Sarah Skeen
Biographic Data
| ID | 1739274 |
|---|---|
| NAME | Sarah Skeen |
| GIVEN NAMES | Sarah |
| FAMILY NAME | Skeen |
| SIGNATURE | SKEEN S |
| AFFILIATIONS | Stellenbosch University |
| ORCID | 0000-0002-7464-2861 |
| VERIFIED | Yes |
| TOTAL WORKS | 40 |
| TOTAL CITATIONS | 14 |
| AUTHOR COUNT | 40 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2014 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
Systematic Review and Meta-analysis of Prevalence of Mental Disorders and Suicidality Among Children and Adolescents Living with HIV in South Africa
Despite progress in HIV prevention and treatment, global data suggests that youth living with HIV remain at risk of mental disorders and suicidality. However, reliable epidemiological data from South Africa (SA) are limited. We conducted a systematic review and meta-analysis to synthesize evidence on the prevalence of mental disorders and suicidality among SA children and adolescents (≤ 19 years) living with HIV. Following PRISMA guidelines, we s…
Experiences of Children with Intentional Injury in a Low-Resource Setting in South Africa
Longitudinal associations between violence exposure and adolescent conduct problems in a high‐adversity, South African setting
BACKGROUND: Violence exposure is a well-established risk factor for adolescent conduct problems, yet longitudinal research in high-adversity, low- and middle-income countries (LMICs) remains limited. This study investigated whether early adolescent violence exposure predicts concurrent and longer-term conduct problems, and explored potential bidirectional associations and sex differences in a peri-urban South African community with high rates of …
Health Action in ScHools for a Thriving Adolescent Generation (HASHTAG)
Schools play a crucial role in supporting adolescent mental health, especially in low- and middle-income countries (LMICs), where young people face structural and societal challenges. This study explores the feasibility and acceptability of the Health Action in Schools for a Thriving Adolescent Generation (HASHTAG), a multilevel intervention for at-risk adolescents aged 13–14 in South Africa. HASHTAG includes two components: thriving environment …
Measurement of children’s language environments using automated measurement technology in rural Lesotho
The quality of the home language environment and communicative interactions between caregivers and children are crucial components of child language development. We used the Language ENvironment Analysis (LENA) technology to assess children's language environments (adult word count, conversational turns, and child vocalizations) among a sample of children and their caregivers in rural Lesotho. We assessed whether a parenting intervention led to i…
Long‐term associations between early attachment and parenting and adolescent susceptibility to post‐traumatic distress in a South African high‐risk sample
BACKGROUND: It has been proposed that children and young people living in low- and middle-income countries (LMICs) are not only exposed more frequently to trauma but also have a higher likelihood of encountering traumas of greater severity than those living in high-income countries (HICs). This may lead to higher rates of post-traumatic stress symptoms (PTSS). However, developmental pathways to risk or resilience after trauma exposure in LMICs ar…
Development of a school-based programme for mental health promotion and prevention among adolescents in Nepal and South Africa
Introduction: Adolescence is a critical time for mental health promotion and prevention and establishing healthy behaviours. Implementing universal, school-based psychosocial interventions can improve short- and long-term health trajectories for adolescents. While these interventions may offer important opportunities for fostering skills and relationships, few school-based interventions have been developed for and tested in low- and middle-income…
How do new crises impact HIV risk behaviour – exploring HIV risk behaviour according to Covid-19-related orphanhood status in South Africa
The COVID-19 pandemic resulted in high death rates globally, and over 10.5 million children lost a parent or primary caregiver. Because HIV-related orphanhood has been associated with elevated HIV risk, we sought to examine HIV risk in children affected by COVID-19 orphanhood. Four hundred and twenty-one children and adolescents were interviewed, measuring seven HIV risk behaviours: condom use, age-disparate sex, transactional sex, multiple partn…
Shared experiences, shared support
Adolescence is a critical developmental period marked by significant changes, increasing the risk of mental health problems such as anxiety and depression. Understanding how youth engage with mental health resources is essential. This study explored the role of interpersonal relationships-including peer-to-peer, adult-youth, parent, teacher and mentor relationships, and interactions with mental health professionals-in shaping youth mental health …
A systematic review of economic evaluations conducted on gender-transformative interventions aimed at preventing unintended pregnancy and promoting sexual health in adolescents
Does pre-Covid impulsive behaviour predict adherence to hygiene and social distancing measures in youths following the Covid-19 pandemic onset? Evidence from a South African longitudinal study
