Domestic violence: a long-lasting impact on child health and behaviour


During the summer of 2017, I worked as a volunteer in Albania. I worked with children in two different centers. In one of them, I worked with children in need. The center, for instance, offered activities for children from poor families facing economic and social challenges in their daily lives, for children living in the streets, and for children who don’t go to school.

During the weeks I worked with the children, I noticed that some of the children behaved aggressively. There were a lot of peer conflicts, and some of the children were stressed or they had temperament problems. In addition, some of the children had mental health issues. During the weeks, I started to ask the social workers who work with the children daily: why do these children behave so aggressively, what is the story behind their behaviour. In most of the cases, the answer was domestic violence (DV).

UNICEF has estimated that 275 million children worldwide are exposed to domestic violence every year1. Domestic violence is a problem in Albania with deep roots in the society. A study regarding domestic violence in Albania estimated that 57,7 % of the study population (i.e. children), have been physically battered by a family member, and were facing other forms of domestic violence 8. Due to the paucity of studies regarding the population-level estimates, it is difficult to estimate the actual number of children exposed to or experienced DV in Albania, and the majority of the estimates are regarding females experiencing DV.

Domestic violence is defined as physical, mental, or sexual abuse occurring between family members. Physical abuse includes hitting, kicking, whereas psychological abuse includes verbally insulting, threatening or intimidating. Sexual abuse may occur as coerced sex, for example. DV can also occur as deprivation or neglect, and it can occur inside or outside the home. Domestic violence is a social, medical, public health and mental health problem 2.

Continuous exposure to rage and conflict between family members affects children negatively, and children in the earliest years of life are particularly vulnerable 3. Exposure to domestic violence can impair brain development 4, and studies have shown that children who are exposed to domestic violence suffer from a range of psychosocial symptoms 5. Exposure to DV is also associated with externalizing behaviour and internalizing symptoms 2. DV may lead to difficulties in learning, and limited social skills 1,5. Additionally, children may exhibit violence, risky or delinquent behaviour, or suffer from depression or anxiety 1,5. Furthermore, studies have shown that domestic violence has a negative impact on children’s educational performance which also has long-lasting economic consequences, including poverty 4. All forms of domestic violence are detrimental and in the worst cases even fatal 4.

The impact of domestic violence on children can be life-long and pass from generation to generation. UNICEF’s Executive Director Anthony Lake has said “violence begets violence” 4. What I saw in Albania was that children exposed to domestic violence saw violence as a normal and acceptable form of behaviour. There is a risk that these children will perpetuate violence against their own children or other people in the future 4.

As mentioned in UNICEF’s report, this is “an unspoken problem with no easy answer” 1. But what can be done? What is important is to realize is that violence against children is preventable. UNICEF has listed six strategies that can be used to break the cycle 4. However, the strategies seem to be high-level strategies. As a volunteer, working with the children and seeing the impact of violence on behaviour, I felt powerless. I could not have an impact on the deep root causes of domestic violence, which in this case, among other reasons, could be related to gender roles, power structures, violence against women, attitudes towards violence against children, human trafficking, and low educational rates and poverty, especially among females 6,7.

What can one do as a ‘grass-root worker’? It is important to raise awareness of the issue. In addition, creating activities and interventions that can help children to cope with the consequences of domestic violence is particularly important. By one’s own action, it is important to show that violence is not an acceptable form of behaviour and try to change the attitudes step by step. This is being the agent of change like UNICEF describes 4. Another important factor is education.

According to UNICEF, life skills education helps children to build self-esteem so they can communicate in a better way, solve problems cooperatively, and protect themselves from violence 4. Educational programs can help children find ways to manage life risks and challenges, other than violence 4. Also, peer support system can play a crucial role 4.

As already stated, there is no easy answer for this problem and in order to tackle this problem, governmental actions (e.g. laws, public policies, better documentation) are needed. As UNICEF1 writes, the government has the primary responsibility for securing the safe, secure and violence-free environment for children. However, it was rewarding to know that even as a volunteer, not being able to break the cycle of violence at home, my actions can have a positive impact. As a volunteer working with the children, I can create a safe, stable and supportive environment for the children during the day at the center, and maybe even enhance the change of attitudes against violence. I can be a listener and a good role model. I can create activities or offer tools and ways to reduce stress and help children cope with the impacts of domestic violence.


  1. UNICEF (2006) Behind closed doors. The Impact of Domestic Violence on Children. Available at: <> [1 October 2017].
  2. Cao, Y., X. Zhao, Y. Zhang, X. Guo, Y. Zhang & X. Luo (2016) Effects of Exposure to Domestic Physical Violence on Children’s Behavior: A Chinese Community-based Sample. Journal of Child & Adolescent Trauma, Vol. 9, no. 2, pp. 127-135.
  3. Holt, S., H. Buckley & S. Whelan (2008) The impact of exposure to domestic violence on children and young people: A review of the literature. Child Abuse & Neglect, Vol. 32, pp. 797-810.
  4. UNICEF (2014) Ending Violence Against Children: Six Strategies for Action. Available at: <> [2 October 2017].
  5. Moffitt, T. E. & T. Klaus-Grawe (2013) Childhood exposure to violence and lifelong health: Clinical intervention science and stress-biology research join forces. Development and Psychopathology, Vol. 25, pp. 1619-1634.
  6. Social Research Centre (2006) The State of Albania’s Children 2007. Women and Children in Albania – Double Dividend of Gender Equality. Available at: <> [Accessed 15 October 2017].
  7. Tamo, A. & T. Karaj (2006) Violence against children in Albania. Human Development Centre. Available at: <> [Accessed 15 October 2017].
  8. Haarr, R. N. & M. Dhamo (2009) Domestic Violence in Albania: A National Population-Based Survey. National Institute of Statistics (INSTAT) Albania.



Niina-Maria Nissinen is a young public health professional from Finland. She is the news coordinator at GHNGN. Her main interests include mental health and substance abuse -related research, policies and health promotion, and preventing harm to others.

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