Child Disciplinary Practices in Relation to Household Head Education and Beliefs in Five Middle East and North African Countries: A Cross-Sectional Study- Further Analysis of Multiple Indicator Cluster Survey Data.

Abstract

Introduction: Internationally, eight out of ten children are exposed to violent discipline by their caregivers. To reduce the prevalence of violent discipline against children, we should understand the social and economic factors that affect the choice of disciplinary methods. Despite the high prevalence of violent discipline in the Middle East and North African (MENA) region, only a few studies explored disciplinary methods in this region. Aim: This study aims to determine the prevalence of positive and violent disciplinary practices in five selected MENA countries and assess their association with household head education and beliefs of physical punishment. Methods: This is a cross-sectional study design based on available secondary data from the Multiple Indicator Cluster Survey on its fourth round (MICS-4). A child was selected randomly from the household, and the Parent-Child Conflict Scale (CTSPC) tool was used to report disciplinary methods the child encountered during the last month period preceding the survey. Univariate and multivariable logistic regression were used to investigate the association between disciplinary practices with household head education and respondent's beliefs of physical punishment. The analysis was conducted using pooled data from all selected surveys and also for individual countries.

Result: The overall prevalence of positive discipline was only 15% (95% CI: 14.4-15.8), in the five countries, while the prevalence of violent discipline was 80% (95% CI: 79.0 -80.5). The prevalence of positive discipline was highest in Qatar (40%; 95% CI: 35.0-44.4) and lowest in Tunisia (5%; 95% CI: 4.3-5.9) while the prevalence of violent discipline was highest in Tunisia (93%; 95% CI: 92.1-94.1), and lowest in Qatar (50%; 95% CI: 44.7-55.0). Overall, the household head education was not significantly associated with either positive or violent discipline after adjusting for covariates. However, respondents believe of disciplinary methods were significantly associated with both positive and violent discipline (OR=5.88; 95% CI: 4.97-6.96) and (OR=6.27; 95% CI: 5.40-7.28), respectively. Conclusion: High rates of violent discipline in the MENA region might indicate an increase in mental, behavioral, and social problems and disorders in our future generation. Rapid action is needed to reduce the worsening of violent discipline, and it is consequences. There is a need for educational programs for caregivers to teach them alternative non-violent methods of discipline. Besides, these numbers should inform policymakers about the importance of the existence and the implementations of laws, policies, and regulations to protect children from all forms of violence to protect our future youths and ensure their health and wellbeing.