Our data indicate that impulsivity may predict adolescent engagement in hygiene behaviours post COVID-19 pandemic onset in a high risk, sub-Saharan African setting, albeit with a small effect size. For future pandemics, it is important to understand predictors of engagement, particularly in the context of adversity, where adherence may be challenging. Limitations include a small sample size and potential measure shortcomings
Effect of caregiver depression on adolescent internalising and externalising behaviour
Adolescents living in low- and-middle incomeand middle-income countries are at a particular risk of poor mental health. Caregiver mental health plays a crucial role in a child’s emotional and behavioural development and may directly impact a child’s risk for future development of mental health problems. Data collected as part of a two-decade longitudinal multiphase research project were used. Participants, originally women in their third trimeste…
Parenting in Adversity
Caregiving by older adults is a common phenomenon, enhanced in the era of HIV infection. This longitudinal study was set up to examine the effect of caregiver age, relationship and mental wellbeing on child (4–13 years) outcomes (psychosocial and cognitive) in a sample of 808 caregiver- child dyads in South Africa and Malawi. Respondents were drawn from consecutive attenders at Community Based Organisations (CBOs) and interviewed with standardise…
First 1,000 days
BACKGROUND: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depressi…
A mixed-methods feasibility study of Nyamekela4Care
In South Africa, health and care service providers (SPs) face many interconnected challenges at work, including inadequate training and supervision and high levels of burnout. Nyamekela4Care (N4C) was developed as an integrated intervention for SP teams, to support their ability to provide high-quality care through providing a structure for operating regular team meetings that includes training, empathic skills development, administration, case s…
Depression, anxiety, and psychological distress among caregivers of young children in rural Lesotho
Good mental health is a critical resource for mothers and caregivers of young children , given the central role of mental health in enabling responsive caregiving. However, fulfilling caregiving responsibilities under challenging circumstances such as extreme poverty, food insecurity, and gender inequality intensifies vulnerability to poor mental health. Previous research focuses on mental health of mothers, while in many LMICs children are cared…
Community health workers' experiences of supervision in maternal and child health programmes in low‐ and middle‐income countries
Maternal and child health programmes often use Community Health Workers (CHWs) to help address poor access to health care, particularly in low- and middle-income countries (LMIC). Supervision has long been recognised as a critical ingredient of successful CHW programmes, yet it is often reported as either of poor quality or absent. There is little research on CHWs' own perception of supervision and to the best of our knowledge, there are no revie…
Supporting parents of adolescents
Throughout the rapid and intense changes that adolescents experience, their parents retain important influence over how they interact with the complex factors that shape their development. How parents care for their adolescent children has a deep and lasting impact on their well-being and development. Yet, parents often require support to meet their own and their adolescent children’s needs, which can be achieved through parenting support program…
Book-Sharing for Parenting and Child Development in South Africa
This study evaluated the impact of a parenting intervention on children’s cognitive and socioemotional development in a group of caregivers and their 21-to-28-month-old children in a low-income South African township. A randomized controlled trial compared an experimental group (n = 70) receiving training in dialogic book-sharing (8 weekly group sessions) with a wait-list control group (n = 70). They were assessed before the intervention, immedia…
Adaptation of a gender-transformative sexual and reproductive health intervention for adolescent boys in South Africa and Lesotho using intervention mapping
The IM approach allows for a systematic appraisal of whether components and processes of an existing intervention are appropriate for a new target population before costly evaluation studies are conducted. The findings will be of interest to those wishing to rigourously develop and evaluate gender-transformative interventions engaging men to improve health for all
Associations between caregiver mental health and young children’s behaviour in a rural Kenyan sample
Anxiety and stress were associated with poorer child behavioural outcomes. Our sample reflected a higher prevalence of caregiving adults with mental health symptomology than previous estimates from Kenya, with few high-symptom caregivers seeking support. We discuss further implications for programming and health services delivery
Family disability, poverty and parenting stress
Our findings highlight the importance of developing a comprehensive understanding of the stressors facing households with a disabled member, particularly if that member is a child, so that supportive interventions can adequately cater to the needs of caregivers, and their children, in the context of poverty
