Reducing family and school-based violence at scale in Tanzania: Results from a large-scale pre-post study of the Furaha Teens parenting programme

Background: Despite the rapid dissemination of parenting programmes aiming to reduce violence against children (VAC), there is limited evidence of their effectiveness when implemented at scale in the Global South. The Furaha Adolescent Implementation Research study aimed to address this gap by evaluated the scale-up of Parenting for Lifelong Health for Teens (locally known as Furaha Teens), delivered within the context of a community-wide intervention focused on reducing HIV infection amongst adolescent girls in Tanzania. Methods: Participating families were recruited by local implementing partners in collaboration with Pact Tanzania from 2020-2021. The group-based 14-session programme was delivered to adolescent girls and their parents/caregivers in community or school settings. Quantitative surveys were administered by providers. The primary outcome was child maltreatment with multiple secondary outcomes linked to increased risk of VAC. Multilevel models were used to examine pre-post effects as well as variation by attendance and baseline variables. Results: Pre-post data from 27,319 parent/caregiver-child dyads were analysed, of which 34.4% of parents/caregivers were male. Analyses showed large reductions in child maltreatment (parents/caregivers: IRR=0.55, [0.54,0.56]; adolescents: IRR=0.57, [0.56,0.58]). Female parents/caregivers also reported reduced intimate partner violence experience, and adolescents reported reduced school-based violence. Parents/caregivers and adolescents also reported increased communication about sexual health and reduced poor supervision, financial insecurity, parenting stress, parent and child depression, and child conduct problems. Parents/caregivers and adolescents also reported reduced parental positive involvement and support of education, with those experiencing greater adversity reporting less change than those with less adversity. Conclusions: This study is the first to examine the large-scale implementation of an evidence-based parenting programme in the Global South. Although additional research is necessary to examine potential negative effects on positive parenting and parent support of education, findings suggest that Furaha Teens can sustain its impact on key outcomes associated with VAC when delivered at scale.