International research to improve maternal and child health literacy: The Evidence for Better Lives Study

Manuel Eisner1, Sara Valdebenito1, Aja Louise Murray2, Claire Hughes3, Adriana Baban4, Asvini D. Fernando5, Bernadette Madrid6, Catherine L. Ward7, Joseph Osafo8, Michael Dunne9, Siham Sikander10, Susan Walker11, Vo Van Thang12, Mark Tomlinson13, Pasco Fearon14

1 Institute of Criminology, University of Cambridge, Cambridge, United Kingdom, Department of Psychology, University of Edinburgh, United Kingdom3 Department of Psychology, University of Cambridge, Cambridge, United Kingdom4 Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania5 Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka6 Child Protection Unit, University of the Philippines, Quezon City, Philippines7 Department of Psychology and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa8 Department of Psychology, University of Ghana, Accra, Ghana9 School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia10 Health Services Academy, Islamabad, Pakistan11 Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica12 Faculty of Public Health and Institute for Community Health Research, Hue college of Medicine and Pharmacy, Hue University, Vietnam13 Department of Psychology, Stellenbosch University, Stellenbosch, South Africa14 Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.


Background: Exposure to violence, abuse and neglect is among the most important risk factors for poor psycho-social and physical health of children over the life-course. The Sustainable Development Goals of the United Nations therefore ask member states to take effective measures to better address violence against children. Public health measures to prevent violence should target all age groups. However, it is particularly important to promote and implement measures that meet the needs of parents and their children from the very beginning. This includes exposure to violence during pregnancy, which is known to negatively affect child outcomes in the first years of life. However, there is a continued lack of practically relevant knowledge about the extent to which pregnant women and infants in low and middle income countries are exposed to violence, what the associated risk factors are, and how prevention strategies in the healthcare sector can support parents’ ability to provide a safe and caring environment for their child.

Methods: We will provide an overview of a new research and policy initiative called the Evidence for Better Lives Study (EBLS). EBLS is an initiative by an international consortium of researchers led by the University of Cambridge. It comprises eights study sites, namely Valenzuela (Philippines), Hue (Vietnam), Ragama (Sri Lanka), Tarlai (Pakistan), Cluj (Romania), Worcester (South Africa), Koforidua (Ghana) and Kingston (Jamaica). The present stage of the study includes standardised interviews with convenience samples of 150 women that were conducted during the third trimester of pregnancy in each study site. The interviews were completed following the same protocol and using the same questionnaire in all study sites. It comprises a broad range of practically relevant risk factors that are likely associated with exposure to violence. The collected data also include detailed information on exposure of the expectant mothers to violence at earlier stages of their lives, in the neighbourhood, and by their partners. When combined with an understanding of the current gaps of public health provision in each study sites this evidence can provide a strong basis for advancing health literacy related to violence and neglect in the early stages of children’s life.

Results: We will describe the EBLS study and the research that has been completed to date. We will show initial results on pregnant women’s exposure to different types of violence. We will focus in particular on one aspect of maternal health literacy, namely the belief among pregnant woman that physical punishment will help children to develop well. We will examine how widespread beliefs in support of corporal punishment are among expectant mothers and what factors predict such beliefs.

Conclusions: In the conclusions we will present an overview of how the Evidence for Better Lives research initiative can support policy makers and public health specialists in developing and implementing more effective strategies to address violence against children. In particular, we will discuss strategies may help to address beliefs, among pregnant women, about the beneficial effects of corporal punishment on child development.

Keywords: Maternal and child health, violence against children, prevention science, pregnancy, international.