Drought exposure and the risk of sexual, emotional, and physical violence against adolescents in Zimbabwe, Mozambique, and Lesotho: an observational study

BACKGROUND: Droughts are increasing in severity and frequency, severely impacting agriculture-dependent regions, such as southern Africa. Although direct health effects are increasingly well documented, associations with violence against adolescents remain largely unexplored. This multi-country, cross-sectional study examined associations between drought and risk of intimate partner and non-partner sexual, emotional, and physical violence. METHODS: We combined violence victimisation and demographic data from 20 290 adolescents (aged 13-24 years) in the Violence Against Children Surveys from Zimbabwe, Mozambique, and Lesotho, between 2017 and 2019, with Standardised Precipitation and Evapotranspiration Index (SPEI) drought data for corresponding years. Multivariate logistic regression models, controlling for sociodemographic factors, assessed associations between past-year drought exposure and violence against adolescents. Interaction models explored potential moderating roles of adolescents' gender, age, and rural residence, and sensitivity analyses were used for robustness checks. Secondary analyses examined prolonged drought over the past 24 months. FINDINGS: Drought was associated with increased risk of non-partner sexual violence (odds ratio 1·46 95% CI 1·12-1·90), emotional violence (1·73 1·45-2·06), and physical violence (1·41 1·18-1·68), as well as intimate partner emotional violence (1·51 1·12-2·02) and physical violence (1·39 1·11-1·75). Moderation analyses showed higher risk for adolescent girls and older adolescents (aged 18-24 years) for non-partner sexual violence and non-partner and partner emotional violence, whereas older adolescents had an increased risk for partner physical violence and adolescents in rural areas had higher risk for non-partner physical violence. Prolonged drought over 24 months had positive associations with larger effect sizes than 12-month drought. INTERPRETATION: Drought exposure is associated with increased violence against adolescents in Zimbabwe, Mozambique, and Lesotho. Adolescent girls, older adolescents, and those living in rural areas are at heightened risk. Adolescent and youth-focused, gender-sensitive violence prevention strategies must be integrated into early warning systems with sustainable climate adaptation measures used in prolonged drought settings. FUNDING: The Reuben-AfOx scholarship, University of Oxford; The Natural Environment Research Council (NERC); the European Union's Horizon Europe Programme; and Oak Foundation, Wellspring Philanthropic Fund.