Instructive roles and supportive relationships
These findings highlight the important roles that CHWs can assume in providing both instructive and supportive care to clients; as deepening relationships may be key for encouraging behavior change, these findings pinpoint the need to bolster training and support for CHWs in similar programs. They also emphasize the importance of integrating more channels for client feedback into existing programs, to ensure that clients' voices are heard and acc…
Accelerators for achieving the sustainable development goals in Sub-Saharan-African children and young adolescents – A longitudinal study
From fathers to peers
Associations between parental trauma, mental health, and parenting
Balancing roles and blurring boundaries
As demand for health services grows, task-shifting to lay health workers has become an attractive solution to address shortages in human resources. Community health workers (CHWs), particularly in low-resource settings, play critical roles in promoting equitable healthcare among underserved populations. However, CHWs often shoulder additional burdens as members of the same communities in which they work. We examined the experiences of a group of …
From fathers to peers
Alcohol use during pregnancy in rural Lesotho
How do pregnant women and new mothers navigate and respond to challenges in accessing health care? Perspectives from rural South Africa
Accelerators for achieving the sustainable development goals in Sub-Saharan-African children and young adolescents – A longitudinal study
Mental health of carers of children affected by HIV attending community-based programmes in South Africa and Malawi
There is strong evidence that both adults and children infected with and affected by HIV have high levels of mental health burden. Yet there have been few studies investigating carer mental health outcomes in the context of HIV in Malawi and South Africa. The objective of this study was to assess the mental health of carers of children affected by HIV as a part of the Child Community Care study, which aims to generate evidence on the effectivenes…
Child development in HIV-positive and HIV-affected children in South Africa and Malawi—What role for community organisations
Do not forget the boys – gender differences in children living in high HIV-affected communities in South Africa and Malawi in a longitudinal, community-based study
Gender is an important factor in child development. Especially in sub-Saharan Africa, girls have often been shown to be less likely to access education compared to boys. The consequence of this has been that that programmes addressing child development are often aimed at girls in order to redress gender imbalances. This study examines the effect of gender on the development of children attending community-based organisations in high HIV-affected …
Exposure to violence and psychological well-being over time in children affected by HIV/Aids in South Africa and Malawi
Many of the risk factors for violence against children are particularly prevalent in families and communities affected by HIV/AIDS. Yet, in sub-Saharan Africa, where HIV rates are high, efforts to prevent or address violence against children and its long-lasting effects are hampered by a lack of evidence. We assessed the relationship between violence exposure and mental health among HIV-affected children attending community-based organisations in…
Community-based organizations for vulnerable children in South Africa
Community-based organisations (CBOs) have the potential to provide high quality services for orphaned and vulnerable children in resource-limited settings. However, evidence is lacking as to whether CBOs are reaching those who are most vulnerable, whether attending these organisations is associated with greater psychosocial wellbeing, and how they might work. This study addressed these three questions using cross-sectional data from 1848 South Af…
Can cash break the cycle of educational risks for young children in high HIV–affected communities? A cross–sectional study in South Africa and Malawi
BACKGROUND: Household cash grants are associated with beneficial outcomes; enhanced if provided in combination with care. OBJECTIVES: This study describes the impact of cash grants and parenting quality on 854 children aged 5-15 (South African and Malawi) on educational outcomes including enrolment, regular attendance, correct class for age and school progress (controlling for cognitive performance). Consecutive attenders at randomly selected Com…
Paid staff or volunteers – does it make a difference? The impact of staffing on child outcomes for children attending community-based programmes in South Africa and Malawi
Our findings show that in order to most optimally impact on child outcome 30 community-based workers (CBWs) should ideally be paid with trained staff. Specialised input for more severe child difficulties is needed
Research Priorities for the Intersection of Alcohol and HIV/Aids in Low and Middle Income Countries
The harmful use of alcohol is a component cause for more than 200 diseases. The association between alcohol consumption, risk taking behavior and a range of infectious diseases such as HIV/AIDS is well established. The prevalence of HIV/AIDS as well as harmful alcohol use in low and middle income countries is high. Alcohol has been identified as a modifiable risk factor in the prevention and treatment of HIV/AIDS. The objective of this paper is t…
