Chapter 13 authors: Andrew Dawes and Amelia van der Merwe

The Nature of Structural Violence

Structural violence can be defined as any constraint, restriction, or limitation on human potential due to economic and political structures of power. This also includes unequal access to resources, political or economic power, education or healthcare, legal standing, and inequitable quality in these services. Unequal social conditions can be normalized under the social psychological “just-world hypothesis,” when individuals with resources who internalize principles of fairness and equity, rationalize inequities that those without resources simply get what they deserve.

Impact of Structural Violence on the Young Child

Structural violence skews exposure to developmental risk and opportunity, resulting in inequitable access to resources that can ameliorate risk and support positive development. Children living in poverty have very limited access to potable water and sanitation, food security, quality health care, education which prevents the achievement of their full developmental potential.

The South African Case

South Africa has a long history of structural violence and oppression of people of color in all African countries colonized by the Europeans, with the exception of Angola. This structural violence resulted in land redistribution to whites, vastly unequal state funding allocated to segregated health, education, and welfare services, as well as detention without trial and torture of those in resisting apartheid.

South Africa, Post 1994: A Rights-oriented Policy Regime

Following the 1994 South African case, pro-poor policies began developing, dedicating most of the funding to social protection, education, and health. It was also determined that schooling and health services would be free to children under the age of six who attended state services, and also to women who were pregnant. Despite any gains or benefits that have arisen since the 1994 policies, South Africa remains to be one of the most unequal countries in the world. In a 2011 consensus, it was observed that 54% of children were found to be living in households spending less than 2 USD per day. In addition, there were other problems that became apparent such as very minimal integration or coordination of services to ensure that the multidimensional needs of young children are met.

Addressing the Consequences of Structural Inequalities for Young Children

The Essential Package of services for support of a strong early start to life is designed by Ilifa Labantwana. It includes interventions to improve systems of delivery of health, social, and early learning services. There is a randomized trial that is conducted, testing the effectiveness of parenting interventions on the reduction of harsh punishments and maltreatment. The trial is delivered by paraprofessionals to promote maternal well-being and health, prevent malnutrition, and promote sensitive care. Such interventions are used to test effects of providing essential package of services in target communities. This method is not directly peacebuilding, but evidence suggests that provision of a sound foundation for development will increase the number of future citizens with capabilities for constructive social engagement and productive lives, and will also reduce the number of individuals who are unable to participate successfully in society and who may be drawn into conduct contrary to peace.

The Essential Package of Early Childhood Services and Support

Key components of the Essential Package include nutritional support, primary level maternal and child health services, social services, stimulation for early learning, as well as support for primary caregivers. In order to gain buy in of government and other stakeholders and to increase chances of implementation, the package should be aligned to services already provided in government policy and programs.

Nutritional Support

Poor nutrition negatively impacts the learning capacity and physical development of a child, and has serious consequences for adult productivity and economic development. The impact of poor nutrition is the most severed if experienced during the prenatal period and first 2 years of life. Essential services to reduce risk of low birth weight, postnatal malnutrition, and compromised neurological development include breastfeeding and nutrition education for pregnant mothers, micronutrient support for pregnant women, children under 2 years who fail to thrive get vitamin A and iron, and children of the ages 1-5 given deworming medication every 6 months.

Primary Level Maternal and Child Health Services

Maternal mental health services are often neglected, even though it is key risk factor for poor child development outcomes. Screening children for developmental delay and disabilities is essential, even if there is no accessible referral system.

Social Services

Children should be registered within 30 days of birth. Eligible children can receive the unconditional Child Support Grant cash transfer, only if it takes place before their first birthday. Children under the age of six are to be provided with a child protection service that is responsive, processes reports efficiently, and ensures prevention of secondary traumatization. It is also important enforce that children who are in the child protection system, are to be provided with basic psychosocial support.

Support for Primary Caregivers

Nurturing and supportive parenting during the first years of life has a strong impact on the social, emotional, and intellectual development of a child. Often times, caregiver capabilities are compromised in poverty and other stressful environments, meaning support for vulnerable caregivers to assist and provide them with nurturant care is essential for the caregiver, as it reduces the risk of neglect and undernutrition in the child.

Parenting education antenatally and thereafter on should include information on smoking, alcohol, drug use, child neglect, dietary requirements of infants as well as basic information on the provision of affectional care and nonviolent discipline, neonatal development, nutrition, health, injury prevention stimulation of literacy, motor dev and cognition, social service access. Caregivers who have been identified at high risk for mental health problems are provided with basic psychosocial support and caregivers who for other reasons are unable to provide care for children, are given access to childcare services that are monitored and subsidized.

Stimulation for Early Learning

Access to early learning stimulation enhances the ability of children from impoverished backgrounds to benefit from schooling. Preschools may not be accessible for all, so other forms of early learning is required. State subsidies ensure greater participation and access to food provided as part of daily program. The Essential Package recommends poor children have access to one of following: free home visiting interventions in which stimulation for early learning provided, preferably through inputs to both caregiver and child (children under three), free or subsidized center-based program or a free weekly quality playgroup, with activities oriented toward readiness to learn in school (ages three to five), or roy and book libraries that provide learning resources for children 0 to 5 in poor communities.

Conclusion

One of the most important levers in this endeavor is the UNCRC, as it commits nations to act in best interests of their children, and they can be held accountable when they do not do so.