence on women and child survivors: an attachment perspective","volume":"40","author":"Levendosky","year":"2012","journal-title":"Psychodyn Psychiatry"},{"key":"2025121407310647000_7.2.e013583.28","doi-asserted-by":"publisher","DOI":"10.1037\/a0035207"},{"key":"2025121407310647000_7.2.e013583.29","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1001\/2013.jamapediatrics.324","article-title":"Resolution of intimate partner violence and child behavior problems after investigation for suspected child maltreatment","volume":"167","author":"Campbell","year":"2013","journal-title":"JAMA Pediatr"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-013583","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:31:16Z","timestamp":1765726276000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-013583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,2,28]]},"published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1136\/bmjopen-2016-013583"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-013583","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2]]}}}