What will it really take to end the HIV epidemic
International audience
Associations between young children’s exposure to household violence and behavioural problems
Little is known about how young children in low- and middle-income countries (LMICs) experience violence in their homes, and how different types of household violence may affect child development. This study reports on levels of exposure to household violence and associations with child behavioural outcomes in preschool-aged children in western Kenya. A sample of 465 caregivers, whose children (n = 497) attended early learning centres supported b…
Balancing roles and blurring boundaries
As demand for health services grows, task-shifting to lay health workers has become an attractive solution to address shortages in human resources. Community health workers (CHWs), particularly in low-resource settings, play critical roles in promoting equitable healthcare among underserved populations. However, CHWs often shoulder additional burdens as members of the same communities in which they work. We examined the experiences of a group of …
Improving mother–infant interaction during infant feeding
How do pregnant women and new mothers navigate and respond to challenges in accessing health care? Perspectives from rural South Africa
Associations between parental trauma, mental health, and parenting
Book-Sharing for Parenting and Child Development in South Africa
This study evaluated the impact of a parenting intervention on children’s cognitive and socioemotional development in a group of caregivers and their 21-to-28-month-old children in a low-income South African township. A randomized controlled trial compared an experimental group (n = 70) receiving training in dialogic book-sharing (8 weekly group sessions) with a wait-list control group (n = 70). They were assessed before the intervention, immedia…
Adaptation of a gender-transformative sexual and reproductive health intervention for adolescent boys in South Africa and Lesotho using intervention mapping
The IM approach allows for a systematic appraisal of whether components and processes of an existing intervention are appropriate for a new target population before costly evaluation studies are conducted. The findings will be of interest to those wishing to rigourously develop and evaluate gender-transformative interventions engaging men to improve health for all
Associations between caregiver mental health and young children’s behaviour in a rural Kenyan sample
Anxiety and stress were associated with poorer child behavioural outcomes. Our sample reflected a higher prevalence of caregiving adults with mental health symptomology than previous estimates from Kenya, with few high-symptom caregivers seeking support. We discuss further implications for programming and health services delivery
Family disability, poverty and parenting stress
Our findings highlight the importance of developing a comprehensive understanding of the stressors facing households with a disabled member, particularly if that member is a child, so that supportive interventions can adequately cater to the needs of caregivers, and their children, in the context of poverty
Instructive roles and supportive relationships
These findings highlight the important roles that CHWs can assume in providing both instructive and supportive care to clients; as deepening relationships may be key for encouraging behavior change, these findings pinpoint the need to bolster training and support for CHWs in similar programs. They also emphasize the importance of integrating more channels for client feedback into existing programs, to ensure that clients' voices are heard and acc…
Accelerators for achieving the sustainable development goals in Sub-Saharan-African children and young adolescents – A longitudinal study
From fathers to peers
Alcohol use during pregnancy in rural Lesotho
First 1,000 days
BACKGROUND: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depressi…
A mixed-methods feasibility study of Nyamekela4Care
In South Africa, health and care service providers (SPs) face many interconnected challenges at work, including inadequate training and supervision and high levels of burnout. Nyamekela4Care (N4C) was developed as an integrated intervention for SP teams, to support their ability to provide high-quality care through providing a structure for operating regular team meetings that includes training, empathic skills development, administration, case s…
Depression, anxiety, and psychological distress among caregivers of young children in rural Lesotho
Good mental health is a critical resource for mothers and caregivers of young children , given the central role of mental health in enabling responsive caregiving. However, fulfilling caregiving responsibilities under challenging circumstances such as extreme poverty, food insecurity, and gender inequality intensifies vulnerability to poor mental health. Previous research focuses on mental health of mothers, while in many LMICs children are cared…
Medicine (30 works) · Psychology (25 works) · Psychiatry (20 works) · Developmental psychology (13 works) · Environmental health (13 works) · Mental health (12 works) · Clinical Psychology (11 works) · Nursing (11 works) · Psychological intervention (11 works) · Child and Adolescent Psychosocial and Emotional Development (10 works)