Evidence map›Paper›PMID 42086299›Full record

SynthesisBMJ global health2026

Are parenting programmes effective at scale? Associations with violence against adolescent girls, parenting and mental health in real-world delivery across eight African countries: a meta-analysis of pre-post surveys.

Lucie Cluver, Catherine L Ward, Francesca Little, Inge Vallance, Genevieve Haupt Ronnie, Yulia Shenderovich, Hlengiwe Gwebu, Kufre Joseph Okop, Frances Gardner, Lindokuhle L Ngcobo and 32 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Lucie Cluver *Department of Social Policy and Intervention, University of Oxford, Oxford, UK lucie.cluver@spi.ox.ac.uk.ORCID 0000-0002-0418-835X
Catherine L Ward *Centre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South Africa.
Francesca Little *Department of Statistical Sciences, University of Cape Town, Western Cape, South Africa.
Inge VallanceDepartment of Social Policy and Intervention, University of Oxford, Oxford, UK.
Genevieve Haupt RonnieCentre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South Africa.
Yulia ShenderovichWolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, Wales, UK.ORCID 0000-0002-0254-3397
Hlengiwe GwebuDepartment of Psychology, University of Cape Town, Western Cape, South Africa.
Kufre Joseph OkopDepartment of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Frances GardnerDepartment of Social Policy and Intervention, University of Oxford, Oxford, UK.
Lindokuhle L NgcoboClowns Without Borders South Africa, Pietermaritzburg, South Africa.
Mark TomlinsonInstitute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, Western Cape, South Africa.ORCID 0000-0001-5846-3444
Daniel OliverCatholic Relief Services USA, Baltimore, Maryland, USA.
Zuyi FangInstitute of Population Research, Peking University, Beijing, Beijing, China.
Natalie DavidsonCentre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South Africa.ORCID 0000-0002-7304-1896
Roselinde JanowskiDepartment of Social Policy and Intervention, University of Oxford, Oxford, UK.
Heiletjé Van ZylDepartment of Statistical Sciences, University of Cape Town, Western Cape, South Africa.
Anna BooijClowns Without Borders South Africa, Pietermaritzburg, South Africa.
Nyasha ManjengenjaClowns Without Borders South Africa, Pietermartzburg, South Africa.
Sibongile TsoanyaneClowns Without Borders South Africa, Pietermaritzburg, South Africa.
Muhubiri KabuyayaUniversity of Lubumbashi, Lubumbashi, Katanga, The Democratic Republic of the Congo.
Mukondi NethavhakoneCentre for Social Science Research, University of Cape Town, Rondebosch, Western Cape, South Africa.ORCID 0000-0003-4212-3773
Tendai MutembedzaDepartment of Psychology, University of Cape Town, Rondebosch, Western Cape, South Africa.
Alison KolerPact Tanzania, Dar es Salaam, United Republic of Tanzania.
Amon ExaveryPact Tanzania, Dar es Salaam, United Republic of Tanzania.
Anne Schleymothers2mothers, Mbombela, Western Cape, South Africa.
Charles BibuyaCatholic Relief Services, Kinshasa, The Democratic Republic of the Congo.
Daisy KisyombeStrategic Information, Pact Eswatini, Mbabane, Hhohho, Eswatini.
Esther NydetaburaPact Tanzania, Dar es Salaam, United Republic of Tanzania.
Farai CharasikaCatholic Relief Services Zimbabwe, Harare, Zimbabwe.
Gideon MaviseCatholic Relief Services Zimbabwe, Harare, Zimbabwe.
Henry MbuyiCatholic Relief Services, Kinshasa, The Democratic Republic of the Congo.
Jack NgangulaPact Zambia, Lusaka, Zambia.
Jeldau RieffStepping Stones International, Gaborone, Botswana.
Joyce WamoyiNational Institute for Medical Research Mwanza Research Centre, Mwanza, United Republic of Tanzania.
Lisa JamuStepping Stones International, Gaborone, Botswana.
Nomsa MonareStepping Stones International, Gaborone, Botswana.
Richard SavoCatholic Relief Services Zimbabwe, Harare, Zimbabwe.
Samuel BojoAgency for Research and Development Initiative, Juba, Central Equatoria, South Sudan.
Styn JamuStepping Stones International, Gaborone, Botswana.
Thomas KipingiliPact Zambia, Lusaka, Zambia.
Vengai MacGerald MujuruClowns Without Borders South Africa, Pietermaritzburg, South Africa.
Jamie LachmanDepartment of Social Policy and Intervention, University of Oxford, Oxford, UK.ORCID 0000-0001-9475-9218

Funding

Medical Research Council (MRC) UK MC_UU_12017/14
6 · The paper itself

Abstract

introductionEvidence-based parenting programmes are widely used to prevent violence against children and improve parenting and mental health. Despite hundreds of randomised trials, little is known about their outcomes when delivered at scale within routine delivery. This study assesses the WHO-endorsed and UNICEF-endorsed Parenting for Lifelong Health programme for caregivers and adolescents, delivered through non-governmental organisation and government in Botswana, the Democratic Republic of the Congo, Eswatini, South Africa, South Sudan, Tanzania, Zambia and Zimbabwe, with support from the President's Emergency Plan for AIDS Relief (PEPFAR), the United States Agency for International Development (USAID) and the European Union.

methodsPre-post surveys for caregivers and adolescents were integrated into service data collection between 2016 and 2022. Abbreviated standardised measures of physical abuse, emotional abuse, approval of corporal punishment, positive involved parenting, monitoring/supervision, caregiver depressive symptoms, parenting stress and adolescent depressive symptoms and externalising behaviour were used. Individual country scores were analysed separately for caregivers and adolescents using generalised linear mixed-effects models, and cross-country data were combined using a random-effects meta-analytic model.

results123 050 participants were included (93% retention, 57 908 adolescents (96% female), 56 423 caregivers at follow-up). In all-country meta-analyses, estimates showed reduced physical abuse (-65%; 95% CI 51% to 74%), emotional abuse (-59%; 95% CI 48% to 68%) and approval of corporal punishment (-55%; 95% CI 48% to 60%). Positive involved parenting increased (+52%; 95% CI 24% to 87%) and poor supervision/monitoring decreased (-48%; 95% CI 34% to 58%). Caregiver depressive symptoms (-25%; 95% CI 8% to 48%), parenting stress (-46%; 95% CI 41% to 52%), adolescent depressive symptoms (-22%; 95% CI 1% to 38%) and adolescent externalising behaviour problems (-43%; 95% CI 29% to 54%) all declined. There was heterogeneity in pre-intervention scores and extent of change between humanitarian and development settings, and between different target groups, but strong consistency across caregiver and adolescent reports.

conclusionIn eight African countries, including humanitarian and pandemic-affected contexts, an evidence-based parenting programme showed consistent associations with reduced violence against adolescent girls and improved parenting and mental health.

Indexed as

Mental HealthParentingViolenceAdolescentAfricaChildFemaleHumansMaleProgram EvaluationSurveys and Questionnairesafricachild healthglobal healthmental health & psychiatryviolence

Identifiers

PMID42086299
PMCPMC13141112

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.