Are We Doing Enough to Prevent and Respond to Workplace Violence Against Adolescents?

Since the groundbreaking UN Convention on the Rights of the Child, substantial progress has been made in protecting children from all forms of violence and harm (including from harmful working environments and violence against children). Yet, in 2020, about 160 million children were in child labor, made up of 63 million girls and 97 million boys, representing 1 in 10 worldwide. Since 2016, the number of children in hazardous work has risen sharply to about 79 million.¹ In the poorest parts of the world, increasing macro- and micro-inequalities have escalated the population of children in labor over the past decade.

The well-being of children continues to be hampered by the failure of most governments in Africa in protecting them against the throes and vicissitudes of working life. In societies where there are adequate safeguards for children, the precursors for children entering work, particularly hazardous work, are considerably minimal. When children are compelled to work because of household economic circumstances, regulations are better enforced. Unfortunately, many millions of children around the world work in profoundly precarious circumstances and conditions. Although we admit that child work is not a recent phenomenon, globalizing and urbanizing norms have escalated inequalities, pushing millions of children into work.² Despite the many hazards that child workers are exposed to, however, the experiences may not be entirely negative for all.³

In most developing countries and sub-Saharan Africa, adolescents in work face several vulnerabilities: They work under extreme hazardous conditions in large plantations, fishing, and domestic settings, among others, with paltry wages and earnings. In much of Africa, rural–urban migration without corresponding sustainable employment opportunities, many accompanied and unaccompanied children are in work, often as street hawkers, head porters, and domestic workers.^4,5 In these settings, child work remains a strong economic need.⁶ In addition, there are many intersecting structural factors, such as the COVID-19 and HIV/AIDS pandemics, discrimination, and gender inequality that also may increase both the likelihood of adolescents working and the propensity for the risk of violence against children and young people.⁷

EFFECTS ON ADOLESCENTS

This article reviews and adds to the Knight et al. study published in this issue of AJPH (p. 1651), which measured workplace violence as “self-reports of violent acts perpetrated by an employer or adult in a work-related position of authority, or by peers at the workplace” among a cohort of adolescents recruited at primary schools participating in the endline survey of a trial. This and other studies have found that the increasing numbers of children in hazardous work have enormous threats to their well-being and safety. This is complicated by the vast and many sectors and spaces where adolescents work, which can frustrate interventions aimed at tackling the problem. Although the spaces and settings where adolescents experience violence are varied and many (e.g., domestic and school settings), workplace violence against children not only impacts survivors’ mental health (e.g., depression, anxiety, posttraumatic stress disorder, loss of self-esteem) and physical health (e.g., substance and alcohol abuse, self-harm) but also has strong potential of affecting their perspectives on work in adult life, which in turn can create internalized acceptance of workplace violence.

NATURE, MANIFESTATION, AND MAGNITUDE

Workplace violence often occurs in four main forms: criminal intent, customer client, worker on worker, and personal (domestic violence) relationship. The prevalence of any of these types is dependent on the nature of the industry.⁸ For instance, customer–client workplace violence is dominant in health care settings and more in North America and Asia than in other parts of the world.⁹ Customer–client violence is well documented among female sex workers¹⁰ and in worker-on-worker workplace violence.¹¹ Currently, we know very little about the prevalence of workplace violence against adolescents. To our knowledge and in concurrence with other authors (Knight, et al., p. 1651), workplace violence (measured as physical attacks, verbal threats, and sexual harassment) against adolescents is exceptionally scant, except for a few studies.^12,13 Although a rich body of evidence exists on violence against children and adolescents, such as in domestic and school settings, it is only now that studies such as that of Knight et al. are emerging on the magnitude and drivers of violence in the workplace.¹¹ In that light, we commend the authors for this important and bold attempt at bringing this to policy and programmatic attention. Studies such as this one are crucial because we need a clear and better understanding of the risks and harm spots. For many years, the scholarship on child labor has focused extensively on human capital trade-offs without commensurate discussion of other equally important outcomes or impacts, such as violence, which Knight et al. (p. 1651) tackle regarding two of the four forms of workplace violence: worker-on-worker and personal relationship violence.

CONVENTIONS AND LAWS ARE NOT ENOUGH

Having laws and policies for tackling violence against adolescents is commendable, but their mere existence has proved inadequate in preventing and responding to all forms of violence against children. The INSPIRE framework¹⁴ (implementation and enforcement of laws, norms and values, safe environments, parent and caregiver support, income and economic strengthening, response and support services, and education and life skills) affirms that implementation and enforcement of laws do work. Bold and sustained efforts at penalizing individuals and institutions that expose and subject children to workplace violence, regardless of the setting, is an important step toward protecting children from violence. In Uganda and most other African countries, there are many laws and statutes promulgated to protect children and adolescents, but a weak state of enforcement of these instruments has contributed to creating a culture of impunity—the bane of effectively addressing some of the most pressing and persisting social challenges in the region.

POLITICAL COMMITMENT IS NEEDED

In Shiffman’s¹⁵ seminal framework for assessing political commitment, our attention is drawn to the importance of (1) national political leaders publicly and privately expressing sustained concern an issue, (2) using authoritative decision-making processes to enact policies that offer widely embraced strategies to address a problem, and (3) government allocating and releasing public budgets proportionate to the problem. As affirmed earlier, what are demonstrably missing are domains (1) and (3) as far as the current architecture or landscape for preventing violence (in all forms) against adolescents in the workplace is concerned.

IS THERE A SUSTAINABLE LONG-TERM SOLUTION?

Our simplest answer is yes. Although the interventions proposed by Knight et al. (p. 1651) are unquestionably important in the context of public health, we contend that more could be done. Tackling workplace violence against adolescents lies in targeting the main triggers of adolescents getting into work (especially hazardous work) in the first place. Previous research unequivocally demonstrates that adolescent work is overwhelmingly propelled by poor household economic circumstances in addition to gender and ethnicity, among others.¹⁶ Consequently, it is crucial to target social interventions for households in which the risk of adolescent work is high. We are not oblivious to the fact that eradicating adolescent work completely sounds utopian. Our position is that in increasingly emerging capitalist systems with poor labor regulation systems, placing the responsibility on employers of preventing and responding to workplace violence against adolescents may yield very little impact. For instance, among adolescents who work in domestic settings, the perpetrators of workplace violence are mostly their employers.¹⁷ It thus seems certain that employers are not best placed, and indeed are conflicted, in solving problems they cause. After all, adolescent work in these settings is more of survival, and, without addressing survival needs, little to nothing may be achieved. Long-term resolutions must address child and adolescent poverty and, in the short to medium term, complementary interventions (e.g., safe environments, changing adherence to harmful and gender norms, response, and support services) to prevent and respond to violence against adolescents already